More than 300 Islanders in Medicaid program: Some can’t get prescriptions filled here
As the Shelter Island Heights Pharmacy continues to report that it is working to reinstate those enrolled in the Medicaid program to have prescriptions filled, the Reporter has found how many Islanders have possibly been shut out of receiving medicine from their local drugstore.
According to the New York State Department of Health, there were more than 302 Shelter Island residents receiving Medicaid benefits as of April 30, 2022 for ZIP codes 11964 and 11965. That represents over 8% of the Island’s population, or one in 12. At least 58 of the 302 receiving Medicaid benefits were children, ages between birth and 17.
Those figures could be higher. Data from the New York State Department of Health website notes that its Medicaid numbers are only for those registered with New York State of Health (Affordable Care Act) and doesn’t include those enrolled in Medicaid through local departments of social services.
The data also doesn’t include numbers from at least one subset of less than 50 people in a category, namely, Spanish speaking people in ZIP code 11965.
“All applications are still in expedited status and we anticipate that the pharmacy will be able to accept all Medicaid recipients in the near future,” according to a statement issued last week by a spokesman for Pharmacy owner Stacey Soloviev.
Medicaid provides coverage to residents based on financial information, family size and other factors used to determine eligibility. Any pharmacy can withdraw from the Medicaid program or set limits on the number of Medicaid patients it can serve.
Sometime in December 2022, the Reporter noted that Medicaid recipients here, who had been covered for their prescriptions, were told that might not be the case in the future, and they would have to take those prescriptions to a CVS pharmacy.
For many, that posed considerable difficulty since the Pharmacy is the only drugstore in town. It would mean a ferry trip to the North or South forks and time and expense to get their medications.
For some infirm residents, especially those living alone, it poses even greater difficulties to get their prescriptions.
As of Jan.1, there have been a number of changes in requirements to qualify for Medicaid coverage that may allow some who didn’t financially qualify in the past to be able to receive benefits now. Changes include some people whose incomes were too high to participate in Medicaid programs.
The New York State Department of Health has raised qualification levels to 138% of the federal poverty level so those whose monthly income does not exceed $1,677, or $20,121 annually can qualify.
For a couple, the monthly level for income can’t exceed $2,268, or $27,214 annually. There are companies offering Medicaid coverage, and applicants can also contact the State Department of Health for guidance.