Medicare. Bah Humbug.

I swear I am going to share the photos from the last day of Gramma Camp. But I am postponing the post yet again. 

We have been getting some rain - the good kind. A nice gentle rain with no tornados or flooding or hail or winds that take the trees down. And it has been very pleasant! 

My friend has gone to heaven to join her husband. I attended the memorial with her large group of friends and we spent a lot of time reminiscing and sharing fellowship with her family. She was in my dreams the night before, looking as healthy as she was a year or so ago, talking to me while I cleaned out my purse. I am sure there was a lot of "dream meaning" there, but I am happy to ignore it and just think of her. She faced so much adversity her whole life and what we all remember most was her positive attitude and sweet laugh. 

I am leaving in two days to spend a week at a beach rental two states away that my daughter has arranged. I have not yet started packing, but did refill my "vacation" pill box this morning.  And now I am frustrated, again. 

My husband was able to retire at age 60. The master plan was that we would have all our debts paid, including the house and that I would continue working until age 65 for the health insurance. We were successful with the bills, not so much with my job. My mother was diagnosed with ALS when I was in my early 50's (and passed a few years later) and my dad was suffering from congestive heart failure and leukemia when he suffered a massive stroke. We were blessed that I could leave the workforce and become a caregiver. And a grandchild care provider when we gained 7 more grandchildren in the 5 years following his death.  

Since I am a few months older than my husband (call me cradle robber), I was able to claim a spousal pension that covered the payment for a self-pay health insurance policy with great prescription coverage with a reasonable co-pay and major medical (they paid almost $40,000 for my arm) and we were able to afford office visits, labs etc not on the policy.  But I was looking forward to Medicare. 

I spent way to much time making spreadsheets, requesting information from Medicare, supplemental providers, speaking with "experts", etc before making our choices.  

We have Part A which pays who knows what. We pay for part B which pays for other things. We have a supplemental Part F, only available to a select group that my husband belongs in. I had no idea that you have to reselect a Part D Plan every year until I spent all these energy on a Plan D that started in September when I turned 65 and got a letter that November that raised their rates and deductibles by over 100% for the next year.  

For those new to Part D, which is the prescription coverage, every city (zip code), county and state figure into your rates so that even talking to a neighbor in a nearby town, our costs for the same policy are different. 

An Advantage plan does not work for a variety of reasons in our circumstance, so I do need to select a Part D.  First let me tell you about previous prescription coverage. 

My husband had the same job for almost 40 years. Our insurance coverage varied. When we had five young children, we had high co-pays with no vision or dental coverage, which is why I went back to work at an employer that did offer that coverage for five children with teeth and glasses. As soon as we ran out of children (they all graduated) his plan began to offer dental and vision as well as lower deductibles and more coverage. Which benefited middle aged people with eyes and teeth, too. It did carry an affordable prescription plan. 

The gap insurance we purchased had the same prescription policy that we had previously. The policy had an online option where they kept track of everything for me, sent me emails when it was time to renew to approve shipments and even contacted the doctor for me if I ran out of refills. The cost was unbelievable - $3 for generic, up to $10-$14 for the name brands for a 90 day supply. They arrived with free shipping in my mailbox.

Then we went on Medicare Plan D.  I make a spreadsheet when they release prices for the coming year.  I take into account deductibles, what tier the prescriptions are in so I can see if there is an alternative, my co-pays, etc. And the monthly bill for the privilege of having insurance. The cost for online prescriptions in my zip code are way over budget. The first two years, I did not meet the deductibles for co-pays until December.  

I am still paying so much more than I did when we were under my husband's employer's plan. One of my prescriptions has a $100 copay which I know is miniscule compared to others, but is so much more than it used to cost. Another copay is $70. My blood pressure medicine is only $2.  I am grateful we can afford to pay these copays. 

My designated drug store has a service where you can pick up all your prescriptions at the same time in the same trip. I joined so that they could keep track of refills.  I just picked up my prescriptions and not all were refilled.  One is a 90 day supply instead of whatever the others are so it can't be on the plan. So now I need to keep track of that one. Another was just written and is something I will be on forever. And there are no refills on the original prescription. And it's me that has to leave messages in my doctor's automated system - so you can imagine how that is going. 

If you are still here, I appreciate you reading through my rant. I can see how the elderly (I'm still in my late 60's so let's say elderly is 90) get confused and don't take their necessary prescriptions, can't afford to get their prescriptions, take the wrong prescriptions and give up on prescriptions. It is a confusing mess.   

My neighbor did join an advantage plan that includes vision insurance. She needed an emergency vision procedure and her plan required appeals and more information from her eye doctor. She had to sit with her head still, in the dark, for several days until it was approved. Her doctor shared that it is automatically approved on Medicare. This mishmash of requirements is not fair to anyone trying to make an educated choice, either. She was very satisfied with her plan until this happened. I think that is where we all are. Health insurance is great until you have to use it. 

Lucky for you all I am leaving for a week of R & R!  And I am planning to come back in a much better mood, LOL.  

*Update: the prescription has been filled. And I only owe an additional $45 as a copay. . . .