The financial fun never ends

Let’s see. Today is Jan. 14. And I was told today, by the pharmacy that provides Mom’s drugs at the Alz center, that Medicaid is not covering her prescription medications because she is not enrolled in a Medicare D plan. This is the first I have heard about any such requirement. I applied for Medicaid on June 22. I was in touch with the case worker on a regular basis until Mom was approved in, god, I can’t even remember anymore, I think October. Mom has been receiving meds from this company since the end of August. As far as I know, the pharmacy that provided Mom’s meds at the other nursing home, for just the two weeks, was paid by Medicaid. The word has always been that Medicaid covers prescription drugs in nursing homes. And today I’m told something different. I realize Medicare D exists, but I never enrolled Mom because her retirement insurance provided good prescription drug coverage while I was paying those bills. I don’t know, I hate to be cynical, but it strikes me as a racket that one government program won’t cover medication unless the recipient is enrolled in another government program.

The pharmacy has continued to send me bills for the drugs, after I left a voice mail two months ago and then sent a letter last month indicating that the company should bill Medicaid at the number I provided. My efforts to correspond have been ignored until today, when the company decided that the balance is too high to ignore any longer. It’s $4,450.84. The woman I talked to when I called the company back actually said: “The balance is $4,400, and if it goes any higher, I don’t know what’s going to happen.” Is that some way of threatening me? My response was: “My mother does not have any money, as you might be aware since she is on Medicaid.” The woman advised me to work with the facility to see if I can get Mom enrolled in a Medicare D program. Then she transferred me to the voice mail of the employee who handles this account, where I informed the voice mail machine the same things I told the woman who answered the phone: This is the first I’ve heard about any Medicare requirement; I’ve corresponded twice with your company to tell you to bill Medicaid with no response; Mom does not have the money to cover these costs, as you might have guessed already. And then I called the business manager at the Alz center to let her know what’s going on and see if she has some insight into what the hell is going on and how to connect Mom with Medicare D, stat, even though it is not currently an open enrollment period.

Ironically, today is my blogiversary. I posted my first entry on Jan. 14, 2009. I’ve been reflecting on the past year a lot in anticipation of writing a post about how much things have changed regarding Mom. And how steady things seem to be now. I guess that’s what I get for becoming complacent – a call from the pharmacy company trying to collect $4,500 from me. Lesson learned: If I decide to relax about caregiving and find myself worrying a lot less about Mom, something will surely come along for me to worry about.


4 comments so far

  1. HP on

    Amen sister. Just moved Queen Bee to a new place 10 days before Xmas. I’m sure I have plenty of fun things in store as I get her settled.

  2. Emily on

    HP, I’m sorry to hear you had to move her. Not fun. But I hope it is working out at this point for both of you, and feels like a good fit.

  3. Sherri on

    I’m sorry for your financial headache, Emily. We, too, had some odd insurance issues (I know your issue is a bit different) when Milo had his kidney problems. Giant bills out of nowhere – no notification that there was a problem until months later… Maddening….. Hope it resolves for you soon. On the bright side, congrats on your “blog anniversary” (I just passed my 100th!!! post last week or so :0 on mine.

  4. momsbrain on

    Thanks, Sherri! I just got another call today from the pharmacy. I am ignoring them for the time being. This person’s message was fairly brusk and I am not in the mood for that. I’m hoping the Alz center business manager can help settle everything. Congrats on 100 posts!

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