Current Affairs General US politics (ie, not POTUS related)

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Not sure where to put this, but need to vent and this seems as likely a place to do it.

Patient I saw this morning. He has been working hard to get his diabetes under control and is almost there. Today he told me his employers cut his work hours by half. He can no longer afford his health insurance and quit paying the premium.

I am desperate for him to get one last refill of insulin before he loses coverage so we have time to apply for patient medication assistance (takes at least 4 weeks), but he has minor things like food and rent to worry about.

No idea how I am going to help this guy.

Welcome to the US health care system.
 
Not sure where to put this, but need to vent and this seems as likely a place to do it.

Patient I saw this morning. He has been working hard to get his diabetes under control and is almost there. Today he told me his employers cut his work hours by half. He can no longer afford his health insurance and quit paying the premium.

I am desperate for him to get one last refill of insulin before he loses coverage so we have time to apply for patient medication assistance (takes at least 4 weeks), but he has minor things like food and rent to worry about.

No idea how I am going to help this guy.

Welcome to the US health care system.
Technical question: when did his benefits end? Usually, premiums cover the upcoming month, or at least through the end of the month (July?). Also, in the realm of gaming the system, could he claim he needs refill due to upcoming travel where he would be away from his pharmacy / physician? Another thought: if you know the Pharmacy manager / director - can they talk to their insulin rep about covering some sample doses for this guy? Often, medical and pharma reps have some flexibility in this type of thing where they can give out samples and not have to account for them. We've done the same thing in the past for patients needing implants in surgery that would not be covered but are clearly in the patient's best interest.
 
Technical question: when did his benefits end? Usually, premiums cover the upcoming month, or at least through the end of the month (July?). Also, in the realm of gaming the system, could he claim he needs refill due to upcoming travel where he would be away from his pharmacy / physician? Another thought: if you know the Pharmacy manager / director - can they talk to their insulin rep about covering some sample doses for this guy? Often, medical and pharma reps have some flexibility in this type of thing where they can give out samples and not have to account for them. We've done the same thing in the past for patients needing implants in surgery that would not be covered but are clearly in the patient's best interest.

Yeah, I've worked through all this. This is type of thing is almost a daily occurrence for me. I am a pharmacist (although I work in primary care clinic, not a pharmacy)

Pharmacies can't accept samples from manufacturers. Our clinic does not accept samples from reps - for a lot of good reasons. And it doesn't even really matter when his benefits end. His pay was cut in half - he can't afford the prescription copay (even with the manufacturer savings card) and still feed his family.

We have a charitable fund that I might be able to access, but I can't actually work on any of it until he officially doesn't have insurance.

.
 
Yeah, I've worked through all this. This is type of thing is almost a daily occurrence for me. I am a pharmacist (although I work in primary care clinic, not a pharmacy)

Pharmacies can't accept samples from manufacturers. Our clinic does not accept samples from reps - for a lot of good reasons. And it doesn't even really matter when his benefits end. His pay was cut in half - he can't afford the prescription copay (even with the manufacturer savings card) and still feed his family.

We have a charitable fund that I might be able to access, but I can't actually work on any of it until he officially doesn't have insurance.

.
I realized after I posted that you had probably worked through all this - sorry for my patronizing tone. It's a sucky system where we force people to make those choices.
 
Yeah, I've worked through all this. This is type of thing is almost a daily occurrence for me. I am a pharmacist (although I work in primary care clinic, not a pharmacy)

Pharmacies can't accept samples from manufacturers. Our clinic does not accept samples from reps - for a lot of good reasons. And it doesn't even really matter when his benefits end. His pay was cut in half - he can't afford the prescription copay (even with the manufacturer savings card) and still feed his family.

We have a charitable fund that I might be able to access, but I can't actually work on any of it until he officially doesn't have insurance.
Thank you for your service.

My wife's type 1 diabetic and the Meds-Industrial Complex has driven us at least halfway to the barricades already. Worrying about this stuff all the time constitutes a health problem in itself.
 
Not sure where to put this, but need to vent and this seems as likely a place to do it.

Patient I saw this morning. He has been working hard to get his diabetes under control and is almost there. Today he told me his employers cut his work hours by half. He can no longer afford his health insurance and quit paying the premium.

I am desperate for him to get one last refill of insulin before he loses coverage so we have time to apply for patient medication assistance (takes at least 4 weeks), but he has minor things like food and rent to worry about.

No idea how I am going to help this guy.

Welcome to the US health care system.

the high dose Metformin+glipizide combo ($20-30/month) for a few weeks. Or there is get hyperglycemic check into the hospital and ask the RNs to give you the insulin pen when you get d/c route :(
 
the high dose Metformin+glipizide combo ($20-30/month) for a few weeks. Or there is get hyperglycemic check into the hospital and ask the RNs to give you the insulin pen when you get d/c route :(

Appreciate the thought, but oral meds can’t replace insulin unfortunately and honestly at this point $20-30 is out of his range or I’d do the Walmart $25 per vial insulin. He’s down to well under $20K/year and has 3 kids. His wife lost her job a while back.
He couldn’t get admitted until he is severely hyperglycemic and that won’t happen until well after his insurance is canceled. Then he’d end up with a bill of ten of thousands of dollars for the admission.
 
Appreciate the thought, but oral meds can’t replace insulin unfortunately and honestly at this point $20-30 is out of his range or I’d do the Walmart $25 per vial insulin. He’s down to well under $20K/year and has 3 kids. His wife lost her job a while back.
He couldn’t get admitted until he is severely hyperglycemic and that won’t happen until well after his insurance is canceled. Then he’d end up with a bill of ten of thousands of dollars for the admission.
Can I post you some from Ireland?
 

“Possible attempted suicide”

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Appreciate the thought, but oral meds can’t replace insulin unfortunately and honestly at this point $20-30 is out of his range or I’d do the Walmart $25 per vial insulin. He’s down to well under $20K/year and has 3 kids. His wife lost her job a while back.
He couldn’t get admitted until he is severely hyperglycemic and that won’t happen until well after his insurance is canceled. Then he’d end up with a bill of ten of thousands of dollars for the admission.

Unless he still has a co-pay, humalog is $90-120 for 3mL can go online and get a goodrx perscription card it might save a few bucks if insurance doesn't cover it because too soon or whatever, still that's probably about $70 tho.

There is emergency medicaid, but getting that quickly might depend on who much or little your state hates medicaid. If you own your house tho, you probably don't qualify.
 
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