Patient Assistance Programs Ending?

diabetesfree
By diabetesfree Latest Reply 2014-09-12 16:34:18 -0500
Started 2014-08-06 01:57:39 -0500

A friend of mine who has been getting their prescription insulin for free from the manufacturer was just notified this past week that they will no longer receive their medications from the company. The reason given? The Affordable Care Act (Obamacare). In a nutshell, this person's income is below the poverty level and he can not afford private insurance (or Obamacare). His state (California) has a medicare program called Medi-Cal, but he was never "poor enough" to qualify for it.

According to the letter he received, the company (Novo-Nordisk) has determined that he is now eligible for Mei-Cal, due to the income requirements being relaxed because of additional federal funding. While this may seem like good news, going on Medi-Cal has a number of drawbacks. Among them, no Doctors in this part of the state accept new Medi-Cal (or Obamacare, for that matter) patients. He will no longer be able to see his own Doctor. He must give the state full access to his bank account. He will no longer be able to get some of his current medications, because they are not "approved" by Medi-Cal. All diabetes patients in California are allotted a maximum of one test strip per day for their blood glucose monitors. All in all, he is in a pretty rough spot. Has anyone else had this experience recently? Are patient assistance programs actively trying to get rid of those with low incomes who qualify for free medication? Thanks.


14 replies

crazeknot
crazeknot 2014-08-14 13:57:39 -0500 Report

As 4 Obamadon'tcare . I'm still waiting 4 my free med-Cal ? I'm a full Native American & I'm suppose 2 get some free benefits. Schooling , medical, etc. That's ? I don't care about having 2 sign up 4 Obama care. I live in San Diego, CA. & was suppose 2 have medical by last spring. They can ignore their promises , then so can I. Who says I have 2 obey. Who's going 2 make me .

IronOre
IronOre 2014-08-08 16:39:05 -0500 Report

I also have noticed that drug companies no longer give free medicenes out for a trial period. You have to pay now.

Sly Kitty
Sly Kitty 2014-08-08 14:41:35 -0500 Report

I don't even know where to begin with Obamadon'tcare. I have never paid more for prescriptions and medical supplies since this went into effect. Sick of hearing all the medical professionals tell me that is just the way it is. Sick of not being able to see doctors who I have been going to for over 20 years because they are no longer under the plan.

MarkS
MarkS 2014-08-07 07:23:46 -0500 Report

Just another reason to rate Obama as the worst President in American history along with all the other Democrats that voted for this heinous medical insurance bill. I was told that within the next few years I will not be able to test my blood sugar as often in a day (currently > 6 x per day) since strips will be limited to < 4 per day; an insulin pump will only be partially covered and then only when your current pump breaks (so much for medical technology advancing since no one will be able to obtain new technology); and continuous glucose monitoring will be tough to justify. We have been a country with the best healthcare in the world to one that is rapidly sliding into third world status. While there were things that needed to be fixed in the healthcare system it did not need to be replaced by the fare that it is now. I better not get started on this …

teacherspet
teacherspet 2014-08-06 19:50:23 -0500 Report

I am going to try and make the last three months a short explanation. I live in South Dakota. Our governor decided it was "best" for us not to extend Medicaid or Medicare, thus making it very difficult to qualify for anything if you weren't already on one of these plans. Problem #1. I have been on disability for 20 years nothing to do with diabetes. The day I turned 62…that was it, no more medicaid and other programs. Yet I have three years till Medicare. So finding insurance for a person with multiple problems wasn't easy. It would have been very easy to blame Managed Care, but it was Managed Care who came to the rescue, found me a medical plan I could live with and afford, also two prescription plans that got me free medications for another number of things. I do very much believe that we will see that Managed Care depending on your legislators will decide whether its a good thing for your state or a bad thing. And if you are a Republican state, I'll guarantee it will be a bad thing. So what does your friend do? Have him call Rx Connections, or google Free Medications or Free Medical Help. There are a miriade of companies willing to help you, some charge a minimum amount, I am getting over $2500 in medications for nothing. Check with your hospitals and clinics, many of them have patient advocates who can get your meds and not charge a thing…you just have to pick them up. All is NOT as bad as people want us to believe Help is available if you are willing to look for it and not let pride or party lines dictate what you need and want

teacherspet
teacherspet 2014-08-06 19:50:13 -0500 Report

I am going to try and make the last three months a short explanation. I live in South Dakota. Our governor decided it was "best" for us not to extend Medicaid or Medicare, thus making it very difficult to qualify for anything if you weren't already on one of these plans. Problem #1. I have been on disability for 20 years nothing to do with diabetes. The day I turned 62…that was it, no more medicaid and other programs. Yet I have three years till Medicare. So finding insurance for a person with multiple problems wasn't easy. It would have been very easy to blame Managed Care, but it was Managed Care who came to the rescue, found me a medical plan I could live with and afford, also two prescription plans that got me free medications for another number of things. I do very much believe that we will see that Managed Care depending on your legislators will decide whether its a good thing for your state or a bad thing. And if you are a Republican state, I'll guarantee it will be a bad thing. So what does your friend do? Have him call Rx Connections, or google Free Medications or Free Medical Help. There are a miriade of companies willing to help you, some charge a minimum amount, I am getting over $2500 in medications for nothing. Check with your hospitals and clinics, many of them have patient advocates who can get your meds and not charge a thing…you just have to pick them up. All is NOT as bad as people want us to believe Help is available if you are willing to look for it and not let pride or party lines dictate what you need and want

Dr Gary
Dr GaryCA 2014-08-06 15:44:18 -0500 Report

Hi diabetesfree,

I have heard some similar stories about the changes that have come about with the ACA. I had not yet hear about changes in patient assistance programs. This is really sad!

In terms of healthcare, this is certainly a new world we are living in, with lots of growing pains.

I am sorry to hear about the restrictions you describe. Rough spot is right. I am hoping that the rough edges will be addressed.

Thanks for sharing this.

Gary

diabetesfree
diabetesfree 2014-08-06 11:20:38 -0500 Report

He is not old enough to get Medicare. Personally, I've just had to pay for my insulin and Doctor's bills out of pocket, because doing so is STILL cheaper than any of the Obamacare programs in California. Even with the $99 fine. Plus, no Doctors here accept the new Obamacare plans as insurance. Even the only hospital in the area refused to accept Obamacare plans until this past month. I lost my insurance shortly after the Affordable Care Act was passed and my insurance company raised my rates by 400%. They said that they had to raise rates in order for my plan to comply with the new law. So, it hasn't exactly helped me, either.

I'm not exactly sure what the requirements are with Medi-Cal, but I do know from my experience as an ombudsman that those who are "fortunate" enough to qualify have only two choices in the area for medical care. The emergency room or the open door clinic. Both are overloaded beyond belief. Quality of care is a joke and it's not like you can sue a Doctor for malpractice when the state is paying the bill. My ex-wife was on Medi-Cal and the only specialists she was allowed to see were at least 300 miles away. She was also only allowed 1 test strip per day and when her blood glucose meter broke, they wouldn't replace it.

Sorry, for the rant. I just have yet to see a single, positive thing come out of "healthcare reform" thus far. Putting pressure on drug companies to stop giving out free medicine in order to force people on to government assistance and win political points just seems like a step in the wrong direction to me.

Just Joyce
Just Joyce 2014-08-06 09:59:03 -0500 Report

I thank God everyday that I don't live in California. Has he talked to Social Services to find out exactly what he qualifies for. Yes they want to know what your assets are for the simple fact that assets raise your income level.

If he is on Medicare, he may not quailfy for Medi-Cal however, he has to check into that. He should also check with the state to find out what help is available for senior citizens. Most states have some kind of pharmacy assistance programs and had them before the Affordable Care Act. All it takes it a call to Social Services to find out this information.

Hops
Hops 2014-08-06 08:01:12 -0500 Report

You can contact each pharmaceutical explaining your urgent need for their product with the help of your doctor's prescription. I find it most helpful using local religious organizations to contact your medical providers. I use the Center For Changing Lives run by Lutherans in Minneapolis. You will be inspired by those ready and willing to see you through this medical ordeal.

Gabby
GabbyPA 2014-08-06 06:06:27 -0500 Report

This makes me shutter. I am not a fan of the government nanny state, but it's very sad when those who really need help cannot seem to find it. With stuff like this, death panels are the last things we will have to worry about.

I know I also fall into the black hole of poor, but not poor enough. There are alternative medicines out there that are more "affordable" than the brand names and I would suggest he talk with his doctor one last time before he looses him to get some guidance on that. If not, he can talk to his pharmacist.

artqween
artqween 2014-08-06 03:10:57 -0500 Report

Yea…Diabetesfree, it's all over the world prob. consider helping ur friend by emailing his Senators and ur Senators and vent about it. Everything u told us. And request that he and etc be able to receive what they have been able to receive in their past to maintain their survival. Obamacare unfortunately went another direction because way to many possible unprofessional hands got involved besides Obama himself. They admitted it on tv when it started. Messing the program up. Obama himself kept speaking up about it, on several occasions :(. Ur friend possibly could reach out to Merc I believe for patients who can't afford their med.s,
if he goes to a church, local outreaches in his area, united way in his area, elderly affairs in his area, goodwill in his area, Salvation Army in his area, Medicaid,
SSI… good luck plez keep us posted:(?? how horrible. May he and others never give up on surviving this ordeal but endure?? Taking immed. action, venting,…

jayabee52
jayabee52 2014-08-06 02:20:40 -0500 Report

Howdy DF
I believe that the PPACA (Obamacare) was a bad law for a number of reasons, most of all due to the "Unintended consequences" like you just relayed to us.

I better stop here or I'll rant away about this constitutional monstrosity.

James