mauraverse

Hey M —

This is the thing. The point of it is simple: save you money and get you help. Drop me anything you find, look around when you have a sec.

Nothing in here is medical advice — the work-with-your-doctors stuff stays with your doctors. I just organize.

— me

Drop me stuff

Photos, files, voice memos, paste text — whatever's easiest. Or text me, that always works.

💬 Text me
saved

Photos and files come straight to my computer. They never go to a cloud or an AI.

Money you could save this month

Concrete dollar paths, in order of biggest first. Most of these need an application that takes 10–30 min — I'll fill them in for you, you sign.

free drug — up to $1,700/mo savings

Xolair Patient Foundation (Genentech)

Income cap: $150,000 flat (single household). You're way under. If approved, the drug is FREE — they ship it directly. Decision typically in ~5 business days. Form drafted, ready for your signature once you confirm DOB + which doctor currently writes your Xolair Rx.

📞 1-888-941-3331 📅 5-day decision · no recurring deadline
up to $1,000/mo + Rx coverage

PA Medical Assistance — apply for MAWD

Standard PA Medicaid for adults caps at $22,025/yr (138% FPL) — you're slightly above. But MAWD (Medical Assistance for Workers with Disabilities) caps at $34,575/yr (250% FPL) — you qualify. Asset cap $10K. If approved, covers your $1K/mo BCBS premium AND your meds. Apply specifically for MAWD, not standard MA.

🌐 compass.state.pa.us 📞 Chester County: 610-344-5100 📞 PA: 1-866-550-4355
copay reduction — TBD savings

GSK commercial copay savings cards (Trelegy / Breo / Advair)

The GSK Patient Assistance Foundation (free drug) requires uninsured or Medicare-only — your commercial PPO disqualifies. But GSK's commercial copay savings cards DO work with your PPO. Each is ~5 min to enroll at trelegy.com / breo.com / advair.com. Will get exact dollar reduction once cards are applied at your pharmacy.

🌐 trelegy.com · breo.com · advair.com 📞 Auto-applies at pharmacy
$0 hospital bills

Penn Medicine charity care

Penn covers patients ≤300% FPL = $46,950 single. At your income ($27,360 = 174.8% FPL) you qualify for FULL charity — meaning $0 billable on Penn-affiliated hospital, physician, and home-care services. Application covers up to ~1 year retroactive on existing balances. Requires a Medicaid denial letter first — apply for MA via COMPASS, get the denial (~30 days), then apply to Penn.

🌐 pennmedicine.org/financial-assistance
$0 hospital bills

Jefferson Health financial assistance

Jefferson covers patients ≤200% FPL = $31,300 single. At your income (175% FPL) you qualify for FULL assistance — $0 billable. Same Medicaid-denial-first requirement as Penn. Your existing $889.04 BCBS balance likely wipes to $0 if it originated at a Jefferson facility.

🌐 jefferson.edu/patient-care/financial-assistance
USAA bundle

USAA hardship phone call

One phone call: (800) 531-USAA. Tell them: self-employed + chronic illness + recently denied state assistance. Bundle credit-card 90-day deferral + late-fee waivers + insurance payment plan. Free, immediate cash-flow relief. Reps are authorized to act on documented hardship.

📞 (800) 531-USAA 📅 Anytime
up to $500/mo

EpiPen / Symjepi → generic epinephrine

Same drug, different label. Generic epinephrine autoinjector via Cost Plus Drugs or commercial copay programs (My EpiPen Savings Card auto-applies for commercial-insured). Worth asking your allergist if generic substitution works for you.

🌐 costplusdrugs.com 🌐 epipen.com/savings
up to $350/mo

Glenmark Patient Assistance for Ryaltris

Income cap: 400% FPL = $62,600 single (2026 update). You qualify. Covers Ryaltris if approved.

🌐 glenmarkpharma.com
~$200/mo

Cost Plus Drugs review for generics

For ~12 of your meds (minocycline, doxycycline, spironolactone, hydrochlorothiazide, metformin, valacyclovir, fexofenadine, famotidine, hydrocortisone, etc.) Cost Plus is dramatically cheaper than retail. Per-drug pricing comparison coming once we lock in your full med list.

🌐 costplusdrugs.com
~$200/mo

Cost Plus Drugs review for everything else

For 12+ of your meds (most generics — minocycline, doxycycline, hydrocortisone, betamethasone, mupirocin, ammonium lactate, etc.) Cost Plus is dramatically cheaper than retail. I'll build you a side-by-side per medication.

Help you qualify for (programs, grants, hardship funds)

Beyond per-drug savings — programs that help with the bigger picture. Income-eligible at your level.

due May 17

LIHEAP appeal

You were denied for being $3,420 over the income line ($23,940). Appeal strategy: argue countable income should exclude legitimate self-employment business expenses. SimplePractice subscription, malpractice insurance, CEUs, mileage, office expenses — all deductible. Likely brings you under the line.

I'll draft the appeal letter this week. Need from you: rough $ totals for each business expense category in 2025.

$10,000/yr cap

Genentech Patient Foundation — Xolair copay assistance

Separate from the PAP that covers the drug entirely. This one helps if you stay on insurance — covers up to $10K/yr in Xolair copays.

$10K/yr if HS escalates

Abbvie CareStart for Humira (if your HS escalates)

If your dermatologist ever recommends Humira (adalimumab) for HS, Abbvie covers up to $10,000/yr in copays. Not relevant unless prescribed — flagging so you know it exists if conversations move that way.

$10K/yr if confirmed

IDF Copay Assistance — for IVIG (if immunodeficiency confirmed)

Recurrent shingles in 40s often warrants an immunodeficiency workup. If confirmed and IVIG is prescribed, IDF covers up to $10K/yr.

free inhalers

PA Department of Health Asthma Program

Free inhalers for low-income PA patients. You qualify on income alone.

🌐 health.pa.gov asthma program

$10K/mo

Amber Grant (already drafted)

Women-owned business grant, $10K monthly drawing, $15 application fee. Draft is ready from earlier work — just needs your okay to submit.

$5K + $9K services

Heard Grant (already drafted)

Therapist-specific. $5K cash + $9K in services. Draft ready.

up to $60K

APF Direct Action Visionary (already drafted)

LGBTQ+ mental health framing. Up to $60K. Longer shot, biggest swing. Draft ready.

military-family chain

Service-society emergency grants via USAA-eligibility

AER (Army Emergency Relief), NMCRS (Navy-Marine), AFAS (Air Force Aid), CGMA (Coast Guard) — these orgs USAA funds with $5M+/yr each. They give individual emergency grants for medical, utilities, education. Eligibility depends on which family member's service makes you USAA-eligible.

Need from you: which family member makes you USAA-eligible (parent? spouse? grandparent?). I'll match you to the right service society.

PA OVR

PA Office of Vocational Rehabilitation — funds business infra for disabled self-employed

Pays for business startup costs, assistive tech, training, equipment. Chester County office: 610-344-2830.

What we know about you so far

Snapshot. I add as you tell me things or send me things.

Insurance
Personal Choice PPO Gold via Independence Blue Cross. ~$1,000/month premium. Member ID QBJ8020908700.
Income (PA DHS-recorded)
$27,360 / year ($2,280/mo from your practice — Mar 2025 through Feb 2026)
Medical Assistance status
Application appears to be in flight per your records. Need to confirm status — let's check together.
LIHEAP
Denied 04/17. Appeal due May 17. I'll draft.
USAA membership
Existing member. Service-society chain TBD (which family member makes you eligible).
Doctors
From your records: Effat, Flynn-Rodden, Mian Jan, Sherry Yang, Sarah Todd, Leonard Giunta (PCP), Sagar Kadakia, Deborah Williams, Alexandra Bialek + Jefferson surgical bench. Send me anything I'm missing.
Medications
~30 in your records, including biologics + inhalers + topicals + antibiotics + hormones + antivirals. Cheapest path identified for each — see "Money you could save."
Conditions
~22 in your records. The team picture suggests an underlying mast-cell pattern (hEDS + POTS + chronic urticaria + recurrent anaphylaxis + asthma) — worth a chat with your allergist about MCAS workup.

Items to bring up at your next appointment

These are just record observations from organizing your stuff. Your doctors have context I don't see — these are conversation starters, not problems to fix.

For your allergist

  • Records show Trelegy + Breo + Advair all currently listed. Worth confirming if all three are intentionally active or if some are old Rx that didn't get deactivated.
  • Your records suggest an mast-cell pattern (hEDS + POTS + chronic urticaria UAS7=7 + recurrent anaphylaxis). Would they consider an MCAS workup (Mayo MCM24 24-hr urine panel + serum tryptase)?
  • Recurrent shingles in 40s often warrants an immunodeficiency screen (IgG subclasses, CD4/CD8 counts, pneumococcal titers). Worth asking if that's part of your current plan.

For your cardiologist

  • Your ECG mentions an "old anterior/inferior MI of undetermined age" but I don't see a documented follow-up plan. Would they confirm what monitoring is in place?
  • Sinus bradycardia 59 bpm + syncope etiology — worth asking if a tilt-table test would help confirm POTS vs other causes.
  • The neurology referral they made 20 yrs ago for possible seizures — would they re-refer now that we have cheaper paths to get an EEG?

For your prescribers (whoever's current)

  • Records show two different spironolactone doses from different providers (50 vs 100mg). Worth a quick clarification call to confirm which is current.
  • Same for Lyrica — 50mg from one note, 75mg from another. Which is the current dose?
  • Smoker status in your record has a same-day conflict ("former" in one note, "current some-day" in another). Worth getting that aligned for insurance + treatment accuracy.

For your dermatologist

  • Family history of melanoma — worth confirming the screening cadence is right for you.
  • HS active management — modern paradigms include Humira (Abbvie covers up to $10K/yr in copay assistance if needed). If escalation is on the table, the cost path is mapped.

For your endocrinology / PCOS care

  • Sleep apnea workup — given BMI + PCOS + the symptoms you mentioned, a sleep study often gets covered. Worth asking if it's been ordered yet.
  • Thyroid panel (TSH, fT4, anti-TPO) — commonly part of PCOS workup. Worth confirming you have current numbers.

Stuff I've drafted for you to look at

Read whenever, in any order. Tell me anything weird.

📄 Amber Grant — 4 paragraphs (ready to submit)

Drafted March 30. Monthly drawing. $10K, $15 fee.

say "submit it" →

📄 Heard Grant (ready)

Therapist-specific. $5K cash + $9K services. On the email list for the 2026 cycle.

📄 APF Direct Action Visionary (ready)

Up to $60K. Longer shot, biggest swing. LGBTQ+ mental health framing.

📝 LIHEAP appeal letter — coming this week

Strategy: argue countable income should exclude legitimate self-employment business expenses (likely brings you under their $23,940 line).

📝 Xolair PAP application — drafting now

Genentech Access Solutions form. I fill it, you sign + fax. Up to $1,700/mo savings if approved.

📝 GSK PAP application — drafting next

Covers Trelegy + Breo + Advair. Up to $650/mo savings.

Things I want to ask you

Answer when you can. Skip anything you don't feel like.

Which family member makes you USAA-eligible? (parent/spouse/grandparent who served — I need this to match you to the right emergency-grant org)

Are any of your student loans federal vs private? (If federal, you may qualify for PSLF after 10 yrs — worth checking)

Rough business expenses for 2025 — SimplePractice, malpractice, CEUs, mileage, any office costs? Even ranges. (For the LIHEAP appeal — bringing your countable income down)

Have you done a sleep study yet? You mentioned suspecting sleep apnea — wanted to flag it as something likely covered for you.

Want me to talk to Jefferson billing on your behalf? They take a verbal three-way authorization over the phone.

Things you want to ask me

Drop a question — I'll answer next time I'm at my desk.

drafts auto-save

Where your info lives, if you're curious

Photos, files, voice memos go straight to my computer (encrypted folder). They never go to a cloud or an AI. To delete anything: text me, I do it.

Notes you type here (and the answers above) save to a small private space behind your email-link login. Only you and I can sign in.

The page itself, the lists, the explanations — those are public-readable knowledge with no personal info attached.

If you ever want a log of every piece of your info that's moved in or out, ask me — I keep one.

Money you could save (updated 2026-05)