Monday, March 31, 2014

Yes, I'm sure that's it

Mrs. Baked gets Fentanyl patches every month from a pain clinic. I don't get to see Mrs. Baked very often. Mostly I see her husband, usually in the middle of the day on a weekday. I know Mrs. Baked doesn't work, you know, because of her debilitating illness which requires her to be on the patch and other associated medications for breakthrough pain, etc.

The whole point of Medicaid is to help people out until they can get back on their feet again. Or that's what I thought, anyway. With the Baked family, this appears to be taking a long time because they've been in this situation since 2008. Somewhere along the way Mrs. Baked became out of sync with when the insurance will pay for the patches and when she gets the new script from the doctor. So every month it is a fight and a prior authorization process and Mr. Baked coming down to the pharmacy every day (in the middle of the day when most people are working) to check on the status.

This month Mr. Baked is especially nervous about when he can get his wife's patches. When I inquired as to the unusual "extra" urgency, Mr. Baked tells me that they need them because they're going on vacation. Well, that's nice, isn't it? So to entertain myself further I ask: Where? O where art thou vacationing, my Lord?

As it turns out, the Baked family is going on a cruise ship traveling to the Bahamas for two weeks. So the next day Mr. Baked comes in again and why yes, Medicaid has once again approved another thirty day supply of patches. And there, as Mr. Baked picks up his wife's patches with only a signature, I noticed two things. The first was a large Starbucks beverage of some kind. You know, the ones that cost at least $5. The second thing I noticed was that he was holding one of the new iPads that Apple company is selling.

Now I know all you liberals are just going to tell me not to jump to any conclusions. Yes, I know, it's all just in my mind: Mr. Baked works at night, that's why he's there in the middle of the day. His income is really low and with his disabled wife they qualify for Medicaid. And sure, the vacation was a gift from a family member to help them to deal with all the stress  And of course, the Starbucks was paid for with a gift card from yet another generous person, and he's just borrowing the iPad from someone else.

Yes, of course. I'm sure that's it.


Anonymous said...

You know, if she has a condition that is that long term and debilitating and requires around the clock medication, she should be applying for disability. Yeah, there is a 2 year wait for the medication part to come in but she's already on medicaid and they won't kick her off for getting disability until the medicare kicks in, as far as I

Plus, she could just use her disability income to pay cash for the drugs until it kicks in.

Of course, this all depends on said person actually needing the medication and using it as prescribed. 98932539 12

Crazy RxMan said...

Yes, I'm sure that's it.

Anonymous said...

Why pay (disability) cash when she can pay with another someone else's cash?

pharmaciststeve said...

I am not a big fan of Fentanyl patches on ambulatory patients.The activity and sweating of a ambulatory pt.. those things tend to come lose and/or the pt ends up have to tape them on and/or a patch gets "wasted" because it will not stay on. Also there are some "fast metabolizers" that need to change the patch every 48 hrs. Her basic overall medical costs could make her eligible for Medicaid. Some times couples will technically "divorce" so that the one spouse is eligible for Medicaid. In order to qualify for Medicare/SS disability.. she would have had worked for 20 quarters recently. She may not aware of this until the clock had ticked off for her to qualify and apply.

shenandoah said...

They are both really stoned. You're welcome.