Sunday, January 8, 2017

Medical update: the eyes


I first saw my opthalmologist back in early November.  DX: dry eye associated with PSA, corneal damage present in both eyes. He recommended that I use eye drops:


I returned in Dec, one month later, having followed his instructions of using this product 4 times/daily then eventually cutting back to 3, then 2 times daily. Once I dropped to 3 times, I noted a significant uptick in symptoms, so put myself back on 4 times, just a few days prior to the Dec appointment.

A return visit this week included bringing my charted data of symptoms. 4 times/daily is the amount I need of the drops BUT I continue with symptoms, so he has prescribed 2 RX drops.

 One is to be used three times daily until the bottle is empty.


The second is used twice daily. These 2 new RX's are in addition to the Systane, which I have been able to find big value coupons for, paying with my HSA account, so no OOP cost. I am to return to the Opthalmologist in 2 months, so I also had him send in a 3 month supply to my mail order pharmacy. Costs associated with the visit to the MD are at 10%, just over $7 to me, again paid out through my HSA so no OOP costs.

Meanwhile, I got both the use it up RX drops and a one month supply of Restasis at a local CVS. Since we hit our first deductible for the plan year, we are obliged to pay 10% for all RX's. The use it up drops were $18.84 vs the usual $188.40 and the Restasis was ONLY $46.29 vs the usual $462.90. Luckily, there is a coupon apparently on the Restasis as the Pharmacist applied it to the drug, dropping my cost to $30. $48.84 was paid on my HSA account, again leaving me no OOP costs.

I investigated Restasis on line, and found that there is a copay, cost reduction program. They encourage patients to buy a 3 month supply for the best reimbursement. The 3 month supply costs $1251.68 so my 10% cost is $125.17. Luckily, the co-pay reduction program will reimbuse me $90, so this brings it down to $35.17/3 months or $11.72/month. MUCH better, thank you.

So my medical needs and costs continue, underscoring the necessity for me to find a job with benefits. I would soon go broke otherwise. I've been able to play the system, as it is, and make out OK. I know that my total OOP costs will be $6000/annually, so those funds are placed in my HSA to be available when I need them. This leaves my monthly budget alone. Even with the OTC drops, meds, I can use my HSA for many, if not all of them, again, I've allowed a small cushion to build up over the past few years since moving to a High deduction/HSA plan for medical insurance.

1 comment:

Lee Ann said...

I hope you find a good job with benefits soon.