Back to Square One

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I’m writing this blog post mostly for my own information to keep track of everything that’s happened and is happening now with regard to my healthcare because I realize I am essentially back to square one.

On April 21, I had an intake appointment with Austin-Travis County Integral Care (ATCIC) for psychiatric medication management. At that time I had regular Medicare but had just applied for a Medicare plan through Blue Cross Blue Shield that included Part D for prescription drug coverage. That insurance went into effect on May 1, so the result of my intake with ATCIC was that they don’t accept Blue Medicare Advantage, so I was back to square one with regard to my psychiatric care.

I called around to find another provider and found that CommUnity Care had doctors that would accept my new coverage, so I called them to make an appointment. I was told that they wouldn’t be able to schedule a psychiatric intake unless I had a primary care physician, so being in need of one of them, I asked them to set an appointment with a PCP. In the meantime, I had gotten in touch with my previous psychiatric medication manager and she had called in a month’s worth of prescriptions for me, which meant the urgency to see a psychiatrist wasn’t so urgent, and I could wait until after I saw my new PCP to see my new psychiatrist.

On May 11, I went to see my PCP, who was a nurse practitioner. She was exceptionally thorough and made two medication changes for me. First, she added low dose aspirin to my regimen. Secondly, she asked that I start to double up on my lisinopril/HCTZ. (I would go from taking one 20/12.5 mg tablet twice a day to two twice a day.) She also explained that because I had so many health problems I would need to be seen directly by a primary care physician and not a nurse practitioner, and so she left it to my new doctor to write any prescriptions that I would need.

I called the next day to make the appointment with my new PCP and was told that the earliest appointment they had was June 30 – more than six weeks away. It meant that I would run out of lisinopril/HCTZ for two weeks (since I was doubling up without a backing prescription) before I could get another refill, but I figured I’d cross that bridge when I came to it.

That same day I got a call from CommUnity Care scheduling my psychiatric intake for May 18.

The following day, I got another call from someone else at CommUnity Care saying that I was being referred to another agency for psychiatric services, so I got in touch with my case manager at CommUnity Care (the young lady that had called me in the first place scheduling the intake) to get a clarification. She told me that yes, I had been referred out, so the intake appointment never happened.

Next came the day I ran out of lisinopril/HCTZ, and I called over to CommUnity Care to get a refill called in. I verified three times that they were calling in the combined drug and not just lisinopril. I was reassured that they were calling in the correct prescription. I went to go pick it up and discovered that they had, in fact, called in the lisinopril only version of the drug. I told the pharmacy that the nurse practitioner had called in the incorrect drug and that I would get a new prescription called in the next day.

The next day, I went over to CommUnity Care with the paperwork in my hand ordering the increase to two lisinopril/HCTZ 20/12.5 mg tablets twice a day. I was told that the nurse practitioner had changed my prescription to lisinopril 40 mg once per day. I asked why the change had occurred. I wasn’t given a reason.

The next event was my ER trip when my blood pressure spiked to 205/119. We managed to get it calmed down with a dose of Clonidine and I was given a prescription for hydrochlorothiazide (the HCTZ I was missing) 12.5 mg twice a day. I figured at least I had managed to get back to what I was taking in the first place, finally.

On Friday night, I found my old paperwork from ATCIC, including the list of Medicare providers that they carry, with mine notably absent. And then it hit me: CommUnity Care had referred me back to ATCIC, who doesn’t honor my insurance. I made it a point to call Giselle, my case manager with CommUnity Care to get things straightened out come Monday.

This morning, I was refilling my med trays as I usually do on Sunday morning when I noticed something intriguing about my HCTZ prescription. They wrote it for a quantity of 30 – 15 days’ worth of medication.

So here I am on Sunday evening, realizing that I’m honestly no farther along on this path than I was when I started. I’m once again going to run out of vital blood pressure medication well before I see someone about refilling it, and I have no current leads on getting my psychiatric medications prescribed.

Which in my mind frees me up to start the process of finding a doctor and a psychiatrist over again come tomorrow.

I’m going to call Giselle tomorrow and ask what’s the story, but I’m also going to call around and see if someone can see me earlier than June 30, as my blood pressure is now becoming my primary health concern.

It’s frustrating to feel like I’ve wasted the last month jumping through hoops only to be worse off than when I started and no further along the path to rectifying the situation.

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