No Longer Caught in the Medicare "Doughnut Hole"

The costs of treating a debilitating illness forced her into foreclosure. The healthcare bill could finally bring relief

I’ve had health issues my whole life. I was always in pain, but I wouldn’t slow down. I would just keep plowing ahead no matter what hurt and no matter how bad I felt. I have six kids and, at the time that I “crashed,” two sport horses, our first foal, five cats and two dogs. That was in 2006. At first I thought that I just had a bad flu. I thought, I will wait a couple of weeks and then go to the doctors if it is still bad. So, I waited and then I started to get light sensitivity that I thought that had to do with the migraines I’ve had had all my life. The doctor prescribed doxycycline and the first two days I was on it, I felt okay. I thought, Great, I just needed some antibiotics. But the fourth or fifth day it came back with a vengeance. That’s when my doctors told me I had Lyme disease.

At the time I got sick, my husband and I were self-employed with a mortgage company and we were paying for our own insurance policy. Eventually we had to drop it because the insurance wasn’t covering my care and at the same time, the entire mortgage industry fell apart. My husband went from making lots and lots of money to not making anything overnight. And so he was stuck with a business that is no good and insurance that is no good and a wife that is deathly sick. My mother has been affected by this too. She started to have to dip into her retirement fund to cover my antibiotics and pain medicine because she couldn’t stand to see me writhing in pain.

In April or May of this year I qualified for Medicare (because I am disabled). They paid for my medications up to a certain point but then in October we hit the doughnut hole. We have been paying out-of-pocket for different anti-anxiety medications and anti-depressants and two different antibiotics.

The real expensive medication is my fentanyl patch for the pain. One of my doctors tried to gave me OxyContin and oxycodone (which is cheaper) but that just barely kept me functioning. I was still in a lot of pain every day. I went to the emergency room several times with what felt like a heart attack. It was just intense pain in different parts of my body. To hit the doughnut hole and not be able to afford what you need, it’s like being kicked into hell.

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