Home > Winning the Battle but Losing the War?

Winning the Battle but Losing the War?

April 20th, 2006 at 08:06 pm

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.

3 Responses to “Winning the Battle but Losing the War?”

  1. KNORMAN Says:

    There are hundreds of plans out there for Medicare Part D. You probably want to check which ones pay for your mom's prescriptions and also choose one that has no deductible and no loop hole- Many of the options have a certain amount per year they will pay, and then you will have to pay all the medication costs until you meet a certain limit. This won't be a problem if your mother has ongoing medication that does not exceed the loop hole amount. Also, if you don't sign up for the prescription plan, medicare will up your mother's premium anyways as a penalty. It will take some research, but in the long run, there is a plan out there that will be cost-efficient for you and your mother. I work for DFCS, so I know a little about the new system. Try this website to check out plans: . I hope this helps.

  2. katwoman Says:

    Thank you for the response. Unfortunately, for my mom and her formulary, the total out of pocket costs will be more than most people pay. She doesn't qualify for extra help and her income is more than any subsidized state programs. But her income isn't too high for patient assistance programs. I've had non profits that run programs for seniors run the various plans and they came up with similar results to what I came up with on medicare's website.

    One thing is interesting. We ran the BCBS plans (of which there are 3) and my bro called BCBS. What came up with and what was quoted to my bro over the phone were 2 different things. I wonder why.

    In the end it looks like we will go with a plan. Speaking with pharmacists I found out that I can choose which scrips I want under Medicare D and which I choose to pay for outside Medicare D. This is important since her generics are extremely cheap and can be bought in bulk and split. This tactic can keep her out of the donut hole making sure the expensive meds are fully covered.

    So many tricks.

  3. mjrube94 Says:

    Sounds like you have your hands full. Dealing with bureaucracies (sp?) is never easy. Good luck!

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