It's done. Finally signed my mom into a Medicare D plan this morning so that she'll be eligible starting May 1 and Medicare won't penalize her later for not taking a plan when it was first offered.

I have to admit I don't like it. Costs will be $2000/yr opposed to what she used to pay ($200/yr) before her employer decided to dump the prescription benefit for their retirees. Gone will be the patient assistance programs since most will not allow anyone with any kind of scrip coverage to benefit.

So what do I like? No more paperwork and running around (see earlier blog entry).

If this isn't the ultimate convenience expense, I don't know what is.

While my prior entry had to do with drugs (really, I didn't mean it to) this one has to do with gasoline.

Three weeks ago I was in a distant suburb, one I normally do not travel to, and was stopped by a cop for not having my license plate sticker. He issued me a citation that basically allowed me to keep my license but reappear at the station no more than 3 weeks later with proof of sticker purchase or pay a fine.

Before heading out for the police station I get online and find a Trader Joe's is in the vacinity in addition to another grocer were I happen to have a raincheck for certain items.

So....didn't find anything at TJ's I needed and bought organic cocoa for $4.99 (because I don't have that in my pantry) and organic canned hearts of palm ($1.99). I like variety in my salads.

On to the grocer where I thought I'd use my raincheck for 60 items and found 13 were all I cared for. Plus I bought organic celery ($1.50) and vine tomatoes ($1.25) and organic juices (2 for $4). Except for the raincheck items, I did not have coupons for the rest.

My point here is that had I not had to appear at that police station and waste the gas going out there, I would have never made those purchases at TJ's (really, I didn't need cocoa or hearts of palm) and except for the raincheck items which I could have gotten on another trip, the additional purchase of celery, tomatoes, etc., could have been purchased closer to home for the same money.

My justifying the gas expense for this trip wound up costing me more money.

I don't track money. No spreadsheets or such but I can pretty much tell how I'm doing. If this doesn't make sense think of it as not having to weigh yourself and letting your pants waist dictate how well you're keeping to a certain weight.

That said, despite increases in gasoline, insurance premiums, and having to pay for mom's medications now that she has no prescription coverage, I find the bills are getting paid yet I'm feeling pinched. And when I feel pinched I spend more money! A dangerous and viscious cycle is developing that I have to stop.

The problem appears to be that I'm running in place going nowhere and my brother has picked up on it. These last few days he's been on me to sign up my mom for Medicare D despite the fact that total yearly prescription costs will be higher than not signing her. This may seem counterintuitive but he's sad to see me running around trying to coordinate her meds at the cheapest costs and jumping through all the hoops of various patient assistance programs. Unbeknowest to him, I was secretly thinking the same thing. While the system is navigable it does require a lot of vigilance on the part of the patient (or their advocate, namely me). This gets especially hairy when the patient requires frequent changes in meds and/or numerous meds. I've been fortunate to get my hands on a quantity of prescription offers from various pharmacies in exchange for new business and have used them all but I've also met with sour looks from pharmacy employees in regards to my liberal use of these.

There are also other costs involved that aren't so apparent. Time in having to coordinate with doctors and pharmacies. Honestly, when did it become MY JOB to get the doctor to call the pharmacy back on a refill??? Gas and time in driving to the doctor's office just to get him to write out the new scrip so that I can split pills and get that over to yet another pharmacy to take advantage of a new or transferred scrip offer. Time and energy wasted because the docs receptionist got my request for samples wrong and the doc then feels I'm using him as my own personal pharmacy. Nevermind that he won't take patient emails so that my intentions would have been clear on the first shot!

Then there's the pateint assistance programs. Don't get me wrong, these are wonderful programs that work very well. The problem arises in the cooridination of the reorders (done ONLY through the docs offices and then patient can pick up or have them mailed to the house) and the reapplication process which varies from program to program and of course, involves the doc and his office. If dosages happen to change...more paperwork and time and waiting. If the doc is out of samples while this happens it's off to the pharmacy yet again. More time and gas and, and, and....

It's no wonder I seem like a rat on a treadmill. So what do I do? Spend money to feel good. You see, if I'm out running these scrip errands (or other errands) and gas is going higher and higher it makes all the sense in the world to make multiple stops so that it won't seem like each trip is frivolous. And what would be the point of making that stop if there's nothing to show for it? So I'm shopping. With coupons and sales. Haven't lost a battle yet.