MEDICARE TO SENIORS: WHY DON’T YOU JUST DIE?

If you’re on Medicare, that’s the message you’re getting.

Out-of-pocket costs of Medicare have been going up annually, with ever-higher deductibles and premiums and a massive doughnut hole in prescription coverage that like the energizer bunny just keeps going and going and going. Many of the most fundamental, critical medications aren’t covered at all — emergency and other inhalers for asthma sufferers, nitroglycerin, newer antibiotics. Out-of-pockets costs are terrifying. Now, they’ve added a new twist. Something special to make us feel the love.

Coffin

I had my semi-annual physical a few weeks ago. These are supposed to be no-cost, no deductible preventative visits. Included in the visit were some standard blood tests and vaccinations. Three of the vaccinations were boosters to the vaccinations we got as children: polio, tetanus, diphtheria, whooping-cough (which is making a come-back). One was against shingles, which apparently is an issue for anyone over 60 who had chicken pox.

When I got my statement from Medicare, I expected to find maybe $20 due for the lab. Instead, there was an outstanding balance of $464, all for vaccinations. More than $300 of those dollars was for the shingles vaccine. No way can I come up with this amount of money on our fixed income.

Medicare had covered none of it. It said my “other insurance” (what other insurance? I’m on a Medicare PPO Advantage plan) didn’t pay anything either.

medicare confusion

When my husband’s Medicare statement for his physical arrived, there was another $265 for vaccinations, all boosters. I compared the statements. Garry is not on an advantage plan. He’s on straight Medicare with a “Medigap” policy that never seems to pay anything no matter what the claim.

That was when I realized how they’d done it. Vaccinations are no longer a medical expense. They are prescription medication.

Medicare reclassified vaccinations as prescription medication so they now fall under Medicare Part D. None of the prescription plans ever have — or ever will — cover vaccinations.

Medicare decided it’s cheaper to let old people get sick (maybe they’ll die and save even more money) than to vaccinate them against disease. Because while millions might avail themselves of preventative measures (we are old, not stupid), many fewer will actually contract the illness. Cost analysis won.

I’m so angry, so upset, I’ve been waking up early in the morning already in a rage. Brooding on the kind of mentality which leaves us — people who worked our whole lives and paid tons of money into this system — vulnerable because our government has misused our funds.

I will not go into the history of this mess, except to say it started under Reagan, and has continued apace. With everyone crying crocodile tears over Medicare — while spending the money earmarked to keep us safe in our senior years.

Meanwhile, I’ve got about $700 of medical bills I have no idea how to pay. They never said they won’t pay for vaccinations. They just reclassified them as “medication,” knowing full well that no plan would pay for it. No Medigap plan covers prescriptions, so you are well and truly screwed.

Ever since I turned 65, it’s been a downhill slide.

The day I turned 65, I was dumped by MassHealth (Medicaid). I hoped I’d be protected by my disabled status. I’d been on disability for years which was why I was entitled to MassHealth.

No problem getting around that. Social Security simply reclassified (sound familiar?) me. I’m just old, not disabled. They switched me to standard Social Security. I get the same monthly money, but without medical protection. They also lowered the poverty guidelines so we no longer qualify for the extra help on prescriptions.

“Why don’t you just die already? Stop using up valuable resources.”

Obviously, we’ve outlived our usefulness. So how come we are not dead yet?

When did the United States become such a mean-spirited country? When did we decide it would be better for us to get sick or die rather than give us proper care? How did we come to this? Who are we?

I get the message. Just die already. If you are not outraged, you must think somehow this will never affect you. Think again.


NOTE: Well said, for all of us — of a certain age. The old man was right!

“Generosity. That was my first mistake.” Obviously, not my last.

Apparently we have outlived our value to the society we served so long and so well. You are welcome.

Garry Armstrong



Categories: #Health, Bureacracy, Getting old, Government, Medical, Retirement

Tags: , , , , , ,

75 replies

  1. My poor grandmother whom has worked her whole life and did what she thought was the right things to do in life, is in this nastiness called the donut hole. One of her meds alone cost 641.00 per month and she is also on a fixed income. I feel so awful that our older generation is suffering because of our greedy government and these awful insurance companies. I’m so sorry that my grandma has no way to afford her prescriptions

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    • I too am approaching the donut hole and I don’t know what I will do. It is a terrible thing to do to people.

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      • I, too, was surprised by the shingles shot — Medicare paid for the injection, but not for the vaccine. I could apply to my Part D plan for payment of the vaccine — but the medical clinic had not attributed the full amount of my payment to the vaccine, either, so I could only claim about 90% of it — how frustrating!

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        • It was a fair bit of change out of pocket. It seems wrong. Why wouldn’t they want us inoculated against things that will cost them more to treat than prevent? What is the reasoning.?

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  2. Spreading the word (via Twitter)! Not alone…

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  3. I have been and still am on a learning curve with Medicare…..my hubby turned 65 this year and neither of us knew anything about it…..we paid extra for prescription but they are already grumbling about my hubby’s muscle relaxer for his back….he has a degenertive spine and bulging disc…hello? We did pay for the supplemental insurance but so far things are not working as we are paying more out of pocket and it adds up!

    I think the system is totally screwed up…it is ridiculous! Your shots should be covered!!! We have all worked our butts off for our country and also because that is our generation, we work and work hard….and we get treated like this!!! It sucks! I am so sorry for you and I am with you a million %! Thank you for speaking out and sharing your life:)

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    • They grumble about everything, but usually will give it to you with a doctor’s statement of necessity. It’s a sucky system. It takes time to learn how to maneuver through it and I keep being surprised — not in a good way. Best? Call and check with customer service and find out if you need a doctor’s letter so they don’t catch you off guard. They will almost always give you ONE prescription before they demand a letter (and cut you off if you don’t produce it).

      Some stuff, no matter what you do, they just don’t cover it. There’s not much you can do about that. The prescription plans are the weak point of the entire program. But see what you can do because all prescription plans are NOT alike. You want a no-deductible plan with the biggest selection of covered drugs. Get help from the support people at Medicare. They are surprisingly knowledgeable. As I said, it takes time and they keep changing the rules. The laws are inadequate. Remarkably, they are better than nothing and I’ve been on nothing, too. That IS worse.

      Considering how hard we all worked, this is a sad thank you from our government, isn’t it. But at least we have it … and before LBJ, we had NOTHING AT ALL.

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  4. That is so scary. Our medications here in New Zealand are subsidised – we pay $5 per prescription up to $100 and then it is free. for the rest of the year. I get 4 subsidised GP visits of $15 each a year. The only vaccinations we are recommended are the flu vaccinations which is free if you have specific illnesses. Why would you need all those vaccinations if they want you to die off anyway?

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    • I think that’s the point. They price them so high, you can’t afford them. But some of these diseases like Whooping cough? Diphtheria? Polio? Do they really want those coming around again after we beat them?

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      • That is because young mothers will not vaccinate their children. But seriously, are they really necessary for the older population? If, to get non existent money out of them. That has never even been considered here in New Zealand

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        • Whooping cough is back, big time. Shingles has never left but it is more likely to hit you after age 60 when you can least handle it. Tetanus never left. It’s always around. We got booster for it about 20 years ago, but if you hang around animals, it’s always a danger. Not lethal always, but at our age? And with my heart? It would kill me. Diphtheria has never entirely left either.

          The USA is big. Huge population. Open borders. Many international airports. Lots of big cities. So public health is a serious issue. Babies and old people are the MOST vulnerable populations. I’d move to New Zealand in a heartbeat if I could figure out HOW to get there (other than a long slow swim) and what we’d do when we got there. Sounds a lot better than here.

          http://www.cnn.com/2014/06/13/health/whooping-cough-california/

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  5. I think I said it before and I don’t want to sound like a broken record. But our Healthcare system sucks and that includes Medicare. I think that was the biggest shock I had to endure when I came here. I shuck my head 30+ years ago and I haven’t stopped ever since.

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    • It totally sucks, but it’s better than the nothing we had until LBJ gave us Medicare and Medicaid in the 1960s and Obama pushed through AHA a few years ago. Our system is awful. I think calling it a “system” is probably overstating it. The services aren’t even close to adequate, but I’ve lived without health insurance. I almost died of it. The “almost dead” scenario cured me of dismissing what we’ve got as nothing. It’s far from where it should be, but I know what nothing is and this is better than that. I hope I live long enough to see genuine universal health care. I’ve been lobbying for it for my entire adult life and this is, sadly, as close as we have yet come.

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  6. It’s weird that they didn’t tell anyone the vaccinations had been reclassified, so at least you could opt out until you could afford them. I’d be pissed too. I went for years without health insurance. Decades… that’s with bipolar and much of the other chronic crap I have. Then when I finally qualified for insurance, I didn’t — pre-existing conditions and all that good stuff. Thank god they don’t do that shit anymore. But, what I’m trying to say is… I know the fight you’re fighting, and I’m sorry you have to fight it. I hope you find a way. It’s not easy, and it sucks that we have to fight it.

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    • I almost died of no health insurance, so I know exactly what you mean. However horrible it currently is, I remember when we didn’t even have Medicare or Medicaid.

      Apparently they did the switcheroo back in 2009, but no one gets vaccinated regularly — except flu shots which are paid for if you get them in a pharmacy and NOT from the doctor — maybe a few times n a lifetime? So I didn’t know and apparently neither did the doctor. The last time I got most of these vaccinations, I was 4 or 5. I’ve never had a shingles vaccination. I didn’t know it existed. I got a pneumonia vaccination, but that was when I still had Medicaid (MassHealth) and everything was covered.

      Our system sucks. It’s not a system. It’s three systems that barely know about each other and don’t work together. I still don’t understand why, instead of setting up an entirely new medical insurance system they didn’t just expand Medicaid or Medicare using the existing infrastructure. I guess that would have made too much sense.

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  7. Reblogged this on .

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  8. Medicare is a Pandora’s Box monster. It’s the sacred cow of Socialism, but It can single handedly bankrupt a country. The only successful systems I’ve heard of are a combination of Private and Social. Let those who can afford it, pay. This takes pressure off the Social systems and allows them to function with some efficiency. Up here in Canada though, whenever anybody mentions allowing Private pay, people start screaming. So we’re stuck with the same problems you talk about.

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    • Thing is, there WAS enough money. They just raided the account in the 1980s and never put the money back. It didn’t bankrupt itself nor was it the pressure of caring for sick and elderly. It was intentionally bad management.

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  9. I gave you my reponse on your comment on my site. Would just say thank goodness for the Swiss system. I always thought the British NHS was bad enough, but at least you get care for free if you have to wait for it (and hope you don’t die beforehand).

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    • I actually asked the customer service supervisor if having to tell elderly sick people that they aren’t going to be able to afford necessary medications and vaccinations bothers them at all. I said “I couldn’t live with myself, doing your job. How DO you live with yourself?” and she said “Let me see what I can do for you.” And I said, “That would be nice.” We are so screwed up over health care here. Really awful and shameful.

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  10. I was going to write a cynical comment about more tax cuts for the wealthy and the new upswing of the extreme Libertarianism that pretty much feels that if you aren’t rich and get sick you should just die, but I’m too depressed to say anything clever or meaningful.

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    • It’s horrible and I am finding it hard to find anything funny about it. Unless you have a very dark sense of humor.

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      • No, nothing funny, just depressing and very, very scary – it seems I meet more and more “Libertarians” every day that think all government programs should be shut down.

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        • I just had one of the apoplectic customer service telephone events with Blue Cross Blue Shield who are “just following government guidelines” and it isn’t their fault, you see. They are just following orders. Right now, I’d like to kill someone, but I think I’ll settle for a cup of coffee, then wonder how I’m going to work this out because it’s ugly.

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          • I’m sorry, it does sound awful.

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            • It’s a classic Catch-22 setup. To get a “rebate” you have to pay the whole bill, so if you can’t pay the whole bill (though with the “rebate” maybe you could), you can’t get any help. They have made it so Byzantine and require that you run around to many different providers to get your needs taken care of … the ultimate result is that they don’t pay anything and you get screwed to the wall. Made more interesting because I’m pretty sure my doctor’s office will not continue to provide medical care unless I can pay the outstanding $500 balance … which I actually can’t, so when you add it all up … well … I’m not a person who can go very long without medical care. It just makes me sick. Oh, wait, I’m already sick. Damn.

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      • No pithy comments on this one. None at all.

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  11. this is so stupid and sad, makes me cringe on thought of getting old., Bloody government does nothing either.

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  12. Is “Medicare” the same as “ObamaCare” or is that something else again?

    This sort of thing makes me mad :-(. I can’t believe that people who have retired don’t get heavily subsidised/free medical care. Isn’t the government’s primary responsibility to look after the population?

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    • Obama’s AHA is universal health care for everyone. Medicare is a much older plan for seniors and disabled people. Medicaid is a program which is supposed to take care of the poor, to fill the gap between Medicare and reality. There ought to be one system, but because of the weird political situation, it’s three programs.

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  13. We complain like hell over the NHS here… and with good reason in a lot of cases ( don’t get me started). But at least there is a system in place that gets us some kind of care without a price tag. How long that wil last, I don’t know, given the government we have and the streaching of resources, but at least we are not afraid to visit the doctor… a batch of non-elective meds will cost no more than eight pounds… and I think we forget that.

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  14. I had a similar experience with the Shingles shot — the vaccine was not covered, although its administration was. I spoke with the doctor, and found that I could appeal to Part D plan and they would pay for it (or include it against deductible or donut hole expenses). All I needed was a form they sent me and proof that I had paid the bill. The ones that really bother me are the meds that cost a fortune and for which there is no generic (eye drops, for example).

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  15. Marilyn…I’ve been going through this as well. I just had my annual physical and tried to fill a prescription that turned out to be $300 a month–with insurance!!! No way am I going to pay this. Then I tried to fill another prescription that would be nearly this much per month. When I balked, the phamacist said, “Perhaps you haven’t met your deductible.” Seems to me my “rider’ for prescription coverage only works if I don’t need any drugs.

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    • Even generic drugs are insanely expensive. People with chronic illness … good lord, how do they manage to stay alive? I don’t have any medication for asthma except an emergency inhaler, because they are ONLY $50 (no coverage). I can’t afford the stuff that would prevent attacks — that’s almost $400/month. Garry feels guilty any time he has to pay for a prescription and it’s amazing how they just decide one day to stop paying for drugs they used to pay for. Just like that, no warning, no explanation. Some bean counter decides and we find out when we need our medication. I have more than $700 in bills and NO idea where the money will come from. I already sold the silver.

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      • I’m so sorry, Marilyn. Have you talked to them about this? Is it possible there is a deductible that when you meet it they will pay for more? This is what the pharmacist said to me and I haven’t had time to call to see. My condition is not life-threatening. Not at all like yours, so my situation is in no was comparable. Horrible for you.

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        • I have a no deductible plan. They just don’t pay for vaccinations. And vaccines were never part of Medicare Part D. This isn’t about deductibles. It’s about coverage. For ALL of us, not just me.

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          • A shame, and if some had their “druthers” we wouldn’t even have this.

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            • I had a completely pointless yet surprisingly satisfying battle this morning with BCBS. Because they are the ones who set it up so that even getting a modest discount on vaccinations is so Byzantine, no one is going to be able to figure it out … and the benefit is so small, it’s hardly worth the effort. I’ll skip the detail. It’s a complicated way to make sure they don’t pay for vaccinations. Never mind that preventative medicine is the appropriate way to treat people of ALL ages, much less senior citizens. They don’t want to pay and if they have any choice in the matter, they don’t. The secret is to get so sick you get put in the hospital. THEN they pay for everything.

              Or die. Even better!! Then they don’t have to pay for anything ever again. I am so mad about this. There’s smoke coming out of my ears.

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    • If you can fill any prescriptions, you’ve met you deductible or don’t have one. There are a lot of Ned’s they’ve decided to not cover. At all.

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  16. Just before I turned 65 the SSA offered me Medicare/Medicaid. I opted out because I have VA Medical. I carry only Part A. I have zero dollars deducted from my Social Security check for insurance. I pay $8 per prescription per month, period. My insulin alone is $500 a month otherwise. I would simply have to die from complications of diabetes. Nobody cares. Veterans are treated like shit but at least they get medical care. That’s just one reason I don’t celebrate Memorial Day, Veteran’s day or the 4th of July.

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    • I’ve heard this from a lot of people. I wish Garry had been in the service just a bit longer, enough to qualify for medical coverage.

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      • I had to get approved as a hardship case for my own medical benefits. The hardship was a $50,000 a year pay cut when I got laid off from Intel in 2010. I got approved for VA Medical in 2012 after going 2 years without any medical coverage. I guess doing your duty in Southeast Asia from 1969-1973 didn’t count for anything. People wonder why I’m bitter. It’s because I HATE liars.

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        • Garry was in the Marine Corps … until they realized he couldn’t hear. Then they gave him a medical release and sent him home (he was a volunteer). About a month short of becoming eligible for benefits. That is WHY they sent him home. They didn’t want to pay for anything.

          But to be fair, they don’t just treat vets like shit. They treat everyone equally badly, unless, of course, you are wealthy. And politically connected.

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          • I have never had any issues with the VA. I’m extremely grateful for the medical services I get. I’ve only once run into an attitude problem and the person had issues he needed to get treated. I’m always treated with the utmost respect. No issues here.

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  17. I didn’t really want to “Like” this, so much as show my support. It’s not the first time I’m really happy to be living in Canada – I will never understand the system south of our border nor the vehementness against providing universal healthcare for all.

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  18. Your health system is so screwed….its a money making business from I can see with little regard for people’s health concerns……sorry to hear they have done this to you…..

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  19. It makes me furious too. Mean spirited is what it is, and sneaky as they obviously did not bother to make it clear to people that vaccinations had been reclassified. I worry that our own mean spirited government is taking us down the same road.

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    • It’s an international disease and obviously contagious. The easiest “money saving” stuff is cutting health care for the poor, children, and the elderly. We are vulnerable and no matter how many of us there are, we apparently have no power.

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