Saturday, August 28, 2010

Indian on the Warpath to Change Discriminatory Health Insurance Restrictions
My fight to have my Benicar full dosage covered by my Medicare Part D plan (which is managed by United Healthcare) continues. It's been about 4 years that they've been stonwalling and dodging, and out and out refusing my various levels of appeal, and it took them an entire month to respond to my last appeal.

To put it mildly they have tried every possible trick in the book to stall me and my doctor and screw us around.

Those readers who have read my segments on the horrendous acts of many of the major name health insurance companies may remember that United Healthcare was one that had a track record of denying crucial claims.

Medicare made a huge mistake by privatizing their Part D which deals with medications for the elderly and disabled.

Well the letter I finally received from United Healthcare today had me on the warpath. The upshot of it was that I would have to start from scratch and have my doctor initiate the whole appeal process through United Healthcare again before going back to the point I'd reached after several years (which is the final appeal to an outside company called Maximus).

That ship has sailed and my doctor quit doing this on my behalf about a year ago because he was tired of being given the runaround and having them tell his staff they didn't receive his numerous faxes.

Then I received a phone message from United Healthcare (another department), called the woman back, a prepresentative who only identified herself as Ashley F. I read the letter to her and told her that the way they worded it made it sound as if my doctor didn't do what he was supposed to do and that they said he "cited that it was not FDA approved" for my disease, to make it appear as if he himself didn't support my staying on the drug at that dosage. They failed to say that my doctor had sent them alot of information supporting why I could not take the other drugs they had on their formulary, and that he actually sent them research supporting why this drug at this dosage is safe and effective for Sarcoidosis. They were trying to insist that he do this all over again!

Ashley F. then gave me another fax number directly to Maximus and said I should just send a letter to them telling them also that I'd already done all the appealing I could through Uinited Healthcare.

I am still recovering from the flu but will be doing that soon. Now that Carmella is stable I can start putting more time into this, and they'll find out that they have messed with the wrong patient because I don't give up!

The other night when I called the Medicare 800 number, the representative I spoke with checked over 15 other Part D plans and found that literally none of them covered 40 mg. of Benicar 3 times a day! If I can get this changed I think it will help many others too who are on cutting edge treatments that are off-label or new medications. The concept is very simply; if it helps, and it's safe, then the patient should be able to get it.

Why are conservatives griping about government intervention in healthcare, and not about big business sticking it's nose into it??? These are private companies that are denying people medications they badly need to relieve suffering, and often to stay alive for a full lifespan!

Since the time I started on this particular protocol the number of people benefitting with a variety of autoimmune diseases has multiplied about 4 times (and that's just what is counted on the official research site). There are many others quietly on the protocol through their own local physicians who are not part of the online research cohort, many of whom probably are running into the same problem. If they have a fair amount of money they can afford to buy the medication out of pocket, but if not they may have to resort to getting it from third world countries, or they may be unable to get it at all.

I just recently heard that one of the other protocol drugs, Zithromax has stopped being covered by my plan and by most of the others except those with the most expensive premiums.

Yes, they're perfectly willing to cover medications that will reactivate deadly infections and possibly kill me, and anti-cancer drugs that can totally dismantle my entire immune system and open me up to new and deadly infections, but they can't see fit to allow coverage of some simple antibiotics and a medication usually used to treat high blood pressure with a very low risk of side-effects to which I had none at all for 3 some years!

I guess they think that it's less expensive to pay for the doctor's appointments and tests that become necessary when my various organs start malfunctioning several times a year during an acute exascerbation than it would cost them to cover a few more Benicar a day to prevent that...Oh, I forgot...that would be Medicare itself covering all their consequences for not paying for my medication at therapeutic doses. I guess they figure they'll let that be the government's problem! They (meaning United Healthcare) don't pay for that part!

Luckily I have not had to be hospitalized, at least not yet, but I think the last one came pretty close to it. I just hate going to the ER and I probably should have when I had the cardiac and respiratory symptoms but to be honest I didn't have the energy to get out of bed for several weeks. Living alone I really didn't have somebody to go with me anyhow and bring me back home. It was hard enough to drag myself to the GP and the heart specialist via the medical transportation system that had to be set up with three days notice.

I can imagine how many others these insurance companies are making jump through these hoops, and although the National healthcare bill has passed, in its watered-down form it's hard to know how much, how completely, and how soon we'll be protected from such denial tactics.

I would love to speak before Congress about this and I may see if I can set that up. It's getting about time for me to write President Obama again. This seriously needs to be changed. If Maximus is a private company too then I will need all the clout behind me I can get.

Thursday, August 19, 2010

30 Minutes of Fame Thread - Upcoming Events
(Updated Saturday, Aug. 21st)

Thursday, August 19th, 2010
Fame for
9:00-9:30 PM EST
Where to come:
She's offering 25% off during that half-hour and will be throwing in a few surprises, (but you'll have to go check out her store to see what else she's got up her sleeve!)
Vintage Pearl and Pale Yellow 4-Strand Necklace 14-17 Inches

Also to come is another Buy and Replace Treasury;

August 22nd Sunday
August 23rd Monday
Go to;
Please click, comment, and buy! Starts bright and early tomorrow morning!!!!


This is the base for our thread, 30 Minutes of Fame:



8am - 1pm -

1pm - 4pm -

4pm - 7pm -

7pm - 1am -


8am - 11am -

11am - 4pm -

4pm - 7pm -

7pm - 1am-



It stands for "Buy N Replace." We create a treasury with a variety of sellers. Then you "announce" that you're buying from a specific seller in that treasury. Come back with your transaction link, and we'll put your shop in our treasury in place of the one from which you bought!


It's actually something that started in the threads. Fame is where we spend 30 minutes doing nothing but shopping, hearting, and promoting the "Famous Shop" hoping that it gets a least one sale. You can be the Famous Shop by posting a designated numbered post (for example the 5000th post) in the thread :) It's a lot of fun - we hang out, chat, promote, and make friends! Come join us!


Our BNR has garnered 51 total sales!!

Round 01 (Aug 09) - 39 sales!

Round 02 (Aug 10) - 12 sales!

Round 03 (TBA)
For those of you wanting to hear more about Carmella and some of the things I'm currently working on, stay tuned. I'll be updating you sometime in the next few days. Alot is new! More about that later. Now back to sleep...Zzzzzzz.....

Wednesday, August 11, 2010

Next 30 Minutes of Fame Thursday, August 12th at 9:00 EST! See You There!

Join the FAMOUS 30 minute party! You could be featured next!

Learn how to participate here;

Famous shop:
Below is a sneak preview of the beautiful clothing/accessories you can purchase in her online shop;
Dark Cinderella Tutu Dress
Handmade by

Monday, August 09, 2010

30 Minutes of Fame-Special Buy And Replace Treasury
Get Something Bright and Shiny for You or Someone Special and Stimulate The Economy!

Read all about it here in the Etsy shop specially designed for this purpose;

For those of you who don't know what Buy and Replace is, here's how it works;
just buy from one of the 16 featured shops, (and if you have an etsy shop) one of your items will then replace the shop you bought from! This is a great promotional tool, and has great potential to generate sales for many sellers throughout the day, so please consider shopping, clicking on the shops featured, and leaving comments in the area below the exhibited items!

(Re-posted from special etsy shop)
This is the base for our thread, 30 minutes of fame:

We are starting a BNR treasury Monday the 9th.

All the details can be found here.

Moderators for the BNR (etsy/est times): - 730am - 9am - 9am- 12pm - 12pm - 4pm - 4pm - 7pm - off and on all day, 7pm until 1am.

This BNR will close at 1am Tuesday morning, and re-open Tuesday morning at 7am - 7am - 10am - 10am - 2pm - 2pm on.

Sunday, August 08, 2010

AFTERNOON CAT NAP: blank photo art note card
by PaintedMemoriesByRos



Famous Featured Shop:





For the Assortments, if you would like a different mix of cards or all of the same card, just contact Ros through Etsy's private message with what you want for the same price as the set.


Be sure to mention "30 MINUTE FAME" in your message from buyer while you make a purchase.

If you love animals don't miss this chance to get yourselves something you can really use and at a great price! This artist does beautiful work, and besides, who doesn't love to receive a greeting card with a beautiful animal on the cover! The cat above is just a tiny taste of what she has for you!

Tuesday, August 03, 2010

Come One, Come All; 30 Minutes of Fame; You Could Be Next!

Pretty Aventurine and Amethyst Bracelet by Missy Phay625

30 minutes of FAME!!!

Famous Shop:  

Wednesday August 4th at 9:00 pm (EST)

Visit,Chat,Buy,Sell.....You could be next!

Go to this forum thread on Etsy to participate; all are invited! Prizes will be given away!