The Medicare Hotline established by the social security administration reports diminished satisfaction ratings with users who call for help with questions about benefits. I wonder how much of that dissatisfaction is from problems with the way you get information and how much is dissatisfaction with the news you get when you call.
I have seen a number of reports and cases from older adults who have reached the “donut” in Part D benefits- the new drug coverage has a surprise for many people who depend on their insurance to cover medication. When you get to a certain level of expense, they stop paying. The coverage resumes when you reach a new threshold. From about $2400 covered at 75% to $3000 you pay all the drug cost. For some users, accustomed to paying one quarter of the cost of their medication, they suddenly have to pay all of it. That part, the donut, lasts until the drug cost reaches $3051.25 then lowers again. So there is this time bomb of six hundred dollars you didn’t budget. The RAND Corporation reported last month that the real cost isn’t the six bills; it’s that about half of seniors don’t pay it. They miss the medication for as long as ninety days. For hypertension, cardiac and diabetes drugs, there is a higher cost at the point where those conditions cause functional impairment. That point is hastened by “drug holidays”. The difference between what the government expected and what was spent adds up to a rebate from the Part D insurers of … $4 billion! That’s a lot of pills folks didn’t get.
Help doesn’t seem to be available from the Medicare folks but there is a group called The Center for Health Care Rights that can coach you through some of this. If you are a Medicare enrollee living in Los Angeles County and have questions about Medicare or need help resolving Medicare or health insurance-related problems, you can call the Health Insurance Counseling and Advocacy Program at 1-800-824-0780. And the Medicare hotline isn’t just giving bad news. Of more than two hundred people trying to get through the automated answering system, only five got the information they needed. Please press 1 now to exit.