Phucking Medicare

Fuck the songs in my head...Fuck the new Medicare prescription drug plan. I fulfilled my responsibilities by filling out my paperwork in December, yet last night I was unable to fill my prescriptions for antidepressants and migraine meds.

I started this task Tuesday morning. By Tuesday evening I was in a lot of pain from a migraine and Clear Choice Health Plans, my supplememental Medicare provider, could not process my refills.
I was in dire pain so I called my primary care physician and he supplied me with some samples of medication at no cost.

However, this morning, I tried to see if my prescription drug coverage had gone through and I wouldn't have to pay $160 150. No luck. They are still charging me the full price and I'm pissed.

So, I called Clear Choice Health Plans today and asked to speak to management. I was offered to speak to someone in customer service and I insisted on management. I got forwarded to a Bob Brown who was trying to be diplomatic but was obviosly a tool. I asked him if he got migraines and he said he did. I told him I didn't appreciate the hassle this has been since I pay monthly premiums on time and fulfill my responsibilities. He apologized and said he would call the pharmacy himself.

I just received a phone call from Clear Choice health plans, located in Bend Oregon. This tool said my prescriptions are ready and should reflect the right price of $2-5 per drug. I told Ms Tool that I planned on invoicing her for 2 hours of my time. She said go ahead. If I had another choice of drug plans in my rural area I would consider changing, yet I don't have any other options. Ms Tool explained how they just finished entering all the enrollment changes into their data base last night. That's cuttting it mighty close for ill people who require life sustaining drugs.

I want to add that I called Clear Choice two times in the last few weeks to assure myself I wouldn't run into any glitches. I was assured that I was enrolled in the right plan and everything was a go ahead. I did this because I could have serious problems stopping my daily dose of low level anti deperessants or get a debilitating migraine that puts me in fetal position. I have yet to pick up my meds and if there is any problems with the price I will blog about it later.

Squeaky wheel gets the grease.


Phucking Phreaking Medicare (Update 7:51)

Errr... Not. I didn't get shit. No meds, no results. Failed Mission. I could have bailed out my medicine with 150 bucks, but like they say back in NY....Fuck.That.Shit.

I should have a supplemental Medicare policy that works! Instead, I am being told I have a $250 deductible for my medicine.


Not true.


Wrong.


I have to pay $82.50 monthly premium for this??!! My yearly income is low enough and my resources humble enough that I do not have a deductible, as it is under $12,900(according to my Medicare 2006 handbook). I was assured by Medicare two weeks ago that my income information will be forwarded to my health care provider. They also told me I had no deductible. I checked. Apparently, Medicare or Social Security have not completed their task.

I bitched and moaned all day to anyone who would listen from the Department of Human Services in Salem, to US Congressman Greg Walden's office and some Cear Choice representatives that gave me bullshit answers and no recourse. At one point I sneered to some managerial insurance guy about how Medicare should have a help line for problems and I was assured that even those in the supplemental Medicare provider business have NO such number.

From the articles I have read so far Oregon is not the only state experiencing difficulties providing senior citizens and the alter-abled their much needed meds.

Oregon gets 1,200 complaints about Medicare drug benefit

By BRAD CAIN Associated Press Writer
SALEM, Ore. (AP) -- Oregon's human services agency says it has received complaints from 1,200 low-income senior citizens who have had problems getting their medicine under the new Medicare prescription drug benefit that took effect Jan. 1.
An agency official says Oregon is working with the federal government and others to try fix the problems, but potentially expensive emergency actions could be needed if things don't improve soon.Statesman Journal

Vermont is declaring a public health emergency. Maine is particulary bad according to this article from yesterday.

In Vermont, the state legislature last week declared a public health emergency, due to the federal implementation of the drug benefit. Lawmakers expressed concern that state residents were being turned away at pharmacies without the drugs they need.
In Alabama, the Montgomery Advertiser reports pharmacies around the state are having similar problems. "The (insurance) companies weren't prepared for us," Joe Street, a pharmacist at Adams Drugs in Wetumpka, told the newspaper. "It was a bigger load than they thought it was going to be."
The situation is reported to be particularly bad in Maine. With angry pharmacists and Medicaid recipients jamming state house phone lines, the state government ordered pharmacists to bill the state for prescriptions for elderly patients whose claims couldn"t be processed. Consumer Affairs

This story of a 71 year old woamn in DC is similar to mine.

Hewitt had been getting her drugs through the Medicaid program -- at $1 per prescription. She was well aware that coverage was going to end, and she'd need to enroll in a Medicare drug plan by Jan. 1. With the help of her daughter and the Washington, D.C., health insurance counseling program, she enrolled in a new drug plan. And she thought everything was good to go. "They sent me enrollment paper, card, everything," she says.
But when she went to pick up her first prescription, she got a nasty surprise. "They told me $250 deductible, $89 a month and $5 for each prescription," she says. If she didn't come up with $250, she was told, she wouldn't be able to get her medicines.
That information was wrong, however. Those are the costs for people with higher incomes. Low-income patients like Hewitt are supposed to pay no deductible, no premium and no more than $3 per prescription.(ed. that should be $3 for generic, $5 for a name brand) NPR

My supplemental medicare health provider is asking me to send in a form from social security stating that I am eligible for help because of my low income. I have no letter. I have not received such a letter. I have a letter from CMS (Center for Medicare and Medicaid Services) It says I will have a small copayment for each prescription (up to $5). So, I will have to see if Clear Choice will accept this letter as proof that I am eligible for extra help for people with limited income and resources.


I better get some results tomorrow.


One.More.Pill.