Donut holes....yum or yuck?

I really like donuts.  A lot.  Too much.  And that includes donut holes.  That's been about all I know about donut holes.  They taste good.

And then I was told my dad was in the donut hole.  Whaat up with that? How did he get into a donut hole?  How does anybody get into a donut hole?  That means it came from a really big donut.

Background - I'm a continuing student in the "school of hard knocks", the "school of learning by doing", and the "school of now-you-gotta-learn-it-even-if-ya-don't-wanna."  I have not graduated from any of those schools.  I just get promoted each year, despite not necessarily meeting some minimum standard that will ultimately lead me to some type of graduation.  There is no end in sight.  Kind of like what many of us, and our kids, and now their kids, may have experienced in schools.  Gratuitous promotion.  These classes are not  electives.  I have no choice. 

I'm now enrolled in a particular and peculiar class called Medicare.  I'm in this class because my dad is receiving Medicare 'benefits." The learning curve is straight up.

Back to the donut hole.  For about 15 months I've been in charge of my dad's finances and all that the job entails.  Just when I think it's all in order, a surprise bill, a tidbit of insurance, or a piece of previously unknown-to-me history shows up that requires me becoming the person of contact because I have the written Power of Attorney.  

These days I have a close working relationship with a pharmacy used by the assisted living facility where he and his wife live.  The folks there and at the pharmacy are very nice and answer my questions.  Are the drugs generic?  What are they for?  What do they do?  Can you tell me how to pronounce drug names?

For months the pharmacy bill seemed okay.  Whatever that meant.  Then it started to skyrocket.  Over $500 per month!  But the description and drug use wasn't changing too much.  A quick call after a couple of months of enduring that revealed my dad was in the donut hole.

People in the medical fields, and specifically those who deal with Medicare, speak a language completely foreign to me.  They roll off words like 'donut hole' as though I know what they mean.  Finally I figured it out.  And just now I googled it and sure enough I was right, according to Wikipedia which sourced it to Medicare.

This is one whacky system.  This is a system that had my dad go into the hospital for a catheter infection last year, and he came out with a pacemaker! Yes!  I still don't know who made that decision.

Back to donut holes. My dad pays premiums for certain coverages.  Then when his claims exceed what his premiums cover, he pays for everything full price.  Then when those payments get to a certain level, catastrophic coverage kicks in.  The donut hole is the gap in coverage.  Who thought of naming it that?

Next I needed to figure out how to stop this bleeding...insurance bleeding I mean. With the help of the most amazing people at the County Office of Aging, some sense was made of the system.  Those folks are highly trained volunteers and one elderly gentleman walked me through the Medicare website, helped me translate the drug names into ones that Medicare recognized, and then followed up with me three days later.  The Medicare website is actually very consumer friendly and sets up a wonderful comparison of companies and pricing and programs.

Did I want to learn this? No!  But I am learning, slowly.  I'm enrolled in this class by default.  And I'm there  because it's for Dad.

Here's to all who have gone before me, not complaining like me, patiently navigating the system, and helping their family members.  My hat is off to all of you.

Please join me for a beverage and some donut holes.  My treat.

Live richly,  marilyn

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