A couple of days ago, Rick posted some information on Canada’s Universal Health Care system. I am not here to debate which system is better, although on the surface, it sure sounds like Canada has it all over Medicare. What my goal here is, to tell you what I have learned as a recipient of Medicare in the time Russ and I have been subject to its intricacies. Maybe I missed it in Ricks blog, but I wondered about prescription drugs in Canada. Do you have to have an additional insurance policy for drugs and do you have to pay for drugs you use? Do you have dental and/or vision coverage? Is every province on a different plan and do you have to do anything special if you are not in your home province (but still in Canada)?
I certainly welcome any other views as I honestly and sincerely do not know what the answer is. I know that as the population ages, the problems we are already seeing will only escalate. I know that older Americans are running out of money to pay medical bills. I know the system is broken. the question is, how do you fix it?
Someone commented on Rick's post wondering if higher income taxes in Canada might be paying for part of the medical insurance coverage. Can they really be that much higher than here (just wondering)? I thought we were paying through the nose, but maybe it's not as bad as I thought!
We have seen what happens when our government touches anything. It seems to go from bad to worse.
My main concern about universal health care is that if the government is in charge, it can only get worse. With the donkeys we have in Washington running the show, what could possibly go right? Government interference in medical care is my greatest fear but I suppose with Medicare, we’re right there already. If Medicare is any example, then I don’t think I want anymore government run health programs…but read on please.And now a bit about our experience with USA health care. Before Russ was on Medicare, we had private insurance. We paid almost $1200 per month for medical and prescription coverage – no dental, no vision. Plus we still had co-pays. This was under his retirees benefit program from Weyerhaeuser. Can you believe it would have actually been higher if not for the retiree's program? When he turned 65, and when I was declared disabled, we were REQUIRED to go on Medicare.
We didn’t have too much problem with forms, under the private insurance, as the doctors billed the insurance directly. But if the billing code was incorrect, then there were all kinds of problems to resolve.
Now we are both on Medicare. In addition to the Medicare premium of over $100 each per month, we both have a Medicare supplement which picks up part of what Medicare doesn’t pay. We pay about $160 per month for the two of us on this. We also are REQUIRED by Medicare to carry a prescription policy (Part D). Between the two of us we pay about $60 per month for this coverage. My plan is $45. and Russ’s is $15 but I didn’t have a deductible. Are we all confused yet? Try reading the brochures and online resources and then picking the plan that is going to provide the best coverage. IMPOSSIBLE!
Talk about PAPERWORK. Russ is diabetic. He has been on Medicare since April 2011. Our Medicare supplement is with Mutual of Omaha and our RX plan is with Humana. Diabetes supplies (test strips, needles, alcohol swabs, etc.) are considered durable medical equipment rather than drugs
but we have to order them through our prescription plan. So we have to jump through all kinds of hoops and deal with all three insurance payers to get anything done. Multiple calls, letters, faxes, to and from the doctor and just last week Russ finally got some needles - at an outrageous cost. He is already in the "donut hole" so all expenses are out of our pocket. Do we get to quit paying insurance premiums while we are in the donut hole? - not a chance! So we pay for insurance that we cannot use plus pay all RX and durable medical costs out of pocket. Oh, by the way, he STILL has not received any test strips! While the insurance fights back and forth with the doctor, we go to Wal-Mart and buy what we need! His poor doctor must just be frazzled with all the calls to insurance just to get Russ test strips and needles.Russ has been getting his Insulin all along but no needles to inject it with and no strips to test his blood. The latest letter from the insurance (received yesterday) states that they cannot fill the order for test strips as he does not show a diagnosis of diabetes!!! HUH???? They send insulin and needles, receive an RX from the doctor for test strips and they say he doesn’t have a diagnosis of diabetes???? I think their game is to just deny us as long as they can, knowing we will go buy these supplies on our own. When we buy things on our own it does not count against the amount we need to spend to climb OUT of the donut hole!! Can I hear a big "GOTCHA"?
Oh, my prescriptions? I take three and can get a 90 day supply at Wal-Mart or Fred Meyers for just $10 each WITHOUT INSURANCE! But I can get them for FREE from Humana – I only need to pay the $45 per month premium! Let’s see 3 months at $45 = $135. Without the insurance I could get the same medications for $30 for all three for 90 days. Is there something wrong with this picture? Remember, Part D, prescription coverage is REQUIRED!
Part of my question about the Canadian plan was the wait for service. I can call any specialist and get an appointment in very short order. There is little waiting for elective surgery. (Why do they call it “elective” to have a hip or knee replaced? Like you really WANT to have that done?) But this runaround with the diabetes supplies has me wondering what the heck is going on. Talk about a wait for service!
I still don’t know what the answer is. I think a lot of RVers are in this same position or will be as soon as they turn 65. With elections coming up next year, we need to figure this out. I fear that the system is broken beyond all repair as I can see no equitable and sensible solution. Maybe I’ll just move to Canada LOL!! (really I LOVE the USA, I just don’t like our politicians all that much!)
Do YOU have an answer? What has been YOUR experience with Medicare? Maybe our experience is the exception rather than the rule???
Here’s another blog from RV Life is Good that I read and found interesting. Beware, this one is a bit more outspoken.
