Friday, January 27, 2012

NO CLASS AND AM I CRAZY?


Friday mornings at 10:30 I take a cardio dance exercise class. This morning I was working when suddenly I realized it was 10:15 and should be on my way. I grabbed my coat, car keys and pocketbook and dashed out the door.

The gym is only 1¼ miles from my house. During the spring, summer and fall I ride my bike, but it is too cold, wet and dreary most winter days. This morning it was raining.

Friday is the lightest gym attendance day of the week. It was easy to get a parking space and dash inside. I flashed my membership card at the desk attendant and quickly walked to the exercise room. It was 10:32.

Nobody was there.

No teacher, no partners in sweat, nobody.

I immediately got this miserable feeling in the pit of my stomach. It is Friday, isn’t it? Is the class time 10:30? I was sure it was. Maybe it is Friday and the class is not on Friday. Or?....

I assumed I had made a mistake. I walked out to the reception desk and sheepishly asked the attendant if there was a cardio dance class this morning.

Would he think I was nuts? Would he look puzzled and say, no, it’s scheduled another time…?

He pointed to the door, “It was cancelled today.” Sure enough, a sign on the door at eye level announced Friday’s Cardio Dance Class was cancelled due to illness. I was in such a hurry I missed it on the way in.

A sigh of relief.

I was not crazy.

I am not going crazy.

Of course I was concerned about the instructor. Was she ill? Was her daughter ill? But honestly, I was relieved that I was not crazy.

Several years ago I would never have second-guessed myself. I would have assumed someone else made the mistake. 

Fast forward and I am forgetful about where I place things, who called, appointments, names, and the list goes on. I need a calendar to record appointments and events. If errors occur or problems arise, as it did this morning, I wonder if I messed up. Nowadays I find that information I know I know is not on the tip of my tongue. I have to think about it. The information is there, stored in a file deep inside my brain, and eventually I find and retrieve it.

But not always.

Probably just about every baby boomer and older adult who has known someone who has declined because of dementia worries about the worst kind of memory-related illnesses – especially Alzheimer’s.  There are 77 million baby boomers. Health experts predict 10 million will get Alzheimer’s. It reminds me of the talk the college dean gave on the first day of college. Look to the left, look to the right  - only one of you will graduate. Which one will get Alzheimer’s?

The good news is most of us will not. We all have our senior moments, and that is a normal part of the aging process. 

A University of Colorado study found a small amount of physical exercise could protect the elderly from long-term memory loss usually associated with illness. The study was done on rats, but the experts insist this translates to human behavior.

So I will continue to exercise and hope for the best.

A hilarious note to end on - a great song all of us boomers and elders can relate to!




Monday, January 23, 2012

Medicare Madness


This is a tale about something I know nothing about. The main characters are my mother-in-law (MIL) and my husband (Hub). The chief culprit is a non-human entity – Medicare - although if corporations can be people, mega-bureaucracies like Medicare can be people too. Why not?

Hub manages my MIL’s life now, including monitoring her medicine and medical care. Prescriptions are filled by her assisted living facility (ALF) via a local pharmacy. We receive the bills and disburse payment with my MIL’s funds.

The story begins sometime back in December. My MIL’s ALF decided to change pharmacies used to fill patients’ prescriptions. It is convenient for the facility to order, store and disperse the pills.

The facility began a new contract with the new pharmacy in December and ordered a one-month supply of pills for my MIL on December 2nd. My MIL ended up with two sets of pills for December - one from the old pharmacy and one from the new. The ALF returned the unused pills to the fired pharmacy for a refund.

Medicare is a complicated program. It pays for prescriptions, except for a deductible in the beginning of the year. Later in the year when the cost reaches a certain dollar amount recipients pay 25% of the cost of prescriptions, then 100%, and then nothing if another monetary amount is reached. The arrangement starts all over again on January 1st of each year.

My MIL paid 25% of the cost of the December prescriptions from the old pharmacy. We expected a rebate for the cost of the unused pills. We did not get anything. The entire refund went to Medicare. Apparently her 25% was allocated to the cost of the pills consumed, and the cost of the returned pills refunded to Medicare.

The ALF ordered a one-month supply of pills from the new pharmacy again on December 29th. The bill arrives in the mail. My MIL reached a new threshold and has to pay more than the 25% copay.

For December my MIL received no refund for the pills returned and paid more money for the new pills. Who do you argue with? The pharmacy? The assisted living facility? They should have waited for the New Year to order new pills. Medicare? Are you kidding? 

My MIL was a victim of Medicare’s donut hole. A Medicare-eligible person pays a monthly fee for Medicare Part D drug coverage. Medicare initially covers the full cost of prescriptions. When the amount of the prescriptions filled reaches a certain dollar amount, another Medicare provision kicks in. The patient pays 25% and Medicare the remainder. The donut hole is a metaphorical dollar-driven spot where patients pay for a portion of their prescriptions. Patients in 2011 received a 50% discount on drugs when in the donut hole and less on generics. Once the next threshold is reached, $2,840, the patient pays 100% of the cost of prescriptions until the next level is reached - $4,550.  Then the patient pays just 5% of the cost of the prescriptions.


Honestly, I am not even sure all these figures are correct. I am not an expert on any government program, and Medicare is as convoluted as they come. This is a disclaimer – I really do not know what I am talking about.  

This website has a chart and maybe you can figure it out. The chart compares Medicare costs in 2011 and 2012. It is a good website if you need or want to understand the Medicare program.

The medical system is messed up and the elderly, who cannot, do not want to, or are unable to understand the intricacies of the system have no choice but to go along. Hub attempts to supervise my MIL’s medical life, but it is difficult. Too many questions, changes, and too many parties involved.  My MIL believes the medicine is ‘free’ because the pills magically appear when needed. She does not have to pay cash, write a check or hand over her credit card. All the buying and prep work is done behind the scenes.

 Medicine is not free and many drugs are expensive. Medicare pays a portion, my MIL pays a portion - although she is unaware of the expense - and hub gets the aggravation and frustration of dealing with the on-going situation. It is persistent. One issue is solved and another problem arises. ALF bills, pharmacy bills, Medicare disbursements, insurance bills and copays, doctor bills…     

We wonder if the situation will be any better when we are in need of a great deal of medical and personal assistance. We do not want to burden our kids.

There ought to be a better way. We just do not know what it is, now or in the future.