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Marilee J. Layman

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09:47 pm: Completely New Diagnosis
Oh, I still have Late Effect of Stroke, but according to the new neurologist, I'm not having brain seizures. She says for those and for TIAs, the same thing happens all the time. I have some events happen more often than others, but I have different events. She thinks it's migraines without headaches. I did have migraines 30 years ago, for the two years that I was at a job, and people with strokes are prone to migraines. So I'm starting Lyrica (tomorrow, since the pharmacy was closed when we were done) and decreasing the phenobarb one pill a week until it's gone. I'm to call/email her in three to four weeks to let her know what's happening.

Lyrica was the only potential med that doesn't/minorly interact(s) with my other meds or conditions. It's a brand name so I hope it's not too expensive. My copay isn't bad, but Medicare counts up all the costs -- what I pay and what Kaiser pays -- and if I get to $2700 this year, I'm back in the donut hole. I'd already planned to only continue Restasis through February because it's $200 total a month. I figured I'd have it five months a year (takes a month to work), over the winter, because my eyes don't hurt as much when there's more moisture in the air. Plus I can take OTC drops then.

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From:redbird
Date:January 15th, 2009 03:21 am (UTC)
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Lyrica isn't cheap, I'm afraid, but I don't know what you're comparing it with. (Second-hand, but reliable second-hand, reporting, from someone who was ordering it online from Canada to save money.)
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From:mjlayman
Date:January 15th, 2009 03:58 am (UTC)
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Kaiser will get it cheaply, so I won't know until tomorrow what the total cost is. Tomorrow's copay is $30, but the rest will be by mail, so $25. A lot of my meds are generic now. The only ones that aren't are Restasis and Lyrica.
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From:ritaxis
Date:January 15th, 2009 03:42 am (UTC)
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Migraines are so much less scary than seizures or TIAs. It's a good diagnosis. Not cheerful, as you can expect more of it, but not so scary.

But wait -- does Medicare count the money Kaiser pays and the money you pay out of pocket against the amount they pay? Like charging you twice for your copay, you mean?

[User Picture]
From:mjlayman
Date:January 15th, 2009 04:02 am (UTC)
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Medicare doesn't pay anything for my meds directly, it's part of the HMO agreement. They pay Kaiser a flat amount to take care of me, including the meds. So what Kaiser pays and what I pay total is what counts toward the donut hole. I got the EOB today and I was $102 short of the donut hole last year. First time since Medicare Plan D came out that I didn't go into the donut hole.

I appreciate that someone else is getting meds they couldn't afford before because of Plan D, but my medical costs have gone up a lot from before it.
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From:ritaxis
Date:January 15th, 2009 09:21 am (UTC)
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That doesn'ty make any sense at all. They should only count what Kaiser pays.
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From:mjlayman
Date:January 15th, 2009 11:35 pm (UTC)
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Hey, it's Congress that made up Plan D. Well, they approved it.
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