Monday, February 04, 2008

Leaving Optimism

I really haven't a clue about how to describe what has changed my attitude. All I can definitely say is that it culminated today.

I had hoped that the logistic problems with prescription drug coverage for my mom had finally been resolved. Just over two weeks ago I was told that all we had to do was get a termination (of the old coverage with Medco) letter from Alcatel/Lucent (the company to which my dad gave 29 working years) and forward a copy to the new prescription coverage company, Humana. Then they could refile all the paperwork with Medicare and all would be well.

All is not well.

Today, my mom went to pick up a prescription that she HAS to take. The pharmacist said that her coverage had expired. Mom came home in a panic. It was 12:30 pm. Here's what then transpired.

I got all the paperwork out once again, including all the notes that I had made with the previous calls in December and January, and I called Humana, the new drug coverage. After the push button phone routine and a five minute wait, Humana said that the problem was with Medicare. They had rejected the Humana coverage four times. There was nothing that Humana could do until Medicare allowed the coverage through Humana. Call Medicare.

I called Medicare. Yep, push buttons and wait fifteen minutes. Medicare says that they cannot allow Humana until Medco notifies them of termination. Medicare will file a complaint to Medco but I needed to call Medco and insist that they notify Medicare of the termination. Medicare gave me the toll-free Medco phone number.

I called Medco. They have a recorded, voice activated system that got mad at me because none of the questions that were auto-asked applied to this situation. I went in circles because you have to have an active account to answer the questions and the coverage was canceled 12/31/07. Finally, I just refused to answer any questions. The recording cycled three times and then put me on hold for a representative. Twenty minutes later I talked to a human at Medco who told me that Medco is not responsible for notifying Medicare, Alcatel/Lucent is to do it. The lady at Medco confirmed that my mother no longer had coverage through them. I needed to call Alcatel/Lucent to have them notify Medicare.

I called Alcatel/Lucent. I played push button for a short while and then had to wait thirty minutes for a benefits center representative. I gave her the short version of what was going on. And what does she say????
Alcatel/Lucent does not contact Medicare, Medco must do it. I told her that I had just talked to Medco and that they said they couldn't. It had to be done by Alcatel/Lucent. She said that as long as coverage was active, the termination notice had to be from Medco. I told her that the coverage was terminated on 12/31/07. I have a letter from Alcatel/Lucent confirming termination. She said that Medco showed it as active. I told her that I had just checked directly with Medco and that they said it was terminated. She argued and insinuated that I had lied about contacting Medco.

I asked to speak to a supervisor. She said she was the supervisor. Then she said that she would take care of the situation and to expect a call back within 48 hours. I told her that I expected not only the call, I expected the problem to be satisfactorily resolved within 48 hours or the next call that they received would be from my attorney and that I would also take the story to the major Boston news networks.

And she said, "Thank you, m'am". I hung up on her. Two and a half hours on the phone.

My mom went back to the pharmacy and paid full price for her prescription. She's keeping all the receipts because, believe me, someone, other than my mom, is going to pay for this.

And if that weren't bad enough. I've been working on income taxes. I preface this by saying that really and truly, I haven't missed some major (or minor) tax saving item. I read and reread all the instructions, line by line, and triple check. I cannot believe how totally screwed up this country and this state are.

My net income is below the national poverty level. I work very hard, but net very little. It is a monetary sacrifice that I have become comfortable with in order to be able to enjoy what I do. My living expenses are microscopic in comparison to most people. So here I am with a net income below the national poverty level yet I owe tax on that income. Now I don't mind that I have to pay self employment tax. That is paid to cover Social Security income and Medicare once I'm 65+ (assuming the government continues to honor the system by the time I qualify). But I owe ordinary income tax! A very small amount to the feds and twice that to the state. This is the same state that is paying for my mandatory health insurance because I qualify because I'm below poverty level. It's extremely discouraging.

Several weeks ago, a Rockport resident wrote a letter to the editor that was published in the GDT. After a lengthy description of a sequence of events, the writer declared that the multitude of airplane vapor trails that she had seen in a short period of time had left a purplish filmy deposit on her truck. She, upon addition consult with some other friend, believed that what they had seen and the purple film was the government secretly trying to control weather systems.

Wacko, I thought. Now well.........maybe she wasn't so far off. Just not weather. Things are terribly askew.

I'm exhausted, through and through. Now I shall put my head to my pillow and have a good cry before sleep.

7 comments:

Little Wing said...

Sorry for all of the problems, I hear a lot of complaining about Humana out here in California also.
So you actually have state mandatory insurance?
Can you tell me a little how that works?
Do you have a co-payment or anything?
We sure need some of that here in Cali.

Anonymous said...

I am screaming for you! Words don't adequately convey the frustration. And all the while you struggle and do things correctly and get your chained yanked again and again, our government is pouring money and lives into areas of the world that have issues we will never be able to solve. Why can't we take care of the people here for a change.

I had better stop ranting because maybe blogs are being read by the powers that be. They "eavesdropped" before with MLK JR and others and they are probably still doing it.

Tomorrow is the primary here in MA. I know you keep clear of politics on this blog so I will try not to rant and rave. It all seems hopeless but I shall go and cast my vote because I can, My mother was in her 30;s before women were given the right to vote (yes, she had me when she was old!) so I vote even when I think that anyone who wants the job (and power) is probably not fit to run the country.

Hang in there Deb Don't let them, beat you down..

Anonymous said...

Oh dear, Oh dear! Poor Deb. Well, for all our failings - and God they are many! - at least we do get free prescriptions. Mind you, so do all the Nouveau Brits who haven't paid a bloody penny into the system! You'll get no true Justice here, Deb.
Still. Today, the sun is shining. Hope it does in Rockford too.

deb said...

LW, Humana has been great. The problem is that they cannot get her coverage as Medicare has not been told by either Medco or Lucent that her previous coverage was ended. The blame is on either Medco or Lucent for failure to do their job and of course, the screwed up government government system.

Ma mandatory insurance isn't working. Clever idea where individual costs are on a scale based on income. The wealthy most pay in total, some people are partially paying and others are covered totally by the state. It was just reported in the Boston Globe that the state will shortly be billions underfunded for the program as they underestimated the number of uninsured! Also, the state reserves the right to assess an individuals estate for costs. If you fail to obtain adequate insurance you are penalized on you state income taxes. The first year you are denied your exemption and following years additional penalties are added.

I see dr.'s taking advantage of the increased opportunities at the expense of the state.

Mary,I'm still super upset over this whole situation. No worries about 'big brother' I'm sure I'm already on their list because of all the research/reading I did on Cuba a few years back!

Yes, I'll be voting in the primary. I'm voting democratic, just wish I could have both the front runners at the same time...a co-presidency.

Dickiebo, I'm thinking Oz sounds pretty good. And no, the sun is not shining. We had snow (dusting) overnight and now rain all day. Everything is gray and slushy including my brain.

deb said...

Okay, after my last comment I should say that I am NOT pro-Castro. My interest was first in art and architecture and then sociology.

Little Wing said...

Thanks for the information on how that insurance works.
It certainly doesn't sound so great now that you explained it!

deb said...

My explanation was simplified and you can well imagine the complications that are created through legislation without forethought. I did forget to mention that companies are penalized per employee if the company does not provide group insurance.

Right now I am held up filing all our MA tax returns because we have yet to receive insurance verification forms from the various companies (three of us and three different companies). It has created an entire extra page each for MA income tax.

And to all of you...apologies for the misspellings and typos in my a.m. comments. My only excuse, fatigue and I hadn't had my morning coffee!