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No. of Recommendations: 3
A lot of people jump into a Plan D when they're eligible, but I'd suggest first checking which Plan D providers exist in YOUR state; you can do this on line. Then check what they cover for the prescriptions you take now, and what they cost, as opposed to using Wal Mart or other cheap sources vs what the monthly premiums will be for the Plan D you decide would be best.

Plan D can be a good deal IF it will cover YOU for costly special prescriptions YOU need, but you need to look at total costs for the Plan D premiums, any co-pays, and the cost for the prescriptions themselves!

In my first year of eligibility, four years ago, I was able to get a plan that cost me about $13/month, but it paid 100 percent of the cost for my BP meds, which were running about that same amount, so it was a wash. (This was before Wal Mart and others came out with their low cost options.)

The following year, the best available plan jumped to $23/month PLUS a $5 co-pay per med! I dropped the plan. My wife, who takes only a cheap BP pill, too, never signed up at all.

Today, I take a total of four prescriptions for blood pressure and gout. However, my doctor has prescribed generic forms that cost me just $10/90 days for each of them at my local Rite Aid, who grant me Wal Mart pricing as long as I ask for that special pricing every time I get a refill. (That seems odd, but it's how they do it.)

My total cost is thus $10 x 4 prescriptions or $40 for 90 days worth of pills -- about $13.33/month. If I bought a Plan D here now, it would cost me a LOT more than that AND require a co-pay on top of that!

Yes, there is a "penalty" if and when I choose to sign up later on, but so what? It's not that big. Meanwhile, we're saving a LOT of money every month!

Again, I suggest that you check the math and do what works for YOU; never mind what AARP or the "experts" keep yelling at you.

Vermonter
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Vermonter wrote Yes, there is a "penalty" if and when I choose to sign up later on, but so what? It's not that big. Meanwhile, we're saving a LOT of money every month!

As I read Vermonter's post his penalty will be between 25% and 50% of his Part D premiums for the rest of his life, assuming he signs up now. If he waits another few years the penalties will be greater and again last for life.

The penalties are 1% per month. So assume Vermonter has been "saving" the $23/month premium for a 24 months. If he were to return now, his premium instead of being whatever the current premium is, would be 124% of the current premium. But perhaps people in Vermont do not consider 24% and growing penalties important.

Gordon
Atlanta
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One of the oddities of Part D is that you can still get it or switch to a plan with better benefits after you suddenly need expensive drugs. I carry homewowner's insurance because I don't know any insurance company that would write a new policy after the house is on fire. Not a problem with Part D apparently.
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<<The penalties are 1% per month. So assume Vermonter has been "saving" the $23/month premium for a 24 months. If he were to return now, his premium instead of being whatever the current premium is, would be 124% of the current premium. But perhaps people in Vermont do not consider 24% and growing penalties important.

Gordon
Atlanta
>>


Just like with other aspects of health insurance, one major problem is how to get people who are healthy to buy insurance rather than waiting until they are already sick.

A major purpose of these penalties, the "doughnut hole" and all was to give people an incentive to buy into the drug insurance as soon as they became eligible. It's amusing to see Democrats these days proposing to eliminate the doughnut hole, which will give people another incentive not to buy into the Part D drug insurance plan.


Vermonter is certainly entitled to calculate his odds and choose not to buy into the program. How well that will work long term depends on how healthy he stays. He could wind up getting socked hard, dwarfing any savings, if he's unlucky.

It is amusing to see seniors who were clamoring for a drug benefit now choosing not to buy into the program. Of course, many were expecting to get free coverage ---- actually having to pay the cost of what you get changes how attractive it might be.

The same thing, of course, applies to national health care. The middle class with insurance discovers that national health care means higher costs and reduced benefits for THEM, and suddenly it doesn't look nearly as attractive.

The doughnut hole gave the program designers the opportunity to give people an early return on the drug costs, with a countervailing hole in benefits at a certain point. That allowed a certain number of dollars to provide earlier and more generous benefits than without the doughnut hole.

Eliminating the doughnut hole would be an increase in benefits that no one would be paying for, presumably.

Politicians specialize in giving out benefits for free, but finding an extra 1,000 billion dollars to finance a national health care system is a lot harder thing to do, as Obama is discovering.


Seattle Pioneer
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Actually from my view you are not looking at this quite the right way. If this person finds themselves sick down the road and chooses to get XYZ insurance, the XYZ people tend to gain as I understand it. XYZ will get the normal premium which presumably they can make some money with plus the penalty.

This insurance is really not different than you homeowners. Neither pays for what happened prior to purchasing the policy. Neither will pay for anything that happens after the policy ends/lapses.

Gordon
Atlanta
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One of my biggest arguments with Plan D is that we seniors have to wade through a lot of charts and graphs EVERY YEAR to continue to get the best deal, or risk paying huge increasses levied by any company we may choose! If we change, we then have to get into the red tape needed to do that!

If I check the current information for Vermont, let's say, looking for plans that pay for generic coverage, here's what I find -- forgetting any penalties:

Among plans that pay for generic drugs in the coverage gap, the cheapest (CIGNATURE Rx Complete Plan) charges $39.10 per month or $469.20/year, and indicates no deductible. Those who do NOT pay for drugs in the "coverage gap" (if one gets there) typically cost less, but often charge an annual deductible of $265. Even with the cheapest listed coverage ($16.90/month for Humana PDP Standard), we'd be looking at $16.90 x 12 months = $202.80/year + $265 deductible = $467.80/year or $39.00 per month.

I then looked up details for Humana's "Humana Prescription Drug Plans (Humana PDP Standard S5884-061)". Their info indicates a charge of $41.40/month plus an annual deductible of $295.00. This would come to $496.80 + the $295.00 = $791.80/year. Divided by 12, that comes to $65.99/month. That's a significant cost for a retiree!

By contrast, even my four prescriptions, at the cheaper prices I pay, come to about $13.33/month TOTAL. Where are the savings?

Yes, I know I now would face "penalties" if I decided to apply for Plan D. In fact, after 4 years, the "penalties" would probably add up to so much I (we) probably could not afford Plan D any more, anyway!

What a nice "deal" to "give" seniors! (?)

Hence my original post: How many seniors signed up right away, only to find, as I did, that, as the years went by, their rates went up and up and up, to the point where they were literally paying HUGE sums just for this "insurance"?

Yes, maybe I have "gambled". However, I still say this plan is not necessarily a "bargain", and SOME people may be better off to stay away from it -- until or unless it can be stabilized somehow to remain at whatever level a senior signs up for it in the first place.

As the saying goes, "You pays your money and you makes your choice", it seems.

Vermonter
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Gordon:

If he were to return now, his premium instead of being whatever the current premium is, would be 124% of the current premium.

Maybe so.

I guess, then, that I have peed the bed and may as well forget it -- right?

C'est la vie!

Vermonter
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Those who do NOT pay for drugs in the "coverage gap" (if one gets there) typically cost less, but often charge an annual deductible of $265


i thought it was called The "coverage gap" because nothing was covered.

i don't recall any plan (but i had 37 to choose from) that covered during the gap.



What a nice "deal" to "give" seniors! (?)


well it's a kind of compromise --it's better than nothing. If you're on alot of meds, it's way better than nothing.

but the 'choices' do seem obnoxiously complicated .. esp'ly for someone who's brain isn't quite as quick and doesn't do Internets


=
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Well you have two options. You can signup at 124% of the normal premium or wait another year and have the option of signing up at 136% of the normal premium.

When you consider there are normal premiums that cost $10 a month, I think it is worth something to be able to signup without a penalty when something serious develops - as it generally does in the last 5 years of life.

Gordon
Atlanta
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If we change, we then have to get into the red tape needed to do that!

There is no red tape involved. We changed ours last year when Humana's monthly cost went a lot higher. We found one that was half the price for the same coverage and signed up for it and the Humana plan was automatically cancelled.

i don't recall any plan (but i had 37 to choose from) that covered during the gap.

I think most companies offer such a plan, but it is a lot more expensive. After the year started, DH's MD recommended a new treatment. The 30 pills retailed for $4,000 and he would need them forever. The plan would pay about half, but he would be in the donut hole very quickly. Then we would have to pay the full cost until we had spent about $4700 total. After that it would be 5% of the cost....still quite a bit per month. Since we had just started the year, we couldn't change to the donut hole coverage.

There was also another new treatment which involves getting a weekly shot. Medicare pays for that in full, so we are not out of pocket anything because DH's supplemental picks up the rest. Medicare is billed $4800 per week for the treatment! Of course the Medicare approved payment is less (about $1100) and the MD accepts assignment, but it's still a lot and all we can do is hope Medicare continues the coverage.

Carol
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Where can you obtain a Plan D for $10 per month? The cheapest I have seen is $28.50 per month; however, this plan does cover my fenofibrate (generic) with no deductible or co-pay. Right now, through Walgreen's mail-order service, I pay $41.00 for 90 days' supply.

Donna
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i don't recall any plan (but i had 37 to choose from) that covered during the gap.

I think most companies offer such a plan, but it is a lot more expensive.



i was kind of right /mostly wrong.

according to Wiki, approx 25% of plans cover the donut hole, but nearly all only cover generics.

'my' plan covers generics in the gap, but most of my meds have no generic.



-
..... $33.50 /month
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Don't know about $10 plans but I'm wary of any really low cost plan. Just ask people who signed up for Humana the first year Part D was offered how much inflation they've seen in their premiums. Of course most got smart and switched companies long before now.

(At least with bargain offers to switch my phone, cellphone or TV provider if I dig deep enough in the fine print I'll find out what my real cost will be in 6 months or a year.)
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My memory was wrong. The current lowest cost in Georgia is $16.10/ month. The item I was referencing was a Humana Drug only plan in calendar 2008 that was $10.41/month. That plan has been discontinued/changed.

You will find premiums even for the same plan differ by state. One of the side effects of not having a public plan like Medicare. You can find all the plans for your zip code at Medicare.gov -- use the wizard, say you are under 65 and seeking general information.

The $16.10 premium is through First Health.

Gordon
Atlanta
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This insurance is really not different than you homeowners.

It's a LOT different! My homeowners' insurance doesn't try to rip me off every year by sometimes doubling in price.

Vermonter
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When you consider there are normal premiums that cost $10 a month, I think it is worth something to be able to signup without a penalty when something serious develops - as it generally does in the last 5 years of life.

$10/month? Where? For 65+? Not in this state -- not this year.

I simply suggested that people do their own math, and look at their own situations, and then make a choice, without blindly following whatever they are told they "should" do. Simple as that.

We made our choices, and they were not to have Plan D.

Vermonter
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I don't have Plan D. I use an HMO which includes drugs for a $5 co-pay. If I decide to leave the HMO (and someone will take me), I can pick up Plan D at that time w/o penalty.

Horace
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<<This insurance is really not different than you homeowners.

It's a LOT different! My homeowners' insurance doesn't try to rip me off every year by sometimes doubling in price.

Vermonter
>>


That's your homeowner's insurance. I've had the insurance costs more than double when the company changed it to some kind of non standard rating. Other companies weren't so picky.



Seattle Pioneer
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One of the best alternatives to Part D is buying your drugs from the VA if you qualify. Several of my retired friends do that. I certainly don't begrudge veterans that benefit but sometimes it's hard to understand. One friend who uses VA is a multi-millionaire. He served during the Korean War. Protected Germany from the invading Koreans and Chinese.
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One of the best alternatives to Part D is buying your drugs from the VA if you qualify. Several of my retired friends do that. I certainly don't begrudge veterans that benefit but sometimes it's hard to understand.


i just started looking into this.

so far ...it's a bit complicated, but could be worth about $3k/yr .. not to sneeze at



-b
..... what's to understand?
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No. of Recommendations: 13
Those vets that you're wondering about served their country. My DH is a disabled Viet Nam vet who receives his meds from VA. For non-service connected meds, we pay $8.00/mo and receive a 90 day supply for $24. In some cases Walmart is far less money.

For the 10 or so SERVICE connected meds he takes , those are at no cost...at least no monetary cost. The price he is paying is far greater than anything we could pay for monthly.

He receives all but some emergency care from VA, and we are grateful for the care he has received, some emergency, so not.

Funds for VA are sorely lacking, wait times can be devastating, and in some localities, the care is as bad as the facilities. If any think any other National care is going to be great all I can say is "yea, right" At least with the VA, there are veteran service officers from the DAV or American Legion, and each VA facility has on staff patient advocates to help sort thru the maze for obtaining care.

Just don't begrudge those who have served, as you can't possibly know or understand the price they and their families are paying.
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You will find premiums even for the same plan differ by state. One of the side effects of not having a public plan like Medicare. You can find all the plans for your zip code at Medicare.gov -- use the wizard,



i'd heard they vary by county ...so JFSG, i used the website and stuck in my zip and zip from three neighboring counties:

all four lists look same (51 plans, ranging in price from $18 to $129)



-
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I am collecting at a 100% Service Connected Disability rate. I have no problems with the VA health care, save the 2 hour driving time to the nearest VA Hospital!
There is a clinic within a 20 minute drive, but they are only open during normal business hours and have very limited facilities.

Regards,

Grumpy
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Just don't begrudge those who have served, as you can't possibly know or understand the price they and their families are paying.



*i* said something that sounded like i begrudge them ??

i don't

i'd apologize but that i think you totally misunderstood.


=-

some of my best friends are Vets <g>

( all of whom say their only real problem with VA system is accessibility .. many hours to hospital ..and such )
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I sometimes get a little touchy about remarks said about vets and their service....I apologize if I sounded that way.

My DH has received remarkable care from VA, but in order to get him into the system originally, it required a request to our Congressman and his office making some contacts. Even then it was 180 mi r/t to a clinic.

We are now located within a 30 minute drive of an exceptionally well run medical facility, but have been waiting over 6 mo for them to schedule a routine colonoscopy (he has a family history of colon cancer). At James Haley Med. Ctr. in Tampa, the wait time was about 2 weeks. It just shows the differences in locations.

For someone to thnk that VA is a model to base any national health care program on is sheer folly!

'nuff said.
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I certainly don't begrudge a vet who was disabled in service to his country. In fact, I don't think we do enough for those who served in a combat zone. My point was why is a multi-millionaire who spent his overseas time in Germany while the fighting was in Korea and never had a service related injury or illness getting his meds paid for by the taxpayer, especially when there doesn't seem to be enough money for the VA to care for combat casualties?
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I certainly don't begrudge a vet who was disabled in service to his country. In fact, I don't think we do enough for those who served in a combat zone. My point was why is a multi-millionaire who spent his overseas time in Germany while the fighting was in Korea and never had a service related injury or illness getting his meds paid for by the taxpayer


four things --
when he joined, VA medical is part of what was promised
he spent time doing what he was told when he could have spent it doing what he wanted
folks sitting in Germany at that time were geo-political Goats on a Rope.
( he is likely lowest priority )


... but i did sort of feel that way at first .. *i* didn't do anything special, i don't really NEED the help, the program is underfunded ..



now i figure: the Law says i can get the help /and i'll just imagine the money's coming from the taxes of some chickenhawk teabagger <G>



=
( SO American -- underfund a program and then complain that it doesn't work well )
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The hodgepodge of experiences with Part "D" as demonstrated in this thread, especially when combined with the maze of regulations that vary from state to state, does not speak well of our current system.

Just look at the posts re VA. We have one poster saying VA is proof that we shouldn't have a national health care while another poster resents a millionaire friend (who probably has many health care choices) for signing up with this same VA! Even the poster who says it is a poor model points out that service is much better in one location than another- sounds like there are other factors at work than whether the locations are managed by VA.

This is similar to what was found in the recent article in the New Yorker about cost disparities in Texas for towns very near each other. The only variable that accounted for the huge differences in cost was the number of procedures required by doctors.

This is not a simple issue, but some things are ridiculous on their face- e.g., the donut hole, complex brochures that many elderly cannot even wade through, taking tests for coverage when moving from one state to another. Anyone not blinded by ideology can see that this system is a mess and a costly one at that.
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<<I certainly don't begrudge a vet who was disabled in service to his country. In fact, I don't think we do enough for those who served in a combat zone. My point was why is a multi-millionaire who spent his overseas time in Germany while the fighting was in Korea and never had a service related injury or illness getting his meds paid for by the taxpayer, especially when there doesn't seem to be enough money for the VA to care for combat casualties?

>>


There's a lot about war that's a crap shoot, I would suppose. "Survivor guilt" is apparently a common phenomena.

I would suppose that anyone who serves in uniform during wartime is taking a substantial chance with life and limb.



Seattle Pioneer
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<< My point was why is a multi-millionaire who spent his overseas time in Germany while the fighting was in Korea and never had a service related injury or illness getting his meds paid for by the taxpayer, especially when there doesn't seem to be enough money for the VA to care for combat casualties?
>>



Ummm. Imagine you were in Germany facing opposing forces 10X times the strength of your side.

Now imagine the United States is heavily involved in a war half a world away and than the reinforcements anticipated should the balloon go up are not there.

And your enemy knows it.

How well would you be sleeping?

And of course you could be ordered to replace worn out troops in Korea at any time, as well.



Seattle Pioneer
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I apologize for putting my last post on this board instead of the new one dealing with health care reform. My point was stimulated by the Part D discussion, but I think the post would have been better placed on the new board.
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For me, no apology was necessary. I'm unsure how health care reform and retirement can be separated....but of course, I'm a blonde, so maybe that's why I don't understand.
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For me, no apology was necessary. I'm unsure how health care reform and retirement can be separated....but of course, I'm a blonde, so maybe that's why I don't understand.



ditto.

( except for the 'blonde' part )


-
.... grey-hair
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Just don't begrudge those who have served, as you can't possibly know or understand the price they and their families are paying.

Very well said - vets deserve A LOT!! Please thank your DH for me.

Karon
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I think this has been a proper topic for this board. You presented an alternative view on whether to take Part D which was worth looking at for anyone on or near Medicare. Certainly a valid retirement issue. You did not get involved in any kind of political discussion, which belongs on the other board.
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Re penalties:

I just got my latest Medicare booklet and was perusing the Plan D portion.

"The penalties are 1% per month. So assume Vermonter has been "saving" the $23/month premium for a 24 months. If he were to return now, his premium instead of being whatever the current premium is, would be 124% of the current premium. But perhaps people in Vermont do not consider 24% and growing penalties important."

Not so!

As stated in the booklet, the current penalty is $.32 per month x the number of months you have NOT had Plan D since your eligibility. It also suggests that the "average" monthly payment for 2010, without penalties, is about $32.00. (I don't have the book in front of me right now.)

If I have been out of Plan D for, say, 3 years (36 months), that comes to a penalty of .32 x 36 or $11.52 per month. The way I add it up, if the average rate is $32.00 before penalties, even if I rejoined now it would only jump about 36 percent to $43.88 -- not 124 percent!

Finally, as has been pointed out, I can opt OUT until the time when whatever special meds I suddenly need materialize, at which point I can rejoin (during the appropriate signup periods, typically at the end of a year) to get the coverage I need.

Thanks to low rates offered by various pharmacies, I still pay a total of just $40 (and no copay) for 90 days worth of four medications, which comes to a grand total of $13.33 per month for all my medications. That's a lot less than $32.00 (or $43.88 with penalties) PLUS COPAYS per month with Plan D!

Again, do the math vs your own particular situation. Do NOT be stampeded by the government, AARP or anyone else into paying more than you need to.

Vermonter
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I'm going on a Medicare Advantage plan in December when I turn 65. My intent is to wait out the upcoming plan changes until 6-1-10 so that I am able to make a better choice among on the changes.

I too have been figuring out these plan D options when I return to original Medicare, and the prospects aren't thrilling. I take 5 RXs, all available from WMT @ $10/90. Paying $25-30/mo for Plan D while getting meds from WMT at this point makes absolutely no sense. I'll pay more for the Plan than I will for the meds......

Stop helping me government, I can't afford your help!!!!
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I wrote "The penalties are 1% per month. So assume Vermonter has been "saving" the $23/month premium for a 24 months. If he were to return now, his premium instead of being whatever the current premium is, would be 124% of the current premium. But perhaps people in Vermont do not consider 24% and growing penalties important."

I think something is wrong with your calculator.

In your example you used 36 months and came up with a monthly payment of $43.88 -- Last time I checked, $43.88 is 136% of $32.00 -- So to use you plan and 24 months, the $32/month cost would be $39.68 which oddly enough is 124% of $32.00

The other part of this to consider is why you might want to enroll 3 or 5 years down the road. Generally speaking people don't really want insurance until they find the idea of the insurance company paying bills a better deal then the insurance premiums. In your case, if that happens, maybe the converages afforded by the $32/month plan might not satisfy you. So in the future, if you wanted say a $50.00/month plan, that plan also would have the penality -- to use your 36 month time period, the $50.00 plan would cost $68/month.

Insurance is a gamble. Clearly the insurance companies have profit and costs - that is money never spent on anybody's healthcare. The problem for individuals, is nobody is 3.2% in need of those $15,000 per month cancer drugs. You either are 0% or 100% in need.

Gordon
Atlanta
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the risk comes from having a sudden medical crisis, and winding up in a hospital where the drug bills suddenly run $50,000 for a six day stay.

That is when you want comprehensive insurance. And the older you get, the higher the odds are of a stroke or heart attack or medical crisis.

The same for car insurance or house insurance...you don't need it till you need it. And, that 'need' might arise very suddenly when a tornado hits out of nowhere, or someone blindsides you (or you do), or the visibility drops to zero and you drive off the road over a cliff accidentally, or similar......or have a head on with another driver who can't see anything.

t.
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Enlighten me, how can one get $50K in drug bills at a short hospital stay? Easy to spend $50K, but in my view not so easy on drugs.

I was thinking of Cancer and biologics.

Gordon
Atlanta
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Have stroke...some of the meds are $2500 an application ...and you might get several...... easy to run up $10K in a few days..

For heart attacks, I imagine you can run through a small fortune if you need immediate surgery......and then are in rehab for the next 10-30 days.....

You aren't going to get too many generics for strokes and heart attack situations...to start with.....

t.
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I am aware the enzymes to treat ischemic strokes cost over $2,000 (but most insurance plans force you into the generic which is significantly cheaper). In addition these drugs can only be given once in a 6 or 12 month period - the issue is a hemorrhagic stroke with more frequent dosing.

Gordon
Atlanta
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Gordon:

I owe you an apology. Somehow, when I read your previous post I misread your words to mean that the premium would RISE by 124%, which obviously is not what you said. Even so, as others have said, should some costly medication suddenly be needed that I cannot get "cheap" outside the plan, I should still be able to get into the plan when or if needed, after a wait of X months.

Meanwhile, it just is not worth it to us to spend $34 apiece or $68 for the two of us this year (or more, plus copays on various medications) each month, when my wife takes NO medications and mine are available for a total of $13 and change per month.

As I said, you pay your money and you make your choice.

By the way, I still think it stinks that all elderly are supposed to get on line EVERY YEAR to compare plans, and then decide if they want or need to CHANGE plans annually to get a better rate! What kind of nonsense is that?

And what of older people who never heard of a PC when they were younger, have none now, and truly feel overcome if they had to face one?

"Tough"?

Vermonter
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<<By the way, I still think it stinks that all elderly are supposed to get on line EVERY YEAR to compare plans, and then decide if they want or need to CHANGE plans annually to get a better rate! What kind of nonsense is that?>>



I don't think anyone is compelled to do anything if they don't want to.


Perhaps it would be simpler if the government required everyone to join one plan where they liked it or not at whatever rate the government decided they would have to pay. I'm sure you'd complain about that as well, since you've decided it doesn't suit you to join any plan.


Seattle Pioneer
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