I Don't Even Know Why I Am Surprised

Yesterday morning, while I was feeding OZL breakfast, I decided to call Aetna Specialty Pharmacy to order a refill of my Enbrel. After spending so much time getting things sorted out with them last time, I assumed this would be a quick call. (Can you see where this is going? Foreshadowing!!!!)

It started out pretty well. I picked my way through their menus and eventually got in touch with a human, who proceeded to review all of my information with me. I told him I needed a refill and he said he could have it to me tomorrow. I said great! 

Then he said: that will be $250.

No! No it will not. I already spent an absurd amount of time trying to get enrolled in co-pay assistance and the last person I spoke to assured me that the cost to me would be $0. He put me on hold.

Eventually, he came back and mumbled something about me not being properly enrolled. (Who is in charge of this stuff anyhow?!?!) I asked if he could properly enroll me. He said he could. And so I waited on the phone with him for fifteen minutes or so while OZL screamed and he theoretically "properly" enrolled me this time. 

Eventually he said my Enbrel would arrive tomorrow and it would cost me $0, which was exactly what I wanted to hear!

But then he said next time the co-pay assistance would only cover a percentage of the cost, so it wouldn't be free anymore. What?!? Of course, he was unable to tell me what percentage would be covered or what I would have to pay for my next refill. Awesome.

I don't even know why I am surprised.

Although, to be fair, at least the Enbrel actually arrived.

April Articles on Answers.com

You can find a complete list of all the articles I have published on Answers.com by clicking here. Below is a list of the new articles I published in the month of April.

Rheumatoid Arthritis (RA)

• Rheumatoid Arthritis Medications
• Treatment Options for Rheumatoid Arthritis - Part One
• Treatment Options for Rheumatoid Arthritis - Part Two

Juvenile Arthritis (JA)

• Juvenile Arthritis Medications
• Treatment Options for Juvenile Arthritis - Part One
• Treatment Options for Juvenile Arthritis - Part Two 
• Juvenile Arthritis Healthcare Team

Other Types of Arthritis and Related Conditions

• What is Psoriatic Arthritis (PsA)?
• What is Sjogren's Syndrome? 

Arthritis Medications

• NSAIDs

How Do You Dress A Tornado?

I really can't believe it, but OZL will be 11 months old in only 8 more days!! One year ago today I was 8 months pregnant, dealing with RA flares, and being tested for preeclampsia, which I eventually was diagnosed with resulting in bed rest. As soon as I hit 37 weeks, OZL was born via C-section. And, via some insane time warp, he will be turning one next month!!!

These days, OZL is interested in everything. He crawls in all directions at about the speed of light and pulls himself up on anything he can reach, reguardless of whether or not it will actually support his weight (case in point: he pulled a folding chair over on himself in music class this morning.) Most of the time he is speedy and full of energy and a very happy baby. Though he has also spent a fair amount of time over the past week or so being a big old grumpyface since the poor little dude has 5 teeth coming in at the same time.

Getting him dressed in the morning is like trying to dress a tornado. He flips and squirms and wiggles tries to crawl away while my clumsy RA hands fight to snap those tiny snaps and button the little buttons and pull itty bitty socks onto itty bitty feet. If it would only stop snowing I'd just put a clean diaper on him and call it a day! (Welcome to spring in Colorado - we've had more snow in the past few weeks than we got all winter.)

Honestly I have been struggling to keep up with him lately, especially since PT doesn't really seem to be helping. Both my knee and foot and all the muscles around them have been hurting a lot, and my knee has been doing this weird cracking/popping thing. The kneecap hasn't dislocated again (thankfully) but it doesn't feel like it's getting any more stable either. I'm wondering if surgery is imminent - and if it is how on earth I will ever keep up with OZL then?

I do have a college student who comes twice a week to watch OZL so I can have a couple of hours to get my writing done, but lately I've had to use most of her time to go to PT rather than work. So I'm using all of OZL's nap times to do my writing for Answers.com. I'm getting the work done, but I have almost no time to myself to rest or relax these days.

Hopefully I'll find a way to get a break soon!

Ughhhhhhh!

Speaking of "specialty" pharmacies, guess who called me this morning? CVS Specialty Pharmacy. The pharmacy responsible for this nonsense. The pharmacy that almost ruined my Christmas. The pharmacy I stopped ordering my Enbrel from over three months (and two specialty pharmacies) ago.

It was a voicemail with an automated call to remind me that I needed to order a refill. I was changing OZL at the time, so I had to call them back to ask them to please take me off their call list, which I had already attempted once with no success.

This time I at least talked to a human who actually apologized and assured me I wouldn't be getting any more calls. So hopefully that is the end but ughhhhhhhh. What a pain in the butt!! Why oh why can't I just go down the street to my regular pharmacy for my Enbrel?!?!?

In all fairness to specialty pharmacies, there is one that I actually had a great experience with. Wallgreens Specialty pharmacy did a very efficient job getting information from me and then simply proceeded to deliver my Enbrel every month without me even having to call them. The Enbrel just arrived, on time, every month. So if you've got the choice go with Wallgreens! And I only had one delivery from CuraScript but they weren't bad either. Though, now that I think of it, I vaguely remember getting an automated voicemail from them recently as well. So I guess I need to get in touch with them to get off their call list also.

So, in conclusion, specialty pharmacies = ughhhhhhh!

It Just Gets Better And Better

Aetna Specialty Pharmacy called me this morning. They wanted to see if I would be interested in enrolling in their specialty health care management program. The representative explained that if I was interested, the program would assign me a nurse who would support me through my treatment. The nurse would have regular counseling calls with me every couple of months, but would also be available at any time if I had any questions about managing my condition or administering my medication. Although this sounds like a pretty good program for people who have been recently diagnosed, I explained that I have been injecting Enbrel by myself for several years and dealing with RA for even longer than that. I said didn't think I needed help from their program.

The representative said she understood my decision but wanted to let me know that the program could also help me enroll in co-pay assistance. I told her I was pretty sure I was already enrolled in co-pay assistance (after all THAT). But, since I had her on the phone anyhow, I asked if she would be able to check my file to be sure. She said she would be happy to and put me on hold.

Several minutes later she came back and said she was unable to determine if I was enrolled in the co-pay assistance program. She instructed me to call the number on the back of my card for assistance with that issue. 

I'm sorry, but why exactly did you call me again? I thought you were going to help me? Doesn't anyone over there have any idea what's going on? What exactly does it say in my file if she was "unable to determine" whether or not I was enrolled?

It just gets better and better.

Luckily I have my sweet boys to keep me going.