Friday, May 30, 2008

Compare Your Plan Options; giving thanks to my government; or "How I learned to stop worrying and love hypertension, acid reflux and ulcers!"

NOTE: Approaching a landmark birthday [hopefully the last one!] later this summer, I have been inundated for the past six months or more with solicitations from insurance companies for their consideration of my Medicare part B supplemental coverage and Medicare part D subscription drug plans.

It has been a physically draining experience. But I would like to take a few moments to assist others who may be approaching such a significant new phase of life in the near future. While the options for both parts B and D are more numerous than bunnies on a rabbit farm, I have chosen to focus on the Medicare, part D, drug prescription plan.

Medicare's drug prescription plan is reason #38 the U.S. ranks 37th as of 2006 in health care among the world's most economically advanced nations.

It is my hope the valuable experience I have gained these past six months or so will take much of the stress out of the decision making process for others when choosing a Medicare drug plan.

Most importantly, we should not forget to give thanks to our congressmen in Washington for working long and hard in a close symbiotic relationship with the pharmaceuticals, health insurance companies and HMO's to craft a system that guarantees the maximum health of these industries, their lobbyists, and their lobbyist's "customers," our elected representatives.

Here then are the tools I have discovered most helpful in deciding the best Medicare prescription plan, each with its Medicare gap or "do-nut hole" that kicks in to give insurers some relief in case you're too sick and in need of too many, or too expensive, medications.

AARP, that organization founded to advocate for retired people, has been very helpful. One word of caution, however, they recommend but one prescription drug plan themselves. It's through UnitedHealthcare and doesn't mean it's necessarily the best one for retirees. UnitedHealthcare probably paid AARP the most of anyone for AARP to endorse UnitedHealth. Remember, when it comes to health care, concern for yours doesn't come first!

That aside, this AARP provided form proved very helpful. It allows you to list up to 10 medications you're on or will need in the future, their present cost, and what they will cost you under different plans, many with multiple copay sub-plans. I'm not sure how many plans I received solicitations from in recent months, in the 10's, 100's, 1,000's, but I'm sure a number of acres of Amazon rain forest trees gave their lives up for me.

If you'll notice, the worksheet recommends you "print as many as you need" copies for as many plans, their sub-plans and their sub-sub-plans as you're considering.

One of the other reasons to make lots of copies, besides all the incredible choices given (some come with free lunch seminars, or your own personal insurance agents who'll come visit you in your own home!) is the fact you must decide the plan best suiting your needs based not only on your current prescriptions being taken, but the future medical conditions you'll encounter as well. That's because not all plans cover all medications you might need.

During my drug plan selection process, I became very stressed. I developed hypertension, and indigestion soon followed with acid reflux, precursor to peptic ulcers. This was actually a wonderful fate, because I now know some of the medications I will likely need in the future! (It helped whittle down my choices by (just) a couple.)

But what follows are the really wonderful tools that can assist one in making decisions of which drugs they will need in the future. Knowing this, you can proceed with AARP's worksheet knowing that, come 2014, say, you'll probably need anti-cholesterol, hypertension, hepatitis-C, and multiple sclerosis meds. Or maybe, prescriptions for bi-polar disorder, thyroid, gout and rheumatoid arthritis (with the cholesterol problem, no doubt).

Keep in mind, the more you are willing to spend on the aids shown, the more likely their accuracy, which can save you money in the long run.

GOOD - Magic Eight Ball
Keep in mind, it can only give you "Yes" or "No" type answers. Hence, one will need to ask it leading questions and, depending on how "dark" your mood is about the future, it could lead to some maladies one would rather not really face, i.e., "Will I develop alopecia capitis totalis?"

BETTER - A real crystal ball
Better than an Eight Ball, but best read by a professional. May foresee afflictions via images conjured in the ball. However, the interpretations are still rather unspecific. (NOTE: Ignore the $1 bill in above illustration. A professional crystal baller will cost you at least a 100 times that for a short session.)

GOOD - Tarot cards
Like the crystal ball, however, doesn't do well naming specific diseases and the medications you will need for them.

BETTER - The i ching
With more combinations and permutations than tarot, definitive predictions as to your future disorders and diseases may be more specific, helping greatly in cutting down your Medicare, part D, plan options.

WORSE - mechanical "carnie" fortune teller

Least recommended as reliable unless you only have 50 cents to invest in your Medicare, part D, decision making process.

BEST - Your own personal swami.
Reminiscent of the Beatles' transcendent enlightenment years of the 60's, the one most likely to predict what diseases you may face in the future. This could provide you with the most valuable information for deciding which Medicare, part D, drug prescription plan is best for you. But be careful, make sure you procure a licensed professional with an excellent reputation as there are a lot of faker fakirs out there!

FINALLY - Divining Rods

While your choices in choosing the right prescription drug plan may be a bit overwhelming and, yes, while most folks in other advanced nations like France or Cuba don't have to worry about future afflictions they must suffer to determine which plan may or may not cover them, be thankful that here in the U.S. we get a say in it. We get choices. Thousands of choices! And, as a result, decisions to make! Good luck!

(Oh, and by the way, this last aid, a pair of divining rods, are designed to help you locate water underground. They won't actually tell you whether you'll get breast cancer or prostate cancer (if you don't have breasts).

But after finally wading your way through the myriad of Medicare drug options, you may get some ideas of where you might like to stick these rods!


D.K. Raed said...

OMG, I had NO idea! And here I was sooo looking fwd to medicare, knowing that is the only health plan available that cannot refuse pre-existing conditions (unless the pre-existing condition involved working for the govt).

But WOW, pre-existing is NOTHING compared to trying to decide what you may have in the future! Thanks to your illumination, EK and I will be singing The Beatles, "When I'm Sixty-Four" today.

ps, I don't know if this helps, but when my dad was faced w/the Part D "choice", he declined as his insurance "plan" (the V.A.) already covers all his Rx's for zip, nada.

eProf2 said...

When I retired four years ago the only option I had was Medicare and a gap insurance policy as medicare only covers 80% of your total costs. Then, Part D came along. I opted for the AARP Part D for the first year of that option. I spent four or five months trying to figure out how I could package everything into one plan and save some money from the gap insurance program which was nearing $200 a month. I finally went with Humana. The plan requires that I assign my monthly AB&D payments to them (I don't lose Medicare, however) plus $46 a month for full coverage, 100%, or so I think. I won't really know what I've got until I need it. Generic drugs have come down a lot in the past two months with three month supplies costing only $10.00 at our pharmacy, which is a good thing. Still, the whole insurance gig is a big pain in the ass and very complicated. I listened to a medical doctor on NPR trying to figure out what to do for his 80 year old mother. He finally went with an HMO, like mine, and said he was crossing his fingers for good luck. If a doctor can't figure it out, who can? I'm for a single pay full coverage system based on ability to pay -- period! As Michael Moore says, take the profit out of our medical system and we'll end up with better medical, cheaper medical, and more research. Thanks, however, for the primer. Thankfully, I've alread gone down that road -- for this year as you have to declare every year from November to December. Good luck!

Border Explorer said...

I appreciate all the time it took to research and to post this in such an interesting way.
Are you going so let us know when your birthday occurs?

Fran said...

Inadvertantly, you have added MORE things to have to choose! I am leaning towards the Swami & Crystal ball, but am also considering the i ching as a back up.
Our Congressman tells us while people are mired in the gobbeldygook of these Medicare plan choices, there is some fine print that makes the Social Security program eventually go away. He's not so upset about it because his ass is personally covered by the Federal Gvmnt ins program.

All I know is my Mom pays $500 bucks out of pocket EACH MONTH for her meds that Medicare does not cover. That's $6000 a year- and she worked & paid into the system until she was 76 years old. So any extra perk she can glean now I am happy for her... leather orthopedic shoes, a walker- I'm sure she's long since paid for them in taxes taken out of her checks.

So about this birthday..... will you reveal the magic nimber?

Remember this-- having birthdays beats the alternative

horsedooty said...

I have my med insurance thru the VA and without it I have no medical ins. You can say what you want about it but for me it works quite well.

¡yo soy Horsedooty!

dada said...

D.K. - perhaps you and EK will be spared the inundations of the insurance cos. ~ I pray.

That's because MAYBE our next president will activate a single payer plan as eprof advocates. (OK, OK, so much at my failed humor attempt.)

Which coincidentally, eprof, perhaps it was the excellent company or the ample good wine that flowed generously like water down and over the rocks of the Big Rock Candy Mountain, but this past spring at the gracious invitation of our own Border Explorer to a pre-caucus (Texas primary) party at her home, I was feeling a little testy. That's because of the two choices presented us that evening, neither were advocates for a single payer system. The debate was all about who would better provide insurance for all Americans.

Or maybe it was the wine and watching Mrs. Dada spend a couple of hours over a number of days between a nat'l hospital chain and an insurance company trying to resolve an unpaid $10.99 (!) hospital charge for her 83 year old mother.

The cost of resolving that claim by decently paid hosp/insur workers must have been in the 100's of $$ before it was all resolved, not to mention the time invested by both PLUS Mrs. Dada and her mom.

Or, maybe it was just the good wine that, out of dissatisfaction of our 2 democratic choices, I tried to bring "clarity" (as gained in a claret [J/K], I failed) as to what was NOT being addressed that evening in the insuring all Americans as advocated by the two candidates being considered.

Anyway, thanks again B.E. for what was a pleasant evening.

As to the date of my impending birthday, all I can say is I share the same birthdate with my lovely TX senator, Kay Bailey Hutchinson, which has given me an idea!

Maybe I'll just ask senator Hutchinson at our joint birthday party which Medicare options she settled on for herself and then just follow suit?

Yes, why didn't I think of this last December and save my BP and tummy all the stress!

dada said...

HD - several years ago when the new VA wing of the local army hospital was opening up, they were soliciting veterans to come sign up. I didn't go, figuring the only wounds I rec'd during the war were broken hearts.

I'm thinking maybe I should have at least gone and checked out any options they may have offered.

I'm glad this is working for you.

Fran: The i-ching thing may actually be the best possible solution, i.e., if you enter Part D Medicare plans in the next to next outer cirlce (with the yellow/blue/white/red segments (16/qtr circle), each divided into four subsections of their own (for a total of (4x64 = 256 options) and designate each with a specific sub- plan, and then your more likely plans for the inner circles, hang in on a wall, go drink (at least) 3 good ales then throw darts at it, you may come up with an answer of which plan best suits you (assuming you don't have the unfair advantage I do of a Texas senator born on your exact birthdate that you can ask what she's doing for her Medicare healthcare costs come July).

In the meantime, I find your mom's story re meds tragic.

BTW, just got off the phone with family in Portland who reinforced my cynicism with stories of trying to get an elderly mother off those "'t-need-to-order refills-they're-automatic supplies of oxygen. After their doctor told them she didn't need them, THEY CAN'T STOP 'EM! ("There's plenty good money to be made with supplyin' Medicare with the tools of the trade!).

Same for a wheelchair that was so convenient to procure and which is yours after a couple years of so many $$$/mo. Point being, for the cost of a wheelchair they coulda procured on their own on the open market, they coulda provided 8 or 10 wounded vets with wheelchairs for the same price as the "convenient" wheelchair that Medicare is being bilked to pay for.

Ay, ranked number 37 in healthcare among First World nations, we are!

D.K. Raed said...

"perhaps you and EK will be spared the inundations of the insurance cos. ~ I pray" .... I'm glad you explained that further, Dada, because for a moment, I thought you had just come up with the ultimate euphemism for death!

"MAYBE our next president will activate a single payer plan" .... hahaha and HAH! If it's McC, we can count on what might be called an "early death benefit". Similar to the popular "early retirement benefit", we will be paid some ridiculous amount for checking out early, thus saving govt funds for perpetual war.

BTW, you should still check out the VA just to satisfy yourself. My dad didn't think he'd qualify either, but it's not based on war wounds, it's based on age, income & need. He qualifies for free Rx's, but still uses his supplemental medicare ins for anything other than Rx's. Since the VA is allowed to negotiate drug prices & get volume discounts, unlike medicare, he feels like he is SAVING taxpayer money.

Utah Savage said...

You left out the Runes. My personal favorite.

I have been on the part D for several years. I am also taking every fucking drug known to be particularly expensive and universally necessary for those of us at a certain age. AARP's United Health Care it is. What I hate from AARP is the tons of junk mail i get from them. They want to sell me crap I don't want or need, like life insurance. I have donated my remains to my local teaching hospital, The University of Utah. They will provide the death certificate, pick up the trash so to speak, use what they need and study it like the archaeology lesson it will be. No funeral. Hooray! No expense for anyone. Hooray! And it's iron clad. No one can overrule my wishes in this. They can fight like dogs and cats of the cookbooks, the red leather club chair, etc. But I won't care.

dada said...

DK - Thanks for the VA encouragement. Truth be known, I kinda threw that out there for "audience" feedback. We'll see. (I'm not certain how poor we need to be but, given enough time, I've no doubt those conditions will likely improve in the next few years.)

Utah Savage: Very funny comment and thanks for reminding me of my most serious omission - the runes! No doubt a valuable resource in any important decision making one must do.

Sounds like you have everything pretty well planned out. Isn't it ironic that while here on this Earthly plane, we must remember every Tuesday, Thursday, etc. whatever, to not forget to 'take out the trash' but the day we 'cease,' we become the trash whether we go to some Univ. med lab or are pumped full of preservatives that will eventually invade the ground water and end up in someone's coffee or kid's Kool-Aid.

Fran said...

Your theory is interesting Dada, but your meds list, if shared with your female Senator, may have you on estrogen hormones, and other female related meds. As always, read the fine print.

Border Explorer said...

I really enjoyed our pre-caucus party, Dada--and having you and Mrs. Dada present really topped the evening for me.
Now, Everyone, ANNOUNCEMENT (ahem):
according to Wikipedia--"...Kay Bailey Hutchison (born July 22, 1943)..."

dada said...

Fran: Thanks for the reminder. I'll try to keep this in mind. However, what would happen I wonder if I forget? Would I get more in touch with my feminine side?

And to Border Explorer, "Oh, thanks a lot for making everyone's research cheap and easy!! Pffffth! (grin)

You know, I don't know whether to be proud or scared to death to admit: "I'm four days older than Mick Jagger!"

D.K. Raed said...

News Flash: Kay Bailey Hutchinson and Mick Jagger arrested for a 3 AM illegal entry into a TX Medicare Clinic! Ms Hutchinson says she was there looking for John McCain since he often takes refuge in senior hang-outs during flashback moments. She is his TX "minder" since that is one state Joe Lieberman refuses to enter. She had no explanation for the late/early hour, except to say she hopes McCain will fondly remember her services on his behalf as he makes his Veep selection. Mick was quoted as saying, "Hoi, I were just follering the blond bird who said this place had the best dope!" Neither party seemed to notice the rather shadowy character who slunk out the back door just as they were entering, carrying a shitload of Part D Drug forms ... although one of the back-alley bums would later say, "he looked a bit like Abbie Hoffman, and kept muttering about casting a spell to levitate the building, then he threw a perfectly good crystal ball into the trash & stabbed it with a pair of divining rods before setting fire to the medicare forms". The character was accompanied by a very handsome black and white dog who was chewing on a rubber 8-ball. Police noted that the medicare building appears to have shifted slightly on its foundation, so the character's incantations were not entirely unsuccessful. Border Agents are on the lookout for any person/dog matching this description.