23536;11606490 said:
Have you ever been enrolled in a clinic where people have to pay? (I ask because you're in Canada).
Please bare with me while I try to explain:
The answer is yes... well, for the most part. It's a little complicated here - especially if you don't know the laws regarding Ontario's healthcare system.
The following information is based on my own research and firsthand experiences. Therefore, I could be a little off (e.g. when it comes to seniors, etc.).
All Canadian citizens living in Ontario who are in a methadone maintenance program are automatically covered of all expenses related to the methadone program, such as appointments with the doctor, counselors, medical procedures (surgery), tests (x-rays, CT scans, MRIs), and so forth.
However, the actual cost of the methadone (or any prescription drug) is not covered by OHIP.
Luckily, there are at least two separate types of provincial government funded drug coverage programs in Ontario (AFAIK).
1st is meant for those who are unable to work due to a long term disability, or anyone who is unable to find employment (either because they've tried and not succeeded or they are on short term disability) and applying for and going on welfare (aka Ontario Works).
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This is known as ODB (Ontario Drug Benefits). Anyone who's covered under ODB is also covered 100% for Rx drug related expenses. Technically, ODB recipients must still pay $2 of the usual pharmacy drug dispensing fee, however, most of the time, this fee is waived by the pharmacy (at least IME).
2nd is meant for those who are able to work and are officially employed, but their employer doesn't offer private insurance based drug coverage.
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Known for an unknown reason as Trillium Drug Program (it could be Ontario's official flower, but I'm not sure). Anyone who chooses to register and whose application is accepted (and henceforth covered under Trillium) is also covered 100% for Rx drug related expenses with one condition. Every 3 months, a deductible (based on a percentage of total annual gross pay earned by the employee) must be paid first before Trillium takes over the rest of the cost of any further prescriptions within the three month period.
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Assuming you read the aforementioned blabber (and understood it as I'm not very good at explaining these things), there's at least four reasons I can think of as to why a MMT patient might not be able to pay for his/her methadone:
1) - The patient is able to work but is not employed because (s)he refuses to try and find a job (which means no welfare+ODB coverage),
2) - The patient has recently been fired with just cause, and will not be receiving any severance pay, will not be eligible for employment insurance, is broke, and has not yet filed for Welfare coverage.
3) - The patient is disabled and doesn't have private insurance drug coverage either because his/her employer doesn't offer it, or because the patient isn't employed to begin with. The patient also is not aware that drug coverage is available for anyone who is considered disabled.
4) - The patient - whether disabled or not, whether being able to work or not, whether employed or not - doesn't know about the fact that a government funded drug coverage program even exists.
23536;11606490 said:
The most common drama I've seen in clinics is sick-ass people begging for the clinic to extend their credit because they're broke. The clinics I've gone to will put you on a forced taper of -10 mg each day you don't pay, but I've heard of clinics that just stop serving you altogether.
My clinic presently has a zero tolerance policy regarding any patient who is unable to afford his/her methadone (and any other medication also dispensed with the methadone).
What happens is, if you walk in to dose, and you are not covered by insurance - whether it's private (employer based) or public (ODB, Trillium) - then they'll tell you that you need to pay before being allowed to drink your methadone. And if you aren't able to afford paying, then they'll refuse to serve you -
no exceptions. You're basically fucked. And I think that is so wrong. Especially when you consider that many methadone patients here have also been prescribed moderate to high doses of benzos for a long time.
Some people have tried to go to the hospital afterwards to explain their situation, but the hospitals here don't carry any methadone afaik. And they certainly won't allow the patient to substitute the methadone for an equivalent dosage of another narcotic. At best, they'll give the patient their benzos for the day and then they'll send them home.
They should at least give you a few days to come up with the money. In fact, they used to do that, but apparently a lot of patients end up not paying after their time was up and instead quit the program. That's what I was told anyways.
It's all about the money here. They could care less about the patient if (s)he can't pay. I already voiced my concerns about that to my counselor. I told her it reminds me of when I couldn't pay my drug dealer. He couldn't care less about how dopesick I was if I didn't have any money to pay him.
So yeah, I definitely sympathize with these people. It's just so wrong what the clinic is doing to them. Not even a "feetox". Straight up "fuck off if you can't pay."
I've already petitioned my mayor about this, but I haven't heard anything back yet (and since he's a conservative/republican, I might not get a reply at all).
Sorry for the wall of text.
P.S. - Anyone please feel free to correct me if I'm wrong about OHIP/ODB/Trillium/etc.