Florida Waiting Lists

[gregftl]

I had some thought this morning on the ADAP/Ryan white funding crisis and I had a couple of ideas.

I wonder if the states in trouble have ever thought of having people pay small co-pays for each medicaton they pickup? Say 10-25dollar copays based on how much the medication costs retail. Of course people with no income couldnt do this.

Also the state should start treating the Ryan White program for medical and dental more like an insurance program. When I lived in the state of Illionois they didnt cut people out of these services at a certain income level. Instead they accepted everyone no matter what the income since these people couldnt get health insurance .....and hence couldnt get health care..... but everyone had to pay for services on a sliding scale based on their income. So for example I made aroud 32,000 a year in Illinois but whenever I had to go in for bloodwork I had to pay around 150bucks....my doctor visit was around 45 bucks, etc. Right now I make that same amount and pay nothing in return here in FL. I had a friend that made around 75 grand back in Chicago and he had to pay 100percent sliding scale. Around 750 for his bloodwork....100 for a doc visit etc etc. Having people pay something based on a sliding scale and bringing more people into the RW program for medical and dental, etc programs and having them pay based on income could also generate alot of money for these programs for states.

[Miss Philicia]

Major metro areas have Ryan White Planning Councils and their meetings are open to anyone.  If you live in Fort Lauderdale you should look into it.

[gregftl]

I've already emailed the head of florida's ADAP my suggestions and she told me they were going to research them. As I am homebound I dont have the luxury of leaving the house and attending meetings. Firing off telephone calls and emails are my only ways to make suggestions.

[Hellraiser]

I've already emailed the head of florida's ADAP my suggestions and she told me they were going to research them.

That's kind of amazingly proactive, good for you.

[tokyodecadence]

That's actually similar to the system set up here in Oregon, which (along with very minor cost-cutting measures, such as having to sever deals with some pharmacies to carry meds, and having those people obtain their meds from a state-run pharmacy) have allowed Oregon to avoid a waiting list.


For instance, I have employer-based healthcare. So after that, I have copays for meds, doctor's visits, etc. So I pay the ADAP program here a monthly premium, and they pay all of my copays, and whatever's left after my insurance pays. it's about 44 bucks a month for me. This is income based, and the same annual renewal song and dance is required. I like it, it makes me feel like I'm contributing to my services (as I am working and capable of doing so), and it allows people who aren't able to work or can't find jobs (the job market here is very stagnant) get access to basic services and meds, at the very least.

[gregftl]

Sounds just like Illinois program.

Illinois took it a step further to cut costs too as i mentioned in another thread they didnt make you go to one of ur local county health department pharmacies to pick up your meds......in IL they contracted thru one CVS pharmacy (who they contract thru now might be different) to send your meds thru the mail. You called up once a month a week before u needed ur refill and u got ur meds in 2 days in the mail.

So no need to have pharmacies to hand out hiv meds in IL. Now, while I know that the county health dept pharmacies dont only serve people with hiv (i think they also serve people on medicaid---not 100percent sure). But i would estimate the percentage of people at these country pharmacies there to pick up hiv meds is probably at least 60-70 percent. And we have 3 of these pharmacies just here in broward county. Plus there is always a line out the door whenever u go in to pick up your meds. Cut out this pharmacy "middle man" or at least scale it back if you dont have people with hiv there waiting for their meds and that would save tons of money too. I also suggested that to the head of ADAP here in florida.

Back in Illinois too Blue Cross had a special health insurance program for people with HIV. Cant remember the exact name of it. Anyways, they didnt discriminate based on pre-existing condition and you could get health insurance thru them. Of course higher premiums, higher co-pays but something do-able for people making 35 grand and up.

Speaking of Blue Cross whatever happened to the health insurance co-ops that were supposed to be setup within 90 days with 5billion dollars of govt money.... after health care reform was passed? It was supposed to be setup as a temporary fix until most of actual health reforms kick in ....in a couple of years. But I've fired off emails to my local senator, country health departments, state health departments, the CDC but have yet to receive a response on how to enroll in one of these programs b/c I could afford it. Seems like after health care reform was passed.....everyone celebrated but then people forgot all about it and forgot to keep people informed on how to go about taking advantage of the changes made in the reform.

[tokyodecadence]

Oh yeah! They totally have mail-order pharmacies available now too. But my pharmacy is still on the list, so no need.

[Dennis]

...Speaking of Blue Cross whatever happened to the health insurance co-ops that were supposed to be setup within 90 days with 5billion dollars of govt money.... after health care reform was passed?

I thought these were going to be put into place within 6 months.

[gregftl]

Hmm I read 90 days online but i bet you're right it's 6months.

[Dachshund]

Yes, it's six months.

[gregftl]

I wonder who in the world we contact to get enrolled in that? I've asked all the state and country health officials and they still have no clue. Would be nice to have a little info at least

[leatherman]

someone else will have to speak to the changes the reform will make (although I believe it should allow people to buy into insurance which can cover their prescription costs); but the federal ADAP program was just renewed in Oct for another four years, so some form of ADAP will be around for a while yet (perhaps it will cover the insurance premiums rather than purchasing the meds in the future).

[Assurbanipal]

I wonder who in the world we contact to get enrolled in that? I've asked all the state and country health officials and they still have no clue. Would be nice to have a little info at least

It's going to be a huge challenge to get pools up and working in all 50 states on time, but, so far, things are moving along.

To date they have gone out to the states to see which ones are willing to modify existing programs to meet the new law (the feds have to bring up new programs for states that won't open up their existing high risk poo or start one). This link http://healthreform.gov/forums/blog/high_risk_pools_update.html indicates that Florida is going to have a pool run by the feds, so the state and county folks have essentially punted...

To get more info, go to Healthreform.gov and search on "high risk pools"  There's also an option to subscribe to email updates on healthcare reform.  But it is hugely complex to set this up, and it will probably be down to the wire on the details.

[Miss Philicia]

Something's beginning to work somewhere because just today I received an unsolicited $250 check from Kathleen Sibileus for my Med-D donut hole.  Little does Ms. Sibileus know that I don't pay anything for the donut hole as the state of PA wraps it around and pays it with Ryan White funds, so now I don't know what to do with the check.

I'm thinking of spending it on coke and hookers, then documenting it on youtube to irritate the teabaggers.

[tokyodecadence]

Thanks for that link! I went looking for something similar to this a while ago, I guess the site wasn't yet up and running.