Awwwww, medicare how we seem to have such a love/hate relationship now for so many years. Medicare, you cause me a lot stress. However, I owe my life to you in some ways. You are difficult to understand, but you usually come through for me. I complain because your policies are confusing and unreliable, but I am still alive because you cover 'just enough' to keep my health under control.
I have been losing sleep, stressed to the MAX, had a few breakdown 'episodes' and have even pondered the thought of "Am I worth all this". I have medicare part A & B. My part B plan will cover my prograf with a 20% copay which ends up being roughly $220 a month. I wouldn't have to worry about the "donut hole" as it does not apply to part B coverage. I also pay extra and I have a Part D plan (prescription costs) Under my current D plan Prograf is a covered formulary drug with a copay of around $7.50 HOWEVER, they denied paying for my prograf due to the fact they could pass the buck to my part B. I just feel like I am on a sinking boat sometimes. A slowly sinking boat. My premiums for my coverages comes to $120 month. . .so now my out of pocket expenses are already at $340.00 I take a lot of other meds than just prograf! I am not sure what those copays will be this year, but hopefully most of my generics will be cheap. It's hard not to feel like my drug cost puts a hardship on Bryan and I. . . .I feel guilty sometimes. I get $889 from medicare subtract the $340 and I end up with only $548, it's just hard to feel like I contribute enough.
Life after transplant has many wonderful things that I get to do. . . unfortunately it also has some pretty stressful and unfair things too. I wish we had more money, I wish I didn't have to deal with insurance, but don't we all? I AM blessed so much to be so healthy and alive & to have the fight to call HUMANA and Medicare and give them a fight. I for one DO BELIEVE that changes in Medicare/Healthcare need to be addressed. Things like what I am dealing with is just a crack in the system. There is no "RULE" so HUMANA can or can't choose to cover it, and ME the patient who has the prescription coverage pays the price for it.
I have even looked into the drug companies "extra help" plans to make sure the patient gets the medication they need. . . .however, patients on Medicare or Medicaid don't qualify for the help. I just wonder sometimes if I am worth all this. Bryan tells me every day I am. I guess to him I am worth it and he is who matters.
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