As you all know I have special needs girls and my good friend also has special needs girls and is a single mom. Medicaid here in Indiana is cracking down and now going thru and refusing to pay for certain meds these girls need..hers and mine. Not sure 'how' they are determining 'which' meds they are now not going to pay for, but one is a seizure med friend's daughter takes (Depakote) and Dallergy (generic as well as name brand version) for my one daughter. That is the one med that after 20 yrs her daughter is finally not having (at least visable) seizures or aura's now since taking and my daughter gets very sick without that allergy med. (nothing comparable to it Medicaide will pay for..asked Dr and pharmacist about it).
Anyone know where we can get these meds super cheap since we are on limited income? it's ridiculous. If they become ill from not being able to get these meds it will cost the gov't MUCH more money with hospitalization etc due to that so they are cutting off their nose to spite their face so to speak. Ugghh. Any help/info is MUCH appreciated! thanks!!
1|1|try going direct to the company meds come from|LindaOh|Martinl3@roadrunner.com|09:13:15|08/02/2011|
most have programs that give meds free explain that medicare isn't going to pay, info should be on their web site Linda 2|1|Try appealing with a letter of medical necessity from the prescribing doctor (neurologist?)...if he can outline her history briefly and show that this med is the only one that is therapeutic for her, it can be approved.|saint6811|waylan@comcast.net|10:18:30|08/02/2011|
" You'll get what's coming to you ... Unless it was mailed."
3|2|I was going to suggest that J we had to do that a couple times with meds for Mom|teener|teenerzacsneenee@yahoo.com|10:27:15|08/02/2011|
>Posted on Aug-02-11 at 10:18 AM (Eastern)
>by 98.213.152.6" You'll get what's coming
>to you ... Unless it was
>mailed."
>
4|1|Already tried going thru the Dr and...|Skaytes|skaytez@gmail.com|11:42:51|08/02/2011|
they are STILL denying it. Sooo stupid as it's gonna cost more in the long run with ER visit,ambulance, etc or maybe long hospital stay. Obviously people making these decisions are not medical professionals just someone trying to cut costs where ever they can to 'look good' to their gov't bosses...
Probably going to have to end up going to the media in the long run as that seems to immediately get their attention and the only way often as well. Geez...everything is always a fight to get what you need. Disgusting, isn't it? :(
5|2|Then I would say the doc didnt provide enough info in the letter that it got denied again.....he really needs to outline her history a bit, with the meds used in the past and the ineffectiveness, then the results from using her current med that works for her....dont have the GP do it, have the neurologist do it.|saint6811|waylan@comcast.net|12:02:00|08/02/2011|
" You'll get what's coming to you ... Unless it was mailed."
6|2|That's heartbreaking!|sunriver|sunriver@gmail.com|12:10:50|08/02/2011|
I hate that you have to fight for the meds your daughter(s) and friends daughter need. It isn't right!
Let's see, you already did the appeal which is also the first thing I would have suggested. Can the doctor get any samples?
Costco sells just about the rock bottom cheapest meds (overall), so maybe see what it would cost to have their pharmacy fill it and then there are the Canadian Pharmacys that were discussed in another thread.
Ask her doctor directly for any suggestions since he/she knows how much she needs this.
Once you find out what Costco charges, please let me know. I'm curious and maybe I can think of some ways to help. I'll be out of town for most of the next two weeks, but I will check back as soon as I can. Maybe we can get you onto that hero site that Linda told me about (now I can't remember what it was called, Honey (Linda), can you tell me again?
Hang in there Kathy! I know that this has to be wearing you down, but I also know you are so strong and such a terrific mom! V. 7|1|Does your daughter have a social worker at all? Wondering if they can help advocate for you? I understand your frustration(more)|dlpavitt|dlpavitt@att.net|12:38:39|08/02/2011|
My husband also has a seizure disorder, and several years ago a new neurologist talked him into getting off dilantin(thank god) and on to one of the newer drugs lamictol. Very shortly after we lost our medical insurance, and it was over $400 per script(ouch). My husbands doctor was also on vacation, and the office help would not give out samples, or let me speak to another doctor, no matter what I said. I finally went in to the office and sat in the waiting room, and when the other doctor came out to get his next patient, I got up, and put my foot to block the door. At first the doctor was not happy, but the first sentence out of my mouth was, talk to me now, or talk to me in the emergency room, where my husband will end up, if you do not talk to me now.
Well within 15 minutes, I had all the samples I needed, with a promise of more if needed. I have no idea if this is the reason, but hubby and I noticed that all of the office people were replaced over the next couple of months. But did wonder about it. The doctor was very upset, that I was being stone walled at the reception desk.
So Kathy, I know how scary it is. I remember being a wreck, and feeling like it was a race against time, worring how long we had until a siezure. YOu and your daughter will be in my thoughts and prayers. Keep fighting Mama, you have TOO!!
If you are a HONEST trader, there is nothing to fear in having a feedback link. If you do not have one, please set one up, BEFORE contacting me for a trade. If you insist on not having a feedback link, please do not contact me to trade. Feedback links protect all of us, on RS. Thanks for understanding. Donna 8|2|Applauding your advocacy for your husband's care, Donna! Oh man, I'd have loved to see that! The office staff seem to get a little self-important sometimes.....like they are the sentries to the king....good grief.|saint6811|waylan@comcast.net|13:23:00|08/02/2011|
" You'll get what's coming to you ... Unless it was mailed."
9|1|help for seizures|cinda68|lacinda68@gmail.com|21:00:34|08/02/2011|
My husband has had seizures since age 2 and was on all sorts of anti-seizure meds for years. He takes dilantin now but recently, the past month, he has been taking iodine supplements and has gone down to only one or two pills a week (dilantin). We take iodoral 12.5mg, twice a day. It helps with other conditions too but we are most surprised about how well it is managing his seizures. Hope that helps. 10|2|I also take dilatin very expensive but also try this...|melpaul|Melpaul199@aol.com|21:38:01|08/02/2011|
For you husband try to contact the drig makes like Abbott for instance who ever make the drugs
I did this before and it workk but you have to be persistent I got ahold of the rep in my area who works for Abbott and tols him of my problem couldnt afford the drugs I need help for awhile
and theytold me they would send a form letter to my dr and he needed to fill out the request
stating I couldn't afford them much lower cost or samples I did get them they were sent to the dr's. office every month and then I went to pick them up I did this for almost 1 yr until I was back on my fwwt again
It's worht a shopt but you need to keep calling
11|3|I also agree with Donna samples at the dr...|melpaul|Melpaul199@aol.com|21:40:09|08/02/2011|
but once again you need to be persistent 12|4|This is my suggestion.....|kdrink|kdrink34@yahoo.com|21:57:30|08/02/2011|
Depakote is generally not a prescription that doctors have on hand to give out as samples due to the age of the drug as well as the blood tests that are involved with taking it......I would look in your state pages for the Medicaid office and give them a phone call. Ask to speak with a Medicaid insurance regulator (that's what they're called here, it may be different in your state). This is not the local office, but the state capital office. explain your situation and ask specific questions as to why Depakote is not covered. It could be that your state is going to a "step-therapy" model". It could be someones mistake. It could be that your state for some reason lists Depakote as a non-covered narcotic or benzo medication. If it is the latter, unfortunately no letter from a doctor will get Medicaid to cover it. Good luck and make that phone call. 13|5| more inside...|Skaytes|skaytez@gmail.com|09:22:20|08/03/2011|
friend FINALLY got Medicaid to authorize the script but for my daughter it's a 'no' at this time still. I know from experience I cannot get to talk to anyone at Medicaid no matter what number I call even the 'help' number. They ONLY want to talk to Drs or professionals. Won't give patients or their caregivers the time of day..just refuse and hang up on you. It's very very frustrating... :( 14|6|Perhaps the following will hopefully help you - See Inside|Newman|BenjiBubbles@gmail.com|09:47:03|08/03/2011|
Access2wellness can help you find the assistance program that best meets your needs.
Nationwide, there are a number of programs that offer free or discounted medicines and medical products to people with limited or no health insurance. But which one is right for you? By answering the eligibility questions, access2wellness can help you find the assistance program that best meets your needs.
http://www.access2wellness.com/a2w/patient-welcome.html
15|7|Newman you rock!|melpaul|Melpaul199@aol.com|09:48:39|08/03/2011|
That's good advise! 16|7|Some More Helpful Info - See Inside|Newman|BenjiBubbles@gmail.com|09:56:46|08/03/2011|
Abbott Laboratories Patient Assistance Program
http://www.patientassistance.com/profile/abbott-20
http://www.patientassistance.com/profile/abbott-363
17|6|That's why I referred you back to the doc, Kathy.....I still think the letter he sent was not adequate to explain the necessity.....it isnt enough that the letter says, " I, Doctor Soandso, say this person needs this med...and thus it shall be"....they have to give the MEDICAL NECESSITY for the med....her history and former use of other meds without success really needs to be outlined.|saint6811|waylan@comcast.net|12:47:32|08/03/2011|
" You'll get what's coming to you ... Unless it was mailed."
18|1|Hospitals have social funds, could you try that? When I broke my femur in Feb. I had to take a medication that cost $1000.00 a week and I had to take it 6 weeks. The hospital paid for it out of a social fund.|lv2qpon|jcummins1@rochester.rr.com|14:48:16|08/03/2011|
I couldn't afford it. Who could? 19|2|The frustration with Medicaid can be, well, frustrating! If they don't want to talk to you as a recipient of Medicaid then.....|kdrink|kdrink34@yahoo.com|22:03:45|08/04/2011|
look in your state pages or on the internet to send an email to the state's compliance officer. If you do this by email look for someone who has a manager or supervisory title. If there are more than 1 listed, send an email to a few of them. Someone will answer you. If they don't, kindly send a letter or email to your governor and then senator. Their aides will get the ball rollings and you should receive a phone call.
The other suggestion would be for you to contact your local hospital and ask to speak to their social worker. Good luck.
Depakote is a covered drug under Medicaid in my state. It's very interesting to me that it is not in your state. I have talked my contacts here and again I am being told that Depakote is not a medication that will be granted by a pharmaceutical company. If this is truly the case, you keep calling the state until someone listens. 21|3|Youu could also call your local T.V. station and plead your situation. I know in Rochester N.Y. when people are on the local news about their financial situations, a lot of times, people send in donations. |lv2qpon|jcummins1@rochester.rr.com|16:25:15|08/05/2011|
:) 20|1|CYE|kids91911|hodgesamy@ymail.com|14:43:00|08/05/2011|
>Posted on Aug-02-11 at 08:45 AM (Eastern)
>by 67.236.174.154As you all know I
>have special needs girls and my
>good friend also has special needs
>girls and is a single mom.
>Medicaid here in Indiana is cracking
>down and now going thru and
>refusing to pay for certain meds
>these girls need..hers and mine. Not
>sure 'how' they are determining 'which'
>meds they are now not going
>to pay for, but one is
>a seizure med friend's daughter takes
>(Depakote) and Dallergy (generic as well
>as name brand version) for my
>one daughter. That is the one
>med that after 20 yrs her
>daughter is finally not having (at
>least visable) seizures or aura's now
>since taking and my daughter gets
>very sick without that allergy med.
>(nothing comparable to it Medicaide will
>pay for..asked Dr and pharmacist about
>it). Anyone know where we can
>get these meds super cheap since
>we are on limited income? it's
>ridiculous. If they become ill from
>not being able to get these
>meds it will cost the gov't
>MUCH more money with hospitalization etc
>due to that so they are
>cutting off their nose to spite
>their face so to speak. Ugghh.
>Any help/info is MUCH appreciated! thanks!!
>
22|1|Thank you everyone!!! More inside...|Skaytes|skaytez@gmail.com|16:53:52|08/05/2011|
I will check out all the info and links. Thank you sooo much!! I have spoken to others here in Indiana and our wondeful (NOT!) governor is cutting everything and everyone he can out to save money ..much at the expense of the poor/elderly/disabled. He has a 'history' of doing things like this so just be glad he isn't running for president like everyone was urging him to. Uggh..that would have been a disaster just waiting to happen! (if you thought Obama was bad, you ain't seen NOTHIN' yet! like they say! lol)
Others are wondering too if they were lucky enough to get the meds or services they need this month, will they still get them NEXT month..or the next month, etc. It's THAT bad and gonna get worse I fear... :( Thank you all again and God bless each of you!