"Sign Here Please"

“Sign Here Please”

It is a good rule of thumb to read any document before you sign it. That seems to go without saying. Yet many of us, when in the doctors office, grab the pen and sign away without so much as a glance at what we have just agreed to.

If you were ever scheduled for same-day surgery, a surgical procedure or even a hospital admission, you were inundated with forms to sign before you got to the correct department. Usually the clerk handing you the form will say, “Sign on the top, initial the sides and sign on the bottom. By doing this, you are giving us permission to do whatever has to be done.” Or, you might be told by signing a document you will be giving them permission to administer anesthesia. But sometimes you aren’t told what you are signing. They just put one form after another in front of you and you just keep signing and initialing. After all, if you take the time to read all of the documents you are asked to sign when you go to the hospital, you will have to allow another half-day and you might miss your surgery appointment!

Make sure you ask the nurse or the clerk to explain what it is you are signing before you actually sign it. One of our clients just sent us a Medicare Summary Notice for a hospital bill totaling $24,265. Medicare paid nothing! The memo in the Notes section of the Medicare Summary Notice said, “The provider’s determination of non coverage is correct. Our records show that you were informed in writing, before receiving the service that Medicare would not pay. You are liable for this charge. If you do not agree with this statement, you may ask for a review”. Suffice it to say, she has no recollection of signing such a statement because as she put it, “I signed so many papers when I was admitted that I had no idea what I was signing”. When Medicare does not pay, neither does your Medicare supplement.

The same rule applies in a physician’s office. There are still some things that the medical profession can do to us that Medicare simply does not pay for. The provider (doctor) must give you a letter in writing, stating that the procedure he wants to do is not covered by Medicare and that you will be responsible for paying his bill. This must be given to you before the procedure is done. If you sign it, you are responsible for paying the doctor. If the doctor doesn’t give you this form to sign and the procedure is done, you are not responsible for paying the doctor and Medicare will explain this to you on your Medicare Summary Notice.

In summation, whether you are buying a car or being admitted to the hospital, be sure to know what it is you are signing. By not paying attention to this detail, you could end up owing a great deal of money.

Sometimes a higher dose pill is the same price as a lower dose one. Splitting pills in half can also save you money. Make sure your doctor and your pharmacist understand what it is you want to do. Do not do this without first discussing with your physician.

Always be proactive and upfront with your physician about the medications you are taking. Most of us manage to see a specialist or two, or three, in addition to our primary care physician. Make sure your primary care physician knows what the other doctors are prescribing for you. This can save you money and prevent adverse reactions.

Does your prescription drug benefit have a mail order option? Buying a 90 day supply through the mail can be far more cost effective than buying prescriptions every 30 days. Most mail order plans offer incentives to use mail order in lieu of the local pharmacy. There is a downside to this. It isn’t fair to your local pharmacist to only purchase antibiotics and other medications that you need immediately. If your pharmacist does not sell a lot of other products, such as the big chain pharmacies do, he/she can very quickly go out of business.

Some people are buying drugs from Canada and other foreign countries. Be very careful! Medicare Part D will not pay for drugs purchased outside of the country. If you are under 65 and have a group major medical plan with a prescription drug benefit, check your benefits booklet to see if foreign drugs will be covered.

Likewise, the same rules apply when purchasing drugs over the internet. Be sure to use a secure site that is from a reputable business. A Verified Internet Pharmacy Practice Site (VIPPS) seal of approval certifies that the web site is licensed and complies with quality and privacy standards, according to the National Association of Boards of Pharmacy. Counterfeit drugs and drugs that have not been stored properly can be very dangerous.

Do not cut costs by skipping doses. It is important that you follow your doctors’ instructions. As stated earlier, if you are struggling to pay for your medications, let your doctor know. There is help available. Some pharmaceutical companies offer free drugs to patients in need. Ask your doctor or contact the manufacturer directly. The Partnership for Prescription Assistance is an organization that helps patients and doctors find assistance programs that provide free or nearly free medications. Go to www.pparx.org or you call them at 1-888-477-2669.

We often hear people complaining about the high cost of drugs. But many of us fail to realize that there have been more advances in medical science in the last forty years than in the entire history of medicine. There are some very, very expensive drugs on the market today that can keep us out of the hospital, or keep us alive. We have a client who told us last week that she had a heart attack a year ago. She had it at the exact same age as both her mother and grandmother. Her mother and grandmother did not survive the heart attack; she did. A year past it, she is living a happy, healthy, productive life. That is due to advances in medical science and pharmacology.

The Declaration of Independence guarantees us the right to life, liberty and the pursuit of happiness. It does not guarantee that we should have paid in full health insurance and prescription coverage. As part of consumer driven health care, we have to all be responsible for a greater share of the cost of our medical care.

Lastly, NJ has the PAAD (Pharmaceutical Assistance Aged and Disabled) and the Senior Gold program for New Jersey residents with low income. The income limit for PAAD in 2007, for single seniors or disabled people is $22,572 or $27,676 for married couples. If your income is more than $22,572 but less than $32,572 if you are single and more than $26,676 but less than $37,676 if you are married, then you may qualify for Senior Gold Prescription Plan. If your income falls into these categories, you can pick up an application for PAAD in any pharmacy or call PAAD at 1-800-792-9745.

This column is intended to offer suggestions and options for reducing your out of pocket prescription costs. It is not intended to render medical advice, and any conversation about altering your prescription usage should occur between you and your doctor.

Irene Card & Betsy Chandler are both licensed insurance professionals working at MIC Insurance Services, a health insurance services company. If you have questions relative to this column or other related topics, we invite you to call (973) 492-2828, browse our past columns on our web site at www.micinsurance.com.

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