Text 35499, 152 rader
Skriven 2009-09-01 21:25:00 av WAYNE CHIRNSIDE (1:123/140)
     Kommentar till en text av ROY WITT
Ärende: Universal health insuranc
=================================
-=> ROY WITT wrote to ROBERT BASHE <=-

 RW> 28 Aug 09 19:06, Robert Bashe wrote to Wayne Chirnside:

 WC>> Well, people such as myself, disabled and ultra-poor have to pay the
 WC>> first 250 of their medicare part D plan.

 WC>> First problem is under medicare part D one of my drugs is not
 WC>> covered and the other's $96  year.

 RB> So in other words, you have no benefit at all, since the deductible
 RB> is $250 a year.

 RW> Ask him if he's on Medicare or SSI and medicaid? 

Medicare and SSDI.

RW>  Medicare has no
 RW> deductable. However, they do have a co-pay, which is what he may be
 RW> talking about. i.e. Medicare Part D covers meds up to 80% of the cost.

After the first 250 before the drugs become free.

 RW> If he's prescribed a drug that is too costly for Medicare, then he

Nope, just proscribed.
Benzodiazapines, all of them across the board.
My generic is 17.50/mo, hardly expensive but an arbitrary decision by the
government, 

 RW> needs to get a generic, which will be much cheaper. 

I insist on the generic and it's 17.50
But if you've under 800 dollars a month to survive and you're
not in subsidised housing...

My only spurge is for the internet connection.
I do not even have a phone or T.V.

 RW> I was prescribed a
 RW> med that my healthcare provider refused to subsidize after 6 months.
 RW> That one only cost me $15/mo. The replacement is Tricor, which I get as
 RW> a generic these days, but it still costs $15/mo.

 RB> Why is there a limitation as to the type of drug? Or is that a stupid
 RB> question?

 RW> More likely, the cost. The med I mentioned above was still under
 RW> protection of the Feds' license to the manufacturer and no generics
 RW> were available. Those then, are expensive drugs.

Not the cost, a lousy 17.50 a month.
Politics rather than medicine decided which drugs would be covered and 
which would not.

 WC>> To get coverage for the second and more expensive drug, $210 a year
 WC>> I'd have to join a prvate plan. A private insurance carrier
 WC>> authorizd under part D.

 RB> Oh, brother! Then you might as well take the private insurance and
 RB> forget Mecicare.

 RW> His state medicaid program will pay for that drug.

No it won't. I am not eligible for medicaid.
However much under 800 a month my check is it is 9 dollars over the income
limit for medicaid.

 WC>> This is generally encouraged however what is generally not known is
 WC>> joining such a private plan loses you a *lot* of options regards to
 WC>> hospitalization and doctor care.

 RB> There's a connection? I must admit I don't understand why.

 RW> One would have less of an advantage not being with a private plan. Most
 RW> hospitals won't even admit you (ER is an exception) without a plan
 RW> unless you pay up front.

They have to on Medicare.

They don't usually accept many of the private plans foisted off 
on the public that follow the advice to Medicare patients on part D
to join a private insurer.

The incentive of course is part D's private insurers option free drugs
that the private insurers may well indeed provide.

But those self same private program options on Part D deprive
you of many options as regards to hospital stay and doctors treatment 
options. 

Like I said in the very first post, it's scam.

Got a month to dedicate to reading the legislation, go for it.
I had nothing else to do.

 WC>> Doughnut hole being a euphamism for medicare part D only covering
 WC>> your medications for the first half of the year as you have a cap on
 WC>> maximum drug costs per year. After that you're on your own again.

 RB> Jeez... so what's the point?

 RW> If he reaches maximum drug costs in 6 months, he's on some very
 RW> expensive stuff. 

Not so expensive, three times my $25.50/mo retail.
I read the entire legislatin at least 8 times, painfully.

RW> There is a gap in drug coverage, but it starts at
 RW> something like $1750...There is 'gap' insurance available to help those
 RW> with high drug costs. You're responsible for costs between $1750 and
 RW> $2800 if you don't have gap insurance. I don't understand this one
 RW> myself, I believe it's just something that Congress screwed up on when
 RW> they added Part D...

Yup, spring for the gap insurance and your rights to hospital stay durations
and doctors procedures are limited.

I read the legislation, it's a gift to the private insurance
and pharmacutical industry and it's a scam to the American people.

Not a great surprise given Congress is bought and paid for.

 RB> The chronicly ill need medicines in a full year, not just in half,
 RB> and not capped. I really don't understand this system.

 RW> The cap is too low, that's for sure. It would have been better if we
 RW> could go to Canada to fill prescriptions. It is said that their drugs
 RW> cost a lot less than ours.

 RB> I might note that my wife is diabetic, i.e. chronically ill, and gets
 RB> her insulin part from private insurance and part from the insurance
 RB> her former employer (the state government) still provides, although
 RB> she is now pensioned. All in all, 100% is reimbursed.

 RW> You can get that here as well, if you subscribe to a gap insurance.

 WC>> Now for the wealthy the deal is a good bit better.

 RB> Well... wealthy. At least better off, who can pay private insurance.
 RB> Not much different here.

 RB> Seems like you have a pretty difficult situation.

 RW> He may have, but it isn't as bleak as he makes it out to be.

And you know this how?
Another master of the mystical arts.

... A pox upon Windows, oh never mind it's already so afflicted.
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