Has Medicaid stopped helping those who have Attention Deficit Disorder?

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A.D.D. is the complete opposite of ADHD and not only kids have this disability. Many individuals with brain injuries have disabilities that are life long, not something that can go away. This is why some adults still have ADD or ADHD their life, a brain cannot heal itself if it's injured to some extent. I care for someone who has a traumatic brain injury, which resulted in many different deficits and never ending disabilities in her life. She injured 3 of her brain lobes, along with a severe brain shearing and had to even have some blood drained from her brain from the bruising. She lost her peripheral vision, many broken bones and internal injuries, along with deficits affecting her even more today; 10 years later. She has had and will continue to have chronic insomnia and Attention Deficit Disorder. She cannot get the right A.D.D. prescription because of her insomnia but the one Adderral DR 30mg truly helped her with even going to college. She couldn't get her degree because of how chronic her insomnia was and arthritis 3 times her age was holding her back. A doctor she had retired and when she changed doctors, Medicaid wouldn't help her with her Adderall XR prescription, even after her doctor specifically wrote Brand Name Required, Medicaid wouldn't pay a dime. She's been on Vivanse which works a couple hours and then it's done. When you don't use your own energy, you won't sleep the best at night and She's up to 15mg of Zolpidem, and 4 Benadryl liquid gels at once and still not sleeping. Up to 400mg Trazidone last time they did this and she went 52 days without sleep, along with a broken arm down stairs and a black and blue eye passing out for a couple seconds up stairs into a brick wall. It's not impossible to go that long without sleep when you have a brain injury. Scary looking into what might happen to her without the medication that's been working for her. She'll just go back to getting prescribed Trazidone, Seroquel, Quetiapine, Lunesta, Ambian, Temazepam etc. Every night added with the 15mg of Zolpidem until she crashes downstairs because her doctor doesn't know what to do to help if Medicaid can't help a partially blind handicapped 28 year old women. Only can go so far, right? She can't even hold a job because of degenerative disk disease and 5 herniated discs in her back. What can anyone do for help? It stops after 10 years when you get worse?

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It's fine to pay 20% the out of pocket, at least Medicaid would be helping but they refuse to help. She needs Adderall CR, they will only help with Vivanse. Quit trying until she is set up in Michigan and noved there i guess. And she goes through a few sleep studies every year both sleep study wristband and the in person, overnight sleep studies that last about a week. 2 weeks bracelet. I'll look more into Michigan, all i can do right now. Thanks again.
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Doctors cannot keep up with all the prescription plans out there. The pharmacist can usually tell you its not covered because it has to be OKd before they fill a perscription. Medicaid usually has pharmacists they deal with, mine is Wallgreens. And yes, before the move you need to check and see if the other state will even take on ur LO. Because of the government Medicaid is cutting back on services. Medicare won't be effected. Where I live, not many doctors except medicaid. Since my nephew liked his doctor, he chose to stay with him and pay the 20percent Medicare doesn't pay. Not all doctors take Medicare especially specialist. You pay out of pocket.
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2 questions;
Has she ever had a test called a "sleep study"?
(You sleep overnight in a facility that monitors your cycles of sleep (or no sleep). This may shed more light on exactly what causes her inability to sleep.

2. If you have tried all the suggestions above to get the name brand meds but can't, have you contacted the manufacturer?
Often times they have special plans or offers for medically needy patients who don't do well on genetics or just can't afford the copay. You'll find the name of the manufacturing company on the name brand medication bottle. Google an address and phone number, ask for assistance.
Good luck.
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Please understand that each state has its own Medicaid program. When she moves to Michigan, she will need to apply to Michigan and get accepted into their Michigan program. Her doctor in Wisconsin, unless it's MediCARE instead of MediCAID, will not be paid by the Medicaid program in Michigan because it's two separate programs. Check with the specialist before she makes the move and coordinate care. Many doctors now limit how many new Medicaid patients they take - you want to explore changing doctors and the paperwork required before she moves and you have a lapse in coverage or medications.
Here is the Michigan government portal with links for services
michigan.gov/mdhhs/0,5885,7-339-71547_4860-225474--,00.html
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Yep, I'll do that too but this doctor is a general doctor. Another reason why Medicaid stopped I think. The specialist retired, maybe things will be different in Michigan than Wisconsin. Within a couple months, she'll be moving there but no idea how much Medicaid and/or Medicare changes between states. Only keeping her sleep specialist from WI because he's been her doctor almost since her accident happened. Still can't understand how having a doctor write T.B.I., doesn't cover it these days. And for some without a brain injury, it does. Really is just grand these days. Thanks for your information.
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I am assuming she is on Social Security. That's why the Medicare/Medicaid. Her prescription plan is with Medicaid so Medicare has nothing to do with it. My nephew was on Vyvanse a few years ago and received a letter from his script provider saying they no longer would cover the script. His phychiatrist had to either call or write a letter to say this was the only med that worked on him. We went thru this every year. Our Office of Aging helps with Medicaid insurance. We were told that if we went to the next tier and paid a monthly fee ($16 was our last payment) that he could get Vyvanse with no problem.
The doctor writing "needs the name brand" is for the pharmacy. If there is a generic brand then Pharmacies will default to that as Prescription plans require that. Just because a doctor writes it on a script doesn't mean a Prescription plan is to except it. You can go ahead and have it filled but you will pay full price.
So, when a med is turned down have the doctor prescribing it call the provider and explain she needs it.
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Thanks everyone, I'll see if she can appeal it. Hopefully she hasn't, new with this. Too many people sell them off and wreck it for those who medically need it. 
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I don't believe that there is a generic YET for XR. But I also believe that Medicare/Medicaid will require that the patient be trialed on the non XR generic before accepting that the XR is really necessary and not just for convenience sake.
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" . . . .even after her doctor specifically wrote Brand Name Required, Medicaid wouldn't pay a dime. . . . ."

Most insurance doesn't pay for Name Brand medications when there is a generic available. And if there is no generic available, there is usually a HUGE co-pay. From the medications that she's taking or has taken, she should be working with a Psychiatrist.
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Has she filed an appeal with Medicaid?

I believe that there is a specific protocol when a doctor wants to prescribe a branded drug to a patient on Medicaid; I believe that the nonbranded generic must be trialed and then the doctor has to write a justification for why the generic didn't work.

I would work with her doctor on filing an appeal for the XR version.
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