[NPInfo] Medicare and changes

[MIRONNYE at aol.com]

Hi
My name is Dee and I am FNP in South Carolina.  Has anyone had the  
frustration I have had with Medicare changing all the patients' medicines?   I work 
with indigent patients and they cannot afford some of the medicines when  
Medicare changes their drug programs.  They are being changed every year  and I spend 
most of the first new year visits changing their medications so they  can 
afford them.  At first, I was happy with this Medicare part D, but  after I 
started getting calls from pharmacies about changing the medicines  because they 
weren't covered on part D, I began to get weary.  Sometimes I  have to change to 
medicines that don't help as well and I feel it is the patient  that suffers. 
 A lot of my patients don't take all of their medicines  because they can't 
afford them.  I had one patient tell me one of her  medicines was $65 and she 
probably will not be getting it. She absolutely  refused to use Crestor as it 
would cost her $111 a month.  And her  cholesterol is well controlled!  She has 
already had stents placed twice;  so I was not too crazy about changing her 
medicine.  Lipitor was even  listed as a tier 3 which would have been $65 or 
more.
 
Also, I just realized I could not order home health for my patients.   I work 
in a nurse practitioner run clinic.  I do have MD who can sign for  this, but 
she never sees these patients-I do.   Now I'm getting forms  saying I can't 
sign for diabetic shoes or equipment.  Am I just being  overly sensitive?
 
Anyone else feeling this frustration??
 
Thanks for letting me vent.
 
D. Devlin, FNP
Columbia, SC



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