I ain't got no money!!

[Arachne]

I have to say that while brand name medications are often the same as generics, they aren't always. The actual DRUG will be the same, but the delivery agent is often cheaper, and sometimes the purity controls aren't as high. I've had very, very bad reactions to the generic versions of two brand medications that I take.

Also, I know a woman (an SC I plan to write about someday, actually) whose husband probably died from quitting smoking cold turkey. Nicotene, among other things, expands blood vessels, I think. It's a stimulant, and a lot of stimulants can do this. I think it also might thin the blood. Point being, if someone has clogged artery troubles, quitting smoking too fast can indeed kill them.

Of course, crazy bleached-hair lady probably didn't know that. She probably was just being melodramatic. And seriously, three dollars? She could have one half sized meal and have three dollars. Bam! Just like that.

[csdrone]

$3 copay? Must be nice. And smoking while getting a cardiac procedure done? Real smart!

[XCashier]

Nicotene, among other things, expands blood vessels, I think. It's a stimulant, and a lot of stimulants can do this. I think it also might thin the blood.

It's actually the opposite; smoking narrows blood vessels and increases blood pressure. http://health.msn.com/centers/cardio...ntid=100096666

Tobacco smoke contains more than 4,800 chemicals. Many of these can damage your heart and blood vessels, making them more vulnerable to narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack.

In addition, the nicotine in cigarette smoke makes your heart work harder by constricting blood vessels and increasing your heart rate and blood pressure. Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure by forcing your heart to work harder to supply enough oxygen.

[AFpheonix]

I have to say that while brand name medications are often the same as generics, they aren't always. The actual DRUG will be the same, but the delivery agent is often cheaper, and sometimes the purity controls aren't as high. I've had very, very bad reactions to the generic versions of two brand medications that I take.

Yes, the binders and colorings can be different, but for the vast majority of people, this isn't an issue. There are occasionally quality issues with some of the generics we get (fentanyl patch and the hypercare roll on come to mind), but those are less of an issue on how the drug works than with their delivery mechanisms. Patches fall off, the roll on tears.

Occasionally we get a coeliac that we have to pull drug info for, and a few people allergic to a food dye. Most every other person who requests brand, however, are usually SC in other ways, which tells me their getting brand because they're rather uptight, or I have a sneaking hunch they're selling their controlled med on the street.

[Arachne]

Yes, the binders and colorings can be different, but for the vast majority of people, this isn't an issue.

It may not be an issue for most people, but it's a pretty big one for me. Both times I've tried generics as a way of saving a little bit of money, I've had very bad reactions to them. The first one, I think the time release wasn't very good, because I felt way over-medicated at first, and it wore off in a couple of hours. For the second one, I can't describe it. (Well, I can, but it's way too TMI for a public forum.) It might have been a strange allergic reaction. Whatever it was, it made for one of the worst nights of my life.

The trouble is that either my sensativity is so rare, or else not enough people who have the same problems come forward with this. I'm having a -very- hard time getting my doctor to remember to check the 'dispense as written' box on the prescription form with any kind of regularity, and even when she does, the pharmacy sometimes gives me generic anyway because "it's the same thing".

I have a feeling that both my doctor's office and pharmacy think I'm an SC because I can be pretty insistant about this.

Anyway, just wanted to clarify that for some people, the generic really won't work. Believe me, I'd take it if I could -- it'd save me a -lot- of money.

I didn't know about the nicotene thing. I guess I shouldn't have listened to the SC's crackpot theories without looking them up. She's awfully convinced that quitting cold turkey killed her first husband. (I know the story of his death blow by blow, by heart. She's told it dozens and dozens of times.)

[Tigress]

Wow, 3 whole bucks for a surgical procedure. One insurance company I used to have charged me a $50 co-pay for any hospital visit. And good luck getting them to pay for any surgery they didn't deem "medically necessary", even after two different doctors with a wall full of PhD's told you that it was surgery or expensive painkillers for the rest of your life. (The latter didn't happen to me, but to a friend.)

Entitlement whores like that make me cry. There are some people that actually need Medicaid and people like her make them look bad.

[AFpheonix]

It may not be an issue for most people, but it's a pretty big one for me. Both times I've tried generics as a way of saving a little bit of money, I've had very bad reactions to them. The first one, I think the time release wasn't very good, because I felt way over-medicated at first, and it wore off in a couple of hours. For the second one, I can't describe it. (Well, I can, but it's way too TMI for a public forum.) It might have been a strange allergic reaction. Whatever it was, it made for one of the worst nights of my life.

The trouble is that either my sensativity is so rare, or else not enough people who have the same problems come forward with this. I'm having a -very- hard time getting my doctor to remember to check the 'dispense as written' box on the prescription form with any kind of regularity, and even when she does, the pharmacy sometimes gives me generic anyway because "it's the same thing".

I have a feeling that both my doctor's office and pharmacy think I'm an SC because I can be pretty insistant about this.

As long as you let us know, we don't mind, unless it's to have to order in something specifically that costs a lot of money for us to get, and we end up with a bottle of it until it goes bad (like a bloody bottle of Motrin 800 mg that the freaking store manager made us order instead of substituting 4 of the OTC 200mg tabs per dose).
The only time I think a brand-only person is an SC is if they're all uppity about other things, too, and make themselves a royal PITA the rest of the time. Otherwise, I'm just happy to give you whatever works best.

Make sure that your doctor does check off the DAW box, though. Oftentimes, it means the difference in a lower copay if the doctor says you have to have brand versus you saying you want it, depending on your coverage.

[protege]

I know, harsh, but c'mon - she's bitching that she can't afford her co-pay because she's poor and on medicaid - yet she can afford cigarettes and rings to fill every one of her fingers - twice - yeah, the human race can do with out leeches like this!

Well, she's probably due to appear on either Maury or Jerry Springer next week, and needs to look her best!

Secondly, what would happen if she couldn't get healthcare? We'd have to find a whole new set of losers for those shows to laugh at. Er wait, Springer already does that. My bad!

[BookstoreEscapee]

My copay is 25 bucks for brand name, 10 for generic. As far as I know the drug I take is not available as a generic yet. If it was I'm sure the pharmacy would give me that. When I get antibiotics, the doc always tells me "I'm giving you Brand" and writes the script that way but the pharmacy automatically gives me generic. Which is fine with me. I wish I could pay 3 dollars... I can't complain though cuz all in all my insurance is pretty decent.

[SongsOfDragons]

I may be retarded but what's copay?

I live in England where we have the NHS. Despite people's moaning about it we're better off with it flawed than none, I always say...plus it means I got my EEG within a month of my second spazz.

[Rapscallion]

We'd call it excess on other insurance, I think. If you need insurance for your car after a bump, you'd pay a £50 excess or whatever. If you need chemicals, you have to pay a certain amount.

Am I right?

Rapscallion

[DesignFox]

A co-pay is what you pay out of pocket on the day your services are rendered be it at the doctor's office, or what you pay for your prescription. The Co-pay is different based on your insurance company's policy and what services you are getting.

Example: Say I have to go to the doctor. I'm lucky. I have good insurance. I go in, see the doc, and pay them a $20 co-pay for the visit. The insurance company pays the doctor the rest of the money owed for the visit.

Say I need a prescription med. According to my policy, I only have to pay the pharmacy $10 out-of-pocket. The insurance company pays the rest.

Insurance over here is sticky though. You really have to watch what plans you pay for- some of them require a deductible- which means you have to pay out-of-pocket a certain amount of money before the insurance company will pick up your bills. You also have to be careful of "pre-existing" conditions. Insurance can REFUSE to cover certain medical expenses if you had them before signing on for insurance with that company. For example, someone like me, who has no insurance. God forbid I get cancer. I'm f***ed for the rest of my life. No insurance will cover me because it will be a "pre-existing condition." I will have to pay for it all myself. Or, maybe, if I've been sick, but had the insurance for a year, they will decide to pick up the tab- it depends on my policy. That's why in the US it is such a big deal to make sure you have constant health coverage... there is no way in the nine-hells you can afford to pay for health care for yourself. And trying to get medical coverage without the aid of an employer's group plan? HAHAHA! TRY to afford THAT! And the coverage is usually just enough to keep you out of bankruptcy- if you don't go bankrupt trying to pay for the coverage each month!

Sorry about the tirade. It just really peeves me that I could get better health-care for less if I up and quit working tomorrow, then I can get working as an honest citizen. I will be very relieved in three months when I qualify for medical benefits at my new job...

[Kilamon]

I may be retarded but what's copay?

I live in England where we have the NHS. Despite people's moaning about it we're better off with it flawed than none, I always say...plus it means I got my EEG within a month of my second spazz.

Often used with major medical policies. The copay provision states what percentage of a claim the company will pay and what percentage the insured will pay. For example, an 80 percent copay provision would provide that the insurer pay 80 percent of claims and the insured pay 20 percent. Other times, it's a set fee like $15 or $3 for specific procedures that don't meet minimums. Ex: SC was having a case of bloaty head so she went and the procedure was $200 total but her healthcare plan (medicaid) does a $3 copay for that procedure. She only pays $3. Responsible Individuals on privatized healthcare (Humana, Aetna, Primacare, Kaiser, etc) have an 80% copay so those individuals pay 20% of the $200 or $40 copay, but maybe $15 of that is upfront at check-in, the rest by a bill. In some cases, the total per year of your copay goes towards a deductable so that if you spend $500 in a year, anything over that limit is paid for by the healthcare corp, except for the $15 copay which always seems to be there.

[TNT]

You also have to be careful of "pre-existing" conditions. Insurance can REFUSE to cover certain medical expenses if you had them before signing on for insurance with that company. For example, someone like me, who has no insurance. God forbid I get cancer. I'm f***ed for the rest of my life. No insurance will cover me because it will be a "pre-existing condition." I will have to pay for it all myself. Or, maybe, if I've been sick, but had the insurance for a year, they will decide to pick up the tab- it depends on my policy.

True, especially with an individual policy, although the conditions vary from state to state. For employer group health policies, it's limited to 12 months... however, in actual practice I've never had one that included a pre-existing condition clause.

And now for an SC story... I was once in the pharmacy at the local hospital, picking up a prescription. The guy in front of me was using a Medicaid card and got a bagful of drugs.

SC: Take this s**t back. I don't take generic drugs.
Pharmacy: It's the law that if there's a generic equivalent, that's what you get.
SC: I don't take generic drugs. Take them back and give me the brand names.
Pharmacy: Sorry, but no, unless your doctor specifically orders a brand name.
SC: I'm telling you, I don't take generic drugs. You think because I'm poor, I'm second class.

Jeez... and there I was, with arguably the best insurance in the world (even better than my current policy, which is pretty high-end) and I had to take generic drugs.

[Gurndigarn]

America has some wonderful things. Things that make the rest of the world look on with awe and wonder.

Our medical insurance system is on the list. Sadly, though, it's not a positive "awe and wonder". Closer to "ewww and downright stupified".