Medicare Part D Fraud

(It’s been almost a month since I last posted. I’m getting lazy I guess.)

So I’m on Medicare and I get Part D, which is the Prescription Drug benefit. It allows you to buy insurance to pay for your medications. Different companies offer different plans, but the goal is to try to pay less for your meds.

When I first qualified for Medicare I was the only one of us getting Social Security. Medicare recommended that I sign up with Wellcare. My monthly premium was only $7 and they paid for all of my medications. Cool!

The following year, the premium increased to $15.

The year after that, the premium increased to $35. This was because my wife started receiving Social Security, and so our joint income increased. We now make approximately $100/month above the Medi-Cal line, so I am no longer receiving “Extra Help” which is the program for those whose income is below a certain mark.  Medi-Cal was no longer subsidizing my premium, so that explains the drastic increase. But here is where I found out the truth about Wellcare: they didn’t REALLY pay for ALL my medications. They pay – get this – about $30 per month toward my prescriptions. So only the cheapest ones are paid for. Medi-Cal (California’s version of Medicaid) paid for the rest. And that means I now have to pay for the expensive ones.

I’ll be switching companies in October, but right now I have to stay with Wellcare, which means I am paying out $10 a month more than I would if I had no insurance what so ever.

I’ve written a letter to Medicare, asking whether or not the Wellcare company is committing fraud or not. I’ll let you know when and if I hear anything.

What did I learn? Do your research.

I found out today when my monthly report came from Wellcare, that they are owned by CVS Caremart.  CVS is a giant chain pharmacy that is in the business to make as much money from human suffering as they can.  I found out this fact because I happened to look at the postage mark on the envelope. There is was – CVS Caremart. I think that might explain why they are worthless.

The new company is through AARP, so I’ll have to join – $12/year.  According to their website, I will pay $22 each month and they will pay for all but one of my prescriptions.  This is how it should be I think. The one prescription they will not pay for (none of the companies I looked at will) is for Norco (hydrocodone/acetaminophen) which I take up to 3 times a day (rarely) for chronic back pain. It is an opioid. No, I am not addicted. Most of the time I can get by with only two a day.

The only downside will be that I have to use Walgreens. I like Costco better. They know me — never ask my name when I show up there. I’ll have to reestablish a relationship at Walgreens.

This means that my monthly expenses will go down by about $125 a month. This is a good thing.

Anyroad, if you or your loved ones are insured with Wellcare, do some research. You may well be paying out way more than you have to.