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@NCCapitol

As Medicaid patients wait for coverage, nonprofits fill gap

Posted February 18

— As Wake County social services works to catch up on a three- to four-month backlog of Medicaid cases, the agency is also turning to a local nonprofit for help.

The county is paying Urban Ministries $20,000 so it can refer Medicaid patients waiting on prescription coverage to the nonprofit's Filling in the Gaps program. FIGs provides vouchers, which Medicaid clients can use for medication at area pharmacies.

"Patients come to us, we see if they're eligible for the use of our fund and we give them authorizations to fill their prescriptions at pharmacies, who give us really good rates," Urban Ministries Executive Director Peter Morris said.

Wake Assistant Human Services Director Liz Scott said that, because providers have a year to bill Medicaid, doctors are often more willing than pharmacies to serve low-income patients with applications idling in the system.

“Providers will often see someone who has a pending application knowing they’ll be able to bill later," Scott said. "It’s hard to get a pharmacy to fill a prescription.”

Morris said that's a problem for many people on Medicaid, who can't afford to pay out of pocket and often have chronic conditions such as diabetes or high blood pressure.

"It's more likely to see people choosing between food and prescription – do a partial fill of a prescription and take their medication every other day instead of every day or, in some months, not fill the prescription at all," Morris said.

While donation drives at local churches pay for most of the FIGs program's $100,000 annual budget, Scott said the partnership was an attempt to avoid some of the problems the county faced as a massive backlog of food stamp cases built up months after the launch of the state's new NC FAST system in 2013.

“Because of the issues that we have experienced in (Food & Nutrition Services), we wanted to be prepared where, if a case was hung up in the system for some system problem and the person had a severe need for prescriptions, that we would be able to refer them somewhere,” Scott said.

It's a problem patients will have to deal with for a while.

Wake County commissioners approved a $1.7 million plan Monday to expand the number of Division of Social Services employees by 36 positions. They're hoping the extra workers will help compensate for a caseload that has grown by about 45 percent over the last five years in family and children's Medicaid alone.

“We have not really met the targets for Medicaid processing in a year," Scott said, noting that the problems predate both NC FAST and new Affordable Care Act rules. "So, we've been pretty consistently behind.”

But even with the extra staff, officials say they won't be caught up on Medicaid applications and recertifications until Oct. 1.

Morris said that, although the $20,000 from Wake County won't cover everyone, it's a start, 

"We'll see how delayed the Medicaid applications can be and see how far we can go," Morris said.

12 Comments

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  • goldenosprey Feb 20, 9:06 a.m.

    Here is how it is supposed to work. If you can not pay for it, you can not have it, WHATEVER it is

    whatelseisnew

    I knew this couple who both worked full time, difficult labor. Their job creators didn't provide insurance. Their 7 year old daughter developed a brain tumor.

    I'd like for you to read your comments to those parents. Sadly, you are unable to do so to the child.

  • aqak33 Feb 19, 6:10 p.m.

    WHAT IS WRONG WITH NC?

  • whatelseisnew Feb 19, 4:27 p.m.

    "Morris said that's a problem for many people on Medicaid, who can't afford to pay out of pocket and often have chronic conditions such as diabetes or high blood pressure."

    Here is how it is supposed to work. If you can not pay for it, you can not have it, WHATEVER it is. Now if someone wants to to give it to you or buy it for you then at least it is being paid for and someone is not being forced to pay at gunpoint.

  • freedomrings Feb 19, 3:34 p.m.

    I've heard so many people call these applicants, lazy, bums, etc. But, no one has given much thought to WHY there's a sudden backlog for Medicaid patients. I believe it's because health premiums and deductibles went up so much they had no choice but to use Medicaid - this would be primarily children. Healthcare Reform does not help everyone and from conversations with my friends and neighbors, all it's done is cause problems for most of us. This is what happened to our family. Content with what we had, budgeting every month, able to afford our insurance. In comes healthcare reform and now we can't afford the new premiums ( that doubled ) and deductibles and were forced to put our son on Medicaid.

  • goldenosprey Feb 19, 1:57 p.m.

    Bless their hearts BIG!!!

    I wish there was a program like this for us oldies trying to survive on... View More

    — Posted by DontVote4LiarsCheatsOrThieves

    "Get a job, gramps!" - a republican

  • Pirate01 Feb 19, 1:26 p.m.

    Not only are they taking more of your money now they are demanding they get it quick!!!

  • DontVote4LiarsCheatsOrThieves Feb 19, 12:40 p.m.

    Bless their hearts BIG!!!

    I wish there was a program like this for us oldies trying to survive on Medicare, but not having any extra cash at all to buy RXs if we need them.

    Our Social Security checks barely even cover safe shelter, utilities and food - BARELY!!!

  • goldenosprey Feb 19, 12:23 p.m.

    Maybe non-profits will be called upon to clean up coal ash too.

  • krimson Feb 19, 11:32 a.m.

    wow...till Oct.??? for medicaid patients really?? I have two young boys....and I have medical... View More

    — Posted by paulpamelasnyder

    They won't help you feed your kid nor will they help you with medical aid... But dang if they won't hand you a Voucher for a Private School owned by a campaign contributor!

  • mike275132 Feb 19, 11:11 a.m.

    Ah yes, the Medicaid mill racket.
    Result - Poor Quality health care and service and prescription rationing.

    The ultimate goal of " Nanny Government " is control of your health care with no options for you.

    Everyone on Government, Single payer controlled "Medicaid".

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