As of today, November 3, 2009 the wait for an appointment at Northwestern Hospital for a screening mammogram is still beyond six months.
The following is a list of mammogram testing sites that have earned the "Breast Imaging Center of Excellence Seal"- the same level of accreditation that Northwestern Memorial Hospital has, from the American College of Radiology:
Breast Center of St. Francis Hospital- Evanston, IL800 West Austin, Suite 551- East Tower, Evanston, IL 60202847-316-3000
DuPage Imaging- Hinsdale, IL908 North Elm Street, Ste 404, Hinsdale, IL 60521630-856-4800
Good Samaritan Hospital- Advocate- Downers Grove, IL3815 Highland Avenue, Downers Grove, IL 60515630-275-5760
Lutheran General Hospital for Advanced Care- Park Ridge, IL1700 Luther Lane, Park Ridge, IL 60068847-723-3100
Resurrection Medical Center Women's Imaging Center- Chicago, IL7435 West Talcott Avenue, Chicago, IL 60631773-792-5556
Rush Breast Imaging Center- Chicago, IL1725 West Harrison Street, Suite 155, Chicago, IL 60612312-942-2027
Tuesday, November 3, 2009
Trouble with Getting Cobra Subsidy?
Having trouble getting Cobra paid for by your former employer? New US Dept of HHS govn't helpline and website have been established to assist you: tele: (866) 400-6689 website: www.ContinuationCoverage.net
What If I Still Can't Afford My Medicine?
Other ways to save on your meds:
Options:
1. If you are taking a medication that ends with "XL", "XR", "CD", or "SR"- then you are probably taking a long acting version of your medicine. There is probably a short- acting generic version of your medication available. The trade off would be that you might have to take a pill two or three times a day instead of once or twice a day. IF YOUR DOCTOR THINKS THIS IS APPROPRIATE FOR YOU, it could save you big bucks.(all examples based on prices from Costco on 5/29/09)
Example 1: Rythmol SR 225, #60 tabs (taken twice a day)- $367/month VS propafenone 225 (generic version of Rythmol) #100 tabs (taken three times a day)- $34/month.
2. If you are taking a medication that is a combo pill, consider taking them as two separate meds. If you are not sure if you are taking a combo pill try Googling the name to find out. Usually you can save money by taking the meds separately, even if there is a generic version of your combo med.
Example 2: Generic Lotrel 10/20, #30 tabs - $81/mo VS amlodipine 10 mg, #30 tabs + benazepril 20mg #30 tabs= $8 + $6 = $14/mo.
3. Try to get free meds from the pharmaceutical company that manufactures the medication. I know I have said this before but it bears repeating! Check out NeedyMeds at http://www.needymeds.org/ and see if such a program exists for your medication.
4. Consider using mail order pharmacies. See some of the reader reviews on LesliesList for recommendations.
5. Pill splitting- ask your pharmacist if it is safe to cut your type of medication. Usually coated pills or controlled-release pills and capsules may NOT be cut. However many pills can be and you can save money by getting the stronger dose and cutting it in half. Example 5: Lipitor 20 mg, #30 tabs- $122/monthVS Lipitor 40 mg, #30 tabs- $123 (but lasts for TWO months because you are taking a 1/2 tab per day)- $62/mo
Options:
1. If you are taking a medication that ends with "XL", "XR", "CD", or "SR"- then you are probably taking a long acting version of your medicine. There is probably a short- acting generic version of your medication available. The trade off would be that you might have to take a pill two or three times a day instead of once or twice a day. IF YOUR DOCTOR THINKS THIS IS APPROPRIATE FOR YOU, it could save you big bucks.(all examples based on prices from Costco on 5/29/09)
Example 1: Rythmol SR 225, #60 tabs (taken twice a day)- $367/month VS propafenone 225 (generic version of Rythmol) #100 tabs (taken three times a day)- $34/month.
2. If you are taking a medication that is a combo pill, consider taking them as two separate meds. If you are not sure if you are taking a combo pill try Googling the name to find out. Usually you can save money by taking the meds separately, even if there is a generic version of your combo med.
Example 2: Generic Lotrel 10/20, #30 tabs - $81/mo VS amlodipine 10 mg, #30 tabs + benazepril 20mg #30 tabs= $8 + $6 = $14/mo.
3. Try to get free meds from the pharmaceutical company that manufactures the medication. I know I have said this before but it bears repeating! Check out NeedyMeds at http://www.needymeds.org/ and see if such a program exists for your medication.
4. Consider using mail order pharmacies. See some of the reader reviews on LesliesList for recommendations.
5. Pill splitting- ask your pharmacist if it is safe to cut your type of medication. Usually coated pills or controlled-release pills and capsules may NOT be cut. However many pills can be and you can save money by getting the stronger dose and cutting it in half. Example 5: Lipitor 20 mg, #30 tabs- $122/monthVS Lipitor 40 mg, #30 tabs- $123 (but lasts for TWO months because you are taking a 1/2 tab per day)- $62/mo
Can't Afford a Colonoscopy?
Can't or don't want to spend $3500 on a screening colonoscopy?
You have other options.
The American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer and the American College of Radiology jointly recommended in March 2008 that an AVERAGE RISK patient over the age of 50 have one of the following screening modalities for the detection of colon cancer:
1. Colonoscopy every 10 years OR
2. High Sensitivity Fecal Occult Blood Testing (HSFOBT) every year OR
3. Flexible sigmoidoscopy (an office-based procedure) every 5 years OR
4. CT colonography (aka virtual colonoscopy) every 5 years OR
5. Double contrast barium enema every 5 years
In October 2008, the US Preventive Services Task Force recommended:
1. HSFOBT every year OR
2. Flexible sigmoidoscopy every 5 years, with HSFOBT in the intervening years OR
3. Colonoscopy every 10 years
What is HSFOBT? This is a test for hidden blood in the stool. A stool specimen is collected by the patient at home, on three different days, and then sent to the lab or doctor's office for analysis. If the test is positive, then a full colonoscopy is warranted to find the source of bleeding. In this case, the colonoscopy is then labeled "diagnostic", instead of screening, and so insurance coverage may kick in to cover it (or not, depending on the type of insurance you have). The cost for the HSFOBT is usually between $50-100. Visit LesliesList.org: http://www.leslieslist.org/low-cost-testing.php?exam=Colonoscopy to see the full range of prices for a colonoscopy test in the Chicago area, from $1000- $3500.
What is Flexible Sigmoidoscopy (aka "Flex sig")?
This is an office-based procedure in which the doctor does a sort of briefer version of a colonoscopy in the office. No sedation is required. Only the left part of the colon (the descending colon) is examined, but this is where 85% of colon cancers originate. Since there are no hospital fees, it is usually a significantly cheaper test, too. More in the $300-500 range, per some of my GI colleagues.
What is Double Contrast Barium Enema and CT Colonography?
These are tests that may also be used for colon cancer screening but are going to be comparable in cost to the colonoscopy.In summary, if you can't afford a colonoscopy, ask your doctor if one of these other more affordable options mentioned above might be right for you.
You have other options.
The American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer and the American College of Radiology jointly recommended in March 2008 that an AVERAGE RISK patient over the age of 50 have one of the following screening modalities for the detection of colon cancer:
1. Colonoscopy every 10 years OR
2. High Sensitivity Fecal Occult Blood Testing (HSFOBT) every year OR
3. Flexible sigmoidoscopy (an office-based procedure) every 5 years OR
4. CT colonography (aka virtual colonoscopy) every 5 years OR
5. Double contrast barium enema every 5 years
In October 2008, the US Preventive Services Task Force recommended:
1. HSFOBT every year OR
2. Flexible sigmoidoscopy every 5 years, with HSFOBT in the intervening years OR
3. Colonoscopy every 10 years
What is HSFOBT? This is a test for hidden blood in the stool. A stool specimen is collected by the patient at home, on three different days, and then sent to the lab or doctor's office for analysis. If the test is positive, then a full colonoscopy is warranted to find the source of bleeding. In this case, the colonoscopy is then labeled "diagnostic", instead of screening, and so insurance coverage may kick in to cover it (or not, depending on the type of insurance you have). The cost for the HSFOBT is usually between $50-100. Visit LesliesList.org: http://www.leslieslist.org/low-cost-testing.php?exam=Colonoscopy to see the full range of prices for a colonoscopy test in the Chicago area, from $1000- $3500.
What is Flexible Sigmoidoscopy (aka "Flex sig")?
This is an office-based procedure in which the doctor does a sort of briefer version of a colonoscopy in the office. No sedation is required. Only the left part of the colon (the descending colon) is examined, but this is where 85% of colon cancers originate. Since there are no hospital fees, it is usually a significantly cheaper test, too. More in the $300-500 range, per some of my GI colleagues.
What is Double Contrast Barium Enema and CT Colonography?
These are tests that may also be used for colon cancer screening but are going to be comparable in cost to the colonoscopy.In summary, if you can't afford a colonoscopy, ask your doctor if one of these other more affordable options mentioned above might be right for you.
How to Save Money on Prescriptions- Pill Splitting
Some real life examples of how to get the best price for your medicines by pill splitting AND comparison shopping:
Consider Lipitor, a dose of 10 mg per day:
If you purchase 30 tabs from Walmart each month, at $100 per month x 12 months = $1200 spent for a 12-month supply. However, if you purchase 30 tabs from Walmart of the Lipitor 20 mg tablets every OTHER month (because 30 tabs will last you 60 days if you are splitting them in two), you will spend $143 x 6 months= $858 over the course of the year. That is a savings of $342/year. HOWEVER, take this one step further and find the lowest available price on Lipitor 20 mg tablets- according to LesliesList that happens to be at Target right now- at $98 for 30 tabs- and your savings become even greater, since $98 x 6 months= $564 spent per year. Compared to the $1200 per year- this saves you a grand total of $636.
Next, let's look at Lexapro, a dose of 10 mg per day:
If you purchase 30 tabs per month from Osco at $110 per month you will spend $1320 per year. However, if you go to the least expensive pharmacy (in this case by using your Savings Card from Walgreens- that can be purchased for $20 per year) you can buy 20 mg tabs, #30 for $92 per month, But remember, you only need purchase them every OTHER month because these tabs will last twice as long. Thus your total expenditure for the year would be $92 x 6= $552. Thus saving you a total of $1320- $552= $768 per year.
Other examples:
Sertaline (generic Zoloft) 50 mg pills at Osco x 12 months= $35 x 12= $420/year vs Sertraline (generic Zoloft) 100 mg pill at Kmart x 6 months= $5 x 6= $30/year$420- $30= $390 per year savings
Amlodipine (generic Norvasc) 5 mg pills at CVS x 12 months= $40 x 12= $480/year vs Amlodipine (generic Norvasc) 10 mg pills at Kmart x 6 months= $5 x 6= $30/year$480 - $30= $450/year
Please note that you can NOT split a pill that is time-released, specially coated or in capsule form. Please ask your pharmacist about whether your medicines are safe for pill-splitting. You will also need to ask your doctor if he or she thinks this is an appropriate option for you.
Consider Lipitor, a dose of 10 mg per day:
If you purchase 30 tabs from Walmart each month, at $100 per month x 12 months = $1200 spent for a 12-month supply. However, if you purchase 30 tabs from Walmart of the Lipitor 20 mg tablets every OTHER month (because 30 tabs will last you 60 days if you are splitting them in two), you will spend $143 x 6 months= $858 over the course of the year. That is a savings of $342/year. HOWEVER, take this one step further and find the lowest available price on Lipitor 20 mg tablets- according to LesliesList that happens to be at Target right now- at $98 for 30 tabs- and your savings become even greater, since $98 x 6 months= $564 spent per year. Compared to the $1200 per year- this saves you a grand total of $636.
Next, let's look at Lexapro, a dose of 10 mg per day:
If you purchase 30 tabs per month from Osco at $110 per month you will spend $1320 per year. However, if you go to the least expensive pharmacy (in this case by using your Savings Card from Walgreens- that can be purchased for $20 per year) you can buy 20 mg tabs, #30 for $92 per month, But remember, you only need purchase them every OTHER month because these tabs will last twice as long. Thus your total expenditure for the year would be $92 x 6= $552. Thus saving you a total of $1320- $552= $768 per year.
Other examples:
Sertaline (generic Zoloft) 50 mg pills at Osco x 12 months= $35 x 12= $420/year vs Sertraline (generic Zoloft) 100 mg pill at Kmart x 6 months= $5 x 6= $30/year$420- $30= $390 per year savings
Amlodipine (generic Norvasc) 5 mg pills at CVS x 12 months= $40 x 12= $480/year vs Amlodipine (generic Norvasc) 10 mg pills at Kmart x 6 months= $5 x 6= $30/year$480 - $30= $450/year
Please note that you can NOT split a pill that is time-released, specially coated or in capsule form. Please ask your pharmacist about whether your medicines are safe for pill-splitting. You will also need to ask your doctor if he or she thinks this is an appropriate option for you.
Who Is Wendell Potter?
From an Op Ed piece by Nick Kristof, the story of Wendell Potter, a former Cigna insurance marketing exec, who decided he couldn't face himself in the mirror any more. Please read on (the story is included in its entirety), to find out why.From NY Times 8/27/09:
Opponents suggest that a "government takeover" of health care will be a milestone on the road to “socialized medicine,” and when he hears those terms, Wendell Potter cringes. He’s embarrassed that opponents are using a playbook that he helped devise.“Over the years I helped craft this messaging and deliver it,” he noted.Mr. Potter was an executive in the health insurance industry for nearly 20 years before his conscience got the better of him. He served as head of corporate communications for Humana and then for Cigna. He flew in corporate jets to industry meetings to plan how to block health reform, he says. He rode in limousines to confabs to concoct messaging to scare the public about reform. But in his heart, he began to have doubts as the business model for insurance evolved in recent years from spreading risk to dumping the risky.Then in 2007 Mr. Potter attended a premiere of “Sicko,” Michael Moore’s excoriating film about the American health care system. Mr. Potter was taking notes so that he could prepare a propaganda counterblast — but he found himself agreeing with a great deal of the film.A month later, Mr. Potter was back home in Tennessee, visiting his parents, and dropped in on a three-day charity program at a county fairgrounds to provide medical care for patients who could not afford doctors. Long lines of people were waiting in the rain, and patients were being examined and treated in public in stalls intended for livestock. “It was a life-changing event to witness that,” he remembered. Increasingly, he found himself despising himself for helping block health reforms. “It sounds hokey, but I would look in the mirror and think, how did I get into this?”Mr. Potter loved his office, his executive salary, his bonus, his stock options. “How can I walk away from a job that pays me so well?” he wondered. But at the age of 56, he announced his retirement and left Cigna last year.This year, he went public with his concerns, testifying before a Senate committee investigating the insurance industry.“I knew that once I did that my life would be different,” he said. “I wouldn’t be getting any more calls from recruiters for the health industry. It was the scariest thing I have done in my life. But it was the right thing to do.”Mr. Potter says he liked his colleagues and bosses in the insurance industry, and respected them. They are not evil. But he adds that they are removed from the consequences of their decisions, as he was, and are obsessed with sustaining the company’s stock price — which means paying fewer medical bills.One way to do that is to deny requests for expensive procedures. A second is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease. A Congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.As The Los Angeles Times has reported, insurers encourage this approach through performance evaluations. One Blue Cross employee earned a perfect evaluation score after dropping thousands of policyholders who faced nearly $10 million in medical expenses.Mr. Potter notes that a third tactic is for insurers to raise premiums for a small business astronomically after an employee is found to have an illness that will be very expensive to treat. That forces the business to drop coverage for all its employees or go elsewhere.All this is monstrous, and it negates the entire point of insurance, which is to spread risk. The insurers are open to one kind of reform — universal coverage through mandates and subsidies, so as to give them more customers and more profits. But they don’t want the reforms that will most help patients, such as a public insurance option, enforced competition and tighter regulation.Mr. Potter argues that much tougher regulation is essential. He also believes that a robust public option is an essential part of any health reform, to compete with for-profit insurers and keep them honest.As a nation, we’re at a turning point. Universal health coverage has been proposed for nearly a century in the United States. It was in an early draft of Social Security. Yet each time, it has been defeated in part by fear-mongering industry lobbyists. That may happen this time as well — unless the Obama administration and Congress defeat these manipulative special interests. What’s un-American isn’t a greater government role in health care but an existing system in which Americans without insurance get health care, if at all, in livestock pens."
Opponents suggest that a "government takeover" of health care will be a milestone on the road to “socialized medicine,” and when he hears those terms, Wendell Potter cringes. He’s embarrassed that opponents are using a playbook that he helped devise.“Over the years I helped craft this messaging and deliver it,” he noted.Mr. Potter was an executive in the health insurance industry for nearly 20 years before his conscience got the better of him. He served as head of corporate communications for Humana and then for Cigna. He flew in corporate jets to industry meetings to plan how to block health reform, he says. He rode in limousines to confabs to concoct messaging to scare the public about reform. But in his heart, he began to have doubts as the business model for insurance evolved in recent years from spreading risk to dumping the risky.Then in 2007 Mr. Potter attended a premiere of “Sicko,” Michael Moore’s excoriating film about the American health care system. Mr. Potter was taking notes so that he could prepare a propaganda counterblast — but he found himself agreeing with a great deal of the film.A month later, Mr. Potter was back home in Tennessee, visiting his parents, and dropped in on a three-day charity program at a county fairgrounds to provide medical care for patients who could not afford doctors. Long lines of people were waiting in the rain, and patients were being examined and treated in public in stalls intended for livestock. “It was a life-changing event to witness that,” he remembered. Increasingly, he found himself despising himself for helping block health reforms. “It sounds hokey, but I would look in the mirror and think, how did I get into this?”Mr. Potter loved his office, his executive salary, his bonus, his stock options. “How can I walk away from a job that pays me so well?” he wondered. But at the age of 56, he announced his retirement and left Cigna last year.This year, he went public with his concerns, testifying before a Senate committee investigating the insurance industry.“I knew that once I did that my life would be different,” he said. “I wouldn’t be getting any more calls from recruiters for the health industry. It was the scariest thing I have done in my life. But it was the right thing to do.”Mr. Potter says he liked his colleagues and bosses in the insurance industry, and respected them. They are not evil. But he adds that they are removed from the consequences of their decisions, as he was, and are obsessed with sustaining the company’s stock price — which means paying fewer medical bills.One way to do that is to deny requests for expensive procedures. A second is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease. A Congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.As The Los Angeles Times has reported, insurers encourage this approach through performance evaluations. One Blue Cross employee earned a perfect evaluation score after dropping thousands of policyholders who faced nearly $10 million in medical expenses.Mr. Potter notes that a third tactic is for insurers to raise premiums for a small business astronomically after an employee is found to have an illness that will be very expensive to treat. That forces the business to drop coverage for all its employees or go elsewhere.All this is monstrous, and it negates the entire point of insurance, which is to spread risk. The insurers are open to one kind of reform — universal coverage through mandates and subsidies, so as to give them more customers and more profits. But they don’t want the reforms that will most help patients, such as a public insurance option, enforced competition and tighter regulation.Mr. Potter argues that much tougher regulation is essential. He also believes that a robust public option is an essential part of any health reform, to compete with for-profit insurers and keep them honest.As a nation, we’re at a turning point. Universal health coverage has been proposed for nearly a century in the United States. It was in an early draft of Social Security. Yet each time, it has been defeated in part by fear-mongering industry lobbyists. That may happen this time as well — unless the Obama administration and Congress defeat these manipulative special interests. What’s un-American isn’t a greater government role in health care but an existing system in which Americans without insurance get health care, if at all, in livestock pens."
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