Economy forcing many seniors to cut on health care

by Judith Graham They are splitting pills or deciding not to refill prescriptions. They’re missing doctors’ appointments, skipping needed dental work, canceling home-care services. As the economy founders, Chicago’s seniors are cutting back wherever they can, and health care is high on the list of items being sacrificed.It’s a dangerous choice for older people, who are vulnerable to illness by virtue of their age. Add anxiety about depleted savings or declining home values, and it’s emotionally destabilizing as well. The specter of want is especially painful for older seniors who witnessed the Depression and have worked hard for a measure of security. But younger seniors are suffering, also, as rising prices undercut the value of fixed incomes. Even those with disabling conditions are thinking about looking for jobs to help make ends meet. Many elderly men and women have stopped going out, increasing their isolation at home and the potential for depression or neglect. Come winter, Melvin DeYoung said, he won’t be turning up the heat. “I’ll be putting on my long johns and an extra sweater,” said the 79-year-old retired police officer, who lives in a subsidized Bronzeville apartment. This summer, DeYoung’s gas was turned off because he couldn’t pay the bill. This generation often prefers not to speak publicly about private matters. But several people were willing to discuss the economic challenges they’re facing. – – – GENOVEVA REYNA, 67, and FAUSTINO REYNA, 68, of Streamwood Senior citizens with mounting medical bills are finding they don’t have the necessary resources to keep up These retired factory workers thought they could manage on about $3,000 a month in retirement income. But bills are mounting as Faustino Reyna pursues treatment for pancreatic cancer, diagnosed in May. The couple had no idea how quickly expenses could escalate when they got sick. Faustino has been hospitalized four times since May, with a $550 deductible charge for each visit. Whenever he sees a medical specialist — currently, at least four times a week — the co-payment is $35. In addition, Faustino’s Medicare Advantage plan — a version of Medicare managed by private insurers — stopped paying for prescriptions in July, when he fell into what’s known as the “doughnut hole.” This is a large gap in Medicare drug coverage that, this year, begins after $2,510 is spent on medications between the plan and the consumer. The coverage kicks in again after the individual has spent $4,050 out of pocket. In August, the bill for refilling five of his 19 prescriptions — the ones running out that month — came to $503. Doctors are giving Faustino samples of several drugs, and the family has applied for assistance from three pharmaceutical companies. One company agreed to the request last week, but the others may not, because the couple aren’t poor. To cope, Genoveva Reyna has stopped seeing the doctor who has been following her recovery from back surgery two years ago. She also has delayed indefinitely a recommended knee replacement for her arthritis. Even filling up the tank to drive Faustino to chemotherapy and radiation therapy is difficult financially. Genoveva now goes to a food pantry, owes a local hospital more than $4,000 and has told her five children and nine grandchildren not to expect birthday gifts this year. “I never knew something like this could happen — that my husband would be so sick and that everything would be so expensive,” she said. – – – CHRISTINE BARTIROMO, in her 80s, of Bridgeport Christine Bartiromo doesn’t complain about having diabetes, spinal stenosis or heart troubles. “Healthwise, I would say I’m good,” said the retired clerical worker who lives on a monthly $1,160 check from Social Security and her late husband’s pension of $626. Bartiromo has health-care coverage from Medicare and a Medicare supplemental policy that fills in many gaps. Still, insurance doesn’t cover some important expenses, such as eyeglasses, adult diapers and over-the-counter products — vitamins, aspirin, cough medicine — she buys at the drugstore. Bartiromo lives alone in an apartment that costs $711 a month. “I don’t buy anything,” she said, describing how she manages. “Except food, and there I’m cutting back. No more cold cuts or steaks, just cereal and milk and a few other things. It’s too expensive.” Every time Bartiromo goes to see her orthopedist, internist or other doctors at Northwestern Memorial Hospital, she pays for a cab that can accommodate her power wheelchair, and that expense adds up quickly. “It’s a lot of money to go back and forth to all the appointments,” she said. Her biggest problem at the moment is dental care. “Oh, my goodness, it’s so high,” said Bartiromo, who recently canceled a dental appointment because she didn’t have money to spare. “I have two broken teeth, and I’m chewing like Bugs Bunny. I know they have to be fixed. I’m not eating so well, and my friends are concerned. But I just can’t swing it.” – – – DENNIS SHAFER, 69, of Oak Park A year ago, Dennis Shafer moved to the Chicago area from California after his 40-year marriage dissolved. For a while he worked as a substitute teacher and a traveling notary. Then the work dried up. Shafer has diabetes and chronic inflammatory demyelinating polyneuropathy, a rare autoimmune disorder that causes constant pain in his arms and legs. To function, he takes a painkiller three times a day. In August, he fell into the Medicare “doughnut hole” and had to foot the entire $1,500 bill for the medication, which isn’t available in generic form. He sold his car to cover the expense. Over years of treatment, doctors have tried every painkiller on the market for Shafer’s condition; this is the only one that works. At this point, Shafer has a week’s supply left of painkillers and no idea how to pay for another month’s supply. After getting several grants from local churches and aging agencies, he borrowed funds this month to pay phone and electric bills when companies threatened to shut off service. Shafer is living on $800 a month in Social Security, his only source of income. He has applied for prescription help from a state program but hasn’t yet qualified. Even when that happens, he said, he won’t have enough for rent, food and other expenses. “All I want is a job, but no one will hire me,” he said. “I feel totally boxed in. My pride is gone.” – – – LAURANN WILLIAMS, 69, of South Shore For 15 years, Laurann Williams has survived on Social Security disability payments. But these days her $988 monthly check barely covers expenses. Williams is lucky in some ways: Her rent in a subsidized senior apartment complex in Chicago is just $259 a month, and she has health-care coverage from both Medicare and Medicaid. But she also has a lot of complex needs to manage, all on her own. “I fall a lot because of my diabetes,” said Williams, who isn’t married and doesn’t have children. Disabled by congestive heart failure, she uses a wheelchair or a walker to get around. She also suffers from migraines, high blood pressure, anemia and restless leg syndrome. Once reading was her greatest pleasure. “Now I have so much trouble with my eyes it’s hard to see,” Williams said. “My problem is, I’m home a lot with nothing to occupy my time and that makes a person feel bad, and from there things go downhill.” She economizes wherever she can. “I can’t buy groceries as often as I need to,” Williams said, admitting she’s eating less. “The things I use to clean the house, I’m buying smaller sizes. Using Bounce or Downy, I don’t do that anymore. I used to go out and see my friends; I don’t do that either. I don’t get out anywhere except to church.” “If only I could get a job part time, just to supplement the check I get,” said Williams, who can’t afford the computer she thinks would help get her started. “I’ve been thinking that’s what I need to do.” Copyright © 2008, Chicago Tribune