No meds for this Schizophrenia patient.

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My brother has had a dx of Schizophrenia for about 20 years now and I'm just so sick of the government changing Medicare and Medicaid so much, I swear it's just to drive sane people insane! It all started 5 years ago when my father died, since my brother is on SSI he got an increase as a benificary from my father. Well the increase kicked him off of Medicaid, so he had to start paying 750.00 a month for Zyprexa. Finally we got him on a Medicare plan for him to pay only 15.00 a month. Flash to today...... He went to pick up his supply and he was told that he now has to pay 380.00 copay each year to receive his meds? Of course no one will talk to my mother or me due to HIPPA and he won't let us look at any Medicare books he may have received because he is paranoid. He only has 150.00 left after rent and groceries each month and we are hoping that the pharmacy will take payments because they have before. It's just crazy that they do this to people in need. Now he will literally be wild for a couple months until it's paid. Anybody have suggestions? Please don't suggest to try to have him declared incompetent or be his POA. Been there done that, judge denied it. I know stupid huh!

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is there any way he could refuse the increase as the beneficiary?

it almost sounds that he'd be better off where he was before dad died...

leslie

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Specializes in Hospice, ER.

I can't offer any advice, only support. So many folks in his position......

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I don't have any useful advice. Just curious, though, why did the judge deny it? I'm taking care of a patient in Med-Surg who is Schizophrenic with parnoia. He's functioning to some degree, but he has a legal conservator (his brother), so what his brother says goes. It makes things a lot easier.

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Social Security told him he could not refuse and they just added it to his normal check.

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Specializes in Family Nurse Practitioner.

Can you and your Mom help him out financially until you can figure something else out? I would hate to think he's not going to get his meds although if he's paranoid and won't let you see his information its possible that he either isn't as stable as you might think or this isn't the whole story. I'm sorry he is having this trouble and wish you both good luck.

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Specializes in psych, addictions, hospice, education.

contact the company that makes Zyprexa--all drug companies have programs where they'll give free meds to people who can't afford them. A place to start is a website called http://www.needymeds.com Doctors should know about it--ones I've worked with did.

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have you seen this page on the ss website?

http://www.ssa.gov/prescriptionhelp/

leslie

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It is one of the functionally crazy things of our system. We will price mental health meds out of the reach of patients. They get sick, end up in the hospital, are restabilized and then the cycle starts all over again. (This is the frustration of 26 years of working in mental health...)

Psychiatric meds for the SPMI should be 100% covered by us through government.

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Specializes in LTC, geriatric, psych, rehab.

I get to deal with this often. A functional middle aged man with schizophrenia manages to care for himself at home. Govt decides to "save money", so they will no longer pay for psych meds. Poor patient can't pay for them, so does without. He has a mental breakdown, pschotic episode, aka goes crazy. Gets put in the hospital's mental unit. Govt will pay for meds there, so man is stabilized. "Obviously" he is "too crazy" to live on his own b/c he "mismanages" his meds (who is mismanaging meds???), so he is referred to our nursing home (ours being one of the few in our part of the state which takes psych patients). So now the state pays almost $4000 a month for nursing home care, when they could have paid say $300 a month for his meds. That is "saving money" for you!!!

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It is one of the functionally crazy things of our system. We will price mental health meds out of the reach of patients. They get sick, end up in the hospital, are restabilized and then the cycle starts all over again. (This is the frustration of 26 years of working in mental health...)

Psychiatric meds for the SPMI should be 100% covered by us through government.

[vent]Our local community mental health department is notorious for giving people a 30-day supply of meds, then scheduling them for a 6-week followup. Sometime about day 20, a lot of patients start getting anxious about how they're going to make it the extra week-and-a-half to their next appointment without meds...by the time the meds run out, they're near crisis...hey, guess who's in the hospital again?[/vent]

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We should think about adopting the french model of 100% coverage for chronic illnesses.

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