You’re on Medicare Who Do You Trust

I sometimes wonder if a doctor knows you’re on Medicare they will just “load you up” with all kinds of prescriptions or supplies and not even payMedicare help, Medicaid help, trust attention to your condition or other prescriptions you might be on.

My dilemma is that my husband, who has congestive heart failure, went to see an endocrinologist the other day.  We were looking for answers on his thyroid, but unfortunately another disappointing diagnosis was made - Diabetes.

Luckily Medicare Part B pays for all types of diabetic supplies and education, and of course our Medigap plan will pay the 20% that Medicare doesn’t pay.

We keep good records on medications, blood tests, and anything else we need just in case we need to see someone else beside his primary physician or cardiologist.  All this information was handed over to the endocrinologist and staff.

At the end of the visit, my husband was given a prescription for his diabetes. First I checked out his Part D plan to see if it was covered, and it wasn’t.  We take it to the pharmacy and they advise that his Part D plan does not pay for this medication at all. It was written out with the brand name, stated it was medically necessary and no substitutions.  In Florida, there is a law that states you have the right for a generic alternative.  In any event, the brand name drug was $83 for a 30 day supply.  The Part D provider won’t pay for this because there are generics available.  The Wal-Mart $4 generic is a heck of a lot cheaper than $83.

We spoke to the physician’s office and explained the situation and they wrote out a new Rx.  This time it was for the generic, but time released and to take 2 x’s per day.  Didn’t make sense to me – a time released prescription in most cases is 1 time per day.  So now this gets my curiosity going.

I started researching the drug, and what I find is an FDA Black Box Warning and this drug should not be given to anyone who has congestive heart failure.    Further reading revealed it should not be prescribed to anyone taking digoxin (there are various names for this drug, which could be digitalis, lanoxin, digitex) or furosemide (Lasix), two drugs my husband takes.

So, who do you trust?  Whether you are enrolled in Medicare, an Advantage plan, covered by any other insurance, or caring for someone do your due diligence and read about your prescription drugs and don’t be afraid to question the doctor.  I put my call in!

--Mary Jane Stern

Comments are closed.