It seems that Medicaid is no longer going to pay for a medication Bil takes because he is not taking the generic. Bil is concerrned and went to his Medicaid Service Coordinator (MSC) for help.
I am so glad to see that Bil took this initiative.
My research seems to indicate that the generic, in this case, is not as effective as the brand name. I take a number of medications and with one exception, they are all generics. I found that one generic just did not work. I take the brand name. I am fortunate in that this (brand name) is not tremendously expensive.
I see where Medicaid is coming from. They need to spend their money wisely. As a taxpayer I agree.
But I also know from the above experience that (despite what health insurers say) that certain generics do NOT work as well as brand name.
At any rate this is a medication Bil needs. Looks like I will be putting on my advocacy hat. But first, Bil will need to try the generic. He will need to communicate with us if he feels any change for the worse.
It will be a challenge for him to put this into words rather than into behavior.
This will be interesting.
UPDATE: The problem is not that Medicaid won't pay unless Bil takes the generic. The problem is, apparently, that the medication has dropped off Medicaid's formulary. His MSC is going to try to get it covered as a generic but needs our assistance. If they won't he will have to pay out of pocket.