County program covers three prescriptions a month and I take six. How do people actually handle this?

Approved for the county program, which took four months, and I am grateful and also stuck.

The three drugs a month thing is real. I take six. Two of them are the ones I would genuinely be in trouble without, two are the ones a doctor added last year and I do not fully understand, and two are cheap enough that I have been buying them anyway.

What I cannot work out is who decides which three. Do I pick? Does the doctor pick? Does a clerk pick? I asked and got told to talk to the clinic, and the clinic said talk to the county, which is the loop everybody on this board knows.

Has anyone actually been through this and come out with a system rather than a shrug?

You are reading the statute right, and the loop you are in is real rather than anybody avoiding you.

Section 61.028 lists the basic health care services a county program must provide and one of them is payment for not more than three prescription drugs a month. That is a floor on the county rather than a ceiling on you, which is a distinction worth holding on to. A county may pay for more. Many do not. The three is what it cannot go below.

Two questions decide most of what happens next and they are county questions rather than statute questions, so nobody on this board can answer them for your county. Does a 90 day supply count once or three times. And does a refill of the same drug count again in the next month. I have heard both answers in different counties and the difference is enormous for somebody on six.

Who picks is the third question and in my experience it is nobody, formally. What actually happens is that the pharmacy fills what is authorized and the authorization was built from a list somebody handed in. Which is why I say this in every one of these threads: take the actual list, written down, names and doses and how often, copied off the bottles or off the pharmacy printout. Whoever ends up making the decision is making it about a piece of paper, and you want that paper to be yours and correct.

Then treat the other three as a separate project rather than as a failure. Cash pricing and pharmacy comparison first, because the cheap ones you are already buying may be cheaper somewhere you have not tried, and manufacturer assistance for anything brand name. Prescriptions without insurance has the layers in order and patient assistance programs has the paperwork, including the renewal date that catches people out. County indigent health care program has the section numbers.

What I will not do is tell you which three to choose. That is a conversation with your prescriber and it is not mine to have.

Agreeing with the last line and putting some shape on the conversation you should be having, because "pick three" is not how a prescriber thinks and asking it that way tends to produce a bad answer.

What is useful to bring to that appointment is the constraint, stated plainly. Say: my county pays for three a month, here are the six, help me work out which ones are load bearing. That is a clinical prioritization question and it is a normal one. Some medications tolerate a gap. Some absolutely do not, and stopping a couple of common classes abruptly is more dangerous than the condition being treated on any given day. That is not something to sort out by reading a forum.

The other thing worth raising in the same appointment is whether any of the six can be consolidated, substituted for something cheaper in the same class, or genuinely stopped. The two you say were added last year and do not understand are the right place to start that conversation, not because they are wrong but because "I do not know why I take this" is worth ten minutes of a doctor's time regardless of money.

I will not comment on how your county counts a 90 day supply. That is not a physician question and I would be guessing.

I am not on the county program but I want to say the consolidation thing worked for me and I nearly did not ask.

Two of mine turned out to be available as one combined tablet. My doctor said it in about four seconds when I finally asked, and I had been paying for two for a long time. It did not solve everything but it moved me from four to three, which in Tomas's arithmetic is the whole problem.

Ask about the 90 day supply question early rather than late. My county counts a 90 day fill as one, which sounds like a technicality and is actually the difference between three drugs and three months.

I would not assume that travels. I would ring and ask before I build any plan on it.

Reporting back because I said I would.

Went in with the list, said the sentence Dr. Ashby suggested nearly word for word, and it went better than any medical appointment I have had about money. Two of the six came off, one because there is a combined version and one because we agreed to try without it and see. So I am on four.

For the fourth I am on a manufacturer program that took six weeks and a signature I had to chase twice. My county counts a 90 day fill as one, same as Cyn's, which I only knew to ask because of this thread.

So the answer to my own question is that there is no system, there is a sequence, and it is: get the list right, ask the prescriber to prioritize, ask the county how it counts, and work the leftovers separately. It took me two months to find that out and about ninety seconds to type.