General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsI just have to rant a little
I spent two a a half hours this afternoon trying to find an acceptable Medicare Part D substitute for the one I had this year, which I really did not like. Why does Medicare have to make it so damn difficult, and why does the website have to be so damn clumsy? I finally picked the one which seemed to be the least offensive, but who can tell? After awhile they all look alike and you can't really tell anything about anything.
*rant mode off*
Aristus
(66,275 posts)difficult and inefficient as possible so when people complain, the anti-government types in our...uh...government can say: "See? Government doesn't work! Let's just privatize everything!"
SharonAnn
(13,771 posts)If it were government run, single-payer, it would be much simpler.
KPN
(15,635 posts)is an important one.
Hermit-The-Prog
(33,239 posts)This is needlessly complicated.
How it should be:
Are you human?
Yes.
You're covered.
walkingman
(7,577 posts)Wounded Bear
(58,584 posts)setting aside elective surgeries, of course.
KPN
(15,635 posts)off the ill and health misfortune?!
Hermit-The-Prog
(33,239 posts)In addition to health care, we pay for an entire industry whose primary purpose is to suck in money and deny services.
IcyPeas
(21,839 posts)I was clueless up until then. I was so stressed out looking at all the plans and all the ifs, ands or buts. I had no idea it was so convoluted and difficult to navigate. I had no idea it was in parts.
I urge people to do some research before their 65th birthday.
kacekwl
(7,010 posts)Democratic party takes over a solid majority in the House and Senate next year they finally do something about this. I can hope right ?
Alice Kramden
(2,165 posts)Hope, work for it, contribute all we can to the Democratic candidates - And as Captain Picard said, "Make it so" !!!
cachukis
(2,229 posts)complained about their anticipated payout. It turns out they made a profit of $695 million or so, as I remember, in the 4th quarter of 1991, right after Andrew.
Congress was befuddled and tried to audit the insurance industry to see where all this money was going.
Congress suggested that shrinking the variety of plans would give them a better way to audit. The insurance companies fought this tooth and nail claiming that they needed to offer different policies, to, in essence, bamboozle the public to make enough money to pay out claims.
Congress bought the argument. The idea of single payer has suffered ever since.
At the time, I sold law books to the insurance industry and saw the industry's take over of health care with the HMO's.
It turns out, the advantage plans are just a feed to the insurance companies.
We need universal single payer health care. The insurance companies can still sell Cadillac plans, but when AI takes over so many more earning opportunities, people will either be dropping like flies or we will allocate some cash flow from the very wealthy for health care and a living wage arrangement. This clash is coming.
The insurance companies are going through the drill right now with homeowners insurance here in Florida.
They are way ahead of the unwary. They are not going to lose money. But most of us are.
The Wizard
(12,532 posts)everyone else is a mind reader.
Ms. Toad
(33,992 posts)It's overwhelming (but that's the program). I was pleasantly surprised that I was able to find the information for our new circumstances (my spouse will be in the donut hole) as easily as I did. Some of what I found surprised me, and makes picking the best plan quite challenging - but the challenge isn't because of the site - it's because #%*! rules, which Congress needs to fix.
Things that surprised me:
Prices for most of our standard drugs are cheaper in the donut hole than before. It turns out that most of the Part D plans pass 50-80% of their negotiated price for the cheaper drugs on to us (so they pay only 20-50%). In the donut hole, the cap is 25%, so the price goes down for the drugs where there is a high pass through price.
Prices for some drugs increase after we emerge from the donut hole. Once you emerge from the donut hole, the price is 5% OR $4.15 - whichever is more. So drugs which cost below $4.15 in the donut hole will increase in price once you emerge.
Things I knew from last year:
Price your plan both through each plan (drug by drug) AND buying each drug without insurance through Costco or GoodRx. We buy more than half of our drugs outside of the Part D plan - it's no surprise, now that I'm looking at the passed on % (which the website provides) that a lot of them are cheaper if we just ignore insurance.
The negotiated prices between companies can vary as much as 40 x (e.g. one plan negotiated $2 for a drug - and another negotiated $80 for the exact same drug). (All of the negotiated prices are available in the website, so you can see exactly what you are paying - and what the insurance company is paying, and you can add up the total spend to figure out when you enter the donut hole.)
I created a big spreadsheet last year for the 24 plans available in my area - using the cheaper of buying the meds via Costco or using the plan price on a drug by drug basis. It saved me $120 (roughly 25%), and my spouse $310 (roughly 30%) over the cheapest plan for each of us.
Based on my spreadsheet this year - I'll be using the same plan. Even though I have significant acute medical conditions (I was shocked when I counted them up recently) they don't end up in long-term medications. So I'm a cheap date as far as drugs go. My spouse, on the other hand, is on lots of medications - and added a new medication this year, which will put her in the donut hole. The only question is when (sometime between April and July). So I have to do lots of different calculations - I'm in the process of building a new and improved spreadsheet which does the "inside the donut hole calculations" I was able to skip last year. It's a nightmare. But the site makes the data I need easy to gather.
If you've got questions about how the website works or how Part D works with a generic plan I can try to answer them for you . . . I've spent way more time than is healthy on the website.
Alice Kramden
(2,165 posts)Kudos on your spreadsheet savvy
Bluesaph
(703 posts)I may need some help for my mom.
Cozmo
(1,402 posts)This has proven to be the most helpful to me. Surely every plan available in your area has inundated you with direct mail, explaining their plans. Nothing worthwhile is every easy.