I have recently begun to receive SSDI, and therefore, Medicare. The change from Medicaid has been stressful, and made more stressful by the stupid rules around Medicare D. The following is my adventure so far.
I received notice on June 19th that I would be put on Medicare. After all the hoopla trying to get the oldsters to sign up before the June 1st deadline, you would think CMS would be right after me to sign up for a prescription drug plan. Not a word have I received from them. I didn't even know if I was supposed to sign up within a month after until I talked to the benefits coordinator at my mental health center. So I got right on it, and went to the Medicare website to sign up.
Now, you must understand that not too long ago I was an RN with thirty years experience, and a pretty good knowledge of drugs and insurance issues. A lot of good that did me. I dutifully typed all my meds into the database, but I accidently pushed a "add dosage" button, and then I couldn't get rid of the error. There is a "remove" button, but it takes you to a "the page cannot be found". Now, I have done simple websites, and I can make a button that takes you where it is supposed to. Why can't the web designers for the federal government do so? This was frustration numero uno.
The second frustration was looking at all the plans that popped up and trying to see what was the best deal. Was this one with a higher deductible, but coverage in the "gap" a better deal than that one with no deductible?
What about this one where my non-generic drugs are preferred brands, vs. that one where the per month cost is lower overall? Decisions, decisions.
I thought to look at Medi-gap insurance, too, and here again there was a myriad of plans, and not much help in deciding what you needed. So I looked at Medicare Advantage plans, that cover more routine care. Finally I got lucky. There are only four plans in my area, and three of them are (mis)Managed Care that would require me to change doctors. Number four was a PPO where my doctor and pharmacy are preferred providers.
Now, I had some idea what I wanted, and I still have my wits about me. I knew a little about how the insurance industry works. I knew my drugs, and most of what I take is generic. I'm not taking any really fancy psychiatric drugs that aren't covered by any of these plans. It still took me a couple of hours to wade through the options. How in the world is an elderly person or someone who is psychotic supposed to wade through this stuff.
Then I get a call back from the plan I've chosen. Because my shiny new Medicare card says I've been eligible since 1994, they are trying to say that I have to wait until open enrollment. That means I wouldn't have any coverage until January, and the $500/month for my meds, plus any Medicare deductibles would come straight out of my pocket for the next five months.
sigh Hopefully, I have faxed them enough documentation that I really didn't have Medicare until recently that I will be able to get on sooner. But, I haven't heard back from them.
Stay tuned, I haven't even tried to have a prescription filled yet. I am sure there are more adventures in store for me.