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Danged Medicare B.S. nonsense.

My dad stayed in the reserves to put in his time to qualify for TriCare, although this was decades before our healthcare system went to hell. He had no idea how good it would be for him (and mom). He sees what I shell out every month and is speechless. TriCare plus MediCare = virtually nothing has to be paid for (relative to me). Healthcare now is 2-1/2 times more than my mortgage was (when I had one).
 
Old_Me said:
i just checked the co-pays on all my other meds, (9 in total each day i take), and thankfully it is only the one that Medicare messed with.

thankfully, the Mrs is safe from the tyranny of price changes from Medicare........for now at least......

anyone know if this is a yearly thing that Medicare moves Tiers/co-pays on meds, like on the first of the new year, or do they do it more than once per year....??????

i haven't had this issue ever before..
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at least in tricare / express scripts the co pays are set for the year.
 
UPDATE:

you guys ain't gonna believe this... :poop:

i just called "my advocate" that is connected with my BC/BS provider, to see if they can help cover this outstanding bill i got the other day...

"you are just over the threshold of income"....

i'm like WTH...???

i said to the guy

"you gotta be kidding me, i'm on SSDI, and i'm making too much money"...??

"yeah, i'm sorry sir, but you are just over that threshold"...

UNBELIEVABLE ........B....S.........

when i was working, and after taxes...??

i was taking home each week, more than i get each MONTH on SSDI

so, i called the mail order pharmacy, and added my new credit card info....

bill paid.

but tell you what, i already started today, to cut back on that med, to only 2 pills a day, rather than the 4 i should be taking.

if this works out..??

i won't have to refill that script until about Thanksgiving time.......

unbelievable
 
Old_Me said:
UPDATE:

you guys ain't gonna believe this... :poop:

i just called "my advocate" that is connected with my BC/BS provider, to see if they can help cover this outstanding bill i got the other day...

"you are just over the threshold of income"....

i'm like WTH...???

i said to the guy

"you gotta be kidding me, i'm on SSDI, and i'm making too much money"...??

"yeah, i'm sorry sir, but you are just over that threshold"...

UNBELIEVABLE ........B....S.........

when i was working, and after taxes...??

i was taking home each week, more than i get each MONTH on SSDI

so, i called the mail order pharmacy, and added my new credit card info....

bill paid.

but tell you what, i already started today, to cut back on that med, to only 2 pills a day, rather than the 4 i should be taking.

if this works out..??

i won't have to refill that script until about Thanksgiving time.......

unbelievable
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Contact the drug company. My dad is 82, has a very nice retirement income and one of the 15 pills he takes daily is about $400 a month. My mom called the company and they get it for free.
 
Old_Me said:
UPDATE:

you guys ain't gonna believe this... :poop:

i just called "my advocate" that is connected with my BC/BS provider, to see if they can help cover this outstanding bill i got the other day...

"you are just over the threshold of income"....

i'm like WTH...???

i said to the guy

"you gotta be kidding me, i'm on SSDI, and i'm making too much money"...??

"yeah, i'm sorry sir, but you are just over that threshold"...

UNBELIEVABLE ........B....S.........

when i was working, and after taxes...??

i was taking home each week, more than i get each MONTH on SSDI

so, i called the mail order pharmacy, and added my new credit card info....

bill paid.

but tell you what, i already started today, to cut back on that med, to only 2 pills a day, rather than the 4 i should be taking.

if this works out..??

i won't have to refill that script until about Thanksgiving time.......

unbelievable
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That just plain sucks……but I know how you feel, I am not old enough yet for Medicare so I have to buy my insurance since my pension plan decided not to supply it for us public employees anymore. I don’t qualify for any subsidiaries cause of the type of pension I have, so I pay full price on my premium, my pension does reimburse me to an extent. Hang in there @Old_Me
 
Bassbob said:
Contact the drug company. My dad is 82, has a very nice retirement income and one of the 15 pills he takes daily is about $400 a month. My mom called the company and they get it for free.
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That is sage advice. I have Tricare for life that pays my meds but I know of what you speak. My sister is married to a man that is 16 yrs her senior and she is caught in the donut hole. He worked construction with full benefits all his life and she has managed a local home town bar for the last 35 years and which never had paid benefits. He is now retired and on SS and medicare so he no longer has the insurance he had his whole working life leaving my sister uninsured. She takes a medication that cost in excess of $600 per month and could not afford it. She called the manufacturer and they are now supplying it to her free of charge. Not a fan of big pharma but if you are in a pinch and contact them they are usually very receptive to helping out if you are really in need. Hey, all you got to do is ask, the worse they can do is say no and you are no better or worse off than before you called.
 
Bassbob said:
Contact the drug company. My dad is 82, has a very nice retirement income and one of the 15 pills he takes daily is about $400 a month. My mom called the company and they get it for free.
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yeah thanks, i was so incensed by this BS, i hadn't thought of that, i just sent off an email to the drug maker in NJ.

nothing ventured, nothing gained.

thanks again.
 
Annihilator said:
That just plain sucks……but I know how you feel, I am not old enough yet for Medicare so I have to buy my insurance since my pension plan decided not to supply it for us public employees anymore. I don’t qualify for any subsidiaries cause of the type of pension I have, so I pay full price on my premium, my pension does reimburse me to an extent. Hang in there @Old_Me
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it's not only medicare that we need, but we also need health care insurance as well, to cover what Medicare does not. i think it is called "Gap" coverages, which is (to me) BS as well.

that's an extra cost to us, and depending on who we go with, or who even accepts us, it can be zero premiums or God there is no limit premiums...

lucky for me, i have BC/BS coverage for like $110 monthly

but that's just for me, the Mrs also has her own coverage, which thankfully, it's cheaper, and with a different insurance carrier.

you know it's funny, the tv commercials say for us to "enjoy your retirement, and go do what you always wanted to do"

uh, yeah, one had better be Bill Gates, or Warren Buffet, to do that, cuz us "normal people" are limited.

I thank God I had an insurance settlement so that i can have my "hobby" of my guns, otherwise, my tropical fish, would have been the only "enjoyment" i'd ever have......and the only way they'd have been great for home defense..??

is if i throw them at the burglar......

can you imagine how "squishy" they'd be if i had to holster one of 'em..?????
 
i tried contacting the maker of the med. they do not give discounts however they gave me a link to a non-profit pharmacy. i filled out the "contact us" form, and now i wait until they can get back to me.

but i also read where "one must qualify".......i think that means of course that i must meet thier income level while on SSDI, like the Blue Cross vendor told me, and denied me.

but, if i can qualify, then the med for a 90 day script will cost me a mere $15.00, that's doable for me.

i'll update after they contact me.

thanks again to @Bassbob that mentioned contacting the maker.
 
My Wife has the dreaded Crohn's disease. She has tried Humira and Remicade turns out she's allergic to both of them. There's this new one called Strellara if I spelled that right. Anyways my benefits will not cover it they claim it costs 30 thousand dollars at least that's what they told us. Her doctors, surgeons and specialists all submitted briefs to our insurance and the drug company that makes it and all said basically NO it is what it is and since it's not a guarantee they are not willing to cover it. On a side note one of my colleagues wife works for big pharma she clears almost 200 grand a year and her bonus last year was two weeks vacation in Hawaii all paid for her and her husband only thing they needed for the trip was spending money oh and she also gets a fully paid and insured BMW to go and peddle her drugs to the different providers.
 
wolfpack076 said:
My Wife has the dreaded Crohn's disease. She has tried Humira and Remicade turns out she's allergic to both of them. There's this new one called Strellara if I spelled that right. Anyways my benefits will not cover it they claim it costs 30 thousand dollars at least that's what they told us. Her doctors, surgeons and specialists all submitted briefs to our insurance and the drug company that makes it and all said basically NO it is what it is and since it's not a guarantee they are not willing to cover it. On a side note one of my colleagues wife works for big pharma she clears almost 200 grand a year and her bonus last year was two weeks vacation in Hawaii all paid for her and her husband only thing they needed for the trip was spending money oh and she also gets a fully paid and insured BMW to go and peddle her drugs to the different providers.
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ain't that a (female dog's description)

these big pharma companies rake in the dough, thru subsidies, grants, and other monies to develop the drugs, and then distribute them thru door to door sales to the doctors.

they rake in more cash than we can ever imagine, making sure as i said earlier, all the "alphabet soup" board members get thier high dollar salaries, and everything else.

all the while we the people have to go broke and either we pay up or get worse and die.

i wish i knew the answer, i really do, but there will be those that'll say "it's business and they need to make a profit, and government needs to stay out"

i was informed some time ago, that some of MY meds are not made here in America, but in India......and there have been some recalls on meds made over there, luckily, mine were safe from the recall.

so he we go, just like anything else, manufacturing is done overseas, for cheap labor and materials costs, and BIG Pharma feeds off of that, and laughs all the ay to the bank...


"Western pharmaceutical companies increasingly began to outsource their packaging and manufacturing activities to India. India is now providing their medicines in nearly all countries."
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pharmaoffer.com

This is why India is the medicine factory of the world | Pharmaoffer

India is the largest exporter of generic drugs, but why? | Blogs about the pharmaceutical industry | All information in one place ✓ News ✓ Articles ✓ Blogs ✓
pharmaoffer.com pharmaoffer.com
 
wolfpack076 said:
On a side note one of my colleagues wife works for big pharma she clears almost 200 grand a year and her bonus last year was two weeks vacation in Hawaii all paid for her and her husband only thing they needed for the trip was spending money oh and she also gets a fully paid and insured BMW to go and peddle her drugs to the different providers.
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I have a niece that graduated college a few years ago and landed a position with a big pharma company. To gauge her knowledge of big pharma practices I asked her how come we pay so much more for the same drugs that go for pennies on the dollar to other countries. She said we pay X5 - X10 cost to pay for research for future drugs. I told her that was a perfect company response and that the extra we pay is to fund them big bonuses big pharma pays out. She chuckled and said, yeah that too.
 
UPDATE

thru the maker of my medication, i was finally able to contact a non-profit supplier located in MO (they called me minutes ago, and i got some good news)

it seems i am "accepted" and they have to do a few things on thier end, like transfer the medication over to them.

in the end..??

instead of getting whacked with a higher Tier 3 co-pay, seems like i'll only be paying $30.00- $35.00 for a 90 day supply.

that IS doable.

more info as it comes in.
 
Old_Me said:
UPDATE

thru the maker of my medication, i was finally able to contact a non-profit supplier located in MO (they called me minutes ago, and i got some good news)

it seems i am "accepted" and they have to do a few things on thier end, like transfer the medication over to them.

in the end..??

instead of getting whacked with a higher Tier 3 co-pay, seems like i'll only be paying $30.00- $35.00 for a 90 day supply.

that IS doable.

more info as it comes in.
Click to expand...
Great news!
 
Old_Me said:
UPDATE

thru the maker of my medication, i was finally able to contact a non-profit supplier located in MO (they called me minutes ago, and i got some good news)

it seems i am "accepted" and they have to do a few things on thier end, like transfer the medication over to them.

in the end..??

instead of getting whacked with a higher Tier 3 co-pay, seems like i'll only be paying $30.00- $35.00 for a 90 day supply.

that IS doable.

more info as it comes in.
Click to expand...
Missouri comes through for the win. Great news OM. :)
 
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