I saw a homeless older man today and his sign said he needed money for the co-pay on his diabetes medicine. I thought how terrible it was that he had health insurance, but still could not afford the medicines he needs. Why are plans set up this way? It seems ridiculous!
Charitable Sort in Portland (Maine)
Dear Charitable Sort,
The person you saw was either lying or does not understand how to get his medicines. An employer plan would have a co-pay, but I’m guessing that a homeless man is not covered by an employer plan.
Medicare drug plans (also called “Part D”) have a co-pay. If he has this plan, then he or someone else is paying the monthly cost for it. It seems unlikely that he would have enough income to pay this monthly fee, but not his co-pays.
He is very likely to have Medicaid. And while it is true that Medicaid has a very small co-pay for drugs, the pharmacy is required to give him his drugs even if he cannot pay. (If he also has Medicare, then Medicaid would pay his co-pays.)
Failing all of that — say he has neither Medicare or Medicaid — then he must have a doctor prescribing the drug. The doctor’s office would be able to help him get his drugs for free through a charity program from the drug maker.
Instead of giving this guy five bucks, offer to drive him to his pharmacy or his doctor’s office and help him get his drugs.