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    luv2bcurious's Avatar
    luv2bcurious Posts: 1, Reputation: 1
    New Member

    Aug 16, 2006, 01:39 PM
    Disabled - Mental Illness - Need Prescription Asst.-SSDI Over Requirements
    I am 47, disabled after working 27 years as a paralegal with a mental illness. My SSDI is 22,560, 1880/month. All programs out there to help assist me get medications I need for physical and mental illnesses are denying me as they say my salary is over the income elegibility.
    I have a very important question. The prescription assistanct programs of the pharmaceutical companies are not suppose to discriminate against you in your decision based on you race, age or in this case disability.
    So, under the Universal Declaration of Human Rights, Article 26 I believe, everyone has the right to health. Well, I was thinking that I believe I am being discriminated against because of my disability because it is because of my disability that is why I am making the income I am which puts me in a bracket to receive no gov't help, or private help. I moved to MD from VA in June. In VA, I received helped with some of my medications I don't know how but here I have been denied and having been denied, I can tell you I will not be able to afford the medications that I need until I get medicare in Sept. 2007. My medications are premarin, synthroid, famvir, zetia, temazepam, abilify, adderall XR (which is 568.00 alone), prozac, klonopin, pilocarpin and I need phengren and mycelex wafers on hand, I also need to be able to get glucose monitoring strips. My diagnosis for which I am disabled is major depression recurrent with psychotic features and adhd. However, I also have Sjogrens Syndrome and Hashimotos Thyroiditis. Since I cannot afford to by all the medications I need like pilocarpin which helps with my saliva glands in my mouth, they stop working properly, which leads to infrection in my mouth and severe pain. I figured my medicines since moving here in MD will be about 1339 a month and that does not include my 450 month rent 250 month food, gas, dr. visits, lab work, etc. So, I am praying to God someone will read this and tell me if I have a legitimate theory behind the discrimination I have received because of my disability which caused the salary and I am not getting the Right to Health as indicated in the Universal Bill of Rights. I have been suffering from depression mainly the last 10 years each about getting worse to the point I had a breakdown and although I tried to work I lost three jobs in six months. Prior to that I had excellent work habits and raised to boys and put them through college. I feel like a failure and I know if someone does not help me I am going to end up giving up because I just cannot keep fighting this system. I am not one to live off the system but I seriously need the system to help me. If the system fails me and there are no loopholes or anyway to help me, I am only going to get worse and not be able to afford the medication and be dead before I will be able to collect Medicare in Sept. 2007 which maybe that is what the gov't wants because I don't understand how they give you such an amount every month based on having been used to living off 66,000 a year and then do not afford you the availability of insurance because your income is too high. So how on earth do they expect you to get better. I feel like what is the since of trying anymore because everyone keeps shutting their door in my face and I honestly need the help. Thank you for your time. So if you can make sense of this mess I wrote please give me some advice if you can.
    jean48329's Avatar
    jean48329 Posts: 10, Reputation: 1
    New Member

    Oct 20, 2006, 01:50 AM
    I would recommend that you seriously check into Part D, Prescription coverage for Medicare part B receiptients. You did not indicate if you are receiving Part B as of yet, so if you are not, you will not qualify for it until you have been disabled 6 months beyond the date of Disability assigned to you by the SS Dept. (I believe, anyway) Beyond that, Part D will not cover some of the RX's, period, as I too, along with many Orthopaedic diagnosis', suffer from clinical depression. You might also try Montel Williams website... he promotes a newer program put on by many of the Drug companies that may assist you as well... good luck, it's not easy out there on Social Security by yourself, is it... I know, and I'm still raising a son!
    Good Luck, and keep your head up... it'll work itself out... also, depending on where you live, some of the larger metropolitan area's have Mental Health Departments that can help with both Doctors and they'll cover prescriptions or part of them as well. There is no reason you should be shoveling out that kind of money for prescriptions!
    velvetjones's Avatar
    velvetjones Posts: 78, Reputation: 11
    Junior Member

    Oct 20, 2006, 03:11 PM
    YOU ARE NOT A FAILURE. THE SYSTEM IS A FAILURE. As you already know, you're not eligible for Part B or Part D without eligibility for Part A. I was reviewing the standards charts for the S99 ("spend-down") program on the MD Medicaid website, which appears to be the only program that you could be eligible for at this time (unless you have assets of more than $2500), but also noticed that they no not seem to have a link to their Medicaid eligibility manual, as some states do. This would give you a better sense of how to "meet" a "spend-down") and become eligible for Medicaid. I would suggest contacting your local office, apply for Medicaid, and tell them to give you in writing:
    1. a breakdown of exactly how they figure your benefits and spend-down amount
    2. what documents (proof of medical expenses, bills paid AND/OR unpaid, Rx and other medical supplies receipts, etc) that you can use to meet your spend-down
    3. which documents to submit that they should use first towards your spend-down amount (dates of service, payment, etc have effect on eligibility [actual coverage] dates), because you are trying to get the earliest medical eligibility effective date
    4. how best to submit the documents needed
    AND they must quote and give a reference to the code or administrative law they used to make their eligibility determinations, etc. Having so much experience as a paralegal should be very useful for making them follow their own rules -- accountability.
    Another thing you may want to do if you are able to work even a few hours per week (or already are) is download the EID Brochure for the Employed Individuals with Disabilities Program at . It is a very interesting program that covers medical and prescriptions, you can get SSDI and work PT, and appears to be very much like, if not exactly like a program that I was the sole eligibility worker for my entire county. You might want to contact me for some help with this, especially if we can find their eligibility manual online. They really use the word "employed" pretty "loosely", and some people in the program that I was handling were working (all disabled folks) maybe 10hrs per month, getting at least min wage, or even self-employed. I believe it is a state program that is matched by federal funds, which is why is was being promoted, at least in the county that I was working in. If that doesn't sound like a program for you, you may want to contact local helplines or your Medicaid office to find out if there are medical providers that offer some kind of assistance, waiver or charity programs. I have been lucky enough to at least be getting some help from the clinic that I go to for MH issues, and discounted Rx. A friend that I turned on to the same program ended up getting almost all of his medications paid for with the assistance of the very same clinic! And to think I had to force him to go there! Anyway, I am going on and on here, but I wish you the best of luck, and feel free to reply or contact me for help through the Medicaid issues.
    stlouisarcher's Avatar
    stlouisarcher Posts: 12, Reputation: 2
    New Member

    Dec 10, 2006, 09:45 PM
    It's a pain, isn't it? (By the way, "pain" isn't the word I chose; apparently I'm being censored! Good thing I'm not trying to comment on dog breeding. Hah!) I'm mentally and physically disabled myself and know exactly what you're going through. It's odd, but in a way I'm lucky to be poor, so eligible for Medicaid as well as Medicare. Just don't move to Missouri--our governor has implemented health budget cuts that not only target the poor and disabled, but PARTICULARLY the mentally disabled. My SSDI is $792/month with a $76 spend-down. The Medicare RX plan helps a great deal, plus the pharmacy I deal with (Medicine Shoppe) waives my co-pays. State laws vary enormously, so I hesitate to make any specific suggestions regarding your situation, but, at the very least, you must have some kind of case manager through your state who is responsible for helping you through some of this morass. And that person has a supervisor. As velvetjones notes, many clinics have social service workers who can be helpful. For example, before my claim was accepted (not until I hired an attorney), a clinic was able to get me some help when I was unemployed and soon-to-be homeless. In my case, I lost my job (fired after I had a breakdown at work), had my car repo-ed, was evicted from the apartment where I'd lived 10+ years, ended up living in a shelter (transitional housing=fancy shelter) with a bunch of women, most of whom were on parole from prison for drug-related offenses. I have no family so I REALLY fell through the cracks. Agencies that helped me before I was evicted include the United Way and Catholic Charities' St. Vincent dePaul Society. I learned to work, work, work the phone. A lot of churches will help (and you don't have to be a member--I wasn't). Of course, for those of us who suffer from major depression, it's hard to do all this on top of being depressed and anxious. I had a friend who drove me around to places when I was borderline catatonic. Please research orgs in your area that help the disabled and mentally ill and advocate for us. There are lots of sources of help out there, but, because we don't have a Federal umbrella program, it's a helluva mess. Legal aid societies can help also. When all the changes in the MO laws came down, I was able to attend a meeting where they gave us a lot of good information. I've found that many state employees know less than we do because funding to teach them changes in these programs has ALSO been cut. Talk about Catch-22. Oh well, one good thing that has come out of this is that I may not have money, but I have the TIME to reach out to others. I am once more amazed and gratified by my own strength and that of those walking (or rolling down) a similar path.
    tracgardn's Avatar
    tracgardn Posts: 8, Reputation: 1
    New Member

    Mar 5, 2007, 08:45 AM
    There are several sites on the internet that can help you get reduces medication even if you make $80,000. My sister has a terminal illness and one of her medications was $1,600 a month,just for one. Then she talked to Cariten who works with Medicare and now she is insured and gets help on all her medications. There are several Medicare Part D programs out there and there is not a level of income on most. I would contact Medicare or look it up on the internet and see about Part D prescription insurances. Even my grandmother is makes a lot also uses one of them and gets all her medications paid for. It will just take some looking into. If you can't find anything let me know and I will be glad to ask them and help you find something. Good Luck!
    imxinxonxit's Avatar
    imxinxonxit Posts: 60, Reputation: 3
    Junior Member

    Aug 7, 2007, 05:25 AM
    Wow, when I look at all this I am overwhelmed ,you poor people. I have a mentallly ill son and he has been denied ssi we are in appeal now he is in a county hospital we can't afford his meds.I will have to look into a few things you all have wonder people give up and live on the streets.It seems as though the mentally ill are a forgotten society and overweight are a daily ridiculed society!
    loflorian's Avatar
    loflorian Posts: 1, Reputation: 1
    New Member

    May 28, 2008, 09:52 PM
    Sinced you live in VA I believe Kaiser is there. Become a member of Kaiser of their senior advantage plan and the ssi medicare pat d plan and you won't have to pay for anything. That's what ha[ppened to me. I live out here in San Diego and my social worker at Kaiser got me on the senior advaNTAGE PLAN because I am on social security and suddenly I was put on part D and suddenly I had no co pays for any of my dr s visits, hospital stays, ambulance rides, medications or counselor visits. I was amazed! And medicare pays for Kaiser. I am Bipolar/schitzoaffective/borderline personality disorder. So you can imagine how overwhelmed I was with all the bills and trying to get the money for everything, but now I have it. See if you can get it too.
    reikiwmn's Avatar
    reikiwmn Posts: 31, Reputation: 1
    Junior Member

    Jun 4, 2008, 08:17 AM
    Hmmmm, perhaps check to see if you have Northstar in your area and if you are eligible for it. Not sure due to your age, but it could be possible. My daughter, who is much younger is on and she says there are people your age who are on it. It is like medicare or medicade for mental health.
    ordgar's Avatar
    ordgar Posts: 1, Reputation: 1
    New Member

    May 13, 2011, 12:20 PM
    I also have mental issues that really affect my life I've lost multiple jobs never lasting longer then 6 months ( from getting fired or walking off to avoid being arrested from episodes) I have rollorcoster moments of depression of feelings of being thrown away and left to rot. My wife wants to leave me I can never make my relationships work. I feel like the world is collapsing all around me.I have sufferd through this alll my life.I was in Emotional Handicapped classes from the time I was in 1st grade right up to graduation.I don't even have a real diploma, and for the life of me I can't understand how if me and my wife get a divorce then they (the gov.) well reinstate my medicade! Wha , so not only did my family throw me away from embarrassment of my condition now my government takes my meds that they want me to be on and takes them away.I do not know what to do anymore , I am at my wits end about all this.On one hand they want me to get better and take my meds so I don't blow up and kill everyone, but when I am honestly trying to reach out and take my meds the government drops tha ball again.I am half way considering just walking into the woods and falling off the planet cause it seems no one cares about the human anymore just what they can profit off them.I have been of my meds now for 3 months was on them for 2 and had a 10yr hiatus off my meds because I did not know who to go to for help.I don't want to get backeracted because I have had that many times and it's a nightmare hall, they strapped me down for 3 days stright my last visit and I had no clothes on and they turned up the a/c in the room I was in. horrible things happen to us in there and no one believes us because wholl believe the crazy person? He;s crazy is what they tell me.I hjust feel reallly sad not crazy, I just feel really sad...
    bassantc's Avatar
    bassantc Posts: 1, Reputation: 1
    New Member

    Jan 31, 2012, 02:17 PM
    Although I really sympathise with your illnesses, I think it's time you stopped feeling sorry for yourself. I too am on long term sick with anxiety and depression and have lived with a daughter with mental illness for years.I am living off £568.00 per month and receive no help from the government. I have a mortgage amd bills to pay. The difference is because you are used to earning such a large amount of income per month you are used to it but you should be prepared to down size your property. I have had to downsize twice and with two children, so whatever you do stop whinging! You may find you will be much happier with far less outgoings, and hopefully come off some of those tablets... they seriously cannot be helping you. Get a healthier life style or maybe pay a carer to look after you.. but remember one thing... God knows and understands your needs and he will guide you through this difficult stage... Stop worrying... what will be will be... leave it up to God... but keep praying to him.. he will hear you.. ALSO think abount the starving children in the third world countries and also many families without homes caused by the on-going earthquakes... it makes you realize how well off you really are.. Having money is not the answer to your problems I will imagine that lonliness is... start meeting new people.. join clubs and start having some fun.. GOOD LUCK... don't mean to be harsh, but hope this helps... Why are you so different to anyone else?. DO you go to church? If not that's all you need.. go to the Kingdom Hall it's great! You will meet nice people and don't forget to read your bible every day it will give you all your answers... GOD BLESS YOU... keep smiling

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