Safety Net

I hope you don’t think this is me crying poor, because I know how lucky I am in so many respects. In fact, I often use the types of figures below to show my patients how financially lucky we are to be treated in the Australian healthcare system, and not in a user pays system like the United States of America.

We stay in a public hospital and never know anything about the $2000 per day that it costs the Government to enable you in that bed to have access to whatever you might require. You have blood test after blood test, and you don’t pay for it. Your meals come free, and you don’t have to pay the doctor, the nurse, the nurse’s aide, the ward clerk, the person who takes your blood, the physiotherapist, the occupational therapist, the social worker, the pharmacist and so on. You may have to pay a small fee for the podiatrist, and the TV, and your discharge medications when you leave.

When compared to the tens of thousands that Americans or their health insurance providers have to pay it’s nothing at all!

But at the end of the day, poor health does comes at a financial cost. That cost may not be anywhere near what it could be, and might not compare to someone else’s cost, but it’s a cost regardless and this is just my example.

I take 8 different oral medicines, be they tablets or capsules or dissolving tablets. I take all of these every day, and some of them a couple of times a day. I think I do an alright job of keeping up with it all, and I’m a pharmacist. I can tell you that my respect for patients who manage their own medications has sky rocketed this year!

An 80 year old lady tells me off that top of her head that she takes these 6 in the morning (and she names them by name!) and these two in the evening, and she is meant to take this one but she’s getting this side effect and so she talked to her doctor and now she only takes it every second day, and her insulin has just been changed and now it’s 8 units in the morning but if her blood sugar level is over 10 she takes 12 units, and if she has to go out in the morning she doesn’t take her fluid tablet til she gets back etc!

It’s exhausting to listen to, and I always congratulate them because they do an amazing job! With all of my medicine specific education I am still not doing as good a job as that! All the things that patients have said over the years are coming home to roost.

“I can’t tell you off the top of my head, but if I had my list I could tell you. You should be able to find my list in my history; I gave it to them in ED”

At which I inwardly groan, knowing that in 99 cases out of 100 the list will be nowhere to be found and no one will know anything about it, and the patient is now a useless reference, with their knowledge locked firmly in their brain, and no release key to be found. It’s so unfortunate. I recommend every patient to create their own medication list, or I do it for them when they are being discharged home but whoever borrows it first in the hospital seems to put it with the odd socks and off it goes into the ether.

So I’m always thrilled to have an A type personality carer who have neatly run off 10 copies of the medication list; one for every medical professional who asks for it! Of course I’m less thrilled when they start going all A type on me because Mother’s glucosamine is being given once a day instead of twice, and her cholesterol tablet is meant to be night not morning, and when will someone attend to her rash; it’s not itchy or sore but someone needs to do something about it, right now!

“I’m sorry, I just can’t seem to remember. If you tell me the names I’d remember. If I had the box in front of me I could tell you how I fill it, and I’d remember the tablets. If only I had my tablets with me!”

Another inward groan. This patient from home alone with no next of kin to go to the house and collect the box, so again, knowledge locked inside. And no I’m not going to sit beside you firing off common medication brands in the off chance that one will trigger a memory. I have better ways around that.

But I do then find myself unable to give a full list without at least once or ten times referring to my written list or to the dosette box I make up. It’s a hard job!

And that’s just managing the meds themselves. Then there’re the scripts, the doctors appointments, Medicare, PBS, etc.

So these are my figures. At the 12th October 2015 I had officially spent $1,526.13 on my medications. That’s 8 medications, every day, over the course of the calendar year since January 1st. It sure creeps up on you!

Any patient with a Medicare card and no concessions on 8 medications, or less or more depending on the actual cost of each script, this could apply to you.

It also applies if you are on a pension card, but because pension holders have their prescription costs capped at $6.10 (or whatever it is capped to in each calendar year) you are eligible for the safety net when you reach a certain NUMBER of prescriptions, rather than a certain cost. For example once you have had 62 scripts dispensed, then you’re eligible for the safety net.

Every year the government sets an amount of money which if you spend that amount of money on PBS prescriptions, you will be eligible for the safety net. For 2015 the amount of money is $1,453.90. If you spend this amount of money on your scripts between January and December, you are eliglible for the PBS Safety Net.

How do I know if I’m eligible? Simple mathematics, my friends. Which is simple if you go to the same pharmacy every time like a sensible person would, so that said pharmacy had all of your records and could give you the best care. However being young and mobile I have gone to pharmacies far and wide across the country. And now I have to track them all down! I did have some idea of this coming, so the good thing is I had receipts from every script and every pharmacy; now to track them down!

Macleod Pharmacy

Chemist Warehouse Box Hill

My Chemist Box Hill

Surrey Hills Chemmart

Pharmacy 517

Tathra Pharmacy

Chemist Warehouse Shepparton

Nunawading Amcal Pharmacy

Amcal Max Doncaster East

Seeto and Dodd Merimbula Pharmacy

Duh!!

Now I remember why I should always go out of my way to go to the same pharmacy every time!

Instead I chose convenience at the time, and now I’ll have to traipse all over the city, and do some interstate sweet talking to have stuff posted, to get everything together in one place.

Bring on Australia-wide electronic records where every script I have had dispensed is automatically recorded and when I reach the PBS safety net a card is automatically posted to me, and I get a SMS alerting me to my status and card number! Sounds much easier and less time consuming to me.

There are proper forms so that each time you get a script dispensed the safety net stick can be attached, and you gradually build up…but of course that was too logical for me this year as a newbie to the scheme as a patient. Next year I’ll be all over it!

So 1300 words so far, what’s the point of all this?

Well, the safety net does this. Instead of paying some amount of money up to the $37.70 capped price for each prescription that I get dispensed, I will now only pay up to $6.10, the pensioner price!

Can you imagine? The average cost of one of my scripts up til now has been between $15 to $25 usually, with some actually capped at $37.70. So already by living in this lovely nation I’ve been saved a fair bit of cost through this genius Pharmaceutical Benefits Scheme (PBS). And now I’ll be saved a heap more! And if I were already on the pensioner price and reached the safety net?? Zero dollars for the rest of the year for PBS items. I make this disclaimer because even on the safety net, if you are prescribed an item that isn’t covered then of course you still have to pay what anyone else pays.

So this is a major saving to the individual! And I’ve never been so excited about maths, as when I thought to myself that I might be close to the safety net, and found out that I was over!!

Of course now I have to go and line up at Medicare to get a refund for this difference…………………………………………………………………………………yeh.

But it’ll be worth it, won’t it? $6.10 for the rest of the year; I’m getting that tempting sensation to do what all the oldies do and queue down the street to get all of their scripts dispensed on December 31st! Will I, won’t I? We’ll have to wait and see. But the sales junkie inside of me is stirring…

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