Hi all -
I'm glad this was brought up; I was just put on this stuff 3 days ago (100MG), was given a 30 day free supply, courtesy of Astra-Zeneca... And trust me - they can afford to give ALOT away.....
Problem is - more and more ins. co's (I have Aetna for now - soon to be insureless since I've already 'capped out' for the year) have mandated formularies - which more/less means that they don't care what you doctor tells you you need, the ins. co. has teh ultimate 'say' as to what you get...
For Generics, I used to pay $10, $20 for Brand. Now they changed that to 80%, I pay 20%. Now for some, that was in my favour; for others, they went up. For Brand names, like most of what we take, they 'meet you half way' (50%)... Isn't that special? So instead of having to pay $20 per brand name, I now have to pay 50% - and all that on $150/week with what I get on DB. They also capped the amount they would cover - whether generic or not - at $2,000 PER YEAR... I can literally eat that up in 2 months; in fact, just got a letter from them saying I've hit the maximum on Outpatient psych, counseling, or other 'mental health services; another one stating I have EXCEEDED my maximum on diagnostic testing and I should 'expect a bill for the difference from the provider'; and the third one said that "I need to plan ahead and/or talk to my doctor about current medications as I have utilized $1,872.00 YTD for RX coverage...... So in 3 months time, I used up damn near everything - and I still have to cough up another $142.00/month.... Well, obviously THAT will not be paid since I literally have no coverage for anything......
My only saving grace? I have to fill out EACH company's 'poor folk' form in order to get my medications free-of-charge. Another kicker to this? It is only good for ONE medication per manufacturer. Since I have 3 that are made by A-Z, then I guess I have to pick the most expensive one (the Seroquel if they keep me on it) and go sell my behind on the streets to pay for the rest. It will be several months before State Medicaid kicks in, so I may end up having to go without again... It won't be the first time, nor the last, nor am I the only one that is up against several high-profit corporations.....
I know DaveyJ (hope your move went well by the way - I apologize for not writing to check on ya
] has INCREDIBLE resources that helped me out. He pointed me towards NIMH and other agencies that offer 'some' assistance. There's a waiting line, so be prepared. By the grace of God, I found a local behavioural clinic that offers low-to-no cost services, depending on income, nd they have on-site case workers to sign you up for State Medical (in Indiana, they call it "Hoosier Healthwise"). i guess it is not truly 'medicaid' bcuz you have a monthly premium to pay, of course dependent upon your income and family size, but I tell ya'll this - it is 100 times BETTER than any private insurance I ever had. Everyone is doing cut-backs left & right, the people who need care aren't getting it, and we're paying more and more out of our money trees that are takign over our property... I mean they are just SOOO pleantiful that I don't have a right to say a word..... Yes, sarcasm is what gets me 'over' this beauracracy for the most part....
What I REALLY do not understand is how good ol GWB and Congress passed a RX coverage for Medicare, for older people, who have to go to a damn classroom 'class' just to get information. It's further ridiculous that pharmacists have to be scheduled to handle 900 senior citizens who don't understand the Encyclopedia's they were sent about their coverage options. The kicker of them all? If they don't decide by May (I think it got extended bcuz no one knows what the hell is going on with the programs), they get PENALIZED - yes PENALIZED BY HAVING $$ TAKEN FROM THEM EVEN IF THEY DO NOT ELECT COVERAGE IN TIME!!!! Then, you are STUCK with that company that you 'chose' for a minimum of one year!!!!
I had to work w/an elderly friend of mine who is quite intelligent, but bcuz of having 300 different choices, she and I LITERALLY had to go medication by medication, price by price, and plan by plan to determine the 'most economical' choice. For example, she is on the following:
1. Lipitor
2. Singulair
3 Advair
4. Arthri??? something or another
5. Zocor
(and some generics).....
Now, Plan "A" will cover 1,2, & 4 for chump change, but no coverage for 3 & 5. Plan "B" will cover 2-5, not too great, and no coverage for 1; Plan "C" will NOT cover any, but will offer a 10% discount on them until she spends $1,000 per year and then she'll get all 5 for 80% covered. The plans go on and on and on......
Now, should her doctor change to antoher medication, she runs the risk of it either being non-covered by that provider or on the '^%&# discount" formulary. To top it all off, we went to TWO different seminars and about 5 different pharmacies - all of which gave conflicting information and really didn't know what they were talkig about.
Finally, we took 2 FREAKIN' WEEKS and did the math, etc. ALL ALONE and found out that plan "AHE-2" (being a smarty here) was the 'best choice' as long as her physician(s) keep her on the same meds. No offense AT ALL to any seniors out there, but I, as a 28 year old, had a hell of a time helping her - and I can only imagine what you [seniors] have gone, going, or are going to go through.. This was NOT thought out at all - this was put together with the DRUG CO's in mind, and again, if you DO NOT elect coverage,
YOU STILL HAVE TO PAY PREMIUMS!!!!
I don't know about anyone else, but I'd rather pay some flat-fee a month, have EVERYTHING covered whether I use it or not, and
NEVER EVER EVER have to choose between eating, paying my house pyament, car payment, or MY HEALTH... It TOTALLY disgusts me that the USA 'PROCLAIMS" to be the richest, best, and fairest country in the world when we
CANNOT EVEN TAKE CARE OF OUR OWN!!!
We spend MORE money for taking care of our 'obligations' to others BEFORE we take care of our own people.... If we spent just a FRACTION of what we did on this 'war on terror' on heathcare, I'd be willing to bet a hell of a lot of our OWN NEEDY PEOPLE would be taken care of. We ouldn't be living in poverty or relyig on food stamps, others, charities, etc. JUST TO LIVE.... I'm in this sinking ship - and I guarantee I'm on it with many many people - even people on here!! It's no wonder that they had to change bankruptcy laws and raise credit card minimums - WE CAN'T AFFORD HELTHCARE AND WE'RE FILING BANKRUPTCY'S LEFT & RIGHT TO GET OUT OF THE TENS OF THOUSANDS WE OWE TO HEALTH PROVIDERS... It's a HUGE shame that the ones who do NOT have to worry about these things are the ones who made it SO MUCH HARDER for those who DO worry every minute of the day if they are going to be able to eat tomorrow...
My final thought: If all our legislators were FORCED to use the plans they came up with for 6 months, they would ALL be crying a new lake, not a river.. As per usual, the rich get richer and the poor get poorer and screwed... Some will defend this with "well, it is better than nothing at all" and yes, this has merit - but VERY little... Just as I said in the beginning, I had 3 months of 'grace' where I didn't have to worryabout paying for all this... For the remaining 9 months, I have to concoct plans to break-in to pharmacies so I can get my meds. This is beyond sad; this is a disgrace.....
Sorry all for going off the deep-end on this one; I'm not in a manic phase nor a depressive phase right now so I had to get it out while I still could..... Hope ya'll are doing well and are doing the best you can with what you have......
I also have added two questions to this posting as a "poll":
1. Do you feel Americans have access to AFFORDABLE and QUALITY healthcare (Yes/No)?
and
2. Do you feel that the Medicare RX program is beneficial to MOST senior citizens OR the Drug Companies? (Seniors/Drug Co's)?