Question about patient assistance programs for dad

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FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 8/18/2009 7:21 AM (GMT -7)   
Hey guys - so this isn't exactly crohns related.  My dad has COPD and Barrett's esophogus/acid reflux.  Needless to say, his meds are very important.  He has Medicaid w/ the supplemental insurance through blue cross or something.  The way it works is they cover all his meds up to a certain amount (say $4000) then he has to pay the next $4000 out of pocket, and then they pick up the rest after that.  Even with the amount that they cover he still has to pay big copays and his insurance premiums.  Anyway the space where they don't cover your meds is often referred to as the "donut hole." 
 
I just found out he has been cutting his COPD dose in half (taking it twice a day instead of 4 times a day) to make it last.  He is having trouble paying the copays as it is let alone once he is the donut whole and paying it in full.
 
I am researching different assistance programs that are out there for him.  Most require you to not be eligible for any insurance programs.  He has insurance, he just isn't covered for the next 4k.  Anyone deal w/ this (even w/ crohns meds) and find assistance during the donut hole time?
27 Year old married female.  Graduated law school this year and waiting for results of the bar exam.  Start a new job sometime in September.  Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night.  I take xanax prn for situational anxiety (aka no easy bathroom access). 


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 8/18/2009 7:26 AM (GMT -7)   
I can't remember if he has medicaid or medicare but he has the one for retired people over 65 not the one for low income people. Thanks!
27 Year old married female.  Graduated law school this year and waiting for results of the bar exam.  Start a new job sometime in September.  Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night.  I take xanax prn for situational anxiety (aka no easy bathroom access). 


humboldtmom
Regular Member


Date Joined Jun 2003
Total Posts : 280
   Posted 8/18/2009 9:11 PM (GMT -7)   
Fitzy, Medicare is the one for over 65, He can get Part D to help with medicines. Also, if his supplemental offers "by mail" scripts it is usually cheaper as you get 3 months at a time. I have read that Walmart can be as low as $4.00 per script, I don't know how many meds fit that category. Sorry I don't know any assistance plans. If his supplemental is the Part D with medicare, he may be better off going with one of the insurance companies, their donut hole might not be as large. I had my Mom signed up with one, I can't remember the name, she died two years ago. Wish I could be more helpful, but surely someone else will know more. Good luck, Bets

HabsHockeyFan
Veteran Member


Date Joined Jan 2006
Total Posts : 3130
   Posted 8/19/2009 4:52 AM (GMT -7)   
Fitzy...I have a donut hole too and I am not on medicare. I have an HSA plan where I have a very high deductible, then coinsurance. My donut hole is just more lopsided!

I would advise that you check with the drug provider for discounts or assistance.
Also, make sure his doctor knows what he is doing and maybe the doc can help.
Is your Dad a Vet? Can he get some help there.
Do you have access to an ElderCare program? We had to do this for my husbands mother and we are trying to do it for his father. They are a great resource as they know all of the options for assistance for the elderly (even if they aren't very elderly)

Sorry not a great solution, but ElderCare has really helped us keep from having to support my in-laws when we can't
Dx'd '90 (emergency rupture), symptoms ignored long before that, '03 fistulas and bad flagyl reactions, B12 weekly, Pentasa [until I surrender to the bigger meds]
I'm riding on the escalator of life....


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 8/21/2009 11:50 AM (GMT -7)   
Thanks guys. My dad is a vet and there is assistance there but he supposedly can't use it because he has "insurance" and by insurance they mean the Medicare part D - so even though he has to pay in full the next chunk of his meds he can't get help from most assistance places. I think his pensions make his income too high for traditional assistance programs. I will have him talk to his doc and Walmart is a good idea - his COPD meds are generic, except for albuterol since there is no discount for that now.
27 Year old married female.  Graduated law school this year and waiting for results of the bar exam.  Start a new job sometime in September.  Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night.  I take xanax prn for situational anxiety (aka no easy bathroom access). 


Homeboy
Veteran Member


Date Joined Dec 2005
Total Posts : 637
   Posted 8/21/2009 1:04 PM (GMT -7)   
/www.panfoundation.org/

Give the place above a try, I think they are wonderful. They gave me a 4,000$ grant for the year to cover copays, they even sent me a little card that is similiar to an insurance card to use at the pharmacy. If you fax everything to them, they will need last year's income taxes, I got a reply in about 2 weeks.

Good Luck
FaceBook; http://www.facebook.com
cadillac_rick@hotmail.com


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 8/21/2009 1:11 PM (GMT -7)   
Thank you!!
27 Year old married female.  Graduated law school this year and waiting for results of the bar exam.  Start a new job sometime in September.  Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night.  I take xanax prn for situational anxiety (aka no easy bathroom access). 

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