Tuesday, August 21, 2012

Overdose!

Today, it isn’t the meds talking. It is me talking about the meds.

Prior to reading this post, it bears mentioning. Since the age of 14, I paid into the system before becoming disabled due to illness. I don't sponge. I pay out of pocket for Medicare Part A, B, and supplemental Part D, plus co-pays, clinics visits, hospital stays and have no dental coverage.

Now proceed.

You may remember my recent struggle obtaining a prescription that would cost me $562 out of pocket. I eventually got the medicine for $3 due to coverage by the MassHealth Safety Net. Now, the plot thickens.

Two days prior to double knee surgery, I attempted to fill a different script. I run into the same problem, but find out that MassHealth stopped my Safety Net coverage. Supposedly, I received an eligibility renewal form, which has yet to turn up. When I contacted MassHealth to refute this, and question what happens now, this was the response.

Sorry for your inconvenience. We’ll send a new form. You’ll need to complete it and send back for review. And what’s the turnaround time? 59 days from the day we receive your completed form.

Ok, let’s see. This were 5th grade math comes in handy. 3 days to send out form, 1 weekend to complete form, 3 days for them to receive it. Up to 59 days to determine my eligibility status…Um, so I may know by Halloween. Thank you for your assistance.

It gets worse. Post-surgery, my doctor needed me to take blood thinner injections for 10 days. He mentioned my insurance may not cover them. I was prepared and they did cost $231 out of pocket. Figuring this was a one-time drug and was essential to my recovery, I purchased it.

Back to present day. My mom kindly went to CVS to pick up a script I’ve been taking since last November and regularly costs me $40. Not today. $251! When she returned home, I was outraged and called my Medicare Part D supplemental prescription drug plan (WellCare) for answers. He says, “You are in the ‘Donut Hole’”. So, now I’m trapped in a F’cking munchkin.

No. It means, now I will be charged up to 60% on generic prescriptions and 50% on name brands out of pocket. I reached my coverage limit for the year. Apparently being on disability due to cancer with complications causing avascular necrosis, leaving me physically handicapped doesn’t justify a need for better healthcare.

Supposedly, social security offers aid that I once had but was dropped as of January without my knowledge. Tomorrow, I will spend all morning on the phone with social security in a venture for prescription drug aid. If they can’t help, I’m screwed. I don’t clear enough each month to afford the number of medications I take.

I try to end all of my posts with hope. Tonight, I go to bed scared. I won’t survive without the medication. Where is the hope in that?

I’m out.

1 comment:

  1. Adam, this is terrible. The"donut hole" needs to close. It makes me sick that people care so little about health care / insurance reform. If they had to experience 1/8 of what you do I know their tunes would change. Thank you for putting your personal story out there. Unfortunately far too many Americans run into the same absurdities when trying to stay healthy in the shadow of life-threatening illness. It's not right. Be well.

    ReplyDelete