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Author Topic: Who pays in FL? Got M'caid share of cost, $1,328. ADAP says no because of this?  (Read 662 times)

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Offline gulfcoastFL

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  • Posts: 31
. I went to my local ADAP office in Tampa Bay area, all paperwork in hand. After going through what I had, was denied help from ADAP, not for income or anything but because I had a letter from FL state assistance saying I was approved for "medically needy" with a $1,300 number following it.  Could not get approved for straight Medicaid.
  I take Triumeq, costs about $2,500 a month. I didn't get any kind of card to take to the pharmacy (CVS). Just told by ADAP to take that paperwork to CVS.

My question is, knowing triumeq costs 2,500 and "my share of cost is $1,300"  under Florida's "medically needy" that I have...should the pharmacy say, oh this drug far exceeds that $1,300 number...we'll take care of it and it will be no $ out of your pocket?...
ADAP was conflicting in there answer but said basically that's how it works.  Everything I've read implies I have to spend that $1,300+ out of my own pocket 1st before FL will start to help.

Or, am I expected to spend $1,300+ and then get reimbursement somehow?
If I have to pay upfront it's not something that I'll be able to use.

Any feedback, especially if familiar with FL would be much appreciated !!!
« Last Edit: October 31, 2015, 06:01:25 PM by gulfcoastFL »
"We all think and feel differently as the years go by"  Thank you, Grey Gardens.

 


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