Sorry I didn’t do a post today. I’d completely forgotten we had a doctor’s appointment. To make matters worse, we’re still locked in battle with the insurance, which seems to think Dan’s diabetes should go untreated because any meds that treat it are not covered. And we don’t have a second mortgage’s worth of money to hand.
That’s life. We’re doing battle. This was the inevitable result of Obama Care’s regulating insurance. Every year it goes up and it covers less.
This too shall pass one way or another. Right now I have a righteous mad, and I’m going to have some tea, then write fiction to calm myself.
I would very much like the government out of our healthcare yesterday, please and thank you. But it’s going to get worse before it gets better.
So, tea and fiction.
According To Hoyt 
When I get angry and frustrated with the world in general I write a Mil-Sci-Fi story about the corruption in the world. Lot’s of people die, lots. I generally feel better afterwards. No one in real life dies, and I can kill off politicians for fun. I have them meet their just rewards, where as in real life too many of those scum sucking evil son’s bitches ride off into the sunset. Protected by the same people who are sworn to hold them accountable. In that world, they get killed as well.
“Sorry congressman we’d love to come your rescue, but you ordered everyone to remain in position so no one would try to kill you. You have to lift that order, then we have to draw supplies because you mandated all ammo be locked up. Then we have to fuel all the vehicles, which comes from the main depot. Then we have to get approval for the mission by the mission planners and the anti-bias committee you installed. After we get all that cleared up we should be there in about five hours, give or take a Hour or two” 2nd Lt. Collins replied.
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Certain authors I read often have character “heels” with names that remind me of folks I do not much like. Purely coincidentally of course.
Probably would be rather therapeutic if it wasn’t pure coincidence.
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Andrew Sprugle was unavailable for comment. :)
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Healthcare is so much fun. I help my mother to an out of town (by about a hundred miles each way) appointment, get back to her house, go to open the door, and just collapse. Luckily, my brother arrived there shortly after that and hauled me into the local ER, which after several hours of testing, put me into an ambulance to take me back to the same hospital I had visited with her earlier, and got to spend several days there. After release I’ve been going to follow-ups.
And then I finally received the first of what may be many bills, that afternoon I received a call asking when did I plan to pay them. And not all have finished with insurance processing yet.
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0bamacare did exactly what it was intended to do — drove thousands of doctors and nurses out of medicine, and installed hordes of bureaucrats in their place. Doctors can’t even make medical decisions any more; they have to defer to the bureaucrats.
The more government meddles in medicine, the worse it gets — and the Leftroids demand more government meddling to ‘correct’ the problems!
Government licensing rules arbitrarily limit the numbers of doctors, nurses and hospitals, making medical treatment more expensive and less available.
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“which seems to think Dan’s diabetes should go untreated because any meds that treat it are not covered”
Which is kind of ironic given that in the news right now we’re suddenly hearing about a whole bunch of diabetes drugs that also happen to be very, very good at helping people lose weight.
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yeah. We’re trying to get two of those. But it’s verbotten
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I thought FICUS was running with the idea that he made those drugs, especially insulin, affordable by his totally awesome negotiating ability. I guess not.
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We’re trying to keep him off insulin. These are the newer drugs. And yeah, no.
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Ozempic has kept my dad from going to insulin, and he lost like 40 pounds load off his wrecked knees and spine. But he’s on Medicare; it’s horribly expensive otherwise and a couple times his refills were delayed due to the strained supply from all the people just trying to lose weight (trick is on them; the weight just comes back if they stop taking it).
On a personal note, the cardiologist appt I was referred to back on like Jan 24 is going to be delayed a second time, due to limited staff and hospital scheduling screwups. At least my vertigo seems to have stabilized some (either that or I’m learning to adapt; riding in a moving car requires I keep my eyes closed like 80% of the time), although the neurologist gave me a prescription for amitriptyline to see if it would do anything to the constant headache, and it does nothing for the headache but it does seem to cure my insomnia. Sadly, one of the possible side effects may be increased dizziness…
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Only insulin. And only by undoing an undoing of a Trump-era Executive Order…
The new drugs – ozempic is one, but I don’t remember the names of the others – are too new to be affected by that. Their only approved by the FDA for use in treating diabetes, but it’s been noted that they curb the user’s appetite…
On the other hand, they haven’t been around for very long, which means that possible side effects for would be dieters aren’t known. I think Insty’s had a link or two up that suggests that there might be some possible liver damage from long-term use. Most diabetics would probably say, “Fine, I’ll take it anyway. Liver damage is slower than diabetes.” But people who just want it to lose a few pounds might want to think long and hard about it first.
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Long term side effects aren’t fully documented. However, has been early reports of when used for weight control, and get off it because met target weight, the weight comes back quickly. Pretty much universally. That is a problem. Beginning to look like if you go on it for weight loss, have to stay on it, which may cause additional complications.
With a T2D use, that is going to be a given.
I tend to lose weight, then gain it back. Difference is it does take me more than a few years for the weight to come back. Longer than it took to lose it. Since it takes me a long time to get any weight off, my weight loss/gain yo-yo, isn’t quite as bad (still not good).
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Which shouldn’t be a surprise regarding the weight loss. All that the new drugs do is curb your appetite while you take them. The moment you stop taking one of the new drugs, your appetite is going to come roaring right back as strong as it ever was.
There are some people who will take a look at all of the weight that they lost, and be encouraged enough to keep it off. But the majority of people are probably just going to return to their old habits and put it right back on.
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Yep, got that T-shirt. Was a Large, now a 2XL. At least the 4XL crap got tossed after the first round of weight loss.
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So, the problem is Dan’s knees went, so he couldn’t keep up 45 minutes day exercise, so he started gaining weight….
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Swimming or water aerobics might work.
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Doctor recommended that. He loves swimming. Problem is not being very social.
And I DON’T — can’t — swim, so he has to go do it alone, and somehow it never happens.
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It’s been awhile, but I don’t recall water aerobics actually involving swimming.
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I can’t do aerobics in any way shape or form. I can’t follow the teacher. Probably same reason I can’t swim. There’s issues between the brain and the limbs.
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Maybe try a Y or something like that where you can go together but not necessarily do the same thing? My wife and I started this year, and she goes to yoga or zumba classes while I spend time in the workout room, and our tiny daughter spends time in their Kids Club.
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I DESPISE the gyms. They make me watch CNN, which means someone will eventually die.
I don’t do classes. Explaining to the doc “I’m not ANTI SOCIAL. I’m A-SOCIAL. Please stop telling me to do social things.
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Our gym (not that I’ve been going, Silver Sneakers equivalent so we’re not paying for it) you set the gym equipment to whatever you want to watch, and use tethered ear buds. Otherwise general music. I use Spotify or my phone music stash to bluetooth ear buds.
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Yeah, I’m
runninglimping into that situation, too. I fell in January (the Ides of January sounds so lame), got an impressive bruise on my left buttock/hip (pinched the muscle at the pelvis, looks like), but I hadn’t noticed that I’d twisted my right knee–the one that I half destroyed 3 years ago.The old injury broke the tendon from the quadriceps, repaired, but susceptible to other injuries. The new injury has been slowly getting worse, so finally saw the doc a few weeks ago. Ran into an issue that prevents me from getting an MRI (low chance of it being real, but catastrophic damage if it is, so nope). Looks like the new issue is a meniscus tear, and should be fixable with arthroscopic surgery, if a cortisone shot doesn’t help. I’m doubtful on that. Recovery time from an operation varies with the situation. If they pull out the torn piece, it’s very fast (a week or so), but if they do a repair, the downtime will be a few months.
Bummer on the Metformin. When diagnosed (1998, time flies!) the drug of choice was Tolazamide, but that was too aggressive. Went to Metformin until we moved and I ran out. OTOH, I had a lot of cleanup and construction to do, and lost a bunch of weight, thus helping blood sugars. Still gain some back in winter, but I’d lose it in summer. I tend to compulsive overeating (“Hi, I’m Pete”) but don’t do the 12 stamp dance very well. $SPOUSE helps, and right now I need to stomp that compulsion and figure out what I can do for exercise. I see the adverts for the new drugs and am thankful that I’ve got Metformin as a backstop. With no insurance for drugs, I want to keep it simple.
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Got CT results; severe arthritis, but the CT can’t say much about the meniscus. Since MRI is out, the next options seem to involve needles in the joint (either anti-inflammatory or diagnostic). Might boil down to Fun With Canes. Shrugs.
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There are a bunch of the GLP-1 agonists
Of these I started on Victoza and moved to the weekly Trulicity. I’ve also tried Mounjaro which is the first 2 drug (GIP/GLP-1) cocktail approved. The Mounjaro went off label for me when insurance changed in July so it was back to Trulicity. Honestly the Mounjaro gave me huge issues (Stomach don’t ask you don’t want to know) that I didn’t fully recognize until I transitioned back to the Trulicity. Other than the Byetta (whose twice daily is a pain in the neck) they’re roughly equal. Trulicity at the moment is hard to get, so is Ozempic because it is being used off label for weight loss AND is the base for Wegovy the weight loss authorized version so it is similarly hard to get.
Three recommendations, first look at some of the older drugs (Victoza, Bydureon) they are cheaper and more likely to be covered. I did the Victoza for a year and frankly it worked AS well as Trulicity in keeping A1C/Blood sugar levels in the right (low 6.x for A1C) range. The 30 gauge pen needles were not an issue to use even for me someone who is rather injection/needle shy.
Second if insurance will cover it (and probably even if it won’t) find an Endocrinologist that specializes in Type 2 Diabetes. The GP’s try hard, but the strains placed on them by Obamacare and other modern issues mean they are not as aggressive in treatment, nor as good at monitoring and looking at related issues. The GP’s also tend not to know ALL the potential drugs and pathways.
Finally, look into testing blood sugar twice daily. It gives you warning that things are NOT cooperating faster than the A1C does. A1C is great, but it is an integrating measure over a ~3 month period. The testing is essentially an instantaneous read and lets you correlate with day to day activities. For example I know good old plain white rice will send my blood sugar rocketing if I don’t REALLY limit my intake. Similarly, I now recognize when my blood sugar is headed super low from a rebound and know how to work with that.
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Those “weight loss” drugs can have side effects, putting the pancreas in high gear. Write me privately for details.
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We know. Doesn’t seem to have that side effect for either of us.
BUT insurance changed.
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Wait, being over weight may not be a moral failing? It might be medically treatable?
Le gasp, this is a complete over throw of the natural order of the last ten minutes!
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I think, honestly, that’s why they’re not covering the medications.
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Sounds like MY experience over the years.
I especially loved the Humana rep telling me (in the late 80s) that no, they wouldn’t cover medical weight loss because “by the time you have problems we won’t be covering you.”
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Yep, insurance made the noncoverage abundantly clear in 1991 when I went for the HMR medical fast regime (Lost a bunch of weight, kept it off for 4 years, then gained it all back, lost half of that excess. My body is now paying for not losing it all. Sigh.)
So far, I’m doing all right with Medicare/Blue Cross Medigap. I skipped the Medicare Part D drugs plan, but have had multiple procedures (all but one elective, though those fixed existing and/or imminent vision issues) and haven’t had to pay much more than the eye exam that preceded the cornea dystrophy repair. Might have beat that, but it wasn’t worth the aggravation.
FWIW, I fell on frozen gravel in January, and knee pain has been a result. It’s been getting slowly worse, and the med people think it might be a torn meniscus. MRI can’t be done for a low-probability but catastrophic condition, so I’m hoping that the CT scan tells enough. I suspect I’ll get to meet Arthur the Scope. [shrug] Back to PT, though right now, I have to limit it carefully.
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The exercise boosted my appetite. So, I -gained- weight. Definitely feel better. Definitely seeing strength recovery after my 3 months sick. But was hoping to keep weight off.
My health has improved to the point wher doc says I can gym. So I gym.
Sigh. More PT Drill Sergeant. More PT.
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There’s a lot I don’t like about my insurance. However, one advantage I do have is that since I pay up front and then get reimbursed, I do not have to worry about networks and I get hefty discounts (aka “We won’t charge you for the hours of paperwork”) on things that might not be covered. The difference in prices is … Yeah. Yet another reason I vehemently dislike the oh-so-misnamed Affordable Care Act.
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The local medical near-monopoly gave a 33% discount for cash. I had been getting clot time tests at the charity clinic, and they were charging $13 for the consumables. Went to the hospital (after I switched to an affiliated clinic–the other clientele were getting me twitchy) and tried the test at the Infusion Lab/Coumadin Clinic. $120 bill, marked down to $80. Er, I didn’t think I’d have to pay all that overhead. My clinic doc was willing to do the admin, so for a long time, it was a blood draw, and out of pocket was $60 (and any other lab tests got the blood). Now, it’s a finger stick on a cranky but usable machine, list price $24. Covered, so out of pocket $0. (OTOH, Medigap is north of $2000 a year. On the gripping hand, I’m turning into a frequent flyer…)
When I got flu shots, I’d go to an independent FNP. IIRC, those were running $75 list, and are covered by Medicare. Now with mRNA in the wild, nope.
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C4C
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Maybe useful for one of your ‘non-posting’ days?
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Do not know what happens with BIL whose current insurance does pay for his Type 2 diabetic medication, I think (OTOH they can afford to pay for it). Know the medicare advantage won’t pay for sisters medication. She is barely diabetic (I guess). So she is on something else to get her to lose weight, and hopefully drop the A1C below pre-diabetic. She’s losing weight. Don’t know how the A1C drop is going.
Me? Doctor finally did an A1C test. Hopefully will keep doing them since one sister is now officially T2D, and the other one is pre-diabetic. At 5.5 A1C, not even close. But then I tend to hypoglycemia anyway, so we’ll see.
All the hype on how they’ve forced the prescription companies to drop medicare charges for insulin to $35/month. Great. What about the juvenile T1D? Silence on the T2D newer treatment costs and coverage.
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Metformin was cheap. By some miracle, I managed to get my Type II under control with diet, so I’m officially “prediabetic” and off meds for diabetes. Guess “postdiabetic” isn’t a thing.
I still test blood sugar every other day. Even trying to measure blood pressure daily. If my knee lets me, I want to resume the 13 acre exercise plan. Got lots of pine needles and wood to deal with.
FWIW, $SPOUSE has me take a teaspoon of cinnamon daily; it’s supposed to help lower blood sugar. Maybe. I like cinnamon, so even if it doesn’t…
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Metformin is no longer doing it for Dan, so…
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I don’t take raw cinnamon but have take the cinnamon based pills Costco sells that are suppose to level BS. Didn’t work for me. OTOH I don’t need it to lower BS. Need something to prevent crashes. Probably a good thing I started off cautious and never got to the full suggested daily dose. Crashes aren’t always super low BS, although can be. Crashes are BS that drops faster than should. Although try figuring out what that means. Lets just say the standard diabetic for down to below 140 in two to 4 hours after eating, isn’t a problem, ever. If BS goes over 140, which is not a given, regardless of meal composition.
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I just looked it up, and the studies vary. Some say cinnamon works, others say it doesn’t. I’ve a heavy hand with spices, so a teaspoon in my breakfast doesn’t bother me. I keep fasting BS numbers to 80-90 unless I did something bad the day before, but that’s more like 110. I seldom look at daytime numbers.
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I only look at daytime numbers if I’m feeling lousy. But all it doesn’t tell me much unless down around 100 and I just ate. My fasting numbers run 70 or lower. Overnight was running 80 – 85. It is trending higher lately. Which probably isn’t good. Since the A1C is 5.5, doctor isn’t going to do anything. Frustrating. I tend to low BP too. My thought is if historically tend low BS and BP, and now my BS and BP is trending up, but still “excellent for your age, and weight” (they have to throw in weight), something is changing. Medical doesn’t look at that.
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My mom went from “prediabetic” to “normal” with cinnamon and chromium pills.
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Yeah, I suspect there’s some other factor that determines how well cinnamon works. My body is contrary enough (Metformin gives diarrhea? My constipated colon begged to disagree.) that I’m thrilled when a med (or procedure) acts as expected and doesn’t throw a 3 sigma side effect.
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Yeah, Meformin doesn’t work for me as for others.
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WordPress just ate my 2 paragraph reply. Short version – Ozempic works for my Dad and keeps him from going to insulin. Also, I am still playing musical doctors with the vertigo situation; due to a hospital scheduling screwup, the cardiologist appt I was originally supposed to have on Feb 7 is going to be delayed again. (Also word via the grapevine is part of the problem is that like 20 doctors just severed relations with the hospital’s medical group.)
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Yeah, all reports are that the new drugs are *great* for diabetics. It’s just that they also have a very handy use for something that would put them in *much* higher demand than just to treat diabetics.
Kind of reminds me of Viagra, actually…
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much higher demand than just to treat diabetics
Oh, yes, that’s happening. I’m taking Ozempic, and it’s sometimes tricky to get.
About a year and a half in, down 60#, off insulin, A1C at 7.0 for the first time in a dozen years or so.
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Ugh, insurance troubles. My mom’s diabetic (and we’re pretty sure it’s genetic, despite being type 2). She’s currently waiting for necessary doctor’s appointments in order to get medications and supplies she needs, but she can’t pay for the appointments without an insurance card that hasn’t come.
Personally, I think insurance is the biggest scam, bar taxes, that’s been foisted on modern humanity, and our bureaucracy has only made it 10x worse.
And you know what’s extra stupid? My mom can’t get her insulin, that no one but diabetics needs or wants, without that doctor’s appointment. She can’t get test strips for her blood glucose monitor, either. It’s not like it’s an addictive drug that we’re talking about here! She would much rather not be on it! We’ve tried our best to get her off of the drugs with the worst side effects – such as the Metformin, which literally gave her a stroke.
All this to say, my sincerest sympathy.
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I have a test meter and get test strips all the time. Do not have a prescription for them. Which means insurance doesn’t pay for them. The ones at Costco are behind the pharmacy counter, but do not need prescription to get them. Cannot get the auto tracking types.
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There is a continuous tracking OTC-approved meter for Type II diabetes coming later this year. Cost may be prohibitive ($200+ for 14 day piece of hardware).
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I get my test strips from Amazon. They can be covered under Medicare, but by skipping the prescription, it’s up to me to decide how often to test and what to do with the data. As long as my A1C is under control, the doc is happy, I’m happy, and the budget doesn’t mind.
I’m paying $50 for 90 test strips. I’ve got them on a subscription with the ‘zon. (Verio test system. The meter was very affordable–the turnkey kit with 30 strips is $50 from them.)
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I have the Verio test meter too. $90/50-strips. Costco also carries Accu-Check Guide Me, which is $45/50-strips. Plus, Fred Meyers carries the brand test strips too. I don’t test regularly, only to check the alerts from Pepper (although one alert is for sudden drop which is not always mean low BS, so harder to prove). Did for a long time to prove to current physician that the diagnosis at age 30 hasn’t disappeared (my fingers hurt). How I know if I go over 150, I crash. If I go higher, 180 to > 200, I crash faster. Like 210 -> 90 in 90 minutes, and < 70, in the next 30. Do not do that. Not fun. Not that doctor, or the nutritionist, have a solutions other than “deal”. They did change the diagnosis to hypoglycemia reactive hypoglycemia.
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Assuming that’s not a tyop, that’s really high. I used to get 100 at Costco for $80, then it went to $100, then they couldn’t get it. Walmart sells it, but I found that the company store on Amazon sells 90 for (currently) $50, which is up $5 from the last time.
I put mine on subscription, and time it so I’m just starting the last vial (of 30) when the 3 new ones arrive. 2 months per vial, so it works.
I don’t care for the Verio lancets, and use Accuchek ones that came with my first meter. Also got mine from the ‘zon, but Bi-Mart sells lancets, too. Don’t know if they sell any test strips or meters with the loss of the pharmacy.
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I think you are right. $90/100. The Accu-Check are $45/100. Half the price, and Freds carries the Accu-Check too.
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I use the generic lancets too. I have a box I’ll have forever. Might not change them out often enough.
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That seems somewhat high. Verio one touch run about $75 for 200. The one shot lancets are about $40 for 200 here in MA and neither get insurance coverage for me
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I use the Accu-chek softclix lancets (barring a stint when I went to the bulky generic ones) since the beginning. Amazon sells 200 for under $10.
tps://www.amazon.com/gp/product/B00D3DC7KM/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1
That’s a year’s supply for me, and I’ll get a couple years worth at a time. Got a backup lancing device. Don’t care for the original one, though it works, but is big and clumsy.
Looked at the Verio lancets. They’re OK, but the AC ones are more compact, and I’m so used to them. I’m not entirely awake when I test, and muscle memory saves the morning. :)
(Looks like there’s a 10% savings if you go for a subscription. That showed up for the test strips.)
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Re: insurance card not come, check the webpage and get a digital version. Put on phone or print out the info.
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BIL’s type 2 diabetes is genetic.
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As is ours — Dan and mine — everyone gets it in their 40s. Pretending it’s a sin is goofy.
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FWIW, there seem to be fresh issues with the USPS. Laughing Wolf says both he and the other tenant in his landlord’s house have had their mail returned to senders, and that’s after multiple trips/complaints to the post office. My state tax return went to Portland, OR on March 2nd and fell into a black hole. To add injury to insult, they won’t let me complain until March 3rd. (Looks at calendar. #headdesk). Broke down and sent another copy Priority mail. I’m hearing other complaints about mail delayed or lost in Portland. ($SPOUSE isn’t getting some statements, and some power bills are running really late, both ours and the nearest neighbors.)
We’re starting to switch to online statements/bill pay when practical. Not sure we trust the power company (Warren Buffett owned) and the credit card company (WFB), but the others look like fair game. Next year, I’ll try OR e-file, though being Oregon, it’s slightly screwed up.
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Looks like we got lucky. Tracking shows it delivered and the verification card is back. Whew.
Oregon e-File. I’ll e-file Oregon when they quit charging us for the privilege. We already e-file federal. Federal goes smoothly. OTOH they get more money from us. Sigh. With the Oregon kicker we get just enough back from the state to pay the feds.
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A charge, eh? Why am I not surprised? I just wish they’d offer a FedEx compatible address so I could avoid the USPS. I’d rather pay FedEx 2X dollars than 1X to DOR because [acronym deleted].
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Yes. $29 (not that we checked this year). At least true if using TurboTax.
Federal is free, up to 5 filings. We file ours and our son files. Mom, I help her do her taxes, but she owes nothing and gets nothing back. She just mails them, not certified.
Been doing it this way now for a couple of decades, or more. Feds didn’t get theirs efiled until it was free either.
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OR DOR says that the direct return is free, but you have to have the IRS return in place; the link for them to pull it while filing isn’t there yet. (If they’ll ever do it.) For the interested: https://www.oregon.gov/dor/programs/individuals/Pages/direct_file_OR.aspx
You also have to be signed up for Revenue Online. (I already am.) The tax screwups that aren’t mine seem to come from the state, like the time they “didn’t get” the 1040 I included in the packet. I now include a cover letter as a clue by four.
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Nice!
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I’ve heard of a lot of issues out of Seattle, too– both sorting and on the delivery side. Sent a friend a package, and it had to have a secret handshake to make it to the right location.
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I’ve heard of others, too. Seems the delivery people aren’t fond of being Bezos’s delivery serfs, along with historic USPS issues.
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Accountability for stuff going missing– or “missing”– does seem to really piss a lot of ’em off, yeah.
The issues with getting folks to work in the mess SEattle and Portland have become probably doesn’t help.
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Been dieting (not very strictly) and exercising to keep my T2D in check.
Weight is not going down, but A1c is, and jeans are getting loose. One pair is practically a costume malfunction.
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While we’re at it, we need government twatwaffles out of literally everything else too.
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You’ll get not disagreement from me.
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Recent meme:
“Should the government…”
“Nope.”
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Depending upon Dan’s age (I’m assuming he’s at least approaching Medicare-eligible),
there are Medicare, Part ‘C’ (“Medicare Advantage”) plans that include prescription drug coverage for the same monthly premium as legacy Medicare (“Part ‘B'”).
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We’re both approaching medicare eligible, but have been trying to stay off that treadmill which is even insaner.
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I was told that medicare is mandatory at 65. They won’t let you stay off the treadmill.
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Absent coverage by an employer health plan, the only wiggle room wherein you avoid what the .gov ominously terms “life-long penalty” is whether you sign up for Medicare during the three months preceding the month of your 65th birthday, in which case your coverage starts the first day of your birthday month, or the three months following your 65th birthday month, in which case coverage starts the first of the month after you sign up.
See: https://www.ssa.gov/medicare/plan/when-to-sign-up
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well, we have four years. There’s a chance it will all collapse before then.
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Get pro advice on Medicare. If you sign up late, they stiff you for lots of extra money, for life. (rude metaphor omitted)
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We went to a medicare advantage specialists. Our cost $0. They get paid by their referrals.
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We’re seriously too young for it. And don’t want it.
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No choice unless you have employer paid insurance that covers you both. Even if you are working, required to sign up for medicare. Then if have employer paid insurance the medicare cost can be deferred. But must sign up.
Doesn’t make any sense to not take advantage of the Medicare Plus programs. Have to be careful they cover your doctors, clinics, and medications. The non-HMO’s require an additional monthly co-pay. But even the HMO’s have to cover out of network if you go to an urgent care or emergency clinic. Might have to pay out of pocket, then get reimbursed, but they are suppose to pay.
Mom and sisters all have United Health Mediadvantage HMO. We have Regence Mediadvantage Blue HMO. Regence is only available Portland (maybe Longview/Vancouver, WA) down to Eugene, I-5 corridor. We’ve been with Regence brand for 45 years (3 months less than our marriage). No reason to despise them, so stick with what we knew.
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Beloved Spouse went on when she turned 65, and the shocking thing was how cheap it all was, even with a good Seth of Medicare Plus that covered existing doctors added on, when compared to Obamacare.
Day Job does not have health plan benefits, so we were on the Exchange since my Cobra ended from my last cubical job, so coverage and expenses are a direct comparison.
It’s way less. Way, way less.
And in the past Year Of Lots Of Health Care there was only one hiccup, on approving a relatively new drug that was prescribed. That got ironed out fairly quickly, and while initially it had a pretty high copay, that copay actually dropped a lot over a couple months.
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Hey autocorrupt: Who is this ^Seth^ guy?
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“Set, also known as Seth and Suetekh, was the Egyptian god of war, chaos, and storms,”
A perfect entity for healthcare bureaucrats to worship.
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Yes. 100% I had insurance through day job, but it was lousy (at best it was catastrophic health insurance, paid nothing in the 12 years I had it. Boss paid for it. But only for me. Have I got tales from my co-workers.) I’ve always also had coverage through hubby’s work, then through his retiree insurance. Family coverage. $350/month for all 3 of us (son was < 27 when starting). Ending at $495 for two of us, me full, hubby medicare advantage. Thus, when I finally qualified for medicare advantage and we went to the Regence, open market, not retiree version, our savings per month was $375 (the extra we were paying minus the bite medicare takes out). In addition, our out of pocket dropped, and most of our prescriptions started being 100% paid for. That is one defect the other policy had, the prescription portion was, shall we say “limited”. We didn’t bother. We just paid for the prescriptions. About $100/90-days for both of us.
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If they haven’t messed with it, Medicare part D covers prescriptions. That one is op
I don’t know if it’s changed (suspect it hasn’t), but unless you are already in an insurance plan that’s Medicare compatible, bog-standard Medicare is Part A (hospital), and Part B (clinic/outpatient/equipment and supplies). Those are/were mandatory, but Part D (prescriptions) was optional, though if you declined and wanted to join later, they said you’d have to pay all the back premiums to when you started A & B. Beyond that, I’m not familiar with Part D. Oregon does some funky things with prescription coverage, but I haven’t had the courage to research it. :)
FWIW, I was prescribed Lasix for edema, and a 30 day supply (with no insurance plan) cost $1.30 for the bottle. My other meds tend to cost about a dollar a day total for those three. (Anticoagulant, statin, Lisinopril. It works for me. Sorta.)
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Please ignore the first two lines. WPDE!
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We don’t have Medicare Part D. We have Medicare Advantage, which includes prescriptions. But the prescriptions are categorized into classes. Class 1 is pretty much full coverage up to an annual limit, then part coverage. Haven’t hit that on any of our regular prescriptions. Hubby has list similar to RCPete. Before Medicare Advantage we were paying $60/90-day supply. All I have is my eye drops, which was running $90/3-bottles (~18 weeks), now paid for. In addition I have my prescription for my Rosea, anti-inflammatory low grade antibiotic, the insurance pays 1/2 to 2/3, so not class 1.
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Even though Day Job is basically analyzing huge stacks of health care records statistically to boil them down to a thick sticky gruel of PowerPoint charts, the past year of Real Life has added so very much knowledge of how health care actually works. All of which I would have been ecstatic to never have the opportunity to learn.
Bottom line, in the current US health care system as a transaction, you are not the buyer, and you are not the seller. The only open definition left there for what you are is the product.
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Which becomes very clear when one hit medicare eligible. Or end of the year when you can change plans. The two merged for me given late October birth date. Inundated with fliers in the mail.
Technically hubby would have had to wait for his insurance to transition to the new medicare advantage January of the next year. But because we had retiree family insurance, my change in qualification triggered a “qualifying event”, which meant we both started the new insurance the October I turned 65.
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I just got a dental bill for an extraction I paid in full at the time I had it done. I’m not sure I still have the paperwork from that visit, so I guess I will have to accost someone to try to figure out WTF Yo?
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The only dental billing snag I had was when I paid something and the clerk credited the wrong account. Fixed with a phone call. Hope yours wasn’t cash. I try to be paranoid about keeping records now. (Wasn’t 20 years ago, and had some minor issues.)
I have a propane supplier who sends out invoices on the first of the month. Got surprised when I got a Jan 1 bill for something I paid after Christmas, but they gave me a “Nevermind, it’s our lousy computer system.” Right…. s/computer/billing and I’ll buy it.
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We pay for dental insurance through our dentist. But we make all the payments with credit card. I also track them on spreadsheet for state taxes.
Yes our medicare advantage has dental insurance. Our dentist isn’t in network. Been going to this clinic since I was a kid. Then again since ’85 when we returned to the area. On our third dentist, second one is just recently semi retired. Third dentist is his son. The in network clinic, do not get assigned a specific dentist. Rumor is dentists rotate in and then are gone.
Seriously. Anyone in the area looking for a dentist check out https://www.magnusondental.com/
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Liked the first dentist we had here, then the practice got bought and we left. $SPOUSE tried Aspen and was not impressed. I was pointed to a practice that’s happy with uninsured patients. Not sure of the relative cost, but the work is good and the hygienist I use is friendly and really good. Doesn’t hurt that the treatment room has the best view of Mt. Shasta in Flyover Falls. Since I have “English Teeth”, I’ve had a fair amount of work done.
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some years back my employer was encouraging us to go to a plan variant with a higher deductible but a health savings account they would at least partially match our contributions to. Drops taxable income somewhat and creates an account with investable money that you can tap for healthcare payments without penalty. Admittedly, haven’t had terribly extravagant medical needs, but seems to have worked out okay so far.
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An acquaintance from a shared-interest social group (HEMA, if you really want to know) posted last week about how he loves to convert people to the idea of universal health coverage. I’m not sure what his actual consulting job is, but he also talked about difficult it was to get CEOs and COOs (all old, white males, of course) to put their pronouns front and center.
Universal health coverage (*head desk*) … maybe I can just stab him really hard at our next sparring session ….
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They Believe in socialized medicine like they Believe in socialized everything else. The fact that it fails dismally every time it’s implemented makes no impression on them. The more the government f*ks it up, the more they clamor for the government to fix it.
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There is nothing so simple the government can’t f*k it up.
There is nothing so f*ked up the government can’t make it worse.
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