| Today I received in the mail a survey from Rep. Rick Larsen, on Part D. It got my blood going, so I shall take this opportunity to vent a bit here, er I mean "share my views". The biggest thing that gets to me about Part D, is that it in NO WAY was implemented with the elderly or financially needy in mind. I know, we know it was made into law during Bush's term, so of course it wasn't meant to help anyone but the wealthiest and the big businesses, drugs (I'm sure there were incentives to certain plans by those companies - but I have no hard core facts) and also the mighty Insurance Machine (my shame of being from CT, withh Hartford being the "Insurance Capital of the World"). If I were able to revamp the Part D, first I would eliminate it. I know that for me, to pay both the Rx company a fee, as well as a medical supplement, aka medi-gap like insurance to help defray the cost of Mom's MD visits, and /or hospital, becomes quite prohibitive.. yet, when there was no Part D, we managed to pay one fee to encompass both at a fairly reasonable rate, and return of benefits. But, of course, once something is implemented, there is no way to remove it. So here's my alternative. Part D should be simple. Based on bids (to an independent source, or a committee that is representative of real people without special interests) submitted, a single "brokerage" or "insurance company" would be selected for EVERYONE!!! This would eliminate the confusing choices that Medicare recipients had to select from. For those of you who are not Medicare folk, nor had to choose for a member of your family, in my case my Mother, who could never have been able to negotiate the web of choices, even with the "help" of agents online and via the phone, not all of the options are equal.
- Some only cover certain drugs.
- Some only deal with certain Pharmacies.
- Co-pays vary with each plan.
- Monthly fees are different with each choice.
- Payment options are different, such as some will take it directly from your SSI, some will take money from your checking or savings account automatically, some will take credit cards, some will only take checks.
The implications of choosing a plan locks you in !!!
A good example of this is that my Mother, living at HomePlace, is set up for their system to purchase medicine for her. Their source when Mom entered in February was Payless in Oregon. Therefore, our choice was one that includes Payless as a pharmacy. Later, HomePlace changed their pharmacy to Consonus. This is something that I have no say in. Since HomePlace has residents who have certain Rx needs, they determined that this was the best resource for getting the drugs now. Probably it was financially beneficial. But, the dilemma came up that Mom's plan didn't recognize Consonus. I looked online, I phoned her plan and spoke to multiple people, and still, there was not match. If at that point I had to change plans, there is a penalty fee we'd have to pay. And, based on my earlier research, the one I chose had most of Mom's medicine in their list of acceptible drugs they cover. Luckily, I spoke to Consonus, and she assured me that I received misinformation, and that they do work with Mom's plan. So we managed to avoid a major change (this time). Recently Mom was sent to Sedro-Woolley, to hospital, to get her medicine adjusted and refined. I have not looked into it, and am going to wait until we get out of the "donut hole" (yes, we're paying full price for the next $2,500) to see if a lot of her new medicine is still covered by her plan. If not, I'll have to start from square one again, and research which plan suits her current needs best. Yes, this will incur a penalty fee.
Yes, this may recur if Mom's medicine changes again and aren't covered by her plan.
Yes, if HomePlace changes their resource, it might also require a change of plans for Mom, fee's included. Okay, back to my proposal. There would be absolutely no, none, nein, nicht, nada, rien, zero "donut holes". The idea that there is a point when the plan won't pay ANYTHING towards medication is ludicrous and negates everything about having initiated a drug plan supplemental to begin with. What were they thinking?!? The only thing that I would offer as an option in Part D, would be an "opt-out" clause. This would allow those that are well off, to not have to pay the fixed monthly rate for a drug plan within the Medicare system. Also, it would allow those who prefer to choose their own Medical supplement /Rx combination to do so without penalty. Later, if anyone chose to "opt-in" there would be no penalty. It is simply paperwork, or, a simple binary switch in the code, of 0 to 1. Voila. What we have is incredibly flawed, and I believe that most people have trouble navigating it on the best of days. So, I wonder, why didn't they talk to me first and use my system? The People Speak.
Bah Humbug!
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