[NPInfo] Medicare and changes

[Priscilla Merrill]

Hi, Dee,

Glad to have you on the list.
Yes, I certainly feel the pain.  I’m sure all of us do.  I truly think the
insurance companies should come under a lot more heat than they do.  I saw a
story on one of them being successfully sued in wrongful death and I hope it
happens more.  They seem to have become dictators and the patient is not
their priority.  Unless it's a green guy named Bill.
This constant changing around of meds can't be good, especially in our
fragile elderly population, but who can afford to stay on the meds when the
costs soar?  And those reports of the pill mills in China is truly
frightening and this is our BRAND name meds.  No wonder we can't always
convince our patients to take meds.  They are heading in droves to Wal-Mart,
Target, etc to get the $4 generics.  Are they truly as good?  Times will
tell.  I hope someone is doing research on the outcomes with the switch to
all of these generics.
I think we could prove a lot of deaths from people just getting fed up,
giving up on their meds and the red tape.  It's very sad and we're in the
middle.  It's only getting worse, not better.  I have never had so many
patients attempt and commit suicide as in the past several months.  Two this
week already in our practice!  Some in their 60's, some in their 20's
(largest group), and a couple in between.
As you said, we've never worked harder as a society, yet can't make ends
meet.  Anyone else been seeing more anger in the workplace?  People are
ready to snap everywhere I turn.  OF course, I partially blame our
unbelievable New England winter.
Don't all of us have to fight our own companies?  We're in the loop and know
much but others don't.  Almost every visit I have, I end up having to fight
for something on the bill.  A co-worker with our "good insurance" is
fighting without success so far, a bill for a CEA-125 test.  She had a hyst
by our GYN and DUB and abnormal pelvic exam and with tweaking the ICD code,
they are still refusing it.  Unbelievable!!  The time and frustration
involved makes folks give up and eat the cost.  So wrong for what we pay.
Same with dental.

Hopefully with Spring and hope in a new leader, times will improve.
Sorry for the rant, guess I needed to vent!  

Priscilla Merrill FNP

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of MIRONNYE at aol.com
Sent: Monday, March 03, 2008 11:36 PM
To: npinfo at nurse.net
Subject: [NPInfo] Medicare and changes

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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