In addition to being a traumatic brain injury survivor, I also have epilepsy (since age 9). In one respect, I am fortunate–my seizures can be controlled by three different anti-convulsants. However, due to the “implementation” of the Medicare Prescription Drug Program (Part “D”), many prescription drugs will not be covered under the basic rx plans. Here is a list of those that are not covered. (This list was obtained from a person who has had training re: Medicare Part D.)
It is my understanding that some of these rx’s are used by people with disabilities, specifically, mental health disorders and developmental disabilities:
Barbiturate
Benzodiazepines
Prescription vitamin and mineral products (except prenatal vitamins and fluoride preparation)
Non prescription drugs
Medications used for anorexia, weight loss or weight gain Medications used for cosmetic purposes and hair growth
continued below
The following specific medications in the benzodiazepine class that are excluded from Medicare prescription drug coverage. (Many people do not know the categories of the prescription medications they are taking.) It is helpful to check this list of benzodiazepines because if a dual eligible is taking any of the following medications, they will not be listed on the drug plan formularies:
Alprazolam
Alprazolam Intensol
Ativan Chlordiazepoxide
HCLClonazepam
Clorazepate Dipotassium
Dalmane
Diazepam
Estazolam
Flurazepam
HCLHalcion
Klonopin
Librium
Lorazepam
Lorazepam Intensol
Midazolam HCL
Niravam
Oxazepam
Prosom
Restoril
Serax
Temazepam
Tranxene T-Tab
Triazolam
Xanax
Xanax XR
What are the specific medications in the barbiturate class that are excluded from Medicare prescription drug coverage?
Bellaspas
Bel-Tabs
Butisol Sodium
Eperbel-S
Ergocaff-PB
Mebaral
Meridia
Phenobarbital
Phenobarbital Sodium
Seconal Sodium
Spastrin
This last section (of what is not covered) is a biggie, as some of these, although they are classified as barbituates, have been used theraputically for other reasons. In my specific instance, phenobarbital is used as an anti-convulsant. (Combined with two different anti-convulsants, grand mal epileptic seizures are controlled.) Also, phenobarbital was used by my late father for a cadiac condidtion (in tandem with other rx’s)
Since this diary was posted earlier, I have had a few discussions w/my pharmacist, my doctor, various state and federal agencies.
Per my pharmacist: “This was deliberately made complicated so that people would not be able to understand it. This plan is nothing but a shell-game.”
Per my doctor: “This is crazy. How are you supposed to get their rx’s?” (My answer, “I don’t know. I do know that “enhanced” policies are available that will cover more rx’s than are specified here.)
Dr.’s next comment, “This is crazy. Why the hell get rid of Medicaid? Only the insurance companies will benefit by this.”
He then asked me, “Do you know what we need in this country?” (My answer, “A single-payer national health care system.”)
Dr’s answer, “The problem is who will run it–you need someone w/no axe to grind to do it. You can’t trust the government.” (My answer, “Someone like me?”)
Dr.’s reply, “Yes, someone like you.” But I thought about it for a few minutes and then realized that I do have a few grudges, so I suggested the Medical Assistant–she has been a M.A. for God-knows-how-long. (Definitely qualified!)
There’s more: Today I had a discussion w/several people from different State agencies. The general concensus is that all of the details of rx coverage have not been worked out and may not be until sometime in the spring!!!
Meanwhile, no one really knows wtf is going on, other than the fact that insurance companies are allowed to contact people to determine if a person is interested in purchasing a certain policy. However, the individual specified that there is a con going on–people are being telephoned and asked for their Social
Security Numbers to “determine eligibility” re: the type of policy that may be sold. (Connect the dots!)
Although insurance carriers are allowed to contact people for the sole purpose of selling the “enhanced” policies, they are not allowed to ask for any identifying information. If a person receives a call asking for such information, it is being strongly advised to request that any information be sent through the mail.