Medicare Part D - A Burden on the Elderly?
Accompanied someone to a Medicare Part D meeting today. What a disaster! This is government “efficiency” at its best.
This lady, whom I will not name, has congestive heart failure, hypertension, kidney failure, hyperparathyroidism, anemia and diabetes. At the moment, her medications cost her about $2,400 a year - that’s not counting the Aranesp injections for the anemia, which are extremely exspensive, but are not funded in the same way as the other medications.
As soon as the lady helping my friend realized that I was ready to take notes, she took my friend off by herself. I knew what was coming when that happened … so did my friend.
Anyway, let me relate the practical aspect which was garnered from today’s expedition.
If my friend takes the least expensive of the plans she was told actually covered most of the medications she needs, it would cost her $1,600 a year. Then, she would have a $250 deductible. (Brings it up to $1,850 so far.) Meanwhile, she would have a variable co-pay for each medication she buys, and the ones she really needs the help with were the ones she was told she would only get if she called the insurance company, and then had the doctor justify prescribing them to her.
The insurance would pay up to a certain limit, and then she would reach what the woman called the “donut hole.” Beyond that point, my friend would have to pay all of her medications right out of her pocket, for about another $1000 … a bit more, actually. (Now, were up to $2,850 … NOT counting the copays!!!) After that $1000, the insurance would kick in again.
Meanwhile, the insurance company could change anything - including her copay, the amount the policy cost her, etc., at their discretion at any time, and if they did, she was still forced to finish a one year contract with them
We got into the car, and worked it out quickly without a calculator - but the upshot was clear … and she asked me: “Why on earth would I want to pay an extra $1000 or more just to involve the government in my life???”
Duh!
Why indeed?
She decided that she’s just going to continue paying out of her pocket. I don’t blame her. I told her that I intend to lay down and die before I deal with the government for health care … since I’d probably end up doing just that in their care anyway.
We agreed to forget all about it, and went to eat at a friend’s house, and then watched a movie. I came home late … still have my school work to do. It wasn’t wasted though … I now have a firm idea of what I think about Medicare Part D …
It sucks.
April 20th, 2006 at 11:18 pm
My mother my mother being over 65 is on medicare part D. I, being on disability am on medicare part D.
Since, I also get mediCAID … it becomes a viable program. (however, other state restrictions, still make it a trap …but that’s another story for another day)
My mother, is one of the ones that Medicare part D was designed to help.
My mother is now paying almost double what she was paying when she was buying a supplemental program before Medicare part D took place.
I think, those who are getting medicaid are the only ones who benifited by Medicare part D. (and that probably depends on the state you live in)
In my state, we on medicare went from being only covered for 3 generic, 3 name brand meds a month to whatever is covered on the formulary (and for someone like me ..that’s a HUGE difference! )
I don’t pretend to understand it … I’ve got mine working for me …but don’t ask me to explain it to you … I just know it’s working …
April 21st, 2006 at 9:27 am
“Why on earth would I want to pay an extra $1000 or more just to involve the government in my life???â€
Why is right. Do they think people are that naive? I guess they do.
My Dad was in a similar situation. Recently, he discovered he could get a large portion of his medications covered through our local VA hospital, since he’s an ex-Navy man. So far, it’s worked in his favor.
April 21st, 2006 at 10:26 am
Pk, my dear heart, I’m glad it’s working for you. I hope it keeps working for you.
One of these days I’ll get up the courage to post about the difference in care received … between a good insurance policy, and medicaid. It’s taken me over 20 years to ruminate on my brief experience with medicare as a young woman who was temporarily down on her luck, and I think I’m finally getting enough of a handle of on it to post about it without bouncing off the walls.
Pattie … I think that health care is rather quickly going down the tubes for the very people who need it the most. Frightening.
You’ve just given me the idea to look into the VA for my stuff, since I’m also ex-navy. … But … that’s involving the government again … :p
April 21st, 2006 at 2:13 pm
Moof … medicaid alone is a scary thing! Before I got onto disability …it was frightening …
Medicare/medicaid …is a better combination than either one alone …and has been a pretty good combination, especially since the drug program now works.
The medical coverage is fine …it’s the financial trap you’re stuck in in order to KEEP the medical coverage that you need.
April 21st, 2006 at 5:06 pm
Moof,
I know the application process was easy, but there was a lengthly waiting period. They cover 100% of my Dad’s scripts. So far, it hasn’t been intrusive typical government type stuff to deal with. It’s been about a year, and so far so good. You might look into it. I could save you alot of money.
My dad served on the Joseph P. Kennedy air craft carrier. What did you do in the Navy?
April 21st, 2006 at 5:46 pm
I don’t like it when ‘official’ type of people don’t want you to understand what’s going on.
PLUS… if it looks like they want to take an elderly person away from a not-so-elderly person who could maybe ‘catch them’ at something.
hmmm…
That always makes me very suspicious.
You’re right.
It does suck.
later…
April 22nd, 2006 at 7:18 pm
Moof, I don’t understand it and I should. My plan is that I won’t get old. Sound good?
Flea
April 23rd, 2006 at 6:12 am
Moof: Off the subject…check out josesmexicanrestaurant.com
It is North of Boston, in Cambridge, not far off Rt. 93. Could be a good place to meet. What do you think?
April 23rd, 2006 at 8:02 am
Pattie! In the navy - I was a hospital corps wave. About Joses’ … sound great! When? I’m afraid that might be further for you than it is for me, though … that’s about 1 1/2 hours from me. I’m in extreme southwestern Maine, not at all far from Portsmouth NH. Looking forward to this!!! *does a little moofie dance*
TJ - you said: “if it looks like they want to take an elderly person away from a not-so-elderly person who could maybe ‘catch them’ at something.” … you’re right, and it made me very unhappy. I saw it as a “separate her from the herd” move. My friend has a lot on the ball though, and made up her own mind. She’s a smart lady.
Dr. Flea … You’re just too cute! Now, why do you think you should understand it? Lots of your patients haven’t even got the alphabet down yet, never mind be in line for Medicare!
About not growing old … sounds like a plan. Um … peds dudes don’t get old, do they? You just sort of go from your youth, to other people’s youth, to your second childhood?
My bad … >;o)
April 23rd, 2006 at 5:24 pm
Moof, it should be about the same for me. I’m thinking maybe in a few weeks? I have to go back down to Charlotte and pick a bunch of stuff for the new house next week. Maybe the second week of May? Thurs, Fri, and Sat. are the best days, as I can arrange a sitter. What do you think?
April 23rd, 2006 at 5:29 pm
I watch the television commercials aimed at those who can change to Medicare Part D. These elderly actors are singing and dancing and saying how wonderful it all is and will be. SO not true. Your friend is so lucky that you went with her. This whole thing is another mess.
April 23rd, 2006 at 10:37 pm
Pattie, that’s great! I would be hard pressed to do it right off … I’m not ambulating very well at the moment. Things should be great by the second week of May. Of any given week end, Sunday would be the hardest for me unless it’s later in the day - like evening, even. My schedule is probably more open than yours, so you pick! :o)
Deb, welcome! Thank you for dropping into my humble blog. You’re quite rigth that “This whole thing is another mess.” This is what happens when the government tries to sort things out.
I believe that the government shoudn’t even be involved in this sort of thing. Have a I got a solution to replace them with? No. I don’t. But it seems to me that if enough people worked on it, we could make it happen.
April 24th, 2006 at 12:03 am
Some how …some way … there has to be …
Drug companies would have to stop charging absurd prices would be the first step.
Second step, as an interemediary, those on assistance would have to be allowed to work and still keep their medical assistance.
then who knows what.
It’s crazy … my medications come to $4,284 a month. The job I would have to get to cover that, would be absurd … and in my current health, I couldn’t keep a job that would provide the insurance that would cover that …yet, without the medication, even considering it wouldn’t even be a possibility ..for that matter, breathing without the medication would soon not be a possibility …
it’s a never ending cycle that all seems to start with absurd drug costs …and government rules ..and ..and …and …