update on Jan .. this week's big problem

[Guest guest]

Jan is back living in her apartment. Things are going reasonably well

and Jan is surviving with only a little supervision and a day program

that gives her activities on most days. A week and a half ago she had a

routine check-up and her meds got cut back and she is taken off of

insulin. She had been managing her own shots, although not as well as

her Mom would have liked.

So a week ago, Jan, miss independence, went to the drug store to pick up

her meds. She took her Connect Card which is her Medicaid ID. The most

expensive medicine wasn't ready since it had to be ordered in. They

told her that she had no insurance and made her write a check for over

$300. That wasn't correct. The next day they told her the same thing

and had her write a check for $2100. That was the one which blew her

bank account.

The other day, she emailed me that she was out of money and I went

on-line and surely, she was. The next morning I called the bank, which

was very helpful. The manager had already gotten the information on the

big check which I'd only been able to get the number of. The bank is

used to dealing with these kids. Jan had written it to the drug store

and noted meds on it.

So I called the drug store and talked to them. They said that she had

no medical coverage and when I insisted that she did, the woman on the

other end said that she would put one of the prescriptions into the

computer and clearly she was sure that she could come back telling me

that it was rejected. Well, it went right through. So we started a

discussion about how Janet would get her $2400 plus dollars back.

It is a little more complicated than that because the expensive

anti-rejection drug required pre-approval, or at least same day request

for same and now they are well past same day with a problem of their

making.

I talked to Jan yesterday evening, the first time I could get her. She

gave me a clear picture of her outstanding checks (including her rent)

and I did a wire transfer into her account which I hope will cover it

all. She was the one who told me that she had taken her medicaid ID

with her and she found the sheet that had copies of her medicare card

because one part involved medicare.

The drug store blames it all on Jan. They could have made a phone call

to Chapel Haven to check. They should hardly expect a young woman with

down syndrome to that much money in the bank. They didn't like my

suggestion that their employees need sensitivity training.

Hopefully in a day or two, I'll find a message at work telling me that

they have solved the problem. Otherwise, I'm going up their corporate

ladder real fast.

Rick .. dad to 31 year old Jan, post AML (via transplant) and yes, ds

[Guest guest]

Rick,

I just can't even believe it. Wouldn't you think it would be obvious that

she would at least have Medicaid?? Drugstores piss me off as much as Social

Security offices and Motor Vehicle Departments. Don't even get me started...

Doreen (mom to Adam, 20 yrs old ds, Dan 19 yrs old)

[Guest guest]

I realize I Work in Australia, and I also realize that having a kid with

DS makes you a tad more sensitive than some and IAlso understand our

medical system works way different to yours in USA

But give me a f-ing break- I work in a chemist and I Sure as hell would

make a phone call before making ANYONE- esp someone with a visible

disability - write a cheque for over two THOUSAND dollars. I know you

are prob upset Rick but I am ropeable right now just thinking about

this. I mean there is a thing called customer service...........and

common decency. I don't have 2 thousand dollars on my bank account- why

should she? Man and esp if Jan had correct papers and everything. I

would be gathering receipts and all the names associated with the day

that Jan got her meds and I also would go straight up the corporate

ladder. As an employee I Would expect to be disciplined over this. MAN -

a chemist shop treating ppl like that - I am really upset by this......

You are in my thoughts and hope the chemist does the right thing andf

fixes this for you- all they really need to do is make a few phone calls

and they can fix this- Jan nor you should really have to go and see the

Dr again- the chemist should be able to fix it.............stupid

idiots.......

Sorry guys....Iwill get off my soap box now and go and have a glass of

wine......

>

>

> So I called the drug store and talked to them. They said that she had

> no medical coverage and when I insisted that she did, the woman on the

> other end said that she would put one of the prescriptions into the

> computer and clearly she was sure that she could come back telling me

> that it was rejected. Well, it went right through. So we started a

> discussion about how Janet would get her $2400 plus dollars back.

>

> It is a little more complicated than that because the expensive

> anti-rejection drug required pre-approval, or at least same day request

> for same and now they are well past same day with a problem of their

> making.

>

> I talked to Jan yesterday evening, the first time I could get her. She

> gave me a clear picture of her outstanding checks (including her rent)

> and I did a wire transfer into her account which I hope will cover it

> all. She was the one who told me that she had taken her medicaid ID

> with her and she found the sheet that had copies of her medicare card

> because one part involved medicare.

>

> The drug store blames it all on Jan. They could have made a phone call

> to Chapel Haven to check. They should hardly expect a young woman with

> down syndrome to that much money in the bank. They didn't like my

> suggestion that their employees need sensitivity training.

>

> Hopefully in a day or two, I'll find a message at work telling me that

> they have solved the problem. Otherwise, I'm going up their corporate

> ladder real fast.

>

> Rick .. dad to 31 year old Jan, post AML (via transplant) and yes, ds

>

--

Aussie Leis- mum to BJ - nearly 7 yrs- ds, Natasha 2.5 yrs and 11

months

" Lead me not into temptation; I can find the way myself. "

Rita Mae Brown

[Guest guest]

---

Rick, I am stunned - in my other life before kids, I worked within

the medical field, and cannot believe the person who served Jan,

didn't think to check if she was entitled to any discounts. I would

be certainly checking it all up, and telling these people she needs

her refund asap as she has other commitments. She did not cause the

problem, the staff member did for not checking.

Best of luck

Jan, mother of Trent 20yo w/DS, Shannen 18, 23, 24,

the MOTH, the cat and the goat all from the Land DownUnder

In , doreensav@a... wrote:

>

> Rick,

> I just can't even believe it. Wouldn't you think it would be

obvious that

> she would at least have Medicaid?? Drugstores piss me off as much

as Social

> Security offices and Motor Vehicle Departments. Don't even get me

started...

> Doreen (mom to Adam, 20 yrs old ds, Dan 19 yrs old)

>

>

>

>

[Guest guest]

I'm with you Leis! I would have been infuriated! I'm glad Rick has decided to

go up the ladder with this. That was truly the most unbelievable story I have

heard in a long time and I would have been in their face demanding alot more

than just my money back!

Jackie, Mom to 16ds, 14, and Bradley 10

-------------- Original message --------------

>

> I realize I Work in Australia, and I also realize that having a kid with

> DS makes you a tad more sensitive than some and IAlso understand our

> medical system works way different to yours in USA

>

> But give me a f-ing break- I work in a chemist and I Sure as hell would

> make a phone call before making ANYONE- esp someone with a visible

> disability - write a cheque for over two THOUSAND dollars. I know you

> are prob upset Rick but I am ropeable right now just thinking about

> this. I mean there is a thing called customer service...........and

> common decency. I don't have 2 thousand dollars on my bank account- why

> should she? Man and esp if Jan had correct papers and everything. I

> would be gathering receipts and all the names associated with the day

> that Jan got her meds and I also would go straight up the corporate

> ladder. As an employee I Would expect to be disciplined over this. MAN -

> a chemist shop treating ppl like that - I am really upset by this......

>

> You are in my thoughts and hope the chemist does the right thing andf

> fixes this for you- all they really need to do is make a few phone calls

> and they can fix this- Jan nor you should really have to go and see the

> Dr again- the chemist should be able to fix it.............stupid

> idiots.......

>

> Sorry guys....Iwill get off my soap box now and go and have a glass of

> wine......

>

>

>

>

> >

> >

> > So I called the drug store and talked to them. They said that she had

> > no medical coverage and when I insisted that she did, the woman on the

> > other end said that she would put one of the prescriptions into the

> > computer and clearly she was sure that she could come back telling me

> > that it was rejected. Well, it went right through. So we started a

> > discussion about how Janet would get her $2400 plus dollars back.

> >

> > It is a little more complicated than that because the expensive

> > anti-rejection drug required pre-approval, or at least same day request

> > for same and now they are well past same day with a problem of their

> > making.

> >

> > I talked to Jan yesterday evening, the first time I could get her. She

> > gave me a clear picture of her outstanding checks (including her rent)

> > and I did a wire transfer into her account which I hope will cover it

> > all. She was the one who told me that she had taken her medicaid ID

> > with her and she found the sheet that had copies of her medicare card

> > because one part involved medicare.

> >

> > The drug store blames it all on Jan. They could have made a phone call

> > to Chapel Haven to check. They should hardly expect a young woman with

> > down syndrome to that much money in the bank. They didn't like my

> > suggestion that their employees need sensitivity training.

> >

> > Hopefully in a day or two, I'll find a message at work telling me that

> > they have solved the problem. Otherwise, I'm going up their corporate

> > ladder real fast.

> >

> > Rick .. dad to 31 year old Jan, post AML (via transplant) and yes, ds

> >

>

> --

> Aussie Leis- mum to BJ - nearly 7 yrs- ds, Natasha 2.5 yrs and 11

> months

>

> " Lead me not into temptation; I can find the way myself. "

> Rita Mae Brown

>

>

>

>

>

>

>

>

> Click reply to all for messages to go to the list. Just hit reply for messages

> to go to the sender of the message.

>

[Guest guest]

This is downright scandalous!. It would never happen at the pharmacy

we use. It's private, not one of a chain. I never even have to show our

insurance, or 's medicaid card. It's all in the computer, and just comes

that way without question. When he had a prescription for Zantac a couple

years ago, I told them he would not be able to swallow the pills, and would chew

them, they said that wouldn't work. So the girl said it comes in liquid and

she checked with the doctor, than came to me and said " That will be $250 + and

Medicaid won't pay for it " Quite a shock. She said, Let's see what we have

over the counter. So she went out to the shelves with me and we settled on a

similar product in liquid for about $5 which worked fine. $250, if it were a

one time thing and life-saving wouldn't be bad. Our doctor was shocked when I

told her.

Also last spring I took him to the ER at our local hospital. You hear

stories of people not being let in, or treated, if they don't have insurance

but they never even asked if he had any. After they started treating him, a

woman asked about his Soc. Sec. # and I gave her his insurance card which had

it on. Never even thought about Medicaid. I was impressed that they started

treating him before they even knew if he had insurance. They may have

recognized that he should have Medicaid but didn't ask for that. We only had a

$50

copayment and when we were billed for that I mentioned the Medicaid and never

heard anymore about that. Incidentally, he had a very bad bladder infection

and recovered quickly with treatment.

I would be interested in knowing what pharmacy that was, if it was a

chain and I'm sure a lot of us would. Jessie

[Guest guest]

Makes you wonder how some people get hired! In my early years of marriage,

I worked at a pharmacy. There was a girl who worked there and was on

register when the rest of us were on break. She brought back a customer and

asked us where the propholytics were...I about died laughing.

I don't care much for chain drug stores - our local grocery pharmacy is ok -

but I avoid the Rite Aides and CVS's.

Rick, they should refund her money just like any one else would get a

refund - despite the amount she is owed.

>

>

> Rick,

> I just can't even believe it. Wouldn't you think it would be obvious that

> she would at least have Medicaid?? Drugstores piss me off as much as

Social

> Security offices and Motor Vehicle Departments. Don't even get me

started...

> Doreen (mom to Adam, 20 yrs old ds, Dan 19 yrs old)

>

>

>

>

[Guest guest]

I agree- when I read this I was also outraged. We use a chain drugstore (but

they know us very well.) I dont even have to say anything- I just say things

like " refill amanda's insulin " or whatever it is.

I really feel that the person/people who took care of jan that day took

advantage of the fact she had a disability. That is what is outraging me so

much.

Rick- I think you need stronger action, than just the phone calls.

We'll support ya on your decision in this one.

[Guest guest]

In a message dated 10/10/2004 6:57:24 AM US Mountain Standard Time,

linman42@... writes:

Rick- I think you need stronger action, than just the phone calls

I am in total agreement here. What of the people who have no parent or

caretaker to advocate for them. Even people with more ability than Jan but

easily

intimidated by " those in authroity " could be taken advantage of or BULLIED

(which is what I consider this).

Whether it's a chain , which would probably be easier to get action by, or a

local store, this should be pursued, rectified and Jan should get an in person

apology.

M.

[Guest guest]

THIS MAKES ME SO MAD! Go get 'um Rick!

We used to have a great pharmacist at Walmart, who always worked hard to make

sure 's Rxs were covered either by our private insurance (primary) or

MediCal (secondary). One med in particular, was not covered by private insur

(and even the ENT tried to get an authorization and failed), yet is was covered

by MediCal. $94 for a tiny little bottle of ear drops (which lasts 1 week).

Last time I went there, that nice, competent phamacist had left, and the new

pharmacist (nasty, crabby woman!) told me it wasn't covered by private insure

(duh, I told her that!) and since Medical was her secondary, if the primary

didn't pay, Medical wouldn't pay..... they were only there for copayments, and

it you didn't have a copayment, they wouldn't cover it. Unbelievable..... she

didn't understand the concept of " primary " and " secondary " insurance. I argued

with her for awhile, finally waited until later that day when different techs

were in, and bugged them until they finally figured it out. Turns out, MediCal,

if being used for a copay, the can just slide her card and it's automatically

approved. If it's not for a copay, the computer has a problem, so all the

pharmacy has to do is call in for the OK. At least now I know how the

pharmacist was getting it done, so I call tell everyone how it do it from now

on. HOWEVER, DON'T YOU THINK THEY SHOULD KNOW HOW TO DO THIS?????? Is she the

only person in our town with MediCal?????? Ugggghhhhhhh. Where are these folks

trained? They are responsible for putting the right pills in our bottles, but

they can't THINK.... if the computer doesn't tell them it's so, then it

isn't..... doens't matter what info you give them..... the computer is always

the answer!

, mom to (9) (6 DS), and (5)