It Must Be the First of the Year...

Do you remember Johnny Carson's running gag... "It was so hot..." and the crowd would ask, "How hot was it?" and Johnny would add... "It was so hot that...and deliver a punch line." Well, in MY "Deli World"... "you know it's the first of the year...

• if your grandmother is worried about a $227 gas bill and telling you, "I'll just try to keep the heat down a little lower and put on an extra sweater." We go through this every January - her bill is high, she talks about being "cold as a frog" and putting on extra clothes while she cuts back on heat. Every year I assure her she can afford to keep her house as warm as she likes (which is 80-85 degrees). I know... I know... she's messing with my head!
  


• if your new Medicare Part D prescription drug provider is refusing to cover all of the prescriptions they promised to cover when you enrolled in their plan in November. Aetna didn't even wait one month - they went ahead and refused to pay for two of my grandmother's drugs right off the bat. The doctor was able to get authorization for one, but we are now going to try Nexium for one month instead of Aciphex and see if that works. The kicker is that, on paper, Nexium is $180/month; Aciphex is $150. However, Aetna must have a "deal" with the Nexium maker, because they will approve its use! So we are praying that the Nexium works.
  
  The funny thing there is that, as I explained this to my grandmother, she said, "Honey, that's okay. I've been reading about Nexium, and it's supposed to be real good. Besides, there are lots of things I can try if those insurance companies want me to - I hate for you to have to worry with them." Now, two years ago CignaRx required we try two other acid reflux drugs, and we ended up in a MESS - and back on Aciphex! And I can assure you that she would not be "okay" trying a variety of other drug substitutes, if asked. So we will see where this goes.
  
  
• the cardiologist will start shuffling the six-month "spring" appointment date and time. I think we have changed the upcoming visit twice now. The doc (who I really do like) must have gotten a good deal on a cruise or something toward the end of March!
  
  
• my grandmother starts talking about the dreary weather and how "the four walls are closing in on me." The day after Christmas, she actually told my mom that she had been thinking... "Maybe I should just go to the nursing home, where I wouldn't be so lonesome." LONESOME? Hellooooooo!!! This is the woman who, 1) tells me continually that her biggest fear is having to go to a nursing home, and 2) is so busy she can barely find time to eat and sleep! Just last week, her next-door neighbor told me that "Polly has someone at her house every morning... often more than one car at a time... and sometimes in the afternoons and evenings." It often takes several attempts to reach her by phone - because her line is BUSY! I don't know what hour of the night she is lonely!
  
  
• the forms have arrived to apply for utility assistance, food stamps, and a re-evaluation for Medicare services. Some of the applications require print-outs... bank statements, reports of all prescription drugs purchased, copies of utility bills. The folks at the pharmacy shook their heads in agreement when I said, "My grandmother has exactly the same amount of income/expenses today that she did yesterday... and the government seems to know EVERYTHING else about us, so why don't they know THIS?!" We copied the forms and mailed them to the agencies, and everything is in the works.
  
  My grandmother is anxious to get her utility assistance. She heard on the television news that some elderly persons were receiving $150, so she assumes she will receive that amount. I told her that HER form said $139, based on her Social Security income for last year, which increased for 2009 by $42. So it is likely that she may get something even less than $139. I am quite sure she didn't hear me... she will expect to receive the $150 reported on television!
  

Couple of side notes... the other day my grandmother was telling me about her gas bill and how she was running out of money...

[Grandma] "Aaagh! I don't know how much longer I am going to be able to afford all of this! I'm about out of money!"
[Me] "No, you aren't!"
[Grandma] "Well, I don't know about that!"
[Me] "Well, I do - because I keep your books!"

My grandmother continued discussing how high things were and how high her gas bill was, and finally, I told her, "Please, just quit worrying about all of that. You can afford it, and we are going to make sure you have everything you need. Just turn your heat up and be warm and quit worrying."
Her reply... "Honey, I don't worry! I learned a long time ago that it didn't help a thing to worry!"
I had to laugh, "Well it sure seems to me like you are fretting about this gas bill!"
She answered, "Oh, I FRET, but I don't worry."
Apparently there is a difference in the two!

My sister-in-law reports that her parents, who together sort of make a "whole person" - her dad can't hear or remember - her mother can't see - are having problems with managing their daily affairs. However, her mother refuses to give up control of this and many other things that are honestly beyond her capabilities any more. So... when a recent electric bill was double what it should have been, the parents went into a tizzy. When my sister-in-law finally found the bill in a STACK of papers her mother fumbled through but could not see, the bill - and the checkbook - indicated that a recent payment had never cleared at the power company. The new bill included a past-due amount, which was explained at the top of the bill. But my sister-in-law's dad looked at the BALANCE DUE at the BOTTOM of the bill and did not realize there was an explanation of charges elsewhere. Suggestions to auto-draft all future utility bills were met with fervent protests! So for now, the past-due payment was resolved and things are in a 'hold-your-breath-and-hope-for-the-best" mode.

I can relate to this, as I used to give my grandmother a check to put in the collection plate at church for her monthly tithe. Then I noticed that a check didn't clear for more than three months. I knew that I had specifically given her the check... and she remembered getting it from me... but she could not recall what she did with it. I told her not to worry about it, but of course, it was money for the CHURCH, so she "fretted" for quite some time. One day she phoned and said, "I found the check... it was in the pocket of another purse!" I now have that monthly payment auto-drafted from her bank, and when she asks, "Did you pay my tithe?" I answer, "Yes, I surely did!" I've laughed that the church coffers would be overflowing if we were all as conscientious about our tithes as the little old ladies of the South!

My niece is expecting her first child in May. This will be my grandmother's first great-great-grandchild. She has already made two blankets for the new baby and is feverishly working on a third. We won't have to worry about this baby being warm! Several "little old ladies" in our community in my grandmother's age group (early to mid-nineties) are not doing well in the last few weeks. Mam-ma's neighbor and I were discussing this last week, and she asked, "How much longer do you think Polly can stay alone? She seems like the Energizer Bunny!" And truly, she does. However, we discussed the fact that even a fall could change everything, so I know this is a day-to-day thing. But for now, she is warm, her bills are paid, and she is stitching away between phone calls and visits!

When It Rains...

This is another post from my former pastor's sister, Beka Miles. Her mother, JoAnn Miles is hospitalized in Hot Springs, Arkansas, for complications that began with a colonoscopy just after Thanksgiving. She has just been moved from ICU to the Advanced Care floor in recent days. JoAnn's husband is a retired Methodist minister. Her son, John and her daughter, Beka are Methodist clergy, as are their spouses. Beka and her husband, Len, live in Fort Worth with their two daughters, ages 8 and 10. They are very much members of the Sandwich Generation! Here are some of Beka's thoughts from recent posts.

Len, the girls and I will be heading home to Ft. Worth tomorrow after a stop in Little Rock for a belated Christmas brunch with Len’s family. I came to Hot Springs to help coordinate health care 6 weeks ago Sunday. Save for two short trips home, I’ve been in Hot Springs ever since. Fortunately Len and the girls were able to be here for 6 days over Thanksgiving and then for the last 11 days or so at Christmas. I hate to leave, but mom seems stable and I need to go home. Katherine – 8 years old – said at the table yesterday – in her Godfather voice – “I am going to drag you home if it’s the last thing I do! I’m going to take you home and then lock all the doors so you can’t leave.”

When we get home, we have to deal with the effects of the flooding from several weeks ago. When Len called -- way back when -- asking how to disinfect floors, it turned out that it was not just an overflowing toilet but a serious backup with sewer water standing several inches in my study. Len did a lot of work before he left and then hired a professional service to clean while we were gone. We will still need to replace the baseboards and perhaps some of the sheetrock. So, we’ll continue the process of getting the house back in order when we get home tomorrow. Only recently has Len begun to break the news about how serious the flooding was. I am so looking forward to getting back home, but dealing with the aftermath of a sewage flood is taking the edge off of my happy anticipation.

Over the Christmas break Len has been going back and forth some between Hot Springs and Little Rock to be with his folks. I’ve been waiting until I had permission to ask for prayers for Len’s parents - Pat and Lawson -- who live in Little Rock. Len’s mom has been in poor health, and a big part of Lawson’s life is focused on taking care of her and their home. He was sick a couple of weeks ago and then on Christmas Eve was hospitalized overnight for observation and to get IV’s to replenish him. He is having other doctors appointments this week and next. We ask your prayers for Lawson, Pat and their family. My mother and Len’s dad are the two “healthy” parents, and we have always expected that they would live a long time and have few health problems. They probably will both live a long time, but it has been a shock to have these two be ill.

There’s a story behind this. On Christmas Eve afternoon I was out shopping at the last minute for my Dad’s and Mom’s presents for family members (because Mom had not had a chance to do any shopping ahead of time. ICU is not set up for a satisfying shopping experience.) I was walking around a well-known discount store that that we do not even mention around my mom because she is offended by its less than stellar record on labor issues. (We refer to this chain as “the store that shall not be named.") We were very worried about Mom that day, and Dad had even gone out shopping that morning for a new white shirt so he would not embarrass Mom at her funeral if she were to die. (I’m not kidding you. He actually went shopping for a white funeral shirt on Christmas Eve – just in case.) So, I was in the store and was very much hoping that Mom wouldn’t die while I was there and come appear to offer me a word of peace from the other side of the Jordan.

There I was in the middle of the store worrying about Mom and trying to find appropriate presents. (I ended up getting everyone safety devises -- a not so indirect reflection of my fears for Mom). And I was also trying to get some groceries that would approximate Mom’s Christmas Eve menu. Suddenly, it hit me that I didn’t know how to make her Christmas Eve boiled custard or her gumbo, and that if she crossed over the river Jordan before regaining full consciousness I might never know how to make her boiled custard and gumbo (unless of course that was the word she would give me if she appeared to me from the other side. But she would never give me her boiled custard recipe if she found me in “the store that shall not be named.”)

So, in the middle of "the store that shall not be named," naturally I start weeping and was absolutely beside myself. I did what I always do when I am beside myself – I called Len. “Len please come back. I need you. Boo hoo. Boo hoo.” Len didn’t say, “I’ll be right there darling.” He said, “Well . . . there are some things I need to take care of here.” I’m thinking -- “Things you need to take care of? What could trump my falling apart at the store that shall not be named because of the boiled custard?” Fifteen minutes later I decided to call Len back because he had evidently not understood the gravity of my situation. For the sake of dramatic emphasis, I said to him, “For God’s sake Len, unless somebody there is having a heart attack, please come home! Boo hoo. Boo hoo.”
There was a long pause and then Len said in slow, Len-like fashion, “Well . . . they don’t know if it’s a heart attack or something else.” It turns out that Len was at the emergency room with his father who was having tests and who would later be admitted for the night!

To my credit, I immediately sobered up, put away childish things and said, “You stay there, Len. Don’t leave.” He did leave after awhile and came to Hot Springs for Christmas Eve and Christmas morning and then drove back to Little Rock Christmas Day to spend the night with his folks, so his dad would have a chance to rest. (Len’s dad did not have a heart attack, and they released him the next day.) It looks like Lawson will be okay.

Len and Beka have returned to Ft. Worth for now, and their girls are very glad. Their 8-year-old said, "We were very polite at Mamma's and PawPaw's." Yesterday, Beka was sitting in her mother's hospital room, trying to decipher what she thought was "Watch out!" but was actually "Washcloth." Mamma JoAnn wanted to wash her face! Tonight, she and her daughters have had an early bath and put on pj's to get into bed and read. I'm sure it feels good to be home... sewage problems and all.

Just for Laughs...

I have a childhood neighbor who is like a sister to me. She lost her parents about seven years ago, but before they passed, she had her hands full. With two young girls to rear, and her own career and family to tend to, she and her husband moved back to Arkansas to be near her parents so that she could hopefully assist them. Yeah, right!

Her mother became incapacitated and was in a nursing home for many years, unaware of anything or anyone. Left to his own devices, her dad became even more of a "character," and his life's work became sweepstakes. Maurel was a Santa Claus of a man who always seemed (at least to us) to be jolly and whistling. He was as generous as the day was long. But Maurel was one of those seniors caught in that web of seduction known as "you could be our next million dollar winner if you buy these gifts or subscribe to these magazines." So the post office was kept busy delivering daily packages to Maurel's front door.

Soon the "awards" piled up throughout the house. Several rooms were waist high in "prizes" ranging from thermal blankets to bird houses to tacky jewelry to kitchen gadgets that worked for a day before they broke. What on earth did an 80-something Caucasian man need with a subscription to Ebony magazine... or any of the many others he received? Maurel just knew that a Cadillac or a huge cash prize would be his any day. My friend contacted the state Attorney General, and once, while her dad was hospitalized briefly, she thought she had his "awards" scam stopped. But Maurel was promptly on to her efforts and thwarted them... starting right up where he had left off before the hospital stay. He was so consumed that he would even stake out his mail carrier each morning so he could intercept and get his mail earlier in the day instead of the normal mid-afternoon home delivery. He was so anxious to see if he had won - or what awards were arriving!

There are many more "Maurel" stories, but here are a couple that really made us laugh today...

We all (my husband Bill, daughters Molly and Lucy, and I) were sitting in the living room at Daddy's. We were going to try and make ourselves stay 30 minutes. We were living in another town about 30 minutes away. After a little talk, Daddy disappeared and we looked out the window just in time to see him driving off. So, we were all released. He was good at the 10-minute-at-a-time visit. It was funny.

Then, one day ( this is awful) Molly and Lucy and I pulled up in front of the house. They bounded up the stairs, through the front door and immediately hit the porch. Daddy was sitting in the easy chair - naked - watching a soap opera. It was about 1:00 p.m. I'm sure he had stopped on his way back to the bedroom from the shower. He took about three showers a day. What a thing (literally) for Molly and Lucy to witness. I guess they should have knocked????????????????!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I would love to hear YOUR stories... and share them here with others. We are all in this boat together, you know, and laughter is sometimes all the help we have!

Putting Things in Perspective

My former pastor and I are almost the exact same age, but his parents are a little older - nearing the 80-year mark, while my mother is not quite 70. Lately, John's parents have begun experiencing some serious health issues, and his mother underwent a colonoscopy shortly after Thanksgiving. This led to emergency surgery the same day to repair leaks in the colon - and ultimately remove a portion of the colon AND her gallbladder. From there, everything seemed to go wrong. Her kidneys didn't function well after the surgery, which led to fluid and infection around the heart and lungs. She was placed on dialysis to reduce the fluid and assist her kidneys in removing toxins from her system. THEN, the week before Christmas, she developed more pain - SEVERE pain - that resulted in another surgery - this time to remove MORE colon that was septic and full of colitis, and to do a colonostomy. A third surgery was done to give her a tracheotomy to aid in breathing and a feeding tube. This little human dynamo has become a frail host to more tubes than the kids can count at times, and her survival has been in question more than once in the last couple of weeks.

Through all of this, the children (son John and daughters Debi and Beka) have kept vigil along with their little daddy, a retired Methodist minister who is not altogether well himself, but obviously faring better than his dear bride at this point. One of my pastor's sisters is also a Methodist minister - and the mother of two little girls, ages 8 and 10. Beka and her husband, Len, uprooted the family from Ft. Worth, Texas, to come to Hot Springs, Arkansas, and celebrate Christmas there while making trips to the hospital for ICU visiting hours.

Beka has kept the family updates flowing via a CaringBridge site (http://www.caringbridge.org/), which has been tremendous for those who know the family and want frequent reports, along with a way to respond and share thoughts and encouragement in return. Beka has a tremendous wit, just like her brother John, and she has truly shone in her conveyance of how it is to cope with a mother who was at death's door, an elderly father, and two small children who wonder if Santa Claus will find them in another state. AND... she has found time and strength to minister to other families who were waiting in the ICU... proof that in the worst of situations, God can still use us if we are open to His will.

Here are a few of Beka's more poignant observations - and one truly hilarious incident... I am sure many of us can relate...

• If I could only bi-locate it would be no problem. But I have yet to learn how to be in 2 places at once. Len and the girls are driving in tomorrow, and I don’t know how I’m going to spend time with the girls while also being at the hospital. I bought the girls their presents last week when I was home. We are going to put up a tree for the girls to decorate, and our aunt and uncle sent a turkey. So I think that is set. It’s just the bi-location thing that has me worried.
  
  


• We are having a good Christmas day – much better than we thought we would given Mom’s condition a few days ago. We are pleased at her progress. Dad has a lot of us here at the moment and is enjoying it.
  
  


• We were late to the ICU afternoon visiting hours because Dad is in the habit of helping people, and he can’t bear not helping. At the post office where we stopped to pick up Mom and Dad’s mail on the way to the hospital, there was a young woman who had locked herself out of her car and her lights were on. She didn’t have a cell phone to call anyone or money for a locksmith. At first I couldn’t believe that my frail, distressed, almost 80-year-old father was out in the rain trying to help this young woman while we were trying to get to the hospital.
  
  There were lots of other people – many of them young and energetic who did not appear to be on the way to the ICU - who might have helped. But of course, Dad couldn’t stand not helping, and the fact is, no one else was stopping to help her. So Dad asked her if we could call the police to unlock her car. (He actually said, “Ma’am, if you aren’t in trouble with the police, we’ll call them and they can help you unlock your car. Is that okay?”) We called them, and they were driving up as we left. His deep impulse to altruism can be inconvenient and, at least today, a little frustrating, but I wouldn’t have it any other way. That’s who Dad is. Mom has always put enough money in Dad’s wallet each morning so that he would have a little money to give away, but not so much that it would mess up their finances. She planned for his altruism; suppose we have to the do the same.
  
  


• I promised that I would tell about a man who was on the same floor as Mom in the hospital that first week when she was in a regular room. This is a true story. He is a good natured, if challenging, little guy whose voice reminded me of a combination of Festus (from Gunsmoke days) and Grandpa McCoy (from the real McCoy’s). It was impossible not to notice him because when he was in a regular hospital room he would always (and frequently) yell for the nurses instead of pressing the call button. And when he wasn’t watching CNN, dance shows, or the children’s program Dora the Explorer, he often stood in the door wearing only a diaper – except for those few times when he forgot the diaper and displayed himself in all his . . . not so glorious form.
  
  He sometimes could not find his own bathroom, so would knock on Mom’s door and ask to use hers. My sister -- always polite – would show him back to his room with its own little bathroom. One afternoon my brother, other family members, and I were standing in the hall when this gentleman came to the door in his diaper and asked if any of us were nurses. My brother explained that we were not nurses and said to the man, “You need to find your button.” The man turned around, bent over, put his finger to his backside and yelled, “Buddy, I know where my butt is!”
  
  As the nurses were escorting him back into his room, he yelled, “That boy wanted to know where by butt is. I know where my butt is.” He turned back to John, “Why do you want to know where my butt is? Bud, go find your own butt.” My brother, who like most United Methodist pastors has had lots of training in sexual misconduct and knows not to comment on people’s butts, stood in the hall saying over and over in a calm voice. “Sir, I am not at all interested in your butt.” The little old man is no longer my mother’s neighbor and the hospital seems dull, if more peaceful, without him. Let's hear it for peace and quiet.
  
  


• Our sweet father continues to be a challenge. When there are men around (his brother, son or son-in-law), he will let them park his car. But he doesn’t want his daughter dropping him off and picking him up in front of the hospital and parking his car. When I ask him to let me do that he always says, “I am the papa” (which translates “no.”) Yesterday when we were walking in the rain to his car as he was stepping over tree roots, sunken places in the grass, and two curbs, I tried to convince him to park in the handicap parking spaces from here on out. They are a lot closer, and the path is handicap accessible from those parking spaces to the hospital door. Because of the lupus and arthritis and whatever else, he has a handicap sticker and can rightly use those parking places. But he has so far refused to park there, because, as he explained to me, “What if some old people came and needed those handicap spaces?“ (!!???!!!)
  
  I may have now convinced him on the grounds that if he falls and breaks his leg (as he did last year), it will be a hardship on the rest of the family and he won’t be able to care for Mom. Basically, he will only agree to park there if we can convince him that it is selfish not to! Before the emergency surgery Friday before last, we had a good way to convince Dad to do whatever it was he needed to do (take his medicines, take his nap, eat regular meals, etc). We would say, “We are going to tell Mom on you.” It worked every time. With Mom out of it, we don’t have anything over Dad. We need her fully conscious again so we can have greater leverage.
  
  He does on occasion get tired of being bossed around by his children. Several weeks ago, I asked Mom and Dad to take a moment each day to find several things for which they could give thanks to God. The first day, Dad said that he was thankful, among other things, for his children. The next day, fed up with us, he thanked God that he and Mom stopped at only three kids. He couldn’t have survived any more than that. (Although when you count the original 3 and spouses, they now have 6 and we've all been a part of the healing process) Our daughters Anna [10] and Katherine [8] have told me, “You better be careful, Mom, or Mammaw and Pawpaw are going to put you in time out.”
  
  


• Dad just took the girls, Len and I out to eat at Dixie Café, and we are all sitting in the living room at the moment reading or working on computer. (Len is reading the New York Times on his phone, Katherine and Anna the funny pages, and Dad his science fiction paperback book.) It is uncharacteristically quiet. Dad will head to bed soon. The girls have had had their baths and have put on their pajamas. I’ll read bedtime stories to them shortly, and Len will head to the hospital in a little while for the 8:30 to 10 visiting hours.
  
  One of the gifts of the visiting hours in ICU has been that we’ve had large blocks of time for prayer and reading scripture. It’s a powerful thing to sit with a sibling or my father or husband and lay our hands on Mom and pray together for her. And it has been a joy to read scripture – especially when Dad joins in on the ones he knows by heart.
  
  I’ve read to Mom from the Psalms a lot lately, including these verses from Psalm 27: “13 I believe that I shall see the goodness of the Lord in the land of the living.14 Wait for the Lord; be strong, and let your heart take courage; wait for the Lord!”

Ahhhhh... Technology!

Last week, my grandmother told me that the TV in her bedroom didn't work. I went into her bedroom and turned on the TV. "No," she said, "it's the remote. It won't work." I looked at the batteries - AAA's - and told her maybe they needed to be replaced, and I would get her some more. However, I had just been to the store to do her shopping, so I told her I was not returning that day... but soon. Meanwhile, I determined that the new universal remote control we got a few months ago for her living room television would also work on her bedroom TV. So I told her to carry it with her when she went to bed at night and use it in both rooms until we could return with batteries.

Meanwhile, SHE went to the store (the very same afternoon with a friend), and she got some AAA batteries. She insisted that they did not solve her problem. AND... she told me a few days later, "Now neither one of those remotes is working. That new one worked for about 3 days, and now it's not working either!" So my wonderful husband went over to check out the remote situation. He said he knew in reason what she had done to cause the new remote control not to work - she had accidentally punched the VCR or Satellite buttons and it was no longer in "TV mode." Sure enough, this is what had happened, but the batteries did not do the trick in the bedroom, so she needed a new universal remote control for that room. My husband got her one and programmed it, and he explained again about punching the TV button if ever the remote controls didn't work. We figure she won't remember that if it happens again, but at least we will know the solution when she calls us.

So, when my cousin sent this video, I had to laugh. Not only did it come on the heels of this experience, but it also ties in with how much complex red tape there is to changing to a new Medicare Part D prescription drug provider (which was my task for today). It also speaks to the never-ending barrage of commercials that now crowd our airwaves about the ensuing switch to DTV. A friend of ours commented just recently that he had just about HAD IT with those commercials and how rampant they are! I sent him this video... he loved it!

I hope you don't think it rude of me to share this video here, and that you realize I share it in the hopes we can all find a little levity in these situations. Having said that... here goes!

If It's November, It Must Be Time for New "Part D" Coverage!

Okay boys and girls, say it with me now... "Let's go, Aetna!" You know if it is almost November 15th, it must be time to choose a new Medicare Part D provider! For the fourth time in three years (counting Year One, when someone switched us to another provider without our knowledge and we had to switch back!) we are moving to another insurance provider for my grandmother's prescription drugs. It seems that Humana, who was our provider in 2008 - and who had amazing customer service - is no longer an affordable fit.

In 2008, Humana gave Mam-ma "lifetime authorization" for coverage of a drug known as Aciphex, which controls acid reflux. Her previous provider, CignaRx had required we try other alternatives - other prescription options and OTC Prilosec. None of these worked, and Mam-ma's doctor faxed all of the appropriate documentation to acquire a waiver for CignaRx to cover Aciphex, which is between $150-170 for 30 tablets. In 2008, this came up with Humana, and all I had to to was to tell them that we had been down this road the previous year... I don't believe the doctor had to fax over anything, but maybe. At any rate, they verbally gave me the "lifetime authorization."

The 2009 formulary for Humana does not list Aciphex. Additionally, there will be a $10.60/month premium assessed on even those on total government assistance (Medicare and Medicaid). If a person can't pay this premium, Medicare picks a new plan for you. The last time Medicare picked a new plan (remember, without our knowledge?) it did not cover at least 3 of the drugs my grandmother takes! So I am not going down THAT road for sure! So...I decided if all we would be out was an additional $127.20 per year, that was worth not having to go through hoops to change providers. But just to be sure, I called Humana. Four Customer Service reps, the Medicare rep and 2 days later, I had three people telling me that there would be a monthly premium, two said there would not, NONE of them knew about the $295 "Pre-Initial Coverage Period" fee, and all of the Humana reps said there was indeed a "lifetime authorization" for Aciphex.

What all but the last Humana rep failed to tell me is that for Humana, "lifetime authorization" means until the end of the calendar year. Then all bets are off and you have to appeal/re-apply. My Medicare rep told me from the start that "Aetna looks like your best bet." In the end, she was right... and I called her to tell her so and to clue her in on how Humana views "lifetime authorization."

So, tomorrow is the first day I can make the move... and I will probably wait until next week. My head is spinning from all of these calls and menus and back and forth. I now know the weather in New York, North Carolina, and Dallas! I've been directed to http://www.medicare.gov/ more times than I can count - and I already have an account there with my grandmother's drug info safely stored for quick retrieval, which surprised most of the reps. This is not my first rodeo!

Sadly, though, this maze of confusion will cause countless elderly people who have no advocate to throw up their hands, pay the extra - or worse yet, let Medicare decide for them what plan they get - and they will have no choice. I explained to the Medicare rep this morning that she and her predecessor (who had the good sense to retire and keep what was left of her sanity) are dealing with a generation who may know how to send an e-mail or read something on a website, but for many of them, choosing a prescription drug insurer online is far beyond their scope of computer expertise. Many have never even seen a computer. Unless they have someone to do this for them, they are out in left field.

I also learned from my Medicare rep that I can expect to change plans every year - as the formularies change. She said Medicare regulates some things, but not all, and the private companies can regulate prices and what is covered, and how much, to a large degree. I told her I doubted the average American knew this. I certainly didn't! I was hoping that I had found a company we could settle in with for the long haul, and Humana would take care of my grandmother for the rest of her days. Not so! As long as we have this Medicare Part D program, we can look forward to spending the weeks before Thanksgiving studying formularies, reviewing and comparing plans on http://www.medicare.gov/ and trying to wade through the maze of confusion to figure out which plan is the best and most affordable for the coming year!

I don't mind doing this for my grandmother. I really don't! But it boggles my mind to think about all of the people "out there" who have nobody to do this sort of thing for them. They have no advocate to file the papers to continue their monthly food stamp allotment, their annual assistance with utility bills, their application for Home Health care and whatever else the Department of Human Services feels needs to be added to their file cabinets. They have no one to go to the pharmacy, the utility company, and the bank and secure copies of their statements to prove to the government agencies that THEY HAVE NO MONEY! Since my grandmother's only income is her monthly Social Security check, and the government seems to know everything else about all of us, you would think they already know how much she has and what she can or cannot afford! It would also stand to reason that if she could not pay for Aciphex on December 31, 2008, she still would be unable to afford it on January 1, 2009. That should not require another round of papers from a family physician - especially for the same insurance provider!

So Happy November! I hope you have received your formularies and are carefully examining all of the fine print. I also hope you only have to speak to three representatives or less to get definitive answers. May your phone menus be short and get you to the right person on the first try!

Celebrating a Birthday

Today was my grandmother's 96th birthday. We celebrated by taking her to lunch. My sister and her husband and daughter joined Mam-ma and me for lunch at our hospital cafeteria. (My husband was unable to be there because he has taken his mother to visit HER relatives in Iowa.) A friend who was dining in the cafeteria laughed that we had brought our elderly grandmother to the hospital on her birthday... but the food is some of the best in town, and the view of the surrounding mountains and valleys is spectacular. Not only that, she saw several people she knew, and that was a bonus for her! In all, it was a good day, and a time we will treasure. Who knows how many more birthdays we will get to celebrate with her - especially years that she will be this well!














When I took my grandmother home, there was a packet from her Medicare Part D pharmacy provider informing us of changes for 2009. Bottom line... 2 of her meds will not be covered, AND there will now be a monthly premium plus increases in the insurer's co-pay. So, it looks like for the third year in a row, I will be shopping for a new Medicare Part D provider. I've scouted a couple that are options... but both are going to cost us some $$ - more than we have been paying - and I can't sign up until November 15th, so I have a few more days to research things. It looks like I can save as much as $2000 or more over retaining the plan we have presently, so that is certainly worth the hassle factor!