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Health

Prescription drugs woes -- Seniors often foot the bill under Medicare

The Plumley's
Beverly Plumley and some friends formed a group to fight the state and demand more equal payments in order to keep HMOs available to all Medicare recipients.  
February 25, 1999
Web posted at: 5:37 p.m. EST (2237 GMT)

From CNN Medical Correspondent Eileen O'Connor

WASHINGTON (CNN) -- The bipartisan Medicare commission met Wednesday to try and find a way to cover prescription drugs for seniors -- an expensive proposition. To keep cost down, lawmakers are looking at offering more managed care options to cover medication costs.

The suggestion of managed care scares some who have only had traditional coverage, but Medicare patient Beverly Plumley is one woman who isn't afraid of HMOs.

Plumley suffers from nerve damage and requires an internal pump of medication to control her pain. When she doesn't have it, she's miserable.

The simplest things, like making coffee, can cause excruciating pain. As a Medicare recipient, she and her husband Rod were under an HMO and happy. But the company pulled out last fall, saying the state government allotted less Medicare funds for people in rural Redding, California.

Plumley has returned to a traditional plan which does not cover her pain medication.

She said the transition back to a traditional program was a shock. "It was scarey...because we had drugs covered under the HMO."

As a result, Plumley and some new-found friends formed a group to fight the state and demand more equal payments in order to keep HMOs available to all Medicare recipients.

"There isn't a meeting we've had that I haven't had women in their 80s come up to me with tears in their eyes," Plumley said.

Letters have poured in to the new group from those who've lost HMO coverage, asking for help with confusing new Medicare forms.

The stories are different, but the worries are the same: How to pay for prescription drugs.

One person writes to say he is going to Mexico for medication. "I don't know what will happen after that... I guess it's cheaper to die," the letter read.

Plumley and friends said offering more managed care options, like the reformers in Washington want, can help cover expensive prescription drugs and keep costs down.

Plumley knows the $4,000 a year it takes to resupply her pump is just one concern of many.

"I just know there are thousands of seniors all over the country with worse problems than I have who need help now, not in two years -- they need help now," she said.

Plumley said she can only hope someone in Washington is listening.


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Clinton asks for bipartisan support of Social Security, Medicare plan
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Clinton ignores impeachment, calls for Social Security reform
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Proposed Medicare changes could save billions over time, commission says
February 18, 1999
Medicare options -- Which plan to choose?
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Many HMOs are dropping patients over 65. Here's how to make sure you stay well covered
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The HMO debate - What Seniors Need to Know Now
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RELATED SITES:
Medicare
National Bipartisan Commission on the Future of Medicare
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