I feel bad for old people
Thread Starter
Joined: Feb 2004
Posts: 65,564
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From: Smalltown
I feel bad for old people
Ah the new and improved Medicare prescription program 
I just went to the pharmacy to pick up prescriptions for my mother in law. She has limited assets and her meds were previously covered by the state with small co-pays. Medicare assigned her a plan. It had no deductibles and very small co-pays, or so they said.
Tonight I paid $18.00 for one drug as they told me the plan does not cover any drugs in that family, and $48.00 for another as they charged it as a "Third Tier" drug.
I came home and looked at the paperwork I had here for her. Her assistance plan was supposed to pick up the drug that was not covered by her plan,(the pharmacy computer did not pick that up) and I have yet to find a reason she was charged $48.00 for the other.
I dread the thought of a phone call to try and straighten this one out, so I'll keep looking through the paperwork. The pharmacy is more than willing to help out, but how they can keep track of all the plans and all the exclusions is beyond me.
Due to Alzheimer's disease, Rick's mom can't make the phone calls to find out what's going on. It's good that we can do that for her. I feel bad for the old folks who have no one to help them out with this mess the government has created to "help" people get prescription coverage.
I sure hope this mess called health insurance is straightend out before I reach Medicare age, but I won't hold my breath.
I just went to the pharmacy to pick up prescriptions for my mother in law. She has limited assets and her meds were previously covered by the state with small co-pays. Medicare assigned her a plan. It had no deductibles and very small co-pays, or so they said.
Tonight I paid $18.00 for one drug as they told me the plan does not cover any drugs in that family, and $48.00 for another as they charged it as a "Third Tier" drug.
I came home and looked at the paperwork I had here for her. Her assistance plan was supposed to pick up the drug that was not covered by her plan,(the pharmacy computer did not pick that up) and I have yet to find a reason she was charged $48.00 for the other.
I dread the thought of a phone call to try and straighten this one out, so I'll keep looking through the paperwork. The pharmacy is more than willing to help out, but how they can keep track of all the plans and all the exclusions is beyond me.
Due to Alzheimer's disease, Rick's mom can't make the phone calls to find out what's going on. It's good that we can do that for her. I feel bad for the old folks who have no one to help them out with this mess the government has created to "help" people get prescription coverage.
I sure hope this mess called health insurance is straightend out before I reach Medicare age, but I won't hold my breath.
Thread Starter
Joined: Feb 2004
Posts: 65,564
Likes: 4,798
From: Smalltown
The letter we received for Rick's Mom assigned the plan. It sounded OK. Until you find out different plans cover different drugs; you can switch plans, but each plan will have their own exclusions.
I see nothing in her paperwork mentioning paying 25% of the cost for third tier drugs.
Guess Rick or I will have to make some calls.
I see nothing in her paperwork mentioning paying 25% of the cost for third tier drugs.
Guess Rick or I will have to make some calls.
Registered User
Joined: Oct 2000
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From: Denton, Texas
Lainey:
Just went through the same thing with my mother-in-law. It is a huge pain to figure out what is the best plan. We reviewed all the drugs in each plan and compared them to what my mother-in-law is taking (this is a painfully slow process). When we found a brand that was not covered we went to the Doc and asked if she would write a generic that would be covered. Overall we spent about a week trying to figure out the best plan but, long term it was the cheapest solution as she takes about 7 different Rx items daily.
As far as your pharmacy is concerned the co-pays and costs are all programmed into their system. Errors do occur and taking them back to the pharmacy is the only way to get them corrected. You need to ensure that they have the correct plan number in their system and the latest formulary update.
Hope this helps.
Dan
Just went through the same thing with my mother-in-law. It is a huge pain to figure out what is the best plan. We reviewed all the drugs in each plan and compared them to what my mother-in-law is taking (this is a painfully slow process). When we found a brand that was not covered we went to the Doc and asked if she would write a generic that would be covered. Overall we spent about a week trying to figure out the best plan but, long term it was the cheapest solution as she takes about 7 different Rx items daily.
As far as your pharmacy is concerned the co-pays and costs are all programmed into their system. Errors do occur and taking them back to the pharmacy is the only way to get them corrected. You need to ensure that they have the correct plan number in their system and the latest formulary update.
Hope this helps.
Dan
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Thread Starter
Joined: Feb 2004
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From: Smalltown
Originally Posted by mns2k,Jan 4 2006, 08:06 AM
Lainey:
Just went through the same thing with my mother-in-law. It is a huge pain to figure out what is the best plan. We reviewed all the drugs in each plan and compared them to what my mother-in-law is taking (this is a painfully slow process). When we found a brand that was not covered we went to the Doc and asked if she would write a generic that would be covered. Overall we spent about a week trying to figure out the best plan but, long term it was the cheapest solution as she takes about 7 different Rx items daily.
As far as your pharmacy is concerned the co-pays and costs are all programmed into their system. Errors do occur and taking them back to the pharmacy is the only way to get them corrected. You need to ensure that they have the correct plan number in their system and the latest formulary update.
Hope this helps.
Dan
Just went through the same thing with my mother-in-law. It is a huge pain to figure out what is the best plan. We reviewed all the drugs in each plan and compared them to what my mother-in-law is taking (this is a painfully slow process). When we found a brand that was not covered we went to the Doc and asked if she would write a generic that would be covered. Overall we spent about a week trying to figure out the best plan but, long term it was the cheapest solution as she takes about 7 different Rx items daily.
As far as your pharmacy is concerned the co-pays and costs are all programmed into their system. Errors do occur and taking them back to the pharmacy is the only way to get them corrected. You need to ensure that they have the correct plan number in their system and the latest formulary update.
Hope this helps.
Dan
The pharmacy is always willing to try and help out. There are so many plans/options to be entered into the system that, as you said, errors are bound to happen.
Registered User
Joined: Sep 2003
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From: Bowie
My heart goes out to anyone having to navigate this (or any other) government system. It's not for the faint of heart and you must keep an eye on your blood pressure as the frustration mounts. I'm gearing up for battle on the disability front once again. It's like war. Hang in there Lainey.