Trying to Stay Flexible

My family’s medical Flexible Spending Account (FSA) ran dry with three months left in the year. Ouch! Because FSAs are funded by regular, equal, payroll deductions (pretax!), that means we’ll be dipping into our pockets for our medical expenses on top of the deductions that will continue to be taken out. Double ouch!

At the beginning of the year, our FSA had $5,000 in it. Five G’s that lasted only nine months.

As with everything else, medical expenses are going up. MarketWatch reported on Sept. 29 that the number of prescriptions filled in comparable Walgreens stores “increased 0.6% from the year-ago period, less than the 1.1% increase the prior quarter and the 5.2% increase for quarter ended Feb. 29.”

“Tough U.S. economic conditions are forcing people to delay doctor visits and limit prescription-pill use, a trend that has worsened since the start of the year,” it quoted the company as saying.

Both my husband and I have Type 2 diabetes and take blood-pressure- and cholesterol-lowering drugs as well as antidepressants. For the diabetes itself, he takes an oral combination diabetes medication, and I take insulin, pramlintide (brand name Symlin), and metformin. I also take an oral drug for my asthma. We have strips to check our blood glucose and I put the sensors for my continuous glucose monitor on the FSA. We don’t put the aspirin we take each day, the over-the-counter pills to alleviate some of the arthritis pain in my knees, or insulin pump supplies on it.

As an aside here, Mom was sighing when I talked to her on Sunday that she now has to take blood pressure meds. “I’ve never had to take medicine before,” she said. “It makes me feel old!” Mom is, of course, old enough to be my mother.

We’re very fortunate. My husband is a tenured professor at a state university. They have a tendency not to go out of business. On top of that, when the economy goes south, enrollment goes north as people return to school in an effort to develop new skills. Of course, higher prices are cutting into our income, but at least our lamps are gonna stay lit.

I’ve also been a single mother who needed public assistance for a while, and still try to think of ways to save wherever I can (although I’m not ready to go back to Regular insulin, even if it does cost less than half the price of the rapid-acting insulin I take). A little bit here and a little bit there does add up.

I do take some generic drugs and am giving serious consideration to joining my pharmacy’s flat-rate drug program: $12 for three months’ worth of a generic medication. Hopefully, mine are on the list. I would assume so, since it’s very lengthy. A recent J.D. Power and Associates poll says people who participate in those programs “have higher levels of satisfaction than those who are not in those programs,” according to an article that ran in the Oct. 1 edition of the Orlando Business Journal.

My endocrinologist once prescribed a double dose of a drug, telling me it cost the same as the dose I was taking and could be split. You can buy a pill-splitter at your pharmacy. Just make sure it’s OK to split the medication: You can’t do that with all pills.

Of course, there’s mail order, which tends to be less expensive. Our insurance company made us do that once. For a short time. The outcry was too loud (including mine). I didn’t like it, but I’m not you.

I hear that some states, including New York, have government-sponsored Web sites that allow you to comparison-shop for drug prices. If your state doesn’t offer that service, you can call around. Of course, one pharmacy may charge less for one of the drugs you take and more for another. I’m a great advocate of filling all of my prescriptions at the same pharmacy: It cuts down on the chance of drug interactions since the pharmacist (er, the pharmacy’s computer) knows everything I take and can check for potential problems.

If your doctor prescribes a new medication, ask if a less-expensive drug would be as effective. I can’t find a citation offhand, but recall that, a few years ago, there was a study that said the older, less-expensive drugs for blood pressure were as effective as today’s new, glitzy (and pricey) ones.

Pharmaceutical companies also have programs for people who need a hand getting their drugs. Ask your doctor about them. Don’t be afraid—or ashamed—to say you need help affording the drugs you need for your health. It probably won’t be the first time your doctor has heard it.

The problem with diabetes is that there is no generic insulin, no generic Symlin, and no generic blood glucose test strips, forcing me to pony up a higher co-pay than I do for generics. I’ve argued with my insurance company that it isn’t fair to make somebody dig deeper into their pockets if they have no choice, but nobody there was buying it (no pun intended).

Ah, the things I could do and the places I could go if I had the money I spend on diabetes. Why didn’t I inherit my mother’s genes?