Imagine, if you will, an examination room. Your doctor walks in, and the two of you discuss your current medical situation. You go over pains, aches, medications and maybe even some new research for good measure. He writes you a prescription, and after chatting with the nurse at the front desk about copays and your next appointment, you leave for the pharmacy.

There, you find out that prescription you need, either to get through the day or to live until the next, is going to cost you way more than you expected. If you’re lucky, it’s only hundreds of dollars.

For some in Limestone County, it’s thousands.

“Some of the people that come in here have medications that are literally four or five thousand a month,” Carla Sims said.

Sims works with the Senior Rx program at Athens Senior Center. She describes herself as “basically an advocate,” someone who fights for Limestone County’s senior citizens to see what coverage they have, what they qualify for and how best to get them the meds they need at a price they can afford.

“If someone doesn’t have prescription drug coverage, or they’re in the donut hole, I work with pharmaceutical companies to get their prescriptions at low or no cost,” Sims said.

The “donut hole,” she explained, is the time between reaching the initial coverage limit and reaching their out-of-pocket limit for the year. For those on Medicare Part D in 2018, that could mean you and your plan have $3,750 to spend on drugs covered by the plan before entering the gap.

After that, you pay 35–44 percent of the plan’s cost for covered medications. For brand-name drugs, 85 percent of the total cost goes to your out-of-pocket limit. For generic drugs, only what you actually pay counts.

It costs $5,000 in out-of-pocket expenses to get out of that coverage gap.

“I have people already in that donut hole,” Sims said.

It’s only February.

Limits don’t reset until January 2019.

In the meantime, Sims is working hard to make sure her ultimate goal — no Limestone County senior goes without their medication — is reached. In a single three-month span last year, Senior Rx was able to assist 127 clients in saving almost $73,000.

She also witnessed some of the extreme measures those clients go through when they don’t have that help.

“There was a couple who was actually sharing their insulin,” she said. “One took it one day, one took it the next. It really broke my heart.”

With assistance from Sims and Senior Rx, they were able to apply for additional assistance.

“I didn’t know they’d gotten the letter accepting them,” Sims said, until “they showed up in tears, saying they had prayed for someone to help and now they were saving $800 a month.”

She hopes more seniors will realize there is help for them, and all they have to do is call 256-233-6412 and ask for Senior Rx to start the process.

“I always tell them, ‘I’m gonna go to bat for you,'” Sims said. “I’m gonna beat the path and see what I can find.”

Imagine that.

After the pharmacy

Of course, getting meds at an affordable price isn’t the only problem Limestone Countians face. After a prescription is filled, it can be difficult to track when or how to take the medicine.

This can be complicated further when the writing on the side is difficult to read or memory issues prevent accurately recalling the last time a drug was taken or how much of it was consumed. While the plastic pill organizer is still a popular choice, there are other options available for the more tech-savvy senior.

Medisafe, created by two brothers whose father accidentally double-dosed on insulin, is a free smartphone app that tracks blood pressure, weight, refills and dosages. Users can select from a variety of alarm tones to remind them when to take their meds, and the app will even notify them if there are possible interactions between drugs that should be discussed with a caregiver or physician.

For those who want to avoid dealing with an app, there’s automatic pill dispensers. These devices can be filled, locked and set to unlock at a specified time. Some include alarms or flashing lights to remind users when it’s time to medicate and are available for a one-time cost at your local pharmacy.

Others, like those at MedMinder.com, take it a step further. For a monthly fee, the devices’ compartments flash at specified times to remind users to take their medicine. If they don’t take it in a certain amount of time, the device will send out phone calls, text messages or even contact a caregiver. They can be refilled manually or with pre-filled trays from a pharmacist or caregiver.

The devices also gather information, such as when meds are refilled or removed, for email reports. For an additional cost, caregivers can record custom voice messages, and users receive a watch and necklace that can be used in the event of a medical emergency.

And when plastic and technology isn’t enough, there’s people. While some senior citizens rely on family at home or staff at a residential facility, others have found a middle ground with home health.

The Limestone County Health Department Home Care Program features trained professionals who visit homebound individuals in Limestone and Madison counties. A physician order is required, but the services can come at no out-of-pocket cost.

In addition to physical therapy, post-surgery care and skilled nursing, they also offer medication teaching and management. This can range from checking to make sure clients aren’t taking too much or skipping doses to having a nurse on-call 24/7 in case a client gets confused about the medicines they’re taking.

To learn more, residents and caregivers can call 256-230-0434 or visit bit.ly/LimestoneHomeCare.