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Thread: I'm so frustrated with Medicare, Social Security, etc!

  1. #11
    Senior Member catherine's Avatar
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    Quote Originally Posted by iris lilies View Post
    I find it surprising that you all apparently think there is no bureaucracy in the socialized medicine world. I’m not sure if you all have run into it, but The Gubmnt is pretty good at Providing hoops to jump through to accomplish anything. Certainly some countries are better than others at how they hand out healthcare. Mainly, the grass is always greener…
    Yes, there's always bureaucracy, but their single-payer system is, by definition, streamlined. You don't have employer groups, and managed care executives, and pharmacy benefit managers, and providers and a gazillion health care companies and a gazillion healthcare plans WITHIN the companies and copay vs coinsurance and high deductible/low premium vs. low deductible/high premium and prior authorizations and appeals, and Medicare vs commercial and donut holes and Krispy Kremes.. (oops, I haven't had breakfast---mmm... Krispy Kremes).

    And for all this convoluted mishmash and layers upon layers of stakeholders and high cost, we have horrible health outcomes. The grass is not only greener, but our grass needs to be completely re-sodded!
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  2. #12
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    Read The Nordic Theory of Everything to get a Scandinavian's perspective of our system(s) after moving to the US and getting married. There is no reason it needs to be so complicated and profit-driven.

  3. #13
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    Quote Originally Posted by pinkytoe View Post
    Read The Nordic Theory of Everything to get a Scandinavian's perspective of our system(s) after moving to the US and getting married. There is no reason it needs to be so complicated and profit-driven.
    I think the fact that is is profit-driven explains most of the confusion and frustration.

    People against single-payer medical care say they don't want the government making medical decisions for them. But they are apparently completely happy with a for-profit insurance company making those same medical decisions as to what they can and cannot get.

  4. #14
    Senior Member CathyA's Avatar
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    Our Medigap change starts March 1, and of course, I'm having problems that I didn't have when we were "accepted" awhile back. But what's frustrating me the most is our Part D (prescriptions).
    I'm was hoping we could keep going to Walgreens. It's the most convenient for us, but I've realized the new RX plan prefers CVS. I've been trying to find out how much more it would cost to keep going to Walgreens, and it's near impossible.
    I finally found this new plan's "formulary" online and it's like 100 pages long. Then there's 4 different tiers of meds, and the prices change depending on where you have them filled. If the meds I've been on aren't their "preferred meds", then I either pay a lot more, or change the med. I received their booklet last month and it was about an inch thick. This is all just too crazy for me. Life is too complicated here.

    Another thing I realized was that when you first apply for a Medicare supplement (medigap), they can't NOT accept you for pre-conditions you might have. But.....if you want to change companies later on, because the first company got too expensive, they CAN refuse you. They ask all sorts of questions and even have a representative call and ask you questions. Fortunately, we got accepted, but if I had had that steroid knee injection in the past 6 months, instead of 1 and 1/2 years ago, they would have rejected me. My brain isn't big enough to live in this day and age.

  5. #15
    Senior Member SteveinMN's Avatar
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    Sadly, CathyA, that's everywhere, Medicare or no. That's also something that single-payer is not likely to fix, unfortunately.

    Don't memorize the formulary, either; it'll change next year.
    Success is to be measured not so much by the position that one has reached in life as by the obstacles which he has overcome. - Booker T. Washington

  6. #16
    Senior Member iris lilies's Avatar
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    Cathy, have you considered using a Medicate insurance broker? They sell the supplement policies, they get paid by the in surance companies, they signyou up.

    We met with one yesterday. She gave me more information than I want. At this point, I just want the EASIEST choice which is I think “Then Cadillac Plan” for part G and the rest of it,
    I simply do not cAre. Cost be hanged.

    We have very few health care needs but be ause we go back and forth betwee nurban MO and rural MO this appears to be the best plan.

    I used to insure just for catestrophic things but now I insure for convience.

  7. #17
    Senior Member CathyA's Avatar
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    Thanks everyone. We do have a medicare agent. I don't think we could have figured anything out without her. She helped me with a problem yesterday, so I'd like to give her a day or so to recover, before I bug her again. haha
    She's wonderful. She knows soooooo much and has such a caring heart....which is unusual to find in today's world.

    I was able to finally register online yesterday with my Part D (Rx) supplement. I tried several weeks ago and spent hours either online or on hold on the phone and gave up. But it worked yesterday. YAY! Unfortunately, it didn't work for DH, so he has to call them today. I also have to call them about pricing at different places, since my favorite of Walgreens isn't their "preferred pharmacy", couldn't answer my question. So we'll see.......both DH and I might spend hours on the phone today, just trying to talk to a representative.

    We chose a company that has great rates.............but when I told our Medicare agent that it's impossible to reach them, she said she and other agents have the same problem. She said it's a new company and sometimes they get overwhelmed with all the people choosing them and can't keep up. I'll give them another try today. But I'm not looking forward to it. After a long wait, I hope I can understand the person who answers.......

  8. #18
    Senior Member CathyA's Avatar
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    OMG!!! This is unbelievable. I just got off the phone with someone in the pharmacy (India?) for my new drug plan. I needed find out the difference in cost between Walgreens and CVS for 2 drugs. She could not understand me, and I could not understand her. So.......I had to go through each and every letter of my meds, one at a time, and most of the time she wouldn't get it right. So I had to tell her that I would say the letter and she would repeat it after me. Then I would also have to say the letter and a word that she would understand that started with that letter. I tried to be patient and kind, imagining that she was doing the best she could and no doubt really needed this job. Plus.......she knows a second language, which is more than I do. (except I do know German pretty well). Anyhow........I think I'll write a letter to the company. I just can't go through this every time I need help with something. Am I being an arrogant American? There's just got to be a better way than this. Am I expecting too much?

  9. #19
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    That’s ridiculous and terrible!

  10. #20
    Senior Member SteveinMN's Avatar
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    Quote Originally Posted by CathyA View Post
    OMG!!! This is unbelievable. [snip] Am I being an arrogant American? There's just got to be a better way than this. Am I expecting too much?
    Yes ... and no. If I had to be conversant in the languages natively spoken by people I've contacted in long distance customer service, I would have to speak several localizations of Spanish, languages connected to Indian natives, Tagalog, and, likely, Mandarin. Americans do skate by on the fact that English is a lingua franca (odd using a term most American probably cannot translate but there you are). As long as public companies are chasing stockholder dollars and non-profits are cash-strapped, customer service will not be an area of high investment and this is the way it will be.

    One thing I've found that helps greatly in instances like this, though, is to go to the provider's Web site and see if there is an option for "chat" or "live chat". Spoken language comes with accents and local idioms and is dependent on the quality of the voice line/speakers/headset/etc. (this goes for boh parties). With chat, you type in what you want and everyone has more time to understand and react.

    My experience in working with people in other languages (and them working with me) is that it's easier to follow the written word. You would not have had to spell medication names phonetically -- even if you didn't spell Syklosporein right, the person you were speaking with (or the knowledgebase at their fingertips) could at least check against spellings to give them an idea of what you were referring to. Cuts down on errors in member numbers and things like that, too. Give it a try if you can and see if things go more smoothly.
    Success is to be measured not so much by the position that one has reached in life as by the obstacles which he has overcome. - Booker T. Washington

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