Death by Confusion
Mon., November 28, 10:31 AM
Ever since the talk began about the new Medicare-backed prescription plans, I figured they were all trying to confuse us to death. That’s one way to get out of paying.
The initial news – last year, I think – told us the co-pay alone would be more than we were paying for prescriptions. I ignored it.
During the summer we received qualifying surveys from Medicare itself, for the purpose of determining whether we were eligible for Government aid on our prescription plan. This was so detailed that I despaired of being able to do it – and I do have some experience with this sort of accounting. Then I realized that the first question – a yes/no without details question – concerned your total savings. My IRA alone put us over that one, so I marked it No and sent it back. We have since received four notifications that we are not eligible; we knew it already, but since there are two us on Medicare, everything comes double.
When the latest hype began, with the promises of information and where to call, I thought I was seeing some light. “On October first…” I heard tv and radio ads for specific companies. I received invitations to drive out to Hell’n’gone for seminars. There was mail offering to sell us full insurance to supplement Medicare.
I wanted some information that wasn’t based on a single company. I tried medicare.org, as directed, only to find it hadn’t been updated yet. There is nothing less reassuring than to think you’re going to find answers and be greeted by nothing more than Mr. Dubya’s smiling face. Finally – the 2006 edition of Medicare & You. I started reading it all, and I’ll save you some trouble: start at page 94.
I was nearly at my wits’ end by the time someone actually sent out a formulary. In essence, this is where you have to start. At the end.
If you already have some kind of medical insurance, work with your carrier. But beware of those who are trying to sell you Medicare supplement insurance. In the twelve years that Husband has been covered by Medicare only, we have never had co-pays that were more than what the supplement would cost.
If you have found that you are eligible for Government assistance, by all means phone Medicare for direction. Otherwise, you can work it like this.
A formulary is a list of the prescription medications covered by the plan. Begin with the formularies you have received by mail. You can look at others at Medicare-Part D. (This is the link to Connecticut; you can back up to your own region.) The charts in Medicare & You don’t offer actual formularies but they do give percentages to compare the coverage from different companies. You want to make sure that, after signing up with a company, they will cover your particular meds.
Between us Husband and I use ten different prescription drugs. One company offers all ten of those; another offers eight. We could sign up with different companies if the coverage warranted it, but the same company fits us both. I made the choice based on:
- the formulary;
- the geographical region; and
- the price.
Yes, we will probably “cap out” and have to pay for our prescriptions out of pocket. But we’ve been doing that anyhow, to the tune of $700-800/month. If I can get six to eight months of paying less, I’m ahead. And after I’ve gone through all our savings, I’ll be eligible for help.
Good luck to you all. If you are among those who are not yet receiving Medicare, just pray that they will have gotten it right by the time you do.
