Tuesday, January 23, 2024

Getting used to Medicare

Well, so far, I'm finding Medicare may not be quite what we thought it to be, at least the advantage plan supplement we selected. Today, while checking on in network providers, I noticed a pending claim on our account. I couldn't remember any recent medical visits and had no idea what the charges were, so I opened the claim. Imagine my surprise when I read our part of a recently filled prescription under the new plan was $595.00! And that's only for a 30-day supply! Whoa!

Immediately, I called our pharmacy to ask if the medication was sitting there waiting for pickup. He said it was. I told him the situation and asked him to restock the pills and rescind the recently submitted claim. We can't afford to pay that amount of money for one medication every month. 

Next, I sent a message through the portal to my gastroenterologist explaining the situation to her. I asked if there might be another less expensive medication I could take or perhaps an over-the-counter remedy. I'm waiting to hear back from her. 

The medication has definitely been helpful for my situation but not for that huge amount. When we were still under my husband's employer plan, the medicine was only $25 a month. What a difference. 

I don't understand all the ins and outs of our Medicare Advantage plan yet but the sales rep who helped us pick the one that fit our needs best had warned us this one medication might be expensive. All of the others would be no cost and we were happy with that. 

I don't know what people do when they have medications that they depend on daily and aren't able to afford. And what a shame that the older generation has to suffer while on Medicare. 

We've paid into it all our lives and they don't tell you the nitty gritty facts about it, like you have to pay for plan B from your Social Security check and if you want prescription drug coverage, you have to buy plan D or an advantage plan that covers medicines and other things like dental care, glasses, etc. 

We have a pretty warped health care system if you ask me. It seems the government wants to pay out as little as possible. 

I wish I'd kept track of all the money that came out of my paychecks over the years for Medicare coverage. I'm sure those figures are well above what I'm receiving now. 

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