August 23, 2018, 3:30 p.m.
After my appointment with Dr. Prabaharan, it was only 3:11 p.m.; so I went back to the first floor to Member Services. I checked in and waited to be called.
A short woman with a thick mane of curly red hair appeared and took me back to her office. As soon as I told her about my Lyrica problem, she said, “Oh, you want to go to Medical Financial Assistance,” and she wrote down the name and office number on a Post-It note and gave it to me.
I found the Medical Financial Assistance office and then I realized that I had misunderstood the directions from the pharmacy clerk last week. I should have turned left (instead of right) at the end of the hallway behind the pharmacy.
There was an older woman at the receptionist desk who was extremely pleasant. I told her my story. She nodded in understanding. Her first question was did I need the medicine right away. I told her I had about a week’s worth left and she grimaced. “It takes 6 or 7 weeks to process an application,” she said. I shrugged. “Well, I’ve been through the Kaiser Pain Management program. I’ll just have to use the tools I learned there to manage my pain until I can get some medication!”
The woman looked uneasy, like she was looking for someone whom she identified as “she,” referring to her boss, a woman who was not in at the time. “She should be back any minute now,” the receptionist told me. “She got called upstairs to assist a patient, as happens frequently.” And I thought of my friend from church who was in the hospital for a procedure and couldn’t pay. That’s probably how it happened for him, I thought. She spoke again. “She’s Filipina and can talk a lot,” was her excuse for why she was taking so long with the patient upstairs. I laughed. “Oh, I’m Filipina, too,” I said. “I know how we are!”
She gave me a 4-page document with 3 pages of information and a single-page application on the back. I sat down with it and read it. The most important part was that the maximum amount for a two-person household was way above our combined incomes from Social Security so it looked like I might qualify. I stood and was about to tell the receptionist that I would go now and come back tomorrow with printed information from the Social Security Administration that was required with the application, when “she” walked in. I didn’t see her name tag, so I only know her as a “Patient Financial Advisor” which was on the business card the receptionist had given me.
“She” took me into her office and offered me a seat and I handed her my Kaiser card. She asked questions and I answered as she typed away at her workstation which was placed at an angle so I couldn’t see her screen. There was a large Lexmark printer on the end of her desk closest to me and it started printing out something.
I had the 4-page information/application in my hand when she turned to me and, with a smile, said, “You’re approved!” I couldn’t believe it! “That’s it?” I queried. She then explained that normally they are required to send applications through their Walnut Creek facility for final approval. “But since this is your first time [to apply for Medical Financial Assistance], I can approve you.” She pulled the papers from the Lexmark printer and handed them to me. “This is your official letter of approval,” she said, “and you also should get a copy in the mail in a few days.”
I was overwhelmed with joy and gratitude! “Oh, thank you so much!” I breathed. She pointed out that this was for one year and would not be automatically renewed and I would have to submit another application on or before 8/23/2019.
“I can handle that,” I told her. “Maybe that will be time enough for Pfizer’s patent on Lyrica to expire and ‘they’ will be able to provide a generic.”
“That would be great,” she said, “but only if the generic is as effective as the brand name.”
“I know what you mean,” I said. “When I was given Imitrex 25 years ago, it was only available by injection. Then, later, by nasal spray and, finally, they came out with a table for generic sumatriptan. Luckily, it does work just as well as the brand name Imitrex, which initially was several hundred dollars a month if you didn’t have insurance! Then there’s metformin, which I got initially as the brand name Glucophage and I had no problems. But when I was switched to generic metformin, I had serious digestive issues!”
She then revealed that she had been given metformin with her first pregnancy. And now, since her third pregnancy, she is on insulin. I told her about berberine, which I take now instead of metformin; and it’s just as effective but without the side effects of “daily diarrhea”! “But ask your doctor about berberine,” I said. “I just talked to Dr. Prabaharan about berberine, for me, and he was fine with it.”
She was typing at her workstation as she told me that she is re-activating the last prescription, the one Danny gave me, for a 30-day supply of Lyrica. Then she picked up her phone and made a call to the pharmacy downstairs. “Okay, they will have it ready for you now,” she said.
I stood, again overwhelmed with gratitude, and we shook hands. Good-bye, my new Filipina friend. And I hope your doctor also will support you with berberine.
San Leandro Pharmacy
I checked in at the pharmacy, as I had done many times, and handed the woman my Kaiser card and my approval letter. “This prescription is supposed to be ready,” I said. She entered something on her workstation the said, “It should be ready in 5 to 7 minutes. They’ll call your name.”
I sat down to wait, took a picture of signage, and waited for my name. When I was called, I handed another pharmacy clerk my Kaiser card. He typed on his workstation then went to retrieve the medicine. When he came back, he entered more on his workstation, then turned to me. “Are you aware of the price of this?” he asked, almost in a whisper.
I handed him the approval letter, saying, “It’s supposed to be covered.” He got an “Aha” expression, then asked me to have a seat for a moment, but he kept the letter. When he came back, he “rang up” the medicine on his workstation, then put it and a receipt in a small white bag and handed it to me, as well as my approval letter. And again I was overwhelmed with gratitude. A 30-day supply of Lyrica, at the dose ordered by Danny, was in the bag, along with a receipt.
The receipt said “Total cost = $0.00.” Thank You, Jesus!
