62 replies to this topic

[MattD]

This is a good thread and we all are learning a bit about how messed  our system is.   Maybe  we all be better off to setup our own group insurance for older than s**t slot car guys!   

[John Streisguth]

I share your pain, Phil. The entire system is very confusing. I got my Medicare card in the mail yesterday. It says Medicare Part A and Part B are automatic, unless you decline. My (retired military full benefits) Tricare tells me I absolutely HAVE to agree to Medicare A and B to receive Tricare for Life. So I complied, and did not decline. 

 

The scary part for me, personally, is, I absolutely cannot find an answer to my question: how much is Medicare is going to cost me?. As a fully retired military guy, after three wars with full decorations, I shouldn't pay a dime. But here I am, and they just keep slicing my benefits decade after decade.

 

Bottom line of my frustration is, I won't know how much Medicare will cost me until I get the bill. I don't like surprises. I wish I could have calculated how much Medicare will cost me, BEFORE I made my choice. I could have chosen no Medicare, and gone the VA choice, but I didn't.

 

I feel as if I was forced to make a choice before all the info becomes available. Just like Pelosi: "We have to approve the bill before we can know what's in it"

 

That's how I feel right now. Medicare is being shoved down my throat and I have no clue how much it's going to cost me. I've been doing my homework for months now and this is where I am as a 20 year US Navy retiree. 

 

And I'm not even sick! All I need is BP and chol. meds and leave me alone, I'm fine! And I can't even get that now, since I'm not sick I can't get a doctor appt. therefore I can't renew my meds. 

 

I really hope this pandemic ends up improving the medical system. It was broken long before Corona and it needs to be fixed! 

  Pablo, you should call and see if you can get a "virtual" appointment with your doctor, or if he can just phone in the scrip to the pharmacy since you are already taking the meds.  There are a lot of ways that are being allowed to bypass the in person visits.

[Phil Smith]

And I'm not even sick! All I need is BP and chol. meds and leave me alone, I'm fine! And I can't even get that now, since I'm not sick I can't get a doctor appt. therefore I can't renew my meds. 

 

Wow, Paul! Those are important meds. Who won't see you? The veteran's hospital? That's just hard to believe you can't get your meds.

 

My dad was a vet. Late in his life he had multiple health problems, and he went to a regular doctor to get a second opinion on one of his issues. He told the vet doc what the civilian doc said and the VA immediately ended his benefits. Unbeknownst to my dad was he was not allowed to get any health care outside the VA. Makes no sense but that was the rule. Luckily my dad had a good nest egg, because he was in and out of the hospital many times before he passed.

 

Pretty unbelievable they don't take care of you vets better than that, Paul.

[Pablo]

Tried that. They won't do it, since I am a first-time new patient. 

 

I picked the worst possible time in history to switch primary care physicians. I went from crappy service to no service. I can't get an appointment because I'm not sick. Even if I could get an appointment, I wouldn't want to go; I don't want to be around people who are treating sick people.

 

It sure would be great if they would make an exception in my case, but they refuse to.

[Pablo]

I'm not a vet, I'm fully retired, so I don't use the VA. I could decline my Medicare, which would automatically cancel my retirement health care benefits, and be treated by the VA. It is an option for me, but who wants to do that? Not me.

 

The new primary care doctor told me it would be four months for an appointment. Then a week later they declined to accept me as a new patient due to patient overload. This was BEFORE COVID! So I switched again, to a nurse practitioner, made an appt. then a week later they canceled it due to COVID. My request to have refills was denied due to being a new patient.

 

Looks like the only way I'm going to get refills is if I get sick 

[John Streisguth]

I would start making some noise at the state level.  If you have a history of taking these meds, there's no reason you should be denied. 

 

As much as it sucks to pay out of pocket, can you go back to your previous doc for a prescription refill?  

 

There are guidelines in place to allow people taking controlled substances without this much hassle, I'm sure there has to be a way.

[John Streisguth]

Maybe this helps?

 

If you do not have enough refills remaining, based on clinical judgement and in accordance with state laws, pharmacists can dispense emergency refills of up to a 30-day supply (except for controlled medications). This emergency prescription refill law, known as Kevin’s Law, allows pharmacists to authorize an emergency fill of certain chronic medications if a doctor cannot be reached to authorize a prescription. Each state’s law may differ on:

• The specific medications allowed
• How much of the medication can be dispensed
• How often you can get an emergency refill
• If the medication will be covered by insurance 

Q: My prescription needs a prior authorization, but my doctor’s office is busy. Do you have any other suggestions?

First, many health insurance plans may override a prior authorization for certain necessary medications during a state of emergency. You may have to call your pharmacist to ask your insurance provider for an override code.

[Pablo]

I'll keep trying, thanks John 

[John Streisguth]

Don't take no for an answer...

[Pablo]

I sincerely hope in the aftermath of all this, some good changes result. This is the information age, people should be given more power to diagnose and treat themselves. Yes, I know this goes against the traditions of the medical profession - "being your own doctor isn't smart" theory.

 

I get that. But c'mon, I can check my own blood pressure, monitor my own blood sugar, and get online to diagnose my own symptoms. The medical profession in this country has a stranglehold on us. I think it's time to relax that a little.

 

Should Bunky be able to prescribe oxycontin for himself? Obviously not, and that's not what I mean at all 

 

 

My primary care doctor (before I changed) always seemed like he was just dying to find something wrong with me, every visit. You go in for a follow-up visit that HE told you to do. The receptionist asks why I'm here today. Then the nurse checks my vitals and asks a million questions, asks "Why are you here today. I answer "because the doctor ordered it". Same as last time. Then you wait 20 minutes, the doctor comes in and says "So, why are we here today?" Then takes copious notes. Says "see you in 3 months".  3 Months later, same question: "So, why are we here today?". 

 

And this is the guy who is so much smarter than me, he has the only source of power to prescribe meds for me? Sheesh. He's an idiot who can't read his own handwriting. And he has total control over my meds.

 

Don't even get me started on the "you can't get your blood drawn on the same day as your appointment" event. That's when I changed providers, and it actually got worse from there.

 

Don't worry about me too much, like I said I ain't sick and I'm staying away from those who are. I'm OK on my meds now, thanks to alternate channels  . So don't cry for me. Just pray once this is over, the USA medical profession takes a good long look at itself to change with the times.

 

I've seen medical care all over the world, the good and the bad. Republic of Panama, for example, has great care and it's affordable. They don't play the insurance game. 

[John Streisguth]

Glad to hear you got some way to get the meds you need.  I blame a lot on the HMOs, it added a huge (and expensive) layer of oversight that was touted as saving money...but now it's just another layer of bureaucracy

[Phil Smith]

I'm not a vet, I'm fully retired, so I don't use the VA. I could decline my Medicare, which would automatically cancel my retirement health care benefits, and be treated by the VA. It is an option for me, but who wants to do that? Not me.

 

I was confused by you're retired, not a vet. Seemed like the same thing to me. But I finally got it.

 

I've never understood your Bunky references. Thought it might be a relative so I never ask for fear of being rude. I just Googled Bunky. Now I know you have a rich guy in your family! Can't he pull some strings for you so you can get your meds?

[Pablo]

Phil, you aren't the only one who doesn't know the difference. Most people don't, so I'll share it here:

 

-A "veteran" is someone who did their time in the military and got out. They can receive treatment at a VA Hospital.

 

-A "military retiree" is someone who did at least 20 years, and receives paychecks and full medical benefits for life. 

 

-"Bunky" is a ficticious brother in law I made up as a humorous part of my postings, long ago. Bunky isn't rich. He lives in a trailer out back of "The Wolcott Ranch and Petting Zoo", which is also fictitious humor on my part.

 

Without humor, how would any of us stay sane?