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Smokie Darling (Annie) - 02 Apr 2005 01:05 GMT

I just found out this morning, that the insurance my DH had after
retiring from the Air Force (was Champa now is Tri-Care) is going to
cover most co-pays on my doctor visits. I say most because it won't
cover much of anything if Medicare denies a claim, until it's gone
through a review process.

That's not even the best news. I can get Enbrel (pre-authorized) for
$9 a month! I'm so excited, I may actually be able to use Enbrel.
Well that or Rituxifan (which Medicare would cover a portion of so
Tri-Care would cover the rest).

I'm such a happy little camper that I can hardly stand myself. That
and my RD gave me vicoprofen for evening pain, and it's seeming that I
can manage on one pill for two nights (it ain't great, but at least I
can sleep for more than an hour).

There are times that I think the Big Guy smiles at me and says, "You
know, I never forgot you needed Me, I was just waiting to see if you
understood how things work."

I just wanted to share with those of you who have helped me manage
through the truly bad days I have had.

Smokie Darling (Annie)

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Jo Firey - 02 Apr 2005 01:18 GMT

I'm so happy for you. And you have no idea how easy this is going to be for
you. TriCare for Life as it is called has worked just as smooth as silk for
us ever since we qualified for Medicare. Which has been quite a surprise as
plain ole TriCare was a royal pain in the butt.

Most places accept Medicare or they would be out of business. Then TriCare
pays whatever is left. Including the Medicare deductible. And no premium
for the TriCare.

Enjoy.

Jo

>I just found out this morning, that the insurance my DH had after
> retiring from the Air Force (was Champa now is Tri-Care) is going to
[quoted text clipped - 20 lines]
>
> Smokie Darling (Annie)

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Little Bit - 02 Apr 2005 01:49 GMT

Im so glad to hear this as i go on medicare in 11 months...then i will
have tricare for life.I didn't know the part about if medicare turns you
down tricare wont pay tho.Im so glad i found this group.You'll are so
much help Thank's Litte Bit

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Smokie Darling (Annie) - 02 Apr 2005 02:17 GMT

> Im so glad to hear this as i go on medicare in 11 months...then i will
> have tricare for life.I didn't know the part about if medicare turns you
> down tricare wont pay tho.Im so glad i found this group.You'll are so
> much help Thank's Litte Bit

Little Bit, it isn't that they *won't* pay, they have to review the
medical stuff (and then you pay the deductible, mine is $150) that was
denied by Medicare. They may still pay, but there may be a cost to
you.

Smokie Darling (Annie)

But it is *so* cool that I don't have to do anything to get them
billed, it's sent direct to them from Medicare (wow).

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Little Bit - 02 Apr 2005 02:39 GMT

Hi Annie
Oh okay i understand now thank's for explaining it. Little Bit

Little Bit, it isn't that they *won't* pay, they have to review the
medical stuff (and then you pay the deductible, mine is $150) that was
denied by Medicare. They may still pay, but there may be a cost to you.
Smokie Darling (Annie)
But it is *so* cool that I don't have to do anything to get them billed,
it's sent direct to them from Medicare (wow).

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Squirrely - 02 Apr 2005 05:20 GMT

Annie,

That is great news to hear. Wishing you the best.

Signature

Love and hugs to all
Good thoughts coming your way too.

Squirrely Jo

>I just found out this morning, that the insurance my DH had after
> retiring from the Air Force (was Champa now is Tri-Care) is going to
[quoted text clipped - 20 lines]
>
> Smokie Darling (Annie)

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Harvey R. Stone - 02 Apr 2005 05:53 GMT

> I just wanted to share with those of you who have helped me manage
> through the truly bad days I have had.
>
> Smokie Darling (Annie)

Those days are behind you now Annie and we are happy for you. I know what
you mean about the no sleep which makes tomorrow a whole lot tougher. You
are going to be surprised how quickly Enbrel can go to work. I felt the
difference the next day but you may not be that fast but that is OK. We
all are different.
Harv

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Smokie Darling (Annie) - 02 Apr 2005 19:52 GMT

> > I just wanted to share with those of you who have helped me manage
> > through the truly bad days I have had.
[quoted text clipped - 3 lines]
> Those days are behind you now Annie and we are happy for you. I know what
> you mean about the no sleep which makes tomorrow a whole lot tougher.

You

> are going to be surprised how quickly Enbrel can go to work. I felt the
> difference the next day but you may not be that fast but that is OK.

> all are different.
> Harv

I'm so looking forward to trying it. I was taken off Arava on
Wednesday (30th March), so all I am on is MTX. Let me tell you, my
body is missing the Arava now.

Stupid labs, had the draw done on 1st February, and the lab was sent to
someone else (my RD didn't have it). Turns out my liver panel (which
had always been mid-range normal) was really high - the normal is 0 -
15 and it was 105. We had no idea for two months since they didn't
have the labs, so... Anyway, that's in the past.

Not sure if the RD is going to go with Enbrel, or if he will continue
to try and get Rituxifan approved. Either way will be good for me (I
rather like the idea of no treatment for 6 months between Rituxifan
infusions).

I hope, Harvey, that my results are even half of what you've seen.
That would make me extremely happy. I know I can't undo what's been
done to my joints, but to be able to slow it down would be welcome.

Smokie Darling (Annie)

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Harvey R. Stone - 03 Apr 2005 04:24 GMT

Turns out my liver panel (which

> had always been mid-range normal) was really high - the normal is 0 -
> 15 and it was 105. We had no idea for two months since they didn't
> have the labs, so... Anyway, that's in the past.
>
> Smokie Darling (Annie)

I had a high liver enzyme reading while on Arava due to having the flu and
taking medicine for that and my DMARD. I took Milk Thistle for about 5
weeks and down into the normal range it went. There are no known side
effects in taking MT. You were on Methx and Arava which is really tough on
a persons liver.
This anti-biotic I take for TB is hard on a persons liver and as soon as
I started it ,,, I started the MT along with it. I have not had a bad
reading,,, why take a chance.
Good luck with it all.
Harv

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Newsgroup Spambuster - 03 Apr 2005 23:05 GMT

Yay, Annie, so happy for you!!! It's always nice when you learn you
are going to have better medical coverage!

Donna G

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Cindy - 02 Apr 2005 14:41 GMT

This is great news Annie...I know that Mike will be able to get Medicare
immediatly and we can go back as far as Sept 2002. I told him that since
most of all the medical bills have either been covered or we have already
paid them, that we should only go back until Jan of this year...I won't be
able to get mine until July of this year...So we will pay the back premiums
to Jan of this year for Mike and all these little pesky bills that have been
adding up should shrink quite a bit..
So Happy for you Annie...
And God is always there, but sometimes his way we don't understand..I think
sometimes he is awfully quiet so that we have to listen hard...

Hugs Cindy

>I just found out this morning, that the insurance my DH had after
> retiring from the Air Force (was Champa now is Tri-Care) is going to
[quoted text clipped - 20 lines]
>
> Smokie Darling (Annie)

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firechief - 02 Apr 2005 18:06 GMT

Annie wrote:

> I just found out this morning, that the insurance my
> DH had after retiring from the Air Force (was
> Champa now is Tri-Care) is going to cover most
> co-pays on my doctor visits.

Mary was paying Kaiser about $350 a month for
medical insurance when I met her...and she still
had co-pays for doctor visits and med.

She's now covered by Tricare and her co-pays
for doctors and meds average $50 a month.
She just had her first dental appointment under
the Tricare supplement - no copay for that, but
some procedures do require one.

... When April showers.....she never closes the curtains!

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DeeTee and Bob Taggart - 03 Apr 2005 02:08 GMT

Yep - That's why we went where the Army told us, when they told us, and how
they told us - for 20+ years. Since we (read he) retired, it has paid off
again and again in medical costs. It is sooooo worth the military service.
Right now we're still using military facilities. When we move to Columbus
(probably in September), we'll have to learn a whole new system of civilian
doctors who will bill Tricare. Either that or drive over to Dayton and
Wright Patterson Air Force Base.

DeeTee
________________________________
DeeTee and Bob Taggart
http://www.marykay.com/dtaggart3
http://mysite.verizon.net/vze8fwov/
________________________________

>I just found out this morning, that the insurance my DH had after
> retiring from the Air Force (was Champa now is Tri-Care) is going to
[quoted text clipped - 20 lines]
>
> Smokie Darling (Annie)

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