Medicare Question

Discussion in 'Fibromyalgia Main Forum' started by enjoysue, Oct 16, 2006.

  1. enjoysue

    enjoysue New Member

    Ok, I just gotta vent a whine a bit. Sorry!! I tried knitting a little the last 2 days and it went ok other than it bothered my shoulder some. Woke up last night and oh was I in pain. I have oseoarthritis in my left knee and my low back, elbow/forearm pain and shoulder are killing me plus my whole ribcage top to bottom. I called the ortho to see if he would do the cortisone shot like he wanted to do in my elbow this summer. No answer so I run to the pharmacy for the script for oxycodone because I saw that it wasn't too expensive when I saw the bill from the Medicare Part D. Okay, I think I can afford this, GOOD!! Ahhhhh, nope, the bill was like $85 so I left without it.
    Got home and called the ortho up again and I have an appointment for wednesday. I also called KMart because I heard they were helping out people who'd reached their donut hole. Nope, the pharmacist had the compassion of a dead fish. He couldn't help me with any of my scrips and his only comment was " Those are expensive ones." So in other words for PR they are helping people out on the cheap ones to look good and to heck with the other people? They don't even cover coumadin/warfarin. If I don't have that I'm a goner. I can pay the $20plus for that but it's hard on disability plus I have to substitute cheaper over the counter drugs for the 2 other meds I (prilosec instead of prevacid and Red yeast rice instead of crestor) need so that is eating up the money also. The rest of the meds I am going without because I have no other option. So no sleep med and no oxycodone) I want to try one of the Parkinson drugs because nothing seems to help me and I'm not sure the oxycodone will help.
    I just get no relief and Im very very tired and the drs don't understand they say just excersise more. Ah, if I would if I could and I've done it in the past but if they think it took the pain away they live in a fairy tale.
    I'm so glad that my Medicare Part D and Medicare Advantage plan are from the same company cuz they ended up paying for a stay at the hospital that otherwise wouldn't have been needed had I been able to get the meds I need. Call me horrible but I love the fact that I "stuck it to them."
    My letter that I wrote to the Medicare Rights Center was read in front of a meeting with the House Ways and Means committe (along with some others) in June because of tactics and outright lies by the insurance agent that sold me the medicare advantage plan. I look forward to writing them again to let them know how I am fairing with both my plans now. Heck, as sick as I am I'd give the speech myself though it would cause me even more pain. Okay, I got that off my chest and I don't feel much better. How is everyone else out there fairing with Medicare Part D or is it just me? It only took me 6 months to reach my limit and I didn't even use up all the scipts I was supposed to so I'm guessing that i'll reach it again next year in 4 months or less. Not much to look forward to. I'm usually in a pretty good mood but I'm very frustrated right now and don't know where to turn. Thanks for listening. ~Sue

    [This Message was Edited on 10/17/2006]
  2. Kimba4318

    Kimba4318 New Member

    Hi Sue - I am sorry I cannot help with the Medicare issue. It seems like such a shame to me and a crock of bull! So sorry you are going thru this.
    Hoping someone else can help you. DOn't know what I would do if I could not get my meds that are needed (I am on coumadin too :-( and need the pain meds daily.

    Just a little note that I am thinking of you and wishing you well. Hope this will bump it up for more help. Maybe if you had "Medicare question" or something like that in the title you would get more responses - don't know though.

    I hope you get the help you deserve.
    Hugs
    Kim
  3. caffey

    caffey New Member

    i am sorry I can't help you as I am not from the US except I saw a commercial on A+E about how the drug companies are getting together and giving out meds at low cost or free. Maybe you could watch for it or someone might now. Montel Williams was doing the commercial. All the best.
    Cath
  4. enjoysue

    enjoysue New Member

    Yea, I have seen the commercial too and I went to the website and what i could decipher from it is that I could probably get my tricor for free or reduced rate but I should have almost enough of those til the end of the month because I get those thru a mail order company. Otherwise it appears it won't cover anything else. Here is the info: www.pparx.org I think there is a phone number there also so I will attempt to call it tomorrow and double check everything. Thanks for reminding me about it.
  5. I've had to do this, to 'test new drugs out' see how i'm gonna react, because I've spent $500 on 60 shots (30 day supply) and had to stop them after 23 injections, due to them triggering, rather than stopping my pancreas spasms!

    Could you call the pharmacy and ask how much it would be for half a prescription, I've even asked for just 10 pills. and they WILL do it. Who cares if they get crappy with you....you need pain relief, and can only afford what you can afford, hon. I hate when any of us suffer like this. and the INJUSTICE! GEEZ!

    I'm getting ready to apply (after almost 7 yrs!) for my VA benefits, because, I do NOT want part D, but have to do something for additional coverage, soon. My poor husband is 29, and I'm terrified he's working himself into an early grave, he has high blood pressure (since a teen) and sleep apnea, and now he's 35lbs+ heavier than when we married, he's had surgery, but again, he's heavier now, and still snores/quits breathing...

    I'm praying for VA benefits, because 1.) I'm angry as **** now, 2.) I deserve them! and 3.) paying for Part D, is just MORE money coming out of my check, and apparently from what *I* see, could totally change the meds I'm on, or refuse to pay for them...making me pay out of pocket, and our co-pays now (hubby's work insurance changes EVERY june now, for the past 3 yrs on their coverage!) Our co-pays are already rediculous...

    Hope you can figure something out, I'm so sorry, and sad for you


    Laura
  6. Omacarole

    Omacarole New Member

    Hi Sue,
    Don't know if this will help you or not, but I got in Humana's RX plan and it has no donut hole......however, I pay $58 a month. Generic brands are $7 and Non-Preferred are $30. Check out their formulary and see how much your RX would cost you.....www.Humana.com.

    Carole
  7. JLH

    JLH New Member

    Sue,

    Wow, what a letter you must have written to the Medicare Rights Center for it to be read in front of a meeting with the House Ways and Means committe! Congrats!

    I am on Medicare due to disability; however, I did not elect to take the Part D. I already have prescription drug benefits under my employer's retirement medical package. I pay well over $300 for my monthly premium for my husband and I, but it is great coverage for medical, dental, eye, and prescription drugs.

    My copays for drugs range from $10, $15, to $30, it's according to what type of drug it is. I take about 23 prescriptions monthly, so my drug bill is still expensive.

    I wish that I could offer you some suggestions, but I don't have any for you.

    Janet

    (P.S. If you split long posts into many paragraphs, it makes it easier to read.)
  8. Leaknits

    Leaknits New Member

    You asked how others are doing with the new version of Medicare and I'm sorry, but I have to tell you I'm not doing any better with the Plan D than you are.
    It now costs me more than before the "new and improved" MediCare was enacted...
    And this was supposed to save us money.

    When I was trying to slog through all the 1-800 etc numbers in the MediCare And You book, one of them led me to Humana. The guy who answered the phone there when I called and asked that info be mailed to me, ENROLLED me in the program without my permission.

    I swear it's true. He was mumbling to himself while clicking keys on his computer and I heard him say "Enroll," which was followed by a key-click.

    "Wait," said I, "did you just enroll me in Humana when all I wanted you to do was send me information??"
    "Oh no, that's just something we have to do in order to send out information."

    I ended that call pretty quickly and you know what? I've never received so much as one piece of paper from Humana.

    It's all right, I know by the jerks' actions just how upright Humana is.

    The program I'm in, something called HealthNet Orange, doesn't cover most of the scrips I get each month...I wish I lived closer to Canada!!

    Lea.
  9. enjoysue

    enjoysue New Member

    Kimba4318, thanks for the suggestion to change the title of the message and for the good wishs. Both are greatly appreciated

    Jillstarr, how nice of you to take your father in. You are an angel. I sure hope that the true light comes out in all of this because certain government officials keeps jamming it down our throats on how great this program is. It's hurt me immensely and I get depressed just thinking of what next year will bring when I will be on it for the whole year instead of first joining in March. So many seniors had their drug coverage taken off of their retirement insurance.

    I did hear though that the government has stopped the seige of drugs brought in from Canada. Until the drug companies stop buying their way into congressman and the like we all don;'t stand a chance. *huff* don't even get me started!!

    Hi caffey, thanks for taking the time to reply. Yes, I've seen the commercial and I've gone to the site and it appears only one of my many meds could I possibly be given any assistance. I will call the number though just to make sure. I find it all very sad and I can't imagine being a senior in my situation. Until there is a mass casualty of dying directly related to this it will be the same old same old I'm afraid. I would guess no one will do a study for 5 years or so. We'll see if I am right but I feel alot of undiagnosed depression will result and deaths that will come about as a direct result of the depression and not taking the meds needed to sustain life. Not until it affects a government official directly will anyone care. I've just started a rough draft of a letter I intend to send to government officials and my newspaper. If I make it in the Milwaukee WI paper I'll let yu guys know. LOL i doubt that will happen as this area is a HIGH republican area.

    aintasgoodasIoncewas , I just love that name!! Good luck in getting the VA benefits.I don't know too much about that but I sure hope you are able to get them.
    My pain dr. has been trying to work with me to see what might help me with the pain and had been giving me a 2 week supply but the last time I went she gae me a months worth. I would feel better just getting the half to see if it even helps me. So far nothing has touched the pain and I don't get the high that supposedly others get from it. That's why I admit being totally clueless as to how anyone could get addicted. Hopefully someday I won't have to eat those words! I sure hope that some day you get to be as good as you once were!


    Thanks Omacarole, Are you talking about 2006 or for 2007? I went to the site last night and I didn't see any mention of 2007 unless it is up today. I will check them out and other plans in our state. So far I understand that coverage in the gap means only generic drugs so that doesn't really help me too much and I'd have to do the math and see what comes out but my meds get changed so frequently I'm being asked to be a fortune teller too!

    jlh, yes, I was so excited to see my name and hometown listed that I emailed all my family and friends and in the rush I forgot to even include the link! MRC called me but I had no idea that they had intentions of using my letter in the meeting. They called a 2nd time I think the night before the meeting wanting more info but I was away for the evening and never even returned there call. I have no idea if my insurance agent or company was informed of my letter. I hope not as I intend on telling him myself in person if possible!

    I used to pay well over $300 just for myself in a program for high risk people. I know you know how hard it is to come up with that kind of money living on disability. I'm glad you have your employers retirement package to fall back on. I wonder when I am retirement age if I couldn't get on my first employers insurance. That's iffy as they filed for bankruptsy but are still in business. Thanks for jogging my brain in that regard! I'm almost 48 so I have a long time to wait though :-(

    Thanks for the suggestion about the paragraphs, I started doing that in my other posts too. I'm new so I had to figure out how to do things with your help of course. Thanks!

    leaknits, another knitter??!! Me too!! What kinds of things do you knit?

    I too called last year for all the information packets. I've been waiting for the info to get on the medicare site but now that it is up I don't really have the health or stamina to figure this all out nor to pick a different Medicare advantage plan.

    So how did you get it all straightened out with Humana? Humana was at our local Walmart signing up people left and right. They were not the best plan for me this year but I'll still look at everyone for 2007.

    Have you tried mail order from canada? There was even a brick and mortar store here for that. Not sure how it worked or if they are still in business.
    If you want lets compare what we pick for this year. We probably have different companies and options though I would assume. Because I live near a metropoliton area insurance is more expensive here than if I lived 'up north.'

    I'll try to keep this thread going because I am curious as to how many peope are on Medicare Part D and what luck they are having with it. It's our responsibility to let our representatives know when it is NOT working for us because it adversely affects our health. Thanks everyone!!