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Health news for the Seattle area

Man questions why Medicare pays for sex pump

05:56 PM PDT on Tuesday, May 2, 2006

By ROBERT MAK / KING 5 News

SEATTLE - If you're eligible for Medicare, May 15 is the deadline to sign up for the new prescription drug program. But one man's frustration with prescription drugs led him to try a very interesting experiment.

A lot of people have complained that this new Medicare prescription drug program is downright confusing. Before you pick a plan you may want to pay close attention to which drugs are covered. One man in Spanaway made his point in a very unusual way.

At 76, Tom Tuttle has survived heart attacks, back surgeries and colon cancer. Three years ago one doctor gave him six months to live. He counts on pain medication to get him through the day but he's on a new Medicare prescription drug plan and finding that some of his drugs just aren't covered.

"Every time I call in, I don't know whether they're going to pay for it or not," he said.

In Washington state there are 46 Medicare drug plans, each with a different list of drugs they cover. That means seniors have to choose their plan carefully and on occasion doctors have to change their prescriptions.

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Tuttle counts on pain medication to get him through the day and is confused by a new Medicare prescription drug plan.

"Here’s what they're doing, they're laying all this paperwork on to the doctors,” Tuttle said. “And then, in the meantime, I’m sitting here without my medication."

Frustrated and unable to sleep one night, Tuttle saw an infomercial on TV that caught his attention.

"They were advertising this mechanism for your sex drive, it just brings you closer together, it's hard to explain," he said.

"In the end, they said, also, Medicare pays for this. I thought: ‘No, I don't believe it. I just can't believe it. I thought, ‘Well, I’m going to find out.’"

He called and ordered the Pos-T-Vac vacuum therapy pump.

"I said: ‘I understand Medicare pays for this.’ ‘Oh yes, Mr. Tuttle, pays 100-percent.’

It showed up just seven days later. Tuttle’s point: why is it so easy to get the pump yet such a hassle to get his prescriptions? Medicare workers said the pump and prescription drugs fall under two entirely different programs.

"You’re talking about a huge sea change, as it relates to how people receive their prescription drugs; this is a program in its infancy being compared to another part of Medicare that's been around forever," said Michael Marchand of the Centers for Medicare and Medicaid.

Medicare workers promise the problems with the new drug program will be ironed out over time. And they do warn that despite what the commercials say, some of these products may not be covered by Medicare and customers could be left on the hook.

The pump Tuttle got cost $400. He says he has no need for the product and plans to return it.

So far more than a half million people in Washington state have signed up for Medicare, nearly 70 percent of those eligible.

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