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USA Drug Coverage--Worst?
Fri, 10/27/2006 - 13:28Topic: Insurance Issues
I am a long-time tax-paying American citizen with epilepsy who's now retired, and I am finding that virtually no medical insurance plan (including those offered by our Federal government) covers prescription drugs entirely, or even close to "fairly." Far too soon before leaving my final job did I just assume that because reputable doctors prescribed particular medications, I'd have the most of the cost of them handled. No way! Even with the best plans out there, there's per-calendar-year limit on what one gets "off" on his/her drugs. In my own case, as a NY State resident, I'm covered "almost-fully" up till I have reached the $2000 mark. For me, that's less than pills for three months. After that, I've got to put out nearly $4000 of my own money until the plan begins working once again. Only way around that, or so I'm told by so many people, is to have virtually no money in the bank. Go broke. Claim incapacity. Something's got to be done. More folks are living 'way past age 65 and are getting officially "screwed" by Uncle Sam. And please do not tell me about generic drugs, for the better-working, newer pills no such things exist. If you've run into these "pay-or-don't-get-them" situations, let's hear from you! Thanks.
Re: USA Drug Coverage--Worst?
Submitted by Anonymous on Tue, 2006-11-21 - 07:43
Lastly, I strongly encourage people to write their congressmen or women and let them know what is working and what is not!
Some states have set up programs to help people obtain meds at low cost or to cover costs of Medicare Part D plans. Call your state medical assistance dept or elder services and find out if there is something to help. You can also use this online resource to see what programs may help with cost of meds.
www.pparx.org/Intro.php
Good luck and don't forget to write to your congressman and woman! In New York you have some high profile ones to consider!
Epi_help
Many plans, including many of the Medicare Part D plans are quite limited, especially when you hit the 'donut hole' of amount that each person is required to pay out of pocket. Also, these plans can change what they cover and people may find that their drugs, once covered are no longer covered. Each one has appeals process - people should do their homework and ask their doctors for help appealing the lack of coverage and the medical necessity of a drug.
Lastly, I strongly encourage people to write their congressmen or women and let them know what is working and what is not!
Some states have set up programs to help people obtain meds at low cost or to cover costs of Medicare Part D plans. Call your state medical assistance dept or elder services and find out if there is something to help. You can also use this online resource to see what programs may help with cost of meds.
www.pparx.org/Intro.php
Good luck and don't forget to write to your congressman and woman! In New York you have some high profile ones to consider!
Epi_help