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aquarian

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Everything posted by aquarian

  1. I read that the senate bill would make it so medicaid is no longer required to cover mental health after 2019. "Medicaid would not be required to cover mental health after 2019. For other types of insurance, requirements could change in states that request a waiver." http://www.npr.org/sections/health-shots/2017/06/22/533942041/who-wins-who-loses-with-senate-health-care-bill I agree I don't think it will pass the senate.
  2. I checked out the first NPR link. I don't know if I'd call these "kickbacks" exactly. "The payments in our analysis include promotional speaking, consulting, business travel, meals, royalties and gifts, among others." The NPR piece talks about an "association": "ProPublica's analysis doesn't prove industry payments sway doctors to prescribe particular drugs, or even a particular company's drugs. Rather, it shows that payments are associated with an approach to prescribing that, writ large, benefits drug companies' bottom line." Here's one reason there may be an association: "Doctors nowadays almost have to go out of their way to avoid taking payments from companies, according to Dr. Richard Baron, president and chief executive of the American Board of Internal Medicine. And those who do probably have greater skepticism about the value of brand-name medications. Conversely, doctors have to work to cultivate deep ties with companies — those worth more than $5,000 a year — and such doctors probably have a greater receptiveness to brand-name drugs, he said. 'You have the people who are going out of their way to avoid this, and you've got people who are, I'll say, pretty committed and engaged to creating relationships with pharma,' Baron said. 'If you are out there advocating for something, you are more likely to believe in it yourself and not to disbelieve it.'" If that explanation is true, that doesn't mean that Dr. Z prescribes X and receives $100 in return for writing the script. I used the propublica docdollars tool (I've used it in the past) and my pdoc has received about $500/year from pharma companies for the past 2 years. The breakdown is anywhere from $9-$112 at a time and the category is always food & beverage. One specifically is labeled an "informational meal." I'm not sure what the other food & drink monies are for but I always assumed the drug reps liked to take my pdoc out to lunch or dinner or bring lunch to the office and explain wonderful things about their new drugs to her, plus give her the free samples. Perhaps she has to submit to the food interaction in order to get the free samples? My pdoc doesn't usually push newer drugs on me unless the cheaper drugs aren't working for me. So I switched to pristiq for a time when we though effexor had pooped out on me after a decade but then I switched back to effexor because I didn't notice much of a difference. And I tried latuda at one time as an adjunct because my pdoc didn't want to prescribe me seroquel because part of my problem was fatigue and sleeping all day. I ended up on abilify, but it had been out for a long time before I went on it. When trying stimulants, I ended up on nuvigil first (vs. the older provigil) because that's what she had sample packs of but if the sample pack had worked out for me, I think she probably would have prescribed provigil first since it was similar and cheaper. Then I tried geneic ritalin. Then generic adderall. Nothing new there.
  3. There is such a thing as presumptive disability payments. It's where they're pretty sure you'll qualify so they start paying you benefits before a determination is official. If they don't end up approving you in the end, you do not have to pay back the presumptive payments you received. You can read more about it here: https://www.ssa.gov/ssi/text-expedite-ussi.htm. I don't think the list of types of conditions they provide presumptive disability payments on this page is exhaustive.
  4. I use rxoutreach.org to get 90-day supplies of generic abilify (since the generic price hasn't gone down far enough at local pharmacies and my Part D drug plan is not very helpful). My pdoc is the one who suggested this pharmacy. It's based in the USA. I set up an account and then my pdoc faxed them my prescription. I've gotten 2 shipments so far with no issues. The only thing unusual is that the prescription bottles say on the lid "Honoring God by serving others". They carry seroquel xr (generic), generic seroquel, and generic lamictal. (I'm not sure if the meds in your signature are current.) I would double check first if goodrx has cheaper prices at a local pharmacy because generic seroquel and lamictal are already pretty cheap in my area so might not be worth bothering with rxoutreach depending on dosage. However, generic seroquel xr is significantly cheaper from rxoutreach.
  5. Finally saw my pdoc today and asked her. On the prescription paper where she wrote down the tests she wanted the lab to run, she also wrote down several codes. The code she wrote to make sure the Vit D test would be covered by medicare was E55.9 unspecified vit D deficiency. She said that's because I've had my Vit D levels come back low in the past, so that code works to justify (to medicare) future vit D testing. She used a separate code to justify the iron testing, and there was one code that allows her to test for lots of things including diabetes blood sugar stuff because I take abilify (even though I'm on a tiny dose). By "allow", I mean "medicare will cover". Anyways, just wanted to let you know.
  6. I'm on a tiny amount--5mg once a day--and have been for quite some time (at least a year?). I've actually been thinking about maybe moving up to 10mg soon. I usually only take one dose because even though it seems to wear off after 3-4 hours, if I take a second dose after that, I have a hard time falling asleep at night. So I try to plan anything productive I want to do in the first part of my day so that it actually has a chance of getting done. My pdoc writes the Rx for 20mg/day so that one Rx lasts me 4 months.* And there are some days I don't take any adderall just to take a "break" from it. Probably the most helpful thing for my fatigue though has been an iron pill every other day and 5000 iu daily vitamin D. In fact, maybe the adderall is not even doing much anymore at 5mg, but who knows. I seem to be pretty sensitive to some meds. *Edited this because I realized my math was bad. Although now my pdoc has changed the Rx to 20mg 2x/day since (after talking to pdoc) I'm probably going to try upping my dose to 10mg/day and still would prefer the Rx last several months rather than one month.
  7. My sleep study showed I have pretty good sleep and no apnea. I apparently had a lot of periodic limb movements but the sleep doctor said the movements didn't interrupt my sleep at all so weren't a cause for concern. I kind of figured I moved a lot in my sleep based on how my covers look in the morning and I used to kick my sister in my sleep when I was young and we shared a bed on vacations. My issue is being tired/easily fatigued during the day and sleeping 12+ hours a night. After going over my sleep study results, the sleep doctor offered that I could see one of their sleep psychologists at the sleep center and that I could eventually do a MSLT sleep study if I ever got on a "normal" sleep schedule and wasn't such a night owl. At the time, I couldn't do the sleep psychologist thing because I was still trying to work at a full-time job and there were scheduling issues. In any case, based on the sleep study, normal brain MRI, and some other testing and specialists that didn't reveal much, my psychiatrist felt comfortable trying me on nuvigil, then ritalin, and now adderall. Adderall has really helped me to sleep less at night, rarely take daytime naps, and has overall been very helpful. I think the sleep doctor mentioned that she would only consider stimulants in rare circumstances and I would definitely have had to do the MSLT first (she was the one to mention stimulants, not me, as I was actually concerned about taking stimulants at first because I thought it might make my anxiety issues worse). My pdoc however didn't have any issues with prescribing me stimulants at this point since I had already been through several specialists including a rheumatologist and endocrinologist (the endocrinologist had me collect my pee in a big red jug at home for 24 hrs; that was fun.) And I was treating the only physical issues that were found, low ferritin and vitamin D. I don't think my pdoc thinks I have narcolepsy since we went over some of the symptoms and they didn't quite seem to fit with my issues. (Although back when I was working, I would be so tired I would get really afraid of falling asleep at the wheel when I'd be stopped at a red light on the way to/from work). But I think that was because I was so sleep deprived (not being able to fit in at least 10-12 hours of sleep a night) and the stress of work was exhausting. I think my pdoc currently has one of my diagnoses as idiopathic hypersomnia.
  8. The company I worked for used an insurance company* that provided STD. So I just told my manager I wouldn't be into work and she advised me to call the STD provider to file STD (phone intake) if I was going to be out for more than a certain number of days. Some companies require that you use up FMLA while you're out on STD and mine is one of them. In my experience, FMLA doesn't require a lot of detail or evidence (it requires some, just not nearly as much as STD). For STD, it's best IMO if you have a doctor that's willing to persevere and fill out lots of paperwork and send in medical records when needed. It will just make it a lot easier if your doctor(s) is/are cooperative. I gave very few details to my manager. My intake call for STD was easy--just verified name, address, job title, doctor's contact info, diagnoses, reason for not being able to work, estimate of how long I'd need off, and that's about it. Then the STD company requested info and records from my doctor. It wasn't so bad but my doctor had to keep filling out paperwork in order to justify extending my leave and updating them (STD) on my condition (fatigue, anxiety, depression). Then I eventually transitioned to long-term disability. I did have a few return to work attempts while on STD and my company and STD were pretty flexible in allowing me to try to transition back slowly/gradually, like working every other day or working 2 hrs one day, then 4 hrs for a few days and gradually building up. Anyways, I just thought I'd share my experience, which was at a rather huge company. *So the company I worked for is also the insurance company that provides STD (to its own employees and other large companies). In fact, I worked partly doing phone intakes for STD, which is awkward when you yourself need to go out on STD. Because my location (with all my coworkers) was one of the main 800 lines for STD intakes. So my manager gave me the direct line to someone who works for our company in another city so that I could avoid having one of my coworkers do my intake.
  9. I sell on ebay a few times a month at most. Only had one "problem" customer thankfully, but that's probably because I don't sell a lot. Basically, as San already pointed out, buyers are in the power position and win almost every dispute. So it sucks that you have to wait, but at least you can be pretty sure it will be resolved in your favor. In fact, once I started selling on ebay and read some of the many horror stories on the ebay seller forums, I began to feel a lot more comfortable as a buyer on ebay because ebay/paypal bend over backwards to make people feel "safe" buying there. I've never contacted a seller with a complaint or anything, but I know if I did, either the seller would try to quickly appease me or else ebay/paypal would have my back.
  10. I agree about the no restrictions on assets for SSDI-only recipients. You can have a million saved in the bank and it will have zero impact your SSDI as long as you're not receiving SSI concurrently with SSDI. FWIW, for those whose disability began before age 26, there is something called an ABLE account that you can set up and up to $14,000/year can be contributed to the account. Up to $100,000 of the money in the ABLE account is excluded from your resources. There are certain restrictions on what the money can be spent on though, among other things. https://secure.ssa.gov/poms.nsf/lnx/0501130740
  11. If you live at home or with someone else and don't contribute to rent and some of your expenses, I think there can be a 1/3 reduction in your SSI benefit until you begin to do so.
  12. My dad went through something that progressed to only being able to eat soft foods and a lot of the food collecting in his stomach and throwing it back up sometimes. It sadly turned out to be pancreatic cancer. There was a mass or something and it happened to be in a location where it affected his stomach's ability to empty. (He then had a whipple surgery which gave him some, albeit limited, time.) Anyways, I'm not trying to freak you out or suggest you have terminal cancer, just that I saw how miserable it was for my dad when he had the issue with food not passing through the digestive tract normally. It is serious (whatever the cause) and I'm sorry you're going through this.
  13. Also, the article said PCPs and dentists will have these restrictions, so (for example) I'm assuming people in pain management won't have to worry (for now).
  14. At my local public library, if there are costs associated with an interlibrary loan, the borrower (me) has to pay them (or so the policy reads). However, I've done at least five interlibrary loans and so far they've all been free, maybe because they were able to find the books relatively easily somewhere in the same state I live in.
  15. I always list all of my drugs, even for my dentist and orthodontist. The only time anyone made a comment was a new GP who I saw twice (around 2012) for short office visits because my fatigue and excessive sleeping was so bad I finally was willing to see a GP (until this point I hadn't seen a GP in like 10 years). He kept circling back in both appointments to "You've got to get off the remeron. That's going to make you tired and sleep a lot" in a very animated, insistent way. I kept trying to tell him I've been on remeron (plus effexor) for a decade with no fatigue issues until now and that I was under the care of a psychiatrist. But he was like a dog with a bone and kept going back to the remeron. He didn't even ask if my psychiatrist and I had discussed changing up my meds or anything, which I think might have been a more appropriate way to broach the subject. I have a new GP now and she doesn't say anything much about the meds I'm on.
  16. No, having another illness diagnosed will not affect your SSI amount. SSI is a set amount, the same amount for everyone on SSI. The only things that I'm aware of that can affect your SSI amount is other income (for example, you working or spouse working) or the 1/3 reduction if you're not paying your fair share of rent and living expenses. Here are some informative links: https://www.ssa.gov/oact/cola/SSI.html https://www.ssa.gov/ssi/text-living-ussi.htm https://www.ssa.gov/ssi/text-income-ussi.htm
  17. Yes, I think I vaguely remember this. I've never had an issue taking a variety of somewhat expired meds, including benzos and abilify, and feeling like they weren't working properly. There are some meds I'd never take once they expired (e.g. antibiotics) and I do try to rotate my meds to reduce the amount of expired meds onhand, but I don't stress if occasionally I take something expired.
  18. The B12 I take is over the counter from Sam's Club. It's Simply Right sublingual vitamin B12 2500mcg methylcobalamin. It tastes kind of fruity. However, it's actually expired* since it's Sam's Club size and I take it infrequently. I just looked online and it looks like Sam's Club offers a slightly different product these days. It's Members Mark, still sublingual and methylcobalamin, but now 5000mcg. *The B12 apparently expired in September 2015 but I still take it. My D3 vitamins, however, are current and unexpired. FWIW, it's the Nature's Bounty D3 5000iu from Costco, recommended by my pdoc.
  19. The only vitamins I take other than D3 are an iron pill (325mg ferrous sulfate) every other day and a B12 sublingual pill about once every few weeks. Even with taking the B12 only once every few weeks, the last B12 test I had showed me at above the recommended range. I never had a B12 deficiency to begin with but I think it makes my primary doctor happy to take the B12 just in case since I'm a vegetarian with depression and fatigue issues. I started taking the iron pill when I was so tired I could barely get up and down the stairs to the basement or walk to the back of a big box store. My ferritin levels came back low, so the doctor said to take 2 iron pills a day until my levels went back to normal. Eventually I arbitrarily decided on an iron pill every other day and my iron and ferritin levels have been normal ever since. ETA: My sister kept bugging me to take magnesium so I tried it for a couple weeks but all it seemed to do is make my poops extra soft so I stopped taking it.
  20. Unfortunately I didn't make a copy of the written prescription for myself and my medicare billing stuff doesn't give that level of detail. I've had low Vit D tests in the past, so I'm assuming she used a code that indicated that but I don't know. I can check with my pdoc though when I see her in 3 months. She saved a copy of the prescription so she wouldn't have to look up the codes again if she orders blood tests for me again in a year.
  21. My pdoc recently ordered bloodwork for me including a Vit D test (because I don't see a primary doc every year). She (pdoc) spent quite a few minutes writing up the bloodwork order on her prescription pad and looking up codes related to each test because she said that now that I'm on medicare, medicare is very particular about how often bloodwork can be done and when tests will be covered. Whatever she wrote on the rx pad seemed to work, because the claims came through on the medicare website last week and supposedly I'm not going to owe anything; Part B is covering all of the blood tests she ordered that I had done. So for me, medicare Part B did cover my Vit D blood test. I have a supplemental plan as well but it's a high deductible plan so has yet to cover anything. And FWIW, I'm giving up on D2 for now and have switched to 5000 iu's of D3 daily per my pdoc. Previously I was taking 7200 iu's of D2 per day. I didn't start the D3 until after the bloodwork came back so I'll have to wait awhile to find out if D3 works out better for me. With D2, I was able to keep my D levels hovering just barely in the normal range or slightly below. But my pdoc gave me a mini lecture about the D2 and I've been meaning to give D3 a try anyways so here goes.
  22. I seem to go through spending binges (usually online clothing shopping) a few times a year. I usually can't just buy one or two things that I actually need. I have to go through an entire website (like kohls) and look at ALL THE THINGS to make sure I don't miss anything. So I have to do clearance, womens pants, womens tops, dresses, sleepwear, underwear, sometimes jewelry, etc. This usually takes many hours every day over the course of several days. I kind of zone out while I'm doing all this online browsing. And I get a rush pretty much the whole time. And then get excited when the stuff is delivered (although also ashamed because I have to hide it somewhat from my mom who I live with). And if I find something I like, I often feel compelled to buy it in every possible color combo. And yet I don't wear most of it. Some of it I don't even fit right now because I gained a bunch of weight over the past few years. But even the stuff I fit, I don't really wear and just stick to my usual few pieces of clothing I wear all the time. My room sometimes feels like a giant storage closet for clothes, many of which are still new with tags. I even had to take over half the spare bedroom walk-in closet because I had utilized every spare inch of storage space in my bedroom. One thing that helped me recently was reading those Marie Kondo books (I checked them out of the library). Very easy reads and they've changed my outlook on certain things. Even if you don't follow her method of tidying, her relationship to her belongings, her outlook, philosophy, whatever it is, has really helped me. I'm more content now with the things I've already acquired and try to question myself now when I feel compelled to buy more because it never seems to make me more happy or ultimately content. My strategy now is just to remind myself of all the wonderful things I've already acquired that I do like, and that I'm not really going to "miss out" on something life-changing by not seeing what's available at my favorite stores every season. And I don't visit clothing websites like kohl's anymore because it never ends well, and when I'm in Target, for example, I avert my eyes when I'm walking past the scarf section on the way to the check out (scarves are one of my frequent impulse buys). I recently went through all of my clothes and shoes and it was overwhelming to acknowledge that I had really bought all that stuff. And I realized I have so much stuff, it's hard to even get to any of it easily because it's so packed together. And I forget what I even have. And I have pretty much everything I need. I'm not saying I'm never going to buy anything again, but I feel more "full" than I have in awhile. So for now that feeling of fullness is outweighing any urges to browse clothes and shoes online.
  23. Also, I hope your appeal is successful and you don't end up owing SSA anything. The language surrounding whether one has to repay those type of benefits (received while appealing a cessation) always reads (to me) like it'd be possible for most claimants to successfully waive repayment. And I'm glad you're finally able to start getting treatment again in MA. FWIW, FL seems to be one of the worst for trying to access healthcare when you don't have many/any resources.
  24. For SSDI, depending on age, you have to have a certain number of work credits earned in the 10 years prior to the disability date. If you're under 31 or under 24, the work credit requirements are even less. However, I'm not sure what happens to your work credits while you're on SSDI. I think they may freeze them so-to-speak while you're on SSDI so that they may not be expired even now. It's yet another area I don't know enough about.
  25. Many people apply for SSI/SSDI at the same time. In fact, that seems to be the default more often than not. SSI is for people who don't have enough work credits for SSDI, for people whose SSDI amount is less than what SSI would be (so SSI makes up the difference and they receive concurrent SSI/SSDI), and for people whose SSDI is too high to receive both but they still may be eligible to receive SSI during the 5 month waiting period for SSDI. This all of course assumes one meets the financial criteria for SSI. I still don't know quite how this would work in your situation (it's a situation I haven't come across before) so can't really offer much advice. I am pretty sure that you must apply for SSDI at the same time as SSI if you're eligible for SSDI because SSI is like welfare and if you're eligible for anything else that could offset it, you must. However, are you still eligible for SSDI going forward on a new claim or have your work credits expired? I'm also a little confused. Are you still in the process of appealing the cessation of benefits or are you just appealing the overpayment? I'm on SSDI myself by the way.
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