Asclepios
Share Your Stories
April 16, 2009 • Volume 9, Issue 15
Personal stories are among the most powerful tools we have to make change happen.
When appealing to Congress, reaching out to the media, or working to understand the needs of the general public, the Medicare Rights Center turns to personal stories of struggles and success with Medicare.
If you have a Medicare story to share, we want to hear it. Our website publishes a small sampling of the stories we have gathered in abundance. Below are some of the stories from the recently updated page about Prescription Drug Coverage (Part D), which highlights trends we are seeing.
Aurora, CO
I have a Medicare Advantage Prescription Drug Plan and have already fallen into the doughnut hole. We haven't even finished up with the first quarter of the year 2009. My drug now costs me over $800 for a 30-day supply. It is an antibiotic that has no generic or competitors. So now I have to use my credit card and pay over 15 percent interest on the drug plus my monthly Medicare Advantage plan premiums, which provide no coverage during this time. I will have to take this drug for the rest of my life or until my credit card is maxed out; whichever happens first.
(Submitted March 7, 2009)
Northport, AL
I work with SHIP [State Health Insurance Assistance Program] in Alabama. In January of 2009 we were bombarded with callers who were dual eligible that were reassigned into PDP's [prescription drug plans] with a premium below the benchmark for our state yet the reassigned plans were very expensive. In other words, the plans are below what the LIS [Low Income Subsidy] premium rate is but the reassigned plans did not cover the beneficiary's medications well. For example, one client had been reassigned to a plan that would cost him $8,039 for the year; another had been reassigned to a plan that would cost them $9,297. These people are on LIS and cannot afford this. I went to Medicare Compare and ran a comparison and found a plan that would cost them $200 or so for the whole year, which is appropriate. I enrolled them in the new plans, but the problem is that they do not go into effect until the following month. I wish there was a way during the Annual Coordinated Enrollment Period to help duals get a plan that covers their medications well so it will be an easier transition for the new year.
(Submitted February 13, 2009)
New Baden, IL
In January of this year, when going to refill some of my prescriptions it was a startling shock when I was expecting to pay about $18 to $20 for my meds. I almost fell over when informed it would cost $317. Whereas before there was no annual deductible, now it was $295. All the brand-name drugs went up to $22 and the rest were also more, plus now I must pay $24.90 monthly to the plan. I have stopped taking one brand of medicine that would cost $63 for a refill. Since I must take two different doses of this medication it would cost $126 a month just for this one. Because of the 5 percent raise we got in January I no longer qualify for extra help.
(Submitted March 30, 2009)
Are you getting the care you need? Are all of your drugs covered? We welcome all stories about the health care system. Help us understand what is working and also expose ways in which the system has failed. We want to hear from you.
Medical Record
“The vast number of plan choices in Parts C and D has left many consumers and their caregivers overwhelmed, unable to discern which plan options are best for them. The results of this confusion leave some with insufficient or inappropriate coverage, saddled with unaffordable medical bills or unable to obtain needed health care.” (Proposal to Restructure and Improve Counseling and Education for Medicare Consumers, Medicare Rights Center, March 2009)
“We now urge CMS to adopt auto-assignment policies that assign beneficiaries to plans that maximize coverage of their current medications and offer access to beneficiaries’ preferred pharmacies. In addition, we recommend that CMS require plans receiving beneficiary reassignments to recognize prior authorizations the beneficiary obtained, step therapy requirements the beneficiary completed, and other coverage prerequisites the beneficiary met while enrolled in the previous plan.” (Improving the Medicare Program for Beneficiaries, Medicare Rights Center, November 2008)
“Providing older adults and people with disabilities the option to obtain prescription drug coverage directly through the Original Medicare program, without the insurance middleman, will provide a refuge from the rising costs, instability and gaps of the Part D plan marketplace. A Medicare-run drug benefit will provide stability and peace of mind to people with Medicare who have come to trust and rely on the program for all their other health care needs.” (The Best Medicine: A Drug Benefit Option under Original Medicare, Medicare Rights Center, October 2007)
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Medicare Part D Appeals Help for Advocates Is Here!
Medicare Rights Center’s new Medicare Part D Appeals: An advocate’s manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources.
Register for a FREE copy of this great resource.
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Medicare Part D Monitoring Project
The Medicare Rights Center would like to hear about your experience, or that of someone you know, enrolled in a private drug plan. With information about what the issues are with Medicare Part D, we will be able to demand that those problems be fixed.
Submit your story at http://www.medicarerights.org/issues-actions/tell-your-story.php.
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The Louder Our Voice, the Stronger Our Message
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Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly e-newsletter designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.
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The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives.
Visit our online subscription form to sign up for Asclepios at http://www.medicarerights.org/about-mrc/newsletter-signup.php.
Get answers to your Medicare questions from Medicare Interactive at http://www.medicareinteractive.org.