Silver Threads - 4/16/06
Too Old For This...

Medicare Part D - Not So Easy After All

category_bug_journal2.gif When I wrote about selecting a Medicare Part D prescription drug plan a couple of weeks ago, I gave it an average grade - at least for my simple needs. It might have been a B except that the Medicare website is so badly designed, so let’s call it a C.

Well, hold on just a minute now. The process is not done yet.

After applying for the plan I selected, I expected the next steps would move along as the pleasant woman representing the insurance carrier had explained on the telephone: my “welcome kit” would arrive in a couple of weeks along with an identification card, and I would be billed monthly as we had arranged. If I needed prescription drugs before my card arrived, said the woman, here was a number to call. It all appeared to be reassuringly efficient.

Silly me.

Random mailings and calls began arriving. Medicare sent a form asking for my name and Medicare claim number. Odd, since I already had my Medicare card in hand, but I followed the instructions anyway.

An application for Part D insurance arrived from the carrier I had selected. Having already applied by telephone, I called to ask if they wanted the application on paper too. No, that wouldn’t be necessary. The mailing was an error, probably the marketing department who didn’t yet know I had enrolled. Sorry. Please accept our apologies, etc.

Then an insurance company representative called to tell me there was a snag in my application; it would be longer until my card would be sent than I’d originally been advised. She didn’t know what the hang-up was, but assumed it had to do with a backlog of applications.

A few days later, I arrived home to a phone message from the insurance carrier asking me to call “ASAP” as there was a problem with my application. The tone in the caller’s voice suggested urgency.

That’s when the fun began.

The phone number led to the general customer service line. Each time you call, there are nearly ten minutes worth of menu choices and other questions before you sit on hold for an indeterminate length of time. I had an appointment and so hung up after 15 minutes.

I tried again the next day, went through the menu and the Q&A routine again, and way too long on hold. Eventually, I got a live person who asked why I was calling. “I’m returning your call,” said I. Thence ensued a long series of questions I had just punched into the telephone. When the bureaucracy had been satisfied, the woman once again asked why I was calling. I told her I didn’t know, but it apparently had something to do with my application for Medicare Part D coverage.

Many minutes of silence followed punctuated by my occasional question: Are you still there? At last, the woman said, “I think you’re not eligible for this coverage.”

“You think? asked I. “Well, I’m not sure,” said she.

I will spare you the rest of that conversation and the next one - a close duplicate with a supervisor who added that I am not in Medicare’s database. Since I have a card and a number, I doubted that, but it wasn’t worth having the conversation. She was certain I had never applied for Medicare.

Moving on to the third person - 40 minutes after I’d begun the phone call - I was assured that I am in the Medicare database but, because I had applied for Part D before my 65th birthday, the application had been voided and I would need to apply again.

No amount of explaining that the point had been to apply early so that I would be covered from my birthday forward made a dent. Nor did my suggestion that since my information had not changed in the intervening two weeks, perhaps the best course would be to just re-submit my original application.

Oh, no - that would never do, and I spent another 15 or 20 minutes making a second telephone application. No mention was made this time of what I should do if I need a prescription filled before my “welcome kit” arrives.

Is this what old age is about? Endless time on hold? The same questions repeated five, six, even seven times in one phone call? Mysterious mailings about information already established? Errors in Medicare and insurance records? Urgent-sounding phone calls that are not so urgent? Confused customer service people? Isn't there enough of this in our lives already?

I’m exhausted, and I still don't have a prescription drug card.

This Just In: Part D Cost Increases
The kinks aren't even worked out of the program yet, but Medicare announced last week that the cost to consumers of Part D will increase in 2007:

  1. Deductibles, for those plans which include them, will be allowed to increase by $15 to $265

  2. The coverage limit before the "doughnut hole" kicks in will be increased by $150 to $2400

  3. The maximum out-of-pocket expenses before Medicare pays 95 percent of drug costs increases by $250 to $3850

  4. Total increase in cost to an insured who uses enough drugs to get past the doughnut hole: $351.25

That is, unless insurance companies increase premiums too:

"Insurance companies say they are analyzing what kind of effect the increase will have on next year's premiums, but most say the new coverage limits shouldn't significantly inflate 2007 rates."
- The Wichita Eagle, 15 April 2006

Back in the 1960s or '70s, Senator Everett Dirksen famously said about the federal budget, "A million here, a million there, and pretty soon you're talking about real money."

For elders on fixed incomes, an increase of a hundred dollars here, a hundred dollars there and pretty soon they're choosing between drugs and food.


You know what, Ronni, you havn't even started the standing in line part yet.

You may want to invest in a good set of headphones, so that your ear will not be mashed flat to your head after a marathon call in session to your health-care provider, etc.

You must have the same insurance company I have! I enrolled in Part D ("D" for "Damned if you do..."?) last November and am still waiting for automatic premium deductions to kick in!

"Good golly Miss Molly" the old R&B song just popped into my head while reading your Medicare Part D saga.

Your Medicare experience is so senseless as to almost be funny if you were not experiencing it personally.

My husband and I signed up via telephone for the Medicare Part D( for disaster) and it went smoothly and we got our card in a few weeks and have already used it successfully. So I can recommend AARP United. Efficient and informed helpful, prompt. I know when the insurance companies and the government start tweaking and slowly raising the costs of the plans and the deductions they are going to have thousands of irate elders on their hands. And when the majority hit the donut hole and have to start shelling out big bucks it will be bad.

But looking on the bright side. Many elders will hit the donut hole just in time for the November elections. Another incentive to throw the bums out.

What a mess this all is and so unfair to those over 65. I am one of the lucky ones with a prescription plan already in place. This however, does not keep me from wanting to be active in the politics of Medicare D.

Thank you for this wonderful forum.

I too am fortunate enough to have an excellent prescription plan in place...a fact that makes me feel simultaneously grateful and guilty. I'm certainly no more entitled to decent medical coverage than my peers. However like the folks who actually manage to contact a sentient being during the carnival of phonecall chaos, I just happened to have been in the right place at the right time. There simplt must be a better way.
Chancy, I'm right here with you waiting to throw the bums out. Let's pray their kinfolks ain't waitin' in the wings.

Good grief. What political appointee did Bush put in charge of this fiasco? Undoubtedly some cronie's idiot child...

Considering Medicare is one of the better run parts of the government, I just shudder thinking of what is happening elsewhere....

I have had similar experiences helping the elderly as well as myself. Anyone who thinks ANY program should be run by the government is delusional.

Yikes, Ronni. This post makes me cringe partly because my own application went so smoothly--so far, and I have gotten my first prescriptions. I need a variance on one, however, and that has become a pain in the butt for the pharm and doc. I'm not surprised to see an increase already. It was just too good to be true. I handled all the complexities of Medicare, Medigap, et all with my sisters and stepmom. And the spend down my sister with Parkinsons unfortunately had to do when it became clear she would need nursing care the rest of her life. It became like a full-time job and I was forever on the phone waiting when people didn't know what in the hell was going on. I don't know how any older person not totally cognizant or extremely patient could deal with all this shit. Have you written about the spend down? Fortunately USC's School of Gerontology is nearby and they were a huge help to me in understanding everything--and then selecting nursing facilities. Dear God, now I know why my parents were so adamant they didn't want to be a "burden" on their families. I didn't find it all so burdensome as it was complex and frustrating. Read Rainy Day Thoughts II. Really down your alley. Don't have the address, but will recomment with the address.

Here's the link to Rainy Day Thoughts entry today:

That anyone should be put through what you went through is nothing short of criminal, Ronni.

Didn't you know, you're supposed to be retired, with nothing better to do with your time than make phone calls, sit on hold for long periods. It's really better if you don't ask questions, because the people who are supposed to help you don't know the answers, or they have the wrong answers. They've got more work than they can possibly handle, and besides that their training was inadequate, because the trainer didn't understand how the plan worked either. Talk to their supervisor? You've got to be kidding!

As we all know, the sooner changes can be made in an ill thought out plan the better, so then whenever something goes awry the blame can be placed on it being a new change to an old plan nobody understood anyway.

You certainly should know better than to try to plan ahead, much less complete paperwork, and file early for a smooth transition into Medicare. You're lucky they didn't arrest you and throw you in jail for filing while you were underage.

I'm not sure those of us with coverage that has enabled us to escape "D" can feel overly confident we're totally out of the woods. Our providers, you can be sure, are looking for lower costs and could well conclude, at some future time down the line, a change was the order of the day for us, too.

If you think what I just said reflects an attitude of mistrust, you are correct. I can't believe it could happen, but have seen enough "unbelievable" happenings to conclude anything is possible, if not downright probable.

On a more positive note, at least you haven't received a notice from Social Security informing you that you're deceased. Understand that can take years to straighten out.

As others of you have said, we surely better be ready to vote come election time, after doing our homework on the candidates, lest we get stuck with the "kinfolks" goldenlucyd mentioned.

The can help pay for changes that would otherwise have to be paid for out of a person’s own pocket.

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