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Health Insurance Pitfalls: Treatment Access and Affording Medication

Nowadays, employers with small staff are not required to provide health insurance, and independent contractors are just that – independent of the employer. State agencies are great at finding ways to deny us benefits, which can make getting medication difficult to maintain health. It can be really frustrating.

Needing medication for schizophrenia

Living with schizoaffective disorder is challenging but medication helps. Despite the barriers to treatment there are alternative ways to get what we need to live quality lives. Therefore, don't give up hope. You are not alone on this plight for wellness and health insurance.

I've had many challenges in recovery, but I've overcome them. Still, I have much to learn and strategies to develop. Whenever my wellbeing is in jeopardy I find ways to navigate the system to get what I need. Never throw in the towel.

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We must find ways to get our medications. It is possible.

When my Medicaid application was denied

When I lost my Medicaid I was shocked. Loss of health insurance occurs in many different situations. For example, I lost my health insurance when I relocated from state to state. Transferring benefits from supplemental security income (SSI) to social security disability income (SSDI), etc.

Despite my documented official health diagnosis, I was not eligible for Medicaid health insurance benefits. And, I'm on a 2-year waiting list for Medicare.

Working as an independent contractor and small business for myself as a certified peer specialist (CPS) allows my employer to opt out of providing health insurance. As we know, medication is vital to controlling mental health symptoms in order to function at home and work. Fortunately, I found ways to get insured and the medication I needed.

Getting medication without Medicaid

I learned about patient assistance programs. These programs will provide you with your medications at discounted rates. They work in conjunction with pharmaceutical companies. There are specific criteria to qualify.

Generally, it seems the program is available to patients for certain branded medications. To qualify for the patient assistance program I had to submit various documents pertaining to my income and finances. These programs operate on a sliding scale.

Ask about patience assistance programs

My experience with this program was good. They offered it at my county behavioral health center near me. Plus, the center had an in-house pharmacy. Ask your doctor about patient assistance programs. Other resources and referrals may be accessible at your pharmacy such as discount cards.

Alternative solutions to paying for medication include discount cards from the doctor's office and pharmacy. These coupons have been a tremendous help to me because the monthly cost of my antipsychotics along with my other medicines are significantly high.

Also, where I live in Georgia, Peach State health insurance brokers are accessible. Continue seeking affordable health insurance. Ask your healthcare team for referrals, they might have insight on other clients' insurance companies that you may qualify for in your state.

Schizophrenia and insurance challenges

Yes, there are health insurance pitfalls but there are ways to maneuver the system. If you're stuck and of need of ways to get your medicine remember these tips.

I encourage you to consider the alternative strategies to get what you need; patient assistance programs, pharmacy discount cards, and research health insurance brokers. Don't give up on getting the treatment and medication you need.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Schizophrenia.Mental-Health-Community.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.