Medicare part D - are the drug companies and insurance companies winning? (Congress, drugs)
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A couple years ago, I looked carefully at the part D plans for medicare part D, and signed my wife up for one that I felt we could afford. I was aware of the hole, I was aware of the costs, and felt the cost of coverage was reasonable for the protection provided.
Fast forward a year. Although we moved to an area where medical costs were less, the rate on the same plan increased by 30%. This fall, the rate has more than doubled from the original rate, even though the deductible has never been met and there have been no increase in medications purchased.
At the same time, one medication that was available both as brand name and generic had its formula sold to the generic manufacturer, dropping the brand name product as an option. The cost of the medication has suddenly increased over 500%, now that it has a corner on the market.
I posit that seniors have been the most vocal consumers against the costs of drugs and that Part D was a method that the drug companies and insurance companies could jointly continue to increase the income stream from expensive drugs, while silencing their critics. Now that drug prices are increasing again, the providers of part D can charge more with relative impunity.
When the rate became more than double, I (foolishly) thought that we had to approve the increase in premium or could simply opt out at the end of the fiscal year by not paying the new premium. It turns out that the way the act was written, the insurance companies can change rates and plan policies on a yearly basis and yet the person insured has to contact Medicare during the end of the year "window" to specifically say "No, I no longer want or can afford this."
Our option now is to stop payment and have it go against our credit report, even though we have never received a dime's worth of payout. We are both angry enough to do this, especially in light of the way the government has acted to bail out BS artists and con men.
Of course ;that is the way that congresss wrote the law. You are notified every year tho if you want to change plans or dropout. Since it is SS that requires you to do it personally because it changes their payment to the compamies directly.Of course you will find that the same drugs in or out of the gap are more expensive as they are retail and not negotated prices by the insurance plan.
A couple years ago, I looked carefully at the part D plans for medicare part D, and signed my wife up for one that I felt we could afford. I was aware of the hole, I was aware of the costs, and felt the cost of coverage was reasonable for the protection provided.
Fast forward a year. Although we moved to an area where medical costs were less, the rate on the same plan increased by 30%. This fall, the rate has more than doubled from the original rate, even though the deductible has never been met and there have been no increase in medications purchased.
At the same time, one medication that was available both as brand name and generic had its formula sold to the generic manufacturer, dropping the brand name product as an option. The cost of the medication has suddenly increased over 500%, now that it has a corner on the market.
I posit that seniors have been the most vocal consumers against the costs of drugs and that Part D was a method that the drug companies and insurance companies could jointly continue to increase the income stream from expensive drugs, while silencing their critics. Now that drug prices are increasing again, the providers of part D can charge more with relative impunity.
When the rate became more than double, I (foolishly) thought that we had to approve the increase in premium or could simply opt out at the end of the fiscal year by not paying the new premium. It turns out that the way the act was written, the insurance companies can change rates and plan policies on a yearly basis and yet the person insured has to contact Medicare during the end of the year "window" to specifically say "No, I no longer want or can afford this."
Our option now is to stop payment and have it go against our credit report, even though we have never received a dime's worth of payout. We are both angry enough to do this, especially in light of the way the government has acted to bail out BS artists and con men.
If it's the government that allows this to happen (I suggest a letter to the leading democrats) and if it's the drug companies who raise the prices, why are you blaming the insurance companies?
Of course ;that is the way that congresss wrote the law. You are notified every year tho if you want to change plans or dropout. Since it is SS that requires you to do it personally because it changes their payment to the compamies directly.Of course you will find that the same drugs in or out of the gap are more expensive as they are retail and not negotated prices by the insurance plan.
Our option now is to stop payment and have it go against our credit report, even though we have never received a dime's worth of payout. We are both angry enough to do this, especially in light of the way the government has acted to bail out BS artists and con men.
Check carefully into the penalty that you will be charged if you stop paying and then join a different plan.
It will be added to any new plan and is not a one-time thing. It is an additional percentage that lasts forever.
This is a common frustration. One of the avenues you do have is to contact Medicare and file a complaint indicating you were not aware of the open enrollment. You should be able to do this over the phone (although the wait time is usually excessive.) Medicare may be able to grant you a Special Election Period (or SEP) for which you can have a one time change to any part D plan.
I know this is outside of their own rules and they don't have to grant the election, but they've been pretty liberal about granting these SEP's.
Loren
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Last edited by Keeper; 02-09-2009 at 05:20 AM..
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