Saturday, October 17, 2015

How to Afford Expensive Medications on a Budget

My late husband took 16 medications a day. Some had low co-pays, and a 3-month supply was only $10 to $20. His most expensive prescription drug was Revatio, which required a co-pay of $1,250 for a 3-month supply. The middle-ground co-pays were on average $300 for a 3-monty supply. The total expense was staggering, and only a fraction of his total medical expenses. I managed to buy all of the drugs he needed, but I had to use a variety of methods to do so.

 One word of caution, though. When buying meds from multiple sources it’s imperative that you keep an up-to-date, comprehensive drug and supplement list for the patient. I found this was easiest to do electronically, updating a Word document whenever his medications or supplements changed, and saving a copy of each date’s list. I printed a copy of this list and took it to every doctor's appointment, ER visit or therapy session. I also had the pharmacist at the local pharmacy where I filled my husband’s narcotic prescriptions look at it from time to time to be sure there were no conflicts between his meds.  The easiest path is to apply for Extra Help through Medicare. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 states or the District of Columbia. In 2015, you may qualify if you have $17,655 or less in yearly income ($23,895 for a married couple) and $13,640 or less in resources ($27,250 for a married couple). You can apply for the benefit at any time your income and resources change. In 2015, drug costs for most people who qualify are no more than $2.65 for each generic and $6.60 for each brand-name covered drug. (In 2016, costs are no more than $2.95 for each generic and $7.40 for each brand-name covered drug.)  You can apply for Extra Help online here, or you can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone or to request an application. You can also apply in person at your local Social Security office.  There are state programs to assist with your drug costs as well. Contact your state government for information on Medicare Savings Programs (MSP)—programs in your state that help pay your Medicare premiums, your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance, and copayments, and Medicare prescription drug coverage costs. Some pharmaceutical companies offer assistance programs for the drugs they manufacture. To see if your drug’s manufacturer has an assistance program, visit this site or check out AgingCare's comprehensive Prescription Drug Assistance Program Locator.  There are non-profits that can help uninsured people with their prescription drug costs. One such organization is SCBN Prescription Advocacy. Another option is RXOutreach.  There’s still hope, even if you don’t qualify for an assistance program. Discount warehouses such as BJ’s and Costco consistently offer the lowest prices on drugs. And you don’t have to be a member to shop at their drug stores. You can also negotiate for a lower price with some local, privately-owned drug stores. Don’t be shy about calling around and asking for a lower price on your medication! There are prescription drug discount cards available at low or no cost, but it’s hit or miss on whether the discounts offered will help with your particular med needs. Still, it’s worth looking into. A savings card just might provide significant discounts on the drugs you need.

 And finally, if none of these options are working for you, you can do what many Americans do, and buy your drugs from Canada. I had to resort to this for some of my late husband’s more expensive drugs. The Revatio I mentioned earlier in this blog cost me $550 for a three-month supply when ordered from a Canadian pharmacy, as opposed to the $1,250 co-pay through his Medicare Advantage plan. I bought the generic, and, according to his cardiologist, it was as effective as the brand name. Your first order can take a few weeks to process, so plan ahead if you want to use this option.  Ask your doctor if samples are available to use while you wait for your order to be processed.

Another option is to get two prescriptions; one for a one month’s supply at a local pharmacy and one to mail to the Canadian pharmacy. Some pharmacies will expedite your order for a slight surcharge, sometimes as low as $10.  Different pharmacies offer different prices for the same meds, but you can compare prices on PharmacyChecker. This site checks the safety credentials of the online pharmacies they feature and provides online pharmacy ratings to protect American consumers. PharmacyChecker has been recommended by AARP, CBS, The New York Times, NPR, The People's Pharmacy, and more.

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Thursday, October 15, 2015

Taking a Bite Out of Senior Diet Myths

 


 

Taking a Bite Out of Senior Diet Myths


The varied health concerns of seniors can make it difficult for caregivers to know how to manage their elderly loved one's diet.  Is it normal for a senior to lose their appetite or weight for no obvious reason? What combination of vitamins and minerals does a senior really need? Are supplements safe?  Ruth Frechman, M.A., a registered dietician and spokeswoman for the Academy of Nutrition and Dietetics, debunks some common myths about senior nutrition and offers advice for caregivers:
  1. "A senior can eat whatever they want." Frechman feels that this misconception tops the list as one of the most common senior nutrition myths. "Proper nutrition is important at any age—how you eat affects how you age," she says. The key for seniors, according to the National Institutes of Health (NIH), is to look for foods that are low in calories, but high in nutrients. This includes: fruits, veggies, whole grains, lean sources of protein (fish, poultry beans, nuts)
  2. "A senior's nutritional needs don't change when they get older." Following this line of thought is a big mistake, according to Frechman. There are a few important tweaks older adults should make to their daily diets. The U.S. Department of Health and Human Services advises seniors to cut back on their daily sodium intake, consume a higher volume of whole grains, increase their daily potassium intake, and eat foods fortified with vitamins D and B12.
  3. "Dietary supplement pills are a safe way to make sure that a senior is getting all of their vitamins and minerals." Grocery stores often devote several shelves to vitamin and mineral supplements, but caregivers should be careful when considering giving these pills to their elderly loved ones. Seniors who eat a balanced diet should be able to get all of their nutritional needs met from the food they eat. Using supplement pills to make up for a deficit in an elderly person's diet may cause adverse reactions with prescription medications or cause them to overdose on a particular vitamin or mineral.
  4. "Eating out all the time is fine, as long as we don't get the same thing every day." Caregivers (and seniors who live alone) may find it difficult to find the time and energy to cook meals. This may cause them to turn to dinner options that require less effort and time to prepare, such as restaurant take-out or pre-packaged frozen meals. But, according to Frechman, these seemingly handy short-cuts come with a price: high amounts of fat and sodium. This can be particularly dangerous for seniors with heart problems or high blood pressure.
  5. "If a senior doesn't feel like eating a whole meal, a supplement shake is a fine substitute." Meal replacement and supplement shakes are not suitable alternatives to a balanced meal. When used too frequently, these shakes may cause a host of health problems, including: malnourishment, and diarrhea. A good rule of thumb to follow when it comes to these kinds of drinks is that they should be used periodically as a snack, not a substitute.
  6. "It's normal to lose your appetite as you get older—I shouldn't try to get my loved one to eat if they're not hungry." An older person may lose their appetite for a variety of reasons, none of which should be ignored or brushed off as a symptom of aging. Medication side effects, problems with chewing and digestion, loneliness, depression, and a reduction in the ability to taste and smell are all things that can contribute to a senior's reluctance to eat. Frechman says a lagging appetite can cause a senior to become malnourished. She advises caregivers to entice seniors to eat by making the meal look as appealing as possible; using fancy silverware, lighting candles, and arranging the food in a pleasant manner. It may also be helpful if the senior has an eating companion. Try to schedule in some time to sit down and eat with your elderly loved one when you can.
  7. "My loved one doesn't have diabetes, high blood pressure, or high cholesterol, so they don't need to see a nutritionist about their diet." Frechman feels that all seniors could benefit from consulting with a professional about their diet. She says that there is a great deal of conflicting and incorrect nutrition information out there, so it can be helpful to get advice from a knowledgeable source. Medicare Part B only covers dietary consultations if a senior has diabetes or renal disease. Some Medicare Part C Advantage programs will pay for a person to see a nutritionist, if their doctor deems it, "medically necessary." A senior's primary care doctor may also be a good source of information on proper diets for the elderly.


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Saturday, September 12, 2015

The Hardest Part Is Knowing...

  I think the hardest part of this disease is realizing you have it. Knowing a bit of you is being lost every day.
 Knowing one day, just not what day, but one day you will not recognize your family. The people in your lives, the caregivers if you will, struggle with this daily also.


I overheard our nieces talking over the weekend, asking each other if I was alright, if I had done or said anything I shouldn't have.


Knowing that these two have to ask questions like this just breaks my heart. They see their Uncle Ricky slipping away. I was unable to do the things I used to do with them at the water park.


I watched them, thinking to myself that I always hated to see parents not interacting with their kids at events like this. And now, I was or have become the very thing I hated.


It's the disease, it's always the disease. But just being there with them was enough for them. I know that. They wanted me to go down the super slides with them, as we have always done in the past.
But with this disease, it would never allow me to stand in line, in close quarters with hundreds of people. Even with my dementia service dog, Sam, there are limits, things I just won't do to bring unnecessary stress upon myself.


The Uncle Ricky they once knew, who could do all these things and much more, is no longer here. I do the best I can with them. And that is enough for them.


But I see it in their eyes. I hear the whispers to Aunt and Grandma Phyllis, "Why won't he get in the water?" She just says, "He can't girls..."


This and much, much more is what this horrible disease takes from you. I posted that the weekend went fine. And in a sense it did. I was not stressed, no anxiety, or fear.


But, one must know that the person I was, I am no more. It's hard for adults to realize this, let alone kids...


I wanted to post this so everyone knows and remembers that what once was, the person your Mom, Dad, or whoever it is, is no longer. What they once loved to do could now scare them to death. What they once loved to eat, they may now hate the very smell of it.


It's the disease that does this to us. I'ts always the disease. When I say or do something I would not have done in the past, I find that I don't catch it anymore. I am slipping. We all are who fight this disease.


It is without a doubt the hardest thing anyone will deal with, regardless of whether you are a patient or family member.


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