Drugs Payment Scheme

Freddie

Frequent Poster
Messages
177
In Nov I just started on a drug called Methotrexate 20mg for arithris. I need to take this in injection form once a week on the same day.

I paid €124 on the 2nd of Nov 2019 in my local AllCare pharmacy for this. I received 4 injectable packets for this.

I took my 1st injection that Sat Nov 2nd and then on the 9th of Nov, 16th Nov and the final one on Sat Nov 23rd.

I am due to take one today, Sat the 30th of Nov.

So I called into the same Allcare pharmacy with my repeat prescription. The pharmacist said I needed to pay another €124.

On the HSE page it states the following
Under the Drugs Payment Scheme (DPS) an individual or family will pay no more than €124 each calendar month for:

approved prescribed drugs and medicines

If you don’t have a medical card and you pay more than €124 a month for any of these, you should apply.
So today is the 30th of Nov. I have already paid €124 this month on the 2nd of Nov. I have my debit card receipt showing this. It shows the pharmacy name, it says DPS €124 and the payment/transaction date 02/11/2019 with time of 17:07.

If I pay €124 today I will have paid €248 in the calendar month of Nov.

This is an exact contradiction of what it states on the HSE website.

I thought I should only need to pay €124 and not €248 if I take exactly what the HSE states -

an individual or family will pay no more than €124 each calendar month

Their rule doesn't mention anything about 5 week months or the fact that a prescription contains 4 of a drug to be taken weekly or that all drugs prescribed need to be taken within the same month if they are to be included, or basically anything outside of saying, I should only pay €124 in a calendar month.

I'm not entitled to a medical card and I know I can claim 20% back also
 
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Freddie

Frequent Poster
Messages
177
Some people can say it means this and it means that, under this interpretation....but this calendar month, Nov 2019, I have paid €248 for my medication.

Again the HSE clearly state
Under the Drugs Payment Scheme (DPS) an individual or family will pay no more than €124 each calendar month for:

approved prescribed drugs and medicines
 

asdfg

Frequent Poster
Messages
1,583
While I believe you are correct in your interruption you can always apply for a refund, get a claim form from your Local Health Office, online at drugspayment.ie, or by calling 1890 252 919. Return the completed claim form to the address given on the form. You can check the status of your application for a refund at drugspayment.ie.Apr 1, 2019
https://www.citizensinformation.ie › ...
Drugs Payment Scheme - Citizens Information
 

huskerdu

Frequent Poster
Messages
2,141
The pharmacy are correct to charge you €124 for Decembers medication . It’s confusing when you are on a weekly medication . I’m in a weekly medication also . I’ve been on this fir a number of years

They can only charge you €124 12 times a year. Therefore they should give you 5 weeks medication every third month .

But they cannot give you a full months medication for Decembers for free because you collected it on 30th Nov .

It should all work out as €124 * 12 each year
 

Freddie

Frequent Poster
Messages
177
I needed an injection today, the 30th of Nov so the medication wasnt just for Dec.

So this isnt correct then

Under the Drugs Payment Scheme (DPS) an individual or family will pay no more than €124 each calendar month for:
As I have definitely paid €248 in the calendar month of Nov.

I'm due to take the medication for 3 months so the 12 months you mentioned isnt relevant.
 

asdfg

Frequent Poster
Messages
1,583
The pharmacy are correct to charge you €124 for Decembers medication . It’s confusing when you are on a weekly medication . I’m in a weekly medication also . I’ve been on this fir a number of years [/QUOTE said:
Does this mean that he will get the drugs due on 28th Dec for no payment or does he have to wait until 25th January ( the 3rd month)
 
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llgon

Frequent Poster
Messages
430
Therefore they should give you 5 weeks medication every third month .
This is the reason for the problem. The OP needs to discuss it with the Pharmacist.

If he had received 5 weeks medication for November there would be no issue. The pharmacist may intend to give the 5 weeks supply in the third month. This will effectively be the same thing but won't tie in with the calendar months as the OP expects it should.

Perhaps if asked, the pharmacist will supply one more injection for December which will mean it will be January before another payment needs to be made. This should resolve the issue.
 

huskerdu

Frequent Poster
Messages
2,141
You do need to discuss this with the pharmacist .

The pharmacy will have to give you a fifth week medication in December to cover you to the end of the month. If they don’t , because they haven’t thought of it , just ask .

Weekly medication doesn’t neatly fit into calendar months.

I’m assuming that you got 4 weeks medication on Nov 30th . Therefore you got the medication for Dec , do you had to
Pay for it .

Either way , You will only pay 124 * 3 and you will get enough medication for 3 months , even if it’s not neatly in calendar months
 

Clamball

Frequent Poster
Messages
97
I really sympathise with you Freddie, it can be really difficult dealing with ongoing health issues and the vagaries of the health system at the same time.

The problem might lie in a few places but the solution is to ask the pharmacy to give you a fifth dose to cover November (which you have already paid for) and let the 4 doses you picked up last Saturday cover December.

You doc wants you to take medication once a week for 3 months or 13 weeks. If she wrote take for 13 weeks and if you pharmacy dispensed 13 doses in one go the HSE would have a conniption that you got 3 months drugs for 1 months payment so the HSE tells the pharmacist to dispense 1 month at a time. Now your doc knows this and may have said take 1 dose weekly for 3 months which the pharmacist is interpreting to mean 4 doses x 3 = 12 doses, 4 every month. They don’t see the issue but it means for you do you take a dose last Saturday or miss it because there is 5 Saturdays in November or finish earlier in Jan. Again you should ask your pharmacist for a 5th dose to cover November. Or maybe your doctor is happy for you to have 12 and not 13 doses, a question only she can answer.

there are many people who get caught up in this end of month payment. You are due to get your nexts month supply on sat 28th but what if you are away for holidays or travelling, people often like to have next months a week early to have it in stock etc, so the chemist often will say this will cover Jan so pay the money now for Jan etc.

Maybe you doc said 4 doses for 3 months taken weekly with her forgetting that Nov had 5 Saturdays. So perhaps she is expecting you to finish the medication after 12 weeks which is around the 18th Jan so you pay for 5 doses in Nov, 4 in Dec and 3 in Jan?

Overall talk to you pharmacist, she will help you interpret what your doctor wrote and if it is different to what you recall your doctor saying to you then phone you GP to clarify. And do ask for an extra dose to cover the 5 weeks in November.

Bedt of luck with the health.
 

Freddie

Frequent Poster
Messages
177
While I believe you are correct in your interruption you can always apply for a refund, get a claim form from your Local Health Office, online at drugspayment.ie, or by calling 1890 252 919. Return the completed claim form to the address given on the form. You can check the status of your application for a refund at drugspayment.ie.Apr 1, 2019
https://www.citizensinformation.ie › ...
Drugs Payment Scheme - Citizens Information
Thanks for the info and link there. I'll do this.
 

Freddie

Frequent Poster
Messages
177
This is the reason for the problem. The OP needs to discuss it with the Pharmacist.

If he had received 5 weeks medication for November there would be no issue. The pharmacist may intend to give the 5 weeks supply in the third month. This will effectively be the same thing but won't tie in with the calendar months as the OP expects it should.

Perhaps if asked, the pharmacist will supply one more injection for December which will mean it will be January before another payment needs to be made. This should resolve the issue.
I spoke with the pharmacist about getting the 5 injection for the month with 5 weeks.
 

Freddie

Frequent Poster
Messages
177
I really sympathise with you Freddie, it can be really difficult dealing with ongoing health issues and the vagaries of the health system at the same time.

The problem might lie in a few places but the solution is to ask the pharmacy to give you a fifth dose to cover November (which you have already paid for) and let the 4 doses you picked up last Saturday cover December.

You doc wants you to take medication once a week for 3 months or 13 weeks. If she wrote take for 13 weeks and if you pharmacy dispensed 13 doses in one go the HSE would have a conniption that you got 3 months drugs for 1 months payment so the HSE tells the pharmacist to dispense 1 month at a time. Now your doc knows this and may have said take 1 dose weekly for 3 months which the pharmacist is interpreting to mean 4 doses x 3 = 12 doses, 4 every month. They don’t see the issue but it means for you do you take a dose last Saturday or miss it because there is 5 Saturdays in November or finish earlier in Jan. Again you should ask your pharmacist for a 5th dose to cover November. Or maybe your doctor is happy for you to have 12 and not 13 doses, a question only she can answer.

there are many people who get caught up in this end of month payment. You are due to get your nexts month supply on sat 28th but what if you are away for holidays or travelling, people often like to have next months a week early to have it in stock etc, so the chemist often will say this will cover Jan so pay the money now for Jan etc.

Maybe you doc said 4 doses for 3 months taken weekly with her forgetting that Nov had 5 Saturdays. So perhaps she is expecting you to finish the medication after 12 weeks which is around the 18th Jan so you pay for 5 doses in Nov, 4 in Dec and 3 in Jan?

Overall talk to you pharmacist, she will help you interpret what your doctor wrote and if it is different to what you recall your doctor saying to you then phone you GP to clarify. And do ask for an extra dose to cover the 5 weeks in November.

Bedt of luck with the health.
Thanks for all that Clamball. Not that I want anyone else to have hassle but it was good to see I wasnt the only one!! I've actually called the HSE and asked if they would change the wording on the 1st page of their site referring to DPS. Thank you for the good wishes too.

Under the Drugs Payment Scheme (DPS) an individual or family will pay no more than €124 each calendar month for:

approved prescribed drugs and medicines

If you don’t have a medical card and you pay more than €124 a month for any of these, you should apply.
 
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