As someone on Medicare, I got to venture into the crazy world of Part D this past winter. Today, I received my first "Smart Summary" from the private healthcare insurer I chose to administer my Medicare Advantage Plan (which I pay for in addition to the Medicare Extra Help benefit I was awarded because we are poor enough to qualify). It was a 3 page, pastel-colored mailing with pie charts and breakdowns, laid out like a newsletter. It even has an index. Fancy. It covers a single month, January. Yes, I know it's March, but - clearly - these things take time. I picked up two prescriptions in January. They were both 90 day fills, which is the way I've been buying my prescriptions (online) for the past few years, however I had to use my local in-network pharmacy because I needed them too quickly to get set up with the preferred online pharmacy. I hate Walmart, so I'll just leave it at that. Back to my fancy mail ... The first page has a pie chart explaining how much this plan should mean to me: what I paid ($5.20), what the MEH benefit paid ($22.99), what the insurance company paid ($1.47), and the insurance company discounts ($64.20), and this is equated to the Average Retail Price. In other words, $93.86 is what I would have paid without my savior, my insurance company. Nevermind that last year, when I ordered those exact same prescriptions (online) and paid for them completely out of my pocket, I paid about $30. Remember, in addition to the Medicare premium I paid for January (about $100) and the $29 insurance premium I paid to save me money on prescriptions, I paid $5.20 at the pharmacy, and they paid One Dollar and Forty Seven Cents. Page 2 of this fancy newsletter breaks that down two more times, I guess to make sure I could see how beneficial it is for me to have this coverage. The remaining pages explain other helpful information, definitions of things like "total drug costs" (which was broken down no less than 4 times in the first couple of pages), and specifically a note that they currently are not making changes to their prescription coverage list that may or may not affect these two drugs I take (thanks for the heads up, because I'm not sure I could afford them without my beloved Part D).
end sarcasm
My insurance company that paid LESS THAN I DID for my prescriptions! This wasteful and offensive mailing is a picture perfect example of why the profit needs to be taken completely out of the healthcare system. Poof, gone. Like Canada. The insurance industry is corrupt and it's A SCAM, folks! While I *have* to pay for this because I asked for some help affording treatment for my chronic autoimmune disease (help I paid for all those years I could and did work), every bit of my diabetic 7-year-old's CRAZY EXPENSIVE healthcare maintenance is paid for by yours truly because she has a chronic autoimmune disease. Oh, and the drugs my doctor recommends that I should be taking ... not covered (and not affordable, which is why I asked for help in the first place). Fancy that. Universal Coverage For All. The End.
Thursday, March 8, 2012
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