Health Care Hell

This was going to be a simple rant about the $419 we spent on prescription medicines today – and that was after the insurance company paid their pitiful part. But I find I can’t rant about our current insurance without getting into why we no longer have our previous insurance. So the back story goes like this.

A year and half ago or so, I reached the magic age of 65. Hallelujah! Benevolent Uncle Sam was now going to provide me with Medicare coverage. For months prior to my birthday, I was inundated with information from a multitude of insurance companies offering all manner of coverage. Part B, Part D, supplemental, replacement, on and on… When I tried to get further information about the offerings, I became hopelessly entangled in voice mail hell or disconnected or if I did manage to reach an actual person, told that they didn’t cover our area. Hellooo – why are you sending me brochures if my area is not covered?

I finally settled on one company that seemed to be a major provider in this area. I agreed to allow a representative to come out to the house and pitch their product. The coverage sounded good and the premiums were reasonable – much better than what GolfGuy was paying through a well-known senior citizen organization. Forms were signed, hands were shaken, and the coverage would take effect the 1st of the following month, one week from then.

Early the following morning, GolfGuy had to rush me to the emergency room of the regional medical center in the BigTown. Subsequently, I was diagnosed with cervical cancer, monstrously high blood pressure, and kidney failure (loss of function in one kidney, reduced function in the other). The fortunate part of this is that Medicare coverage had taken effect the 1st of THAT month, even though the other coverage wouldn’t kick in for a week.

The new insurance proved to be quite good through all the months of treatments – co-pays were not unbearable and there were no hassles about payment. GolfGuy signed up with the same company during the open enrollment period. The drug coverage was exceptionally good – I paid $4 each for my 3 prescriptions at Walmart and GolfGuy got his through a mail order place and paid little or nothing. The insurance even paid for our memberships at the local health club where we went for Silver Sneakers exercise class.

Then rumors started flying around the class – the insurance company was going to raise premiums by as much as 400%! That couldn’t be true – but a phone call to the agent confirmed the bad news. The reasons being heard were that there were too many cardiology and oncology (heart and cancer) claims in our county. No brainer – large population of retirees and large population of Downwinders (people adversely affected by the above ground atomic tests by benevolent Uncle Sam in the Nevada desert). And subsequently, a concentration of medical specialists in those areas – drawing people to the facilities. What did the insurance company expect when they set up shop here? However, rates were NOT raised in neighboring counties or throughout the whole state.

Thus, we were forced to change insurance companies. Our agent recommended one that he said was a “good replacement” – this company was looking to take over from the other company. It’s not nearly as good – particularly the drug coverage.

GolfGuy and Dr. Dan have been going around and around with the company, trying to find medications that are effective on GolfGuy’s issues and that they will cover. The company finally came up with some, and those were the ones we picked up today. My one prescription was $4; GolfGuy’s 4 prescriptions totaled $415! At least that’s for a 3 months’ supply, so that brings the cost down to a slightly more reasonable range. The total cost of our prescriptions for this year after a bit more than 3 months has almost reached the total cost for the whole of 2008!

I fear we are locked into this situation until next year when open enrollment rolls around again. Health care has become a huge national shame, and all the high-sounding talk out of Washington, D.C., is but posturing and hot air from the politicians who don’t have to navigate the hell of health care.