In my current nursing classes we are learning a lot about the disparities that exist in health care in the United States. It's a fact that there are disparities in health care for ethnic minorities and people of lower socioeconomic status. I'm not used to being in the latter category, but I know now that we are. So, of course as I'm surrounded by this information five days a week and almost 8 hours a day, I am hyper-aware of the statistics that go with this label. Tonight I went to pick up some of Tony's medication for bipolar disorder. For those of you that don't know, Tony is currently on Medicare. The choice for him to have Medicare as his insurance was a contributing factor as to why I was able to resign from teaching and go back to school part-time. With the attention that his medical condition requires, there was zero possibility of him going without insurance. The Affordable Care Act was in the very early stages when we made this decision, and all the information I found indicated that his premium would be relatively high in order to get the coverage he needs with his condition. Now I'm rambling. Back to my trip to Walgreens this evening. When I pulled up to the drive-thru window, I knew that one of his medications was going to be on the high side...it's a non-generic, new prescription specifically for bipolar disorder. Some of you may have heard of it -- it's called Latuda. It's working really well for Tony and we were previously aware of the cost, so it doesn't "hurt" as much when we pick that up and have to pay a little bit extra. For two medications, with the insurance coverage, it was $110. While I was there I requested that two other medications be filled. When I picked these two medications up at the end of December, the cost was $25 for both of them. Today when I went to get them, I was told I needed to pay another $110! I was speechless, but didn't really have any choice since he was out of the most expensive ($101). When I got home I called the insurance company, which is provided by United Healthcare as a part of Medicare Part D. I was told that in addition to the new $240/year deductible (oh, did I forget to mention that? We met that the first week in January), several medications have been moved to new tiers and therefore cost more.
I probably don't need to tell you that in the five minutes it took me to drive the six blocks home I was livid. How are people on fixed incomes supposed to survive if they have any type of medical condition that requires medication?!? In the end, we were able to apply for financial assistance with Medicare and medication assistance, both through a patient advocate. Our application will be given to the state and the State of Wisconsin will make the final decision as to whether or not we qualify. It is a very humbling experience to have to ask for help. I know this is not permanent. I know that when I finish school we will have more resources available to ensure that Tony gets the medications that he needs. That eases the feeling of unease a little bit, but not much. He is still without his two inhalers, currently, because the company upped the cost to $45 a piece. We are waiting to get one of them in a generic version, but in order to do that our doctor had to receive prior authorization from the insurance company. As if providing a potentially life-saving medication should be delayed because the insurance company would rather make money and have the patient get the higher priced medication. I could go on and on, but I've already said enough.
Please don't mistake this for me asking for help from any of you. I'm not. I just needed to get this off my chest, because it's been eating at me for the last three and a half hours, and I feel powerless to do anything besides what I've already done. Thankfully, the proper steps have been taken and there may be a light at the end of this tunnel that's closer than December 2016 when I graduate with my Nursing degree. I should mention that all of these changes just took effect 1/1/15, which is why this is all so new to us. I probably don't need to mention that of course this has an impact on our fertility treatment plans, considering that we have to be able to support ourselves and a child when the time comes. And here's where I sign off to do my reading for school, and spend some time relaxing. Believe me my plans include a little bit of prayer -- I truly believe that is where I will find the most solace tonight. Thanks for listening, I already feel a little bit better! I'll leave you with this: even when you're uncomfortable, or don't like that you need help...ask for it anyway. You'll sometimes be surprised by the responses you get. And always be true to you.