29 June 2004
Despite drug cards, affordable medicine out of reach
Diana Foreman sat at Maxine Mahoney's dining room table last week delivering a list of medicine costs and bad news. Very bad news.
After Mahoney is removed from Medicaid, she'll be shelling out more money for prescriptions than she's bringing in.
Even with a much-touted Medicare drug discount card. Even with cheaper, generic brands.
The math: A $589 monthly Social Security check minus a minimum of $962 for pills equals ... less than nothing.
"They don't have such a thing as a poorhouse anymore, do they?" the 81-year-old from Jackson asked.
Mahoney is one of 65,000 Medicaid recipients who, on Thursday, will be cut from the federal-state health insurance program for the poor, elderly and disabled.
The move, backed by Gov. Haley Barbour and adopted by the Legislature on May 7, is forcing Mahoney to quickly find a way to pay for 13 prescriptions.
Five for her heart. Some for blood pressure and bone loss. More for arthritis, cholesterol, thyroid, other ailments. Prescriptions she needs to see her 82nd birthday.
Mahoney -- like thousands of other elderly and disabled Mississippians -- received a letter saying Medicare can help them pick a card to cover medicine costs.
Foreman, director of Deliver Me Senior Support Services in Jackson, logged onto Medicare. gov last week and keyed in Mahoney's prescriptions to find out which one of the 39 Medicare-approved drug discount cards works best. Then she had to find out which pharmacies accept the card.
Each card offers a different discount amount -- from 10 to 15 percent -- and a prescription a patient takes may not be discounted on that card.
"It's a joke," Walter Howell, associate state director for advocacy with the AARP, said of the cards.
"Using the drug discount card is really a worst-case scenario," he said. "It's when you have nothing else to go to, because the benefit there is so small."
If people have no family or loved ones to help pay for their prescriptions or physicians who'll dole out free samples, one of the only other options is scouring a list of more than 1,300 free or inexpensive drugs.
But people must be computer literate, "with a lot of time and patience and understanding," to access the information and fill out forms, Howell said. Some physicians must help with the forms, and some drug companies may require them to fill them out again after a few months.
"Very few people 65 and older know how to use the Internet," he said. "It's created a very difficult situation for older Americans."
Mahoney said her two daughters will have to pitch in to help her out.
"I'm going to absolutely trust in God. If he wants me to die, I'll die," she said. "If not, I'll find a way. I've got friends and family and I've got a church."
Barbour has stressed that the changes should not result in anyone going "without proper coverage."
The Medicaid Division is scheduling regional training sessions statewide beginning July 19 in Jackson to provide hands-on assistance, according to a Friday e-mail from Barbour's office.
It also is working to establish local community sites, such as libraries, community centers, schools and 25 regional offices, for people who do not have computers.
Universities, community colleges, community centers and libraries will be approached to provide computer access, and social work students and others required to complete community service hours will be trained to provide hands-on assistance for computer Internet access, the e-mail said.
The division also is working with groups, including county Health Department social workers, community action agencies and church missions, to identify people who are homebound or do not have telephones or transportation.
"Overall approach is: Get the community involved and to take ownership of the mission to help insure all is taken care until other solutions can be developed," the e-mail said.
The Medicaid Division and the governor's office didn't act sooner to educate Medicaid recipients because the final version of the Medicaid Reform Act of 2004 did not exist until about 11 p.m. on May 9, according to the e-mail.
"It was vitally necessary that we knew what the program was that Medicaid was charged to administer prior to setting forth an information campaign," the e-mail said.
To pre-produce brochures, fliers, radio advertising and other information was premature.
"The cost for this single brochure project would easily be $1 per recipient or $720,000," the e-mail said.
"If the Medicaid Budget Act of 2004 then is amended through special session and the information on the original mailing is no longer correct, we would have to spend additional dollars to send out a new mailing. Dollars going to printers and postage instead of health care. We do not have the money to gamble on what the program might be solely to get a jump on the information campaign."
Several pharmaceutical companies provide drugs through Medicare-approved drug discount cards as well as patient assistance programs.
Pfizer Inc., for instance, has programs where patients can get free, 90-day supplies through their doctors' offices. Patients must complete forms every three months to get them.
The company also offers free drugs through federally funded health clinics and hospital partnerships, as well as for patients with specific diseases such as AIDS. Another program offers a $15 flat fee for up to a 30-day supply.
"A public-private partnership can bring real-world solutions to help those that are most in need," said Forest Harper, a Pfizer vice president.
Pfizer gave away $9.8 million in free medicine to more than 30,400 low-income, uninsured Mississippians in 2003, according to the company.
But Dr. Timothy Alford of Kosciusko said sometimes drug companies send the forms back requesting more information from patients.
"Unfortunately, the group of people we're talking about sometimes has trouble with providing the level of accuracy on these forms the pharmacy assistance programs require," said Alford, chairman of the Council on Legislation for the American Academy of Family Physicians. "This is a group of people that sometimes has trouble with literacy."
Alford said doctors must sign off on and sometimes initiate the forms.
"It's an arduous, painstaking process that takes up office staff time that could be better spent taking care of patients directly," Alford said. "This is going to be another layer of hassle in order to get patients the medicines they need."
Medicaid help
www.medicare.gov, 1-800-MEDICARE (1-800-633-4227)
www.phrma.org
www.helpingpatients.org
www.rxhope.com
www.rxassist.org
www.benefitscheckuprx.org
www.needymeds.com
www.qdrug.com
www.themedicineprogram.com
www.mspharm.org
My Medicine Source, 1-866-856-6337
Medicare Replacement drug Demonstration program, www.cms.hhs.gov/researchers/demos/ drugcoveragedemo.asp, 1-866-563-5386. Begins July 6 for seniors with serious diseases including rheumatoid arthritis, cancer and multiple sclerosis.www.medicare.gov, 1-800-MEDICARE (1-800-633-4227)
close window