Well, more specifically pharmacy benefits do.
I was told I was eligible for Medicaid, by Obamacare, but then I was denied for Medicaid when I applied at the start of the year, so I applied for and was accepted by Obamacare, which I am grateful for. Literally two days ago I've been told that I've accepted for Medicaid, so I am in talks with my lawyer about seeing how I can, if I can, switch over, without/with it impacting my whole disability claim I am seeking at the same time, keeping my original doctors, the process going, etc.
The problem?
At the end of last year I suffered two breakthrough grandmal seizures (I usually have one petit mal seizure every few months, never a grand mal and never one the same day within hours after the other). So I was rushed to the ER and kept for observation. I went to the neurologist this year, under my new plan, and was told that my meds would have to be adjusted and upped. No problem there as they're tier one meds under the BCBS plan I have.
The problem is, two other issues. I had a colonoscopy just before the new year, and it revealed problems....somewhat major. I had a blood test which I just today got the results for. Turns out I've been diagnosed with a new diagnosis...Crohn's disease.
I've been told that this requires me to go ASAP on a new script, one which I have to take 6 pills a day for, for the rest of my life. Not a big deal when I already take 20 plus pills a day, but the problem is, these are tier 2 meds....cost that the local pharmacy wanted for them? 1207 dollars.
Turns out I have a 2000 dollar deductible, of which for this year I still owe 1207. So the pills will cost the remainder of the deductible all at once.
From the pharma company I was excited, I received a coupon that said "receive a $30 dollar co-pay for the med. I went into the pharmacy with the coupon. Turns out it only brought the price down to 970 beans or so.. since there is a 150 limit or so on the coupon.
Once I reach the deductible I am set. So basically once I spend 1200 more on my healthcare, which knowing me will happen sooner rather than later, I have to pay a huge amount for these pills, then via magic, they go down to about 40 dollars a script.
And this is for someone who has insurance.....I feel even worse for those people who cannot even get any insurance in the first place.
I have no idea how any of this will turn out. I might get lucky, as the doctor's office has been working with me all day today before I went to the pharmacy and maybe they will stick me on something else, either that or there is hope that the local Jewish Family Services can offer some aid. And there is always hope I can end up on Medicaid until my disability goes thru, but egads... this is a sorry state of affairs when a necessary med can change price overnight with such ease due to paperwork and time.