Who pays?

Several people have asked who pays for all,of the care for Damian.   By The time Damian had his second hospital stay he has maxed out my employer health insurance.    And my insurance has a proviso that states they will not pay for residential care services even if a doctor says he needs it.  Which I have no idea how that can even be legal with the supposed mental health care parity law, but somehow it is.

So we took Damian off of our insurance so his Medicaid benefits would kick in.  The problem we didn’t understand when we did that is…Medicaid does not approve 3 of the “newer” medications he has been taking, so those are paid out of pocket.  They also need to be prescribed by a psychiatrist which is not using Medicaid.  Because Medicaid Drs. cant prescribe these meds that are not on the “approved” list.  So that means we also have to pay a psychiatrist out of pocket to prescribe his meds.

This gets more difficult when he is at PRTF because we have to pay for a psychiatrist to consult with the psychiatrist on staff at Deveroux.  We also have to pay for a pharmacy to deliver the meds to Deveroux.  Essentially even though he is receiving “free” PRTF care with his Medicaid, we are still having to pay roughly $2,000 every 4 weeks.

This is not a cry for financial help, we are managing, but how in the heck do other families manage this?  The answer unfortunately is what they advised us to do, which was surrender our parental rights to the state.  But that doesn’t solve the medication portion.  The state would then have to switch him back to older drugs (that we already tried and were disasterous to his health.  Like the Hadol that gave him muscle seizures and the Lithium that gave him tremors and were destroying his thyroid and kidneys.

We do not need gun control in this country, what we need is solid, comprehensive, systematic compassionate mental health parity.

We do need more substance abuse programs, but what we need even more than that is mental health care that is accessible to people so they don’t “self medicate” with drugs and alcohol.

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