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W1GUH
12-05-2012, 02:40 PM
Hope you never need to know this, but if you do....

Medicare Part B will pick up some prescriptions.

If you've got an expensive prescription and if you don't take it you'll probably die, Medicare Part B will pick up 80% of that expense and I've been told that my Medigap coverage will probably pick up the rest.

That information came direct from Medicare, and I checked with a Duane Reade in the neighborhood and they verified that that's the case.

This info was very difficult to find. It was only after several phone calls to my Rx plan, all of which ended in frustration and prompted me to call Medicare for help in finding a plan that's "right for me." The agent at Medicare was excellent - she looked at my Rx list and saw the expense of that medicine and checked with her supervisor about my situation. It was that supervisor who told her about the Part B coverage.

political comment...

Once again, I'm very, very pleased with how good the telephone support from the government really is. The agents are always knowledgeable, personable, and can do what needs to be done in a very efficient manner. The quality of telephone information from the private sector has gotten better but it can still be spotty.

Don't believe the BS that the government is incompetent and inefficient and that private enterprise is better. That's pure hogwash when it comes to my situation here. It's the Leaders who have their heads up their asses.

And, it would appear, that the CEO's of medicare supplements cherish their bonuses and really don't care about human life.

End political comment

That's the good news.

That news makes this next Bad News not quite so bad.

Medicare supplement Rx coverage SUCKS!!!! (Part D).

My ExpressScripts coverage will only pay 10% of the cost of what they call "Specialized" medicines. This particular prescription (Enoxaparin Sodium Injection) costs about $1600/Mo. and my share is $160/Mo.

What really adds to that suckiness is is that my previous, non-medicare Rx coverage covered that with the usual $10 co-pay.

And while I was on the phone with Medicare, the agent looked for an Rx plan that paid decently for this and she couldn't find one, either.

And, just to make this more of a "fun party" --

I DO have the option of being in an HMO, and THAT coverage includes good Rx coverage. BUT -- HMO's cause all sorts of headaches at Memorial Sloane Kettering, not to mention that my doctor doesn't do that HMO anymore. What a freakin' nightmare this has been since July - and things still are not stable. Cheesh!

OTOH, that's the ONLY problem with my cancer treatment. Chemotherapy is still going better than perfect. All tumors are barely there anymore and what mild side effects I've been having are slowly but surely abating. And that's really the important part, so I guess I'm ahead of the game.

PA5COR
12-05-2012, 04:15 PM
Chemotherapy is still going better than perfect. All tumors are barely there anymore and what mild side effects I've been having are slowly but surely abating. And that's really the important part, so I guess I'm ahead of the game.

That IS what counts, all aggravation aside, your life is the most valuable asset you have.
Cheers for reading you are getting better all the time.

WØTKX
12-05-2012, 04:43 PM
My billing adventures were ridiculous, even with a high end health plan. Seems to be way the game is played. Luckily there is very little going on for me with insurance after the first of the year. With all the changes in the law nobody seems to know what to charge for services.

I have my two year checkup since first diagnosed with cancer in a few days. There has been absolutely no sign of it since mid way through my aggressive treatment regimen.

Hope to get the AOK to get implants, since the radiation weakened my teeth on the lower jaw so much that I lost a bunch. If the jawbone is strong enough now, I can get new teeth. Might have to wait a few months more though.

W1GUH
12-05-2012, 05:00 PM
'TKX:


I have my two year checkup since first diagnosed with cancer in a few days. There has been absolutely no sign of it since mid way through my aggressive treatment regimen.


That's great to hear! Hope it stays away forever, and that those implants work for you. What's the current state of implants? Last I knew (10 years ago) it was still a crap shoot whether or not they'll "take" properly. And back then, I wasn't about to gamble with multiple kilo-bucks. Is it still that way?

And, yea, the agents I've talked to are good people and DO sympathize with my plight. They also say I'm definitely not alone with this BS, as you've also just let me know.

Thanks! And thanks to you, Cor, for the encouraging words.