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PLAN D, FOR DIVORCE?

By Frank Kaiser

When Gloria and Russ Tuttle married, they couldn't imagine that, four years later, a Medicare drug plan might force them to divorce.

Gloria, now 78, and Russ, 80, had known each other for 53 years. So when they each found themselves single again, it seemed only natural to marry and live together in Russ's doublewide out back on his daughter's place in rural Pierce County, Washington.

The newly-weds don't have much. Their combined annual incomes are barely $22,000, most all of that from Social Security. But what was once a good friendship is today a deep affection for one another.

We're in love," avowed Gloria. "We have just enough to live on. What more could we ask?"

That was before the new Medicare Plan D.

Like so many of us at that age, Russ and Gloria have health challenges. Pharmaceuticals keep those challenges in check. Just to breathe, both need Advair, costing about $300 a month each.

All told, substituting generics where possible, the Tuttle's monthly medicine bill at Costco is $1,131. Or, it would be but for drug manufacturer's patient assistance programs. With income below drug company ceilings, the Tuttles qualified to get their drugs cost-free.

Until now.

What was once a lifesaver for millions of less well-off American seniors, most all patient assistance programs now are slamming the door on "anyone eligible" for Medicare's new 700-billion to 1.3-trillion dollar privatized drug fiasco.

Anxiously, the Tuttles looked into the requirements for Plan D. They found their meager income too high to qualify for subsidies.

Russ and Gloria researched alternatives. They attended seminars. They sought help from anyone who would listen. "We found that buying in Canada would cost one third what it does here," said Russ. "But we still couldn't afford it."

They prayed.

They learned that most insurance companies participating in Plan D wouldn't reveal what drugs they currently covered. "They all told us we had to sign up before they'd show us their latest formulary," Russ recounted with disgust.

When a salesman slipped Russ Humana Complete's list of covered drugs, it proved to be the least expensive plan they could find. Still, with co-pays and premiums, and their AARP supplemental covering gaps in Plans A and B, the monthly total is $860, far beyond what their budget can bear.

Family Values

What to do? An elder-law attorney suggested that divorce might be the only way out. Neither of their individual annual incomes is above $11,500. As unmarried singles, Russ and Gloria would fall well under Plan D's $14,355 maximum for individuals, easily qualifying for subsidized medicine.

Divorce? Was that the American alternative?

"We didn't know what to do," Gloria told me. "We couldn't sleep. And when we did, we'd have nightmares." Heartbroken, the couple wrote to every Seattle TV station, to all the newspapers in the area, to Medicare, to AARP, to our president, to their senators and Congresswoman.

Then they waited. And waited.

Only Washington Senator Maria Cantwell responded. "And she went on and on just blowing her own horn," complained Russ, "She never once addressed our Medicare D problem."

Gloria interrupted. "All these politicians talk about 'Family Values.' But when a couple is forced by the government to divorce, they've nothing to say."

The other night, Russ had a dream. In it, all the companies of Big Pharma got together with a drug plan for folks like the Tuttles. An industry-wide patient assistance program was instituted. And all of Gloria and Russ's problems were over.

Except that dreams like that seldom come true. Especially when drug companies today are outright lying to seniors, telling them that under Plan D it's illegal to provide free drugs.

This June will mark Russ and Gloria's Fourth Wedding Anniversary.

Or will it?

If you have any helpful ideas for this fine couple, they'd like to hear from you. You can e-mail them at glorianruss@earthlink.net. Russ and Gloria are so desperate they've asked me to include their phone number as well. It's 360/893-0858. Please, don't abuse it.

Copyright © 2006 - Frank Kaiser

UPDATE, MAY 2, 2006, FROM GLORIA TUTTLE...

Just got word today from my doctor's office that the pharmaceutical companies who provided our medicine FREE through the Patient Prescription Assistance program will continue - even if you choose not to enroll in PlanD.

So - no divorce - hooray! We will have a great 4th wedding anniverary celebration June 4th.

For more information or to find out if you are qualified contact pparx.org or call them at 1-888-477-2669 or contact your doctor's office.

Usually the application and paperwork starts there. They will need proof of your income and a list of your medication. Income limits are between $26,000 to $33,000 - each company has their our eligibility requirements.

As powerful as the drug companies are, they have met their match "SENIORS TO A UNITED FORCE INVINCIBLE" (STUFFIT) -

Again we want to thank all you replied to our article in Suddenly Senior - your response was heartwarming and encouraging and gave us the extra strength, hope and faith to get us through a very difficult 3 months. Praise the Lord and all you good folks. Now we can continue leading our senior exercise group in our church and I can find time to do some watercolors.

God bless you all.

And the rest of the story, from an e-mail in April, 2009...

Just read your email of 4/25 with the sad news that you are in the hospital again- My dear husband, Russ Tuttle was diagnosed with stage 2 esophegal cancer Dec. 13, 2008. Chemo & radiation treatments were started in February - after 2 treatments, he had a very bad reaction to the treatments & was hospitalized for 2 weeks - his body become toxic & he had developed an infection - the oncologist told us she was going to give him a strong dose - and admits she went "over the line"). He went off the treatments & was discharged home after 2 weeks - but after just one night, he was back in the hospital - this time for one week. - after about 1 week, they resumed treatments - and again, after only 2 treatments, he was readmitted to the hospital 4/17 and the plan was to do his treatments in the hospital where he could be monitored better - They hoped they could discharge him AGAIN on Friday, but his bloodwork showed some problem, so they were unwilling to discharge him - his oncologist was out of town until Monday and the other doctors didn't want to sign him out without her ok - hopefully Monday his bloodwork will be ok and she will sign him out. He feels great at this point and his spirits are up - he has a strong faith & positive attitude. So although we miss each other terribly, we did not get divorced due to Plan D - and are so thankful that we have each other & the Lord watching over us, and Russ doesn't have to fight this monster alone. Hope this finds you doing a lot better - we do know what it's like - and we know we will win this battle together - and pray you & Carolyn will too - you both will be in our prayers every day. Best wishes & many hugs - Gloria & Russ in Graham, WA Thanks to you for finding a way to continue Suddenly Senior and also give us updates on your health. "Suddenly Senior" is like a breath of fresh air in this crazy world - our thanks also to Carolyn for the jokes - laughter has proven to be very therapeutic & sometimes it seems like it can be lost when illness like this takes over your life. God bless you both and we pray you both will be feeling better- Gloria & Russ, still happily married in Graham, WA.


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