- L
- J
I have found myself in yet another frustrating and devastating situation thanks to insurance. As I just had my 26th birthday in April of this year, I am no longer allowed to be on my mother's insurance anymore. I was able to sign up for new insurance through work, but unfortunately, having a preexisting medical condition in the United States, means that my health care is not affordable for me or most others in my position.
My Problem:
My new medical insurance deductible is set at $5,250. Before this figure is met out of my own pocket, I am responsible for 100% of my medical and pharmacy costs. After this figure is met, I am still responsible for 30-50% of my medical and pharmacy costs, until my out-of-pocket maximum of $6,550 is met, at which point 100% of my medical costs will be covered.
What does this mean?
I have been told, for example, that my Benlysta auto-injector will cost me $3,602.73 for a one month supply of four needles. When asked about a payment plan, I was told by my pharmacy that a majority of that bill would have to be paid before the medication would even be shipped to me. So this means, I'd have to come up with close to the $3,602 bill just to get my hands on this month's supply of just ONE of my medications. Then I'd have to do the same next month, before my out of pocket maximum could be met.
More than $6,550 in two months.
The good news:
This is hopefully a one time issue for me. Come November (open season for insurance), I have many options for finding better coverage; including my work updating to better coverage or finding affordable independent coverage for myself from another insurance company.
What I need help with:
My problem now is that finding better coverage and finding assistance programs from other sources takes time, but I need my medications or risk losing all of the progress I have made with my health, or worse yet, losing my life to my illnesses simply because I cannot afford my medications. I am begging for help from all of you. Please, help me gather the money I need to pay for these medications while I figure out better insurance options for the future. Any money I get on this go fund me, will go directly towards paying my deductible through medical bills, medications, and doctor's office visits.
I have explained my lupus journey below, if you are interested to read more about my situation.
My Story:
I am a 26 year old who has spent the entirety of her twenties, dealing with chronic medial issues. About three and a half years ago, I was diagnosed with two forms of Lupus, which is a chronic autoimmune disease that develops in some people for still unknown reasons. I have Systemic Lupus Erythematosus (SLE), which can affect many things including my internal organs. I also have Sub-acute Cutaneous Lupus, which affects my skin.
After two years of dealing with severe energy and attention problems, I began developing a rash that started as a quarter-sized red spot on my scalp. Over the next few months, the rash spread to cover the majority of my scalp, face, neck and had begun spreading its way down one of my arms. I visited 8 different medical professionals in the course of about four months including general and nurse practitioners, dermatologists, infectious disease specialists, all of whom were perplexed by my condition and who had never seen anything like it in person, until I was connected with my Rheumatologist. He was finally able to give me the answers I was looking for, but unfortunately, that meant I was faced with two chronic illnesses that as of yet, have no cure.
Now that we knew what was wrong with me, we began our focus on figuring out how to treat it. I was started on large doses of Prednisone, a steroid, with side effects causing weight gain, pain, inflammation, and insomnia. Additionally I was given a medication, Methotrexate, which though proven to help Lupus symptoms in many patients, is also so toxic that my hair began to fall out. I fell into a deep depression for the first time in my life. I shaved my head, and began asking the usual questions of why me? Will I get better? Will I even come out of this alive?
Through all of this, my doctor continued to work with me, changing around my medications, until we finally came to the medications in which I am currently taking; Plaquenil, CellCept, and Benlysta. My hair, though still thin, has mostly grown back. I am off of steroids. I am back to working full time as an ABA therapist working with children with autism; and I just moved into an apartment which I am paying for myself, shared with two other roommates. I am working hard to provide for myself, to pay my own way in this world, despite everyday being faced with joint pain and inflammation, nausea, diarrhea, fatigue, insomnia, depression and anxiety. I push through it all because I don't want Lupus to control my life. These drugs I am taking now have quite literally saved my life.
Yet here I am, despite doing everything I can to stay afloat, faced with impossible figures of money that I have to come up with, just to get these three medications which I very strongly believe are the only reasons I am still alive to tell you this story.
My Problem:
My new medical insurance deductible is set at $5,250. Before this figure is met out of my own pocket, I am responsible for 100% of my medical and pharmacy costs. After this figure is met, I am still responsible for 30-50% of my medical and pharmacy costs, until my out-of-pocket maximum of $6,550 is met, at which point 100% of my medical costs will be covered.
What does this mean?
I have been told, for example, that my Benlysta auto-injector will cost me $3,602.73 for a one month supply of four needles. When asked about a payment plan, I was told by my pharmacy that a majority of that bill would have to be paid before the medication would even be shipped to me. So this means, I'd have to come up with close to the $3,602 bill just to get my hands on this month's supply of just ONE of my medications. Then I'd have to do the same next month, before my out of pocket maximum could be met.
More than $6,550 in two months.
The good news:
This is hopefully a one time issue for me. Come November (open season for insurance), I have many options for finding better coverage; including my work updating to better coverage or finding affordable independent coverage for myself from another insurance company.
What I need help with:
My problem now is that finding better coverage and finding assistance programs from other sources takes time, but I need my medications or risk losing all of the progress I have made with my health, or worse yet, losing my life to my illnesses simply because I cannot afford my medications. I am begging for help from all of you. Please, help me gather the money I need to pay for these medications while I figure out better insurance options for the future. Any money I get on this go fund me, will go directly towards paying my deductible through medical bills, medications, and doctor's office visits.
I have explained my lupus journey below, if you are interested to read more about my situation.
My Story:
I am a 26 year old who has spent the entirety of her twenties, dealing with chronic medial issues. About three and a half years ago, I was diagnosed with two forms of Lupus, which is a chronic autoimmune disease that develops in some people for still unknown reasons. I have Systemic Lupus Erythematosus (SLE), which can affect many things including my internal organs. I also have Sub-acute Cutaneous Lupus, which affects my skin.
After two years of dealing with severe energy and attention problems, I began developing a rash that started as a quarter-sized red spot on my scalp. Over the next few months, the rash spread to cover the majority of my scalp, face, neck and had begun spreading its way down one of my arms. I visited 8 different medical professionals in the course of about four months including general and nurse practitioners, dermatologists, infectious disease specialists, all of whom were perplexed by my condition and who had never seen anything like it in person, until I was connected with my Rheumatologist. He was finally able to give me the answers I was looking for, but unfortunately, that meant I was faced with two chronic illnesses that as of yet, have no cure.
Now that we knew what was wrong with me, we began our focus on figuring out how to treat it. I was started on large doses of Prednisone, a steroid, with side effects causing weight gain, pain, inflammation, and insomnia. Additionally I was given a medication, Methotrexate, which though proven to help Lupus symptoms in many patients, is also so toxic that my hair began to fall out. I fell into a deep depression for the first time in my life. I shaved my head, and began asking the usual questions of why me? Will I get better? Will I even come out of this alive?
Through all of this, my doctor continued to work with me, changing around my medications, until we finally came to the medications in which I am currently taking; Plaquenil, CellCept, and Benlysta. My hair, though still thin, has mostly grown back. I am off of steroids. I am back to working full time as an ABA therapist working with children with autism; and I just moved into an apartment which I am paying for myself, shared with two other roommates. I am working hard to provide for myself, to pay my own way in this world, despite everyday being faced with joint pain and inflammation, nausea, diarrhea, fatigue, insomnia, depression and anxiety. I push through it all because I don't want Lupus to control my life. These drugs I am taking now have quite literally saved my life.
Yet here I am, despite doing everything I can to stay afloat, faced with impossible figures of money that I have to come up with, just to get these three medications which I very strongly believe are the only reasons I am still alive to tell you this story.