Dial “D” for Disaster

If you’re old, read on. If you’re not, ignore this. You have enough other problems in your future as it is.

You might describe my current mental condition as fraught. Or overwrought. Or angry as hell.  It’s not just Putin and his barbarism and nuclear threats. It’s not just the impending doom of climate change, nor the potential death of US democracy. It’s much more immediate than those existential fears. You see, it took me two weeks and hours upon hours of phone calls simply to try to switch my current Part D Medicare drug plan.

It started when I got a letter from my current provider, WellCare, telling me that one of the prescription medicines I take is being moved from “Tier 3” to “Tier 4.” Laboriously unscrambling the calculations needed to account for this change, I discovered that it was going to mean a doubling of my already-high, annual, out-of-pocket costs.

Funny, I get this particular drug mail order to save a hundred bucks or so a year, and the bottles are always labeled “Made in Ireland,” or “Made in Switzerland.” So, with the pills coming from Europe, on a pre-Brexit trip to Britain, I visited a pharmacy to see if I could get it cheaper there. What cost $150 a month here, with insurance, was about $5. But wait, “You’re over 65, so it’s FREE!” Unfortunately, since I didn’t have a prescription from a British doctor, it turned out a false hope. But it does illustrate how much we are pharma-gouged in this country.

Well, back to my hunt for a new drug plan. I first went to the Medicare web site where you put in your meds, put in your zip code, press a button and all the available plans pop up, showing you your estimated out-of-pocket for the coming year. Super. But, when you click on “enroll in this plan” that’s when the trouble starts. That’s when my weeks-long ordeal began.

I began speaking to the representatives for the plans that seemed most economical. Many of these people could barely speak English and sounded, from the background clatter, like they were working on some chicken farm or in a boiler room. I kept getting different figures for the alternative plans I’d seen on the Medicare site. Some were close to what was stated there, some vastly different. I wasn’t going to sign up until I had real confidence that what I was committing to was what I was actually going to get. Once done there’s no turning back until the following year’s enrollment period.

You can’t imagine how many times I had to spell out the convoluted names of all my medications, one letter at a time, using the “A-as-in-Apple” method, so the person on the other end could look them up. And every time they had to look up something I was put on endless hold. Once I was told the company I was looking at didn’t list one of my drugs in their formulary. But when I consulted that formulary on their website after the call, there it was. Prices I got for the same plans were all over the map. One rep even recommended I try another company. Of course, most people I spoke with didn’t really work directly for the insurance company whose number I’d dialed.  And the two people who did never came through on their promised follow-up calls. Yikes!

Finally, finally, I got hold of a young man, an actual native speaker of English. He was very efficient and confirmed with me the same cost information, to the penny, that I’d been able to find on the Medicare site. I told him to sign me up, seeing a light at the end of this very dark tunnel. Thereafter followed a 45-minute, recorded period of his re-verifying all my information, and my listening to and confirming my understanding of unending, rambling disclaimers.

Perhaps I’m to obsessive about this. With a system so clunky, in order to function at all it must depend on most people just shrugging their shoulders and assuming that a few clicks here and there will optimize their results. But, in the case of life-saving medications, and incredible cost considerations, there is no excuse for there not being an easier path to follow.

©2022, David B Bucher

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