Sunday, September 26, 2021

Why A Person Becomes Homeless Upon Reaching Mandatory Medicare Health Coverage - True Experience

Medicare Nightmare The Government Simply Wants The Elderly To Die Off! 

People have the misconception about Medicare. Until you reach the age of "having" to go on Medicare, with no choice or say in the matter, most feel that is a goal in life where all medical costs related to care and medications go down. (Hence the misinformed wanting "Medicare for All.")
My experience 7 weeks into the mandatory Medicare nightmare: My medical costs have increased by $600 a month over what I was paying prior to August 1st. I had Marketplace insurance previously. I paid no premium and I paid a very small amount for some medications and the most expensive medications like Levemir & Novolog (insulin for Diabetes) along with Jardiance (medication for Diabetes), I paid co-pay. I was recently diagnosed with emphysema that requires an inhaler. I now pay almost $100 per month for that . PCP visits were no costs. Specialists, no cost if referred by my PCP. Again, no premium. Now, with Medicare, my Social Security is deducted a mandatory $148.50 per month premium for Medicare and as mentioned, my costs have gone up enormously.
I had to change doctors as well. I pay more co-pays than before. One month into the program, my drug costs are going up. Jardiance went from $126 to $235 from first fill to the second fill. Both insulins started at $126 and have gone up by over 20%. 
Upon entering the Medicare stage of your life, you have to pick a private insurance provider that then gets the sudden mandatory $148.50 premium that you "have" to have deducted from your Social Security. No way to get around it. You can not appeal it.
I was lied to by the person who sold me my Cigna Medicare Advantage policy. I have a document that states that when I & Medicare pay a total of $6,550 in drug costs, I go to what they call the catastrophic stage that reduces the drug costs to almost nothing. This is because I have "Extra Help (Low Income Subsidy -LIS)" based on my low income. The document was the last document sent to me by Cigna. When I call (with many times a 2 hour hold time), I am told that that document should not have been sent and I have to pay, myself, an additional $5,300 in costs before I get a reduction in drug costs. Nowhere in my copy of the policy can I find this, but Cigna is always right. I have talked to supervisors to no avail. My pharmacy has talked to Cigna, to no avail. 
With that being said, I am now shopping for a new insurance provider as the window to change providers opens on October 15, 2021, thru December 1, 2021 (Medicare Open Enrollment).
Right now, I have a grievance pending with Cigna (I expect no results as I was told someone from that department would contact me within 24 hours to 48 hours and I have never received a call.) I have also submitted a complaint to U.S. Department of Health and Human Services Office for Civil Rights but that will take quite some time. 
I grew up hearing about those who are on Medicare having to halve or reduce even more, their medications, or make choice on which medications they have filled because of lacking funds to pay for all that they require for their medical conditions. I used to think that those were exaggerations. Well, lo and behold, I am in that position now, making choices. I already have canceled by Jardiance prescription with my pharmacy, due to cost,  and soon will be looking at doing without insulins.
I just received my monthly cost for medications from three other Medicare insurance providers. Blue Cross Medicare Advantage (HMO) from $1,778.21 to $1,852.63. Aetna Medicare Prime Plan (HMO) $1,054.25 to $1,054.25. And Imperial Insurance Value (HMO C-SNP) $779.17 to $886.29.  (See screenshot for the quotes I have received on 9/26/2021).
Imperial looks to have the best drug prices and benefits. However, I would have to change my PCP once again. That is a major issue with the medical complications I have. Even then I would have to pick and chose the medications I can purchase due to the exaggerated costs by Big Pharma and the ripping off of Medicare by the insurance companies.

Considering the drug costs alone with no other costs such as rent, food, utilities, phone and pet care I have to make a choice. Have my medication and be homeless, or stay in my home and die without medications I need for three chronic conditions and one terminal condition.  That may sound extreme, but my total income per month is $1,269 after the $148.50 I lost in Social Security. Not hard to do the math. That income is both Social Security and the little amount of 1099 contract work I do.
Anyway, just wanted to fill people in that possibly are unaware of the reality of Medicare and what may be in store for people and catch them off guard. My wife who passed in 2020 was on Medicaid due to her disability, and had no costs at all for anything medical related. There is a big difference between Medicare & Medicaid for sure. Some people have both that qualify. I don't qualify unless, lets look at the scenario that I can not treat my diabetes and as a result have to have a leg or both amputated, then I would qualify for both. Reminds me of the saying, "I would given and arm and a leg for..."
Bottom line folks, the reality of the situation is that your government wants you to die off once you reach retirement as then you no longer contribute to the government and society in their eyes, and they feel you are a burden to them and society.  The government works with lobbyists and insurance companies to make sure you cannot afford your life-saving medications, and to make sure Big Pharma and the insurance companies profit in the last year or so of your life before you end up in the ER dead because you simply could not afford your medications.  That is your reward for working all your life and paying into a system.
Sad, but true.
Love and blessings to all.


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