Step 6: Getting Your Medications
So let's say that you are fortunate enough to have found a physician willing to treat you under your workers compensation insurance. The doctor has prescribed you medications for months, which you are now dependent on. You then receive a letter in the mail from the workers compensation company saying that based on an evaluation by one of their doctors, you no longer need treatment, and therefore, they will not pay for your medications. Now what?
Well, there are several options. The first is to appeal the decision so that your case can be pleaded in front of a workers compensation judge. This can take a month or two so it best to get the ball rolling. The patient generally wins these appeals. If you need an immediate fix, the best option is to use your regular insurance to get the medications. If you do not have regular insurance, things get a bit trickier but you can always apply for Medicare or Medicaid so you have the government pay for your medication. Another option, if you have some money stashed aside, is to ask your doctor to write prescriptions for the generic version of the medication. The generic version is far cheaper than the regular version and usually contains the same exact ingredients. Some department stores such as Walmart are selling these medications for very cheap prices.
Another option includes asking your doctor for free trials of medications. Many people don't know that representatives from the drug companies often bring doctors many samples packets of free medications to try with their patients, with the hope that they will prescribe the medication regularly in the future. Some doctors are nice enough to give these free samples to patients in financial need. Another option is to contact the drug company who makes your medication. Many drug companies have programs established for people who cannot afford the medicine. Also, check with your county health department to see if they have any programs established for those who cannot afford medications. Click here for the next post
posted by MedFriendly | 7:11 PM
1 Comments:
I wanted to add another option in regards to getting needed medications. My husbands chemotherapy nurse taught us the following when my husband began chemotherapy.
When a doctor prescribes a medication it is usually for a 30-day supply, however 99% of insurance providers allow patients to refill the medications after 25 days (a few insurance companies make the patient wait until the 27th or 28th day).
The chemotherapy nurse suggested that we always refill my husbands medications as soon as the insurance (and pharmacy) will allow - which for us was the 26th day after the last refill was filled. We would then take the new refill home and begin using the medication in that bottle immediatly, and we would put the other bottle aside.
Now you are probably wondering why a patient would need to do this and why a chemotherapy nurse would suggest it - because after 4 months my husbands short-term disability insurance company started a medical review to determine if my husband was still unable to work. This review took 3 weeks, and during that time the company suspended his medical coverage - leaving us with no medical coverage and no prescription coverage.
The company expected us to pay out of our own pocket, and if they determined during the review that he was still eligible for continued coverage they would reimburse us for the out-of-pocket costs. The problem of course is that with decreased income and medications that cost over $500 per month, we were totally unable to pay for those expenses ourselves and did not have a credit card to use while we waited for the review to be completed.
However, we did have a very smart chemotherapy nurse who had a lot of experience with our particular insurance company, and by teaching us to refill the medications early and saving the few days of 'left-overs' every month, we were able to make it through those 3 weeks without having to pay for pharmacy refills... if we had not had the extra medication set aside, my husband could have been in big trouble because one of his much needed medications was a narcotic pain medication (which by law can not be given as samples from a doctors office, and are insanely expensive).
I have since done this with my own monthly medications, and I when we got hit with a huge blizzard last winter and could not get to the pharmacy for nearly 14 days I did not run out of my medication. If I did not have a supply of emergency meds set aside I would have run out because I was due for a refill the day the blizzard hit.
All patients should consider putting aside2-3 days worth of 'left-over' medication every month until they have set aside at least a 7-10 days supply of emergency medication, but for workmans comp patients they might consider saving the leftovers until they have put aside a 3-4 week supply of emergency medication in case it takes time to fight in court to get their medical coverage returned.
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