an open letter to wellcare value plan pdp S4802-143-0.
Hallejulah! Holy Shit!
(published 12/4/24 at 12:15am, note added at end 12/4/24 at 3:58pm)
Dear Wellcare Value Plan PDP S4802-143-0 Administrators,
I had to pick out a new Medicare prescription drug plan today. Since becoming eligible for Medicare, I have been a customer of Aetna’s Silverscript Plan. It's been fine. But they added a ridiculously high deductible so I choose you today: a plan that I hope will be better than that. Assuming the government websites talk to each other without error, you are now my Medicare Part D Prescription Plan administrator.
I was trying to explain to a friend that one quirk of Medicare is that you pick the drug plan separately each year, unlike the employer paid healthcare plans. Drug plans are called “Part D Plans.” D for drugs I guess? But that’s not the only quirk: none of the letters make sense either. Part B is medical. And Part A is hospital. Part C usually covers part A, B, and D unless you don’t have Part C in which case you do have A and B but not D. If you don’t get D when you should get D, you can be penalized for it. I’m assuming all of that makes sense to you though, because you are insurance people.
I have two bougie meds that keep me from having headaches every hour of my existence. (Bougie meds are the ones who have prime time commercials because America.) The rest of what I take are cheap generics that I can effectively ignore because you will sell them to me for pocket change compared to the hundreds you charge for those those bad boys. There are great coupon programs for bougie drugs but for reasons I don’t understand, those aren’t offered to Medicare and Medicaid patients. I bet you understand why though, because you are insurance people.
Quick question, if you don’t mind. How much of what I’m paying this year to you will go in the jingle fund? I don’t mean the Santa kind. I mean the “ooooooo ooooooo ooooooo Ozempic, you knoo-oo-oow” kind of jingle. I’m sure that license was not cheap but I suppose it should cost money to ruin perfectly good 70s music.
Anyway, I'm an educated person who excels in mental math and problem solving so I should be able to handle this task. Although my brain fog is an increasingly concerning symptom of my MECFS, I’m starting with an IQ in the 99.5th percentile according to some test someone gave me once when trying to figure out why I am the way I am.
And yet it, it required a level of expertise that caused me to stare and blink into the computer screen covered in a complex web of nested internet tabs. Even a person of sound mind who is well rested, recently fed, and adequately hydrated cannot make an educated guess as to which plan is the best one. How are all the octogenarians who can’t use a smart phone picking these plans? It’s genuinely keeping me up at night.
While I appreciated the plan summary that attempts to break down the costs, there was one major issue: there is not one monthly price to compare. You need math equations. But just to be clear, you didn’t give me the equations. You put me in a BYO equation situation. Here are the variables you provided me to work with:
monthly cost of the plan
deductible of the plan
cost of each drug before deductible (sometimes retail cost, except when it’s not)
cost of each drug after deductible
out of pocket max
cost changes due to the donut hole, which you do not explain
cost changes in the price of a specific drug per month to month due to whether you met deductible yet or not
which pharmacy you choose for each individual drug
whether the pharmacy is mail order which saves money except when it doesn’t
whether you get a 30 or 90 day supply
which drugs count toward the deductible and which ones don’t
which drugs are on their list of covered drugs (aka the formulary)
As I’m doing this I have questions that I know your customer service can’t answer: Is there an easy way for my doctor to check which pharmacy is the cheapest or do I need to do that myself and then tell her? Are all Walgreens charging the same prices? Why is Harris Teeter cheaper than everything else when food is their thing? Will the “donut hole discount” works itself out during the coverage gap? What does that sentence even mean?
Eventually, I got tired of trying to figure it out and I selected your plan. I wonder if whoever named the plan evaluated the “Wellcare Value Script” for both the wellness of care and the value of the scripts? Is that a thing insurance people do or is that a marketing gimmick?
I suppose it’s worth pointing out that you offered me the option to receive the plan info packet in braille and a format accessible to the deaf. I haven’t looked whether that’s a law, but knowing what I know about this sort of thing, I bet it’s only offered because of a legal requirement.* But, yup, you’d know, you’re insurance people.
After I made my decision, I was sent a receipt via email that had major “thanks for your purchase” energy like this was as exciting buying something on Cyber Monday. Which I did and it was much more exciting: a pair of those Heritage spoons for myself. Pair of spoons? A set of spoons? Here’s a photo, decide for yourselves whether this thing is a singular or plural. I’m delusional enough to think I will be able to play them and delusional enough to think that they won’t be taken by my children immediately. Maybe that’s secretly why I bought them.
Anyway, while I’m 100% confident about the spoons, I feel like 64% confident about your plan being the best fit for me given literally everything I just pointed out. If I’m wrong about that, I’ll just be fucked and owe more money. But you probably already know that, as it seems the insurance people have designed the system that way.
In conclusion and at risk of being a bit harsh, allow me to share this Christmas sentiment:
"If any of you are looking for any last-minute gift ideas for me, I have one. I'd like Frank Shirley, my boss, right here tonight. I want him brought from his happy holiday slumber over there on Melody Lane with all the other rich people and I want him brought right here...with a big ribbon on his head! And I want to look him straight in the eye, and I want to tell him what a cheap, lying, no-good, rotten, four-flushing, low-life, snake-licking, dirt-eating, inbred, overstuffed, ignorant, blood-sucking, dog-kissing, brainless, dickless, hopeless, heartless, fat-assed, bug-eyed, stiff-legged, spotty-lipped, worm-headed, sack of monkey shit he is! Hallelujah! Holy shit! Where's the Tylenol?"
—Clark W. Griswold Jr.
Oh, and that Tylenol better be in the formulary.
Sincerely,
Jess Badger
If you like this letter, please add your email to my email garden so I can water it and keep it with all the other happy little email addresses in a happy little garden of people I write to. A special thank you to those leaving hearts on my posts as they have helped me find many new readers, thank you! Here is a cute donut to celebrate!
*LOL, it is part of an ADA legal requirement.
edited to add 12/4/24 at 3:58pm
