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Unreasonable Medicare Part D drug costs

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    Unreasonable Medicare Part D drug costs

    OMG, I just got off the phone with Medicare and I am in disbelief. I am currently on Medicaid via AHCCCS in Arizona. My insurance policy is also through Mercy Care. I pay no out of pocket for anything. No co-pays for Dr's, Rx's, hospital stays, DME or anything. My insurance changes by default to Medicare in October of 09. Although I am early with checking into what I should expect would happen, I was told that Medicare would cover 80% of my doctor visits and hospital stays and I would be forced to choose and Rx drug plan through Medicare. I called them this morning, shared with her all of my prescription drugs I was taking and I couldn't believe what she came back with. She said the best plan for me was through something called "Medicare Rx Rewards Standard." She indicated that I would have a monthly premium of $18.60 just to be part of the plan which I think is greedy. In addition she indicated that I would have a yearly deductible of $290.00. Lastly, she said that my monthly amount I would need to pay for my prescriptions would be $254.00. I just about fell to the floor. I do not have that kind of money. I am lost for words with disgust how these drug companies are so filled with greed and have no respect for us, the patients.

    Any feedback on this is greatly appreciated!

    Mike

    #2
    Look at Mercy Care Advantage.

    ETA: Call ABIL in the morning.
    My blog: Living Life at Butt Level

    Ignite Phoenix #9 - Wheelchairs and Wisdom: Living Life at Butt Level

    "I will not die an unlived life. I will not live in fear of falling or catching fire. I choose to inhabit my days, to allow my living to open me, to make me less afraid, more accessible, to loosen my heart until it becomes a wing, a torch, a promise. I choose to risk my significance; to live so that which comes to me as seed goes to the next as blossom and that which comes to me as blossom, goes on as fruit."

    Dawna Markova Author of Open Mind.

    Comment


      #3
      If you don't have that kind of $ I would think you'd still be MediCAID eligible. Dually eligible, at least (both CARE and CAID). I'd ask about this, if I were you. If you have Walgreens pharmacies in your area, check into Wellcare Part D. My Wellcare Part D plan is $29.00/month premium, zero co-pay for my meds. I don't take much, just the usual suspects: Gabapentin, Baclofen, and Oxybutin. (I'm weaning off Oxybutin, though, in favor of Botox for bladder).
      "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

      "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

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        #4
        Michael, I'm on Medicare and purchased a BC/BS plan to cover the 20% gap Medicare does not pay. This particular plan includes prescription drug coverage and it costs me $5700/year or $110/week. There is a quarterly deductible for hospitalization ($1200), continuous prescription co-pay ($15 per prescription), annual deduction for medical care ($200) and there are plenty of things they don't cover at all and I pay out of pocket. Medicare coverage gets worse every year and more expensive. They will bury you with paperwork and coverage denials. If you can somehow stay on Medicaid...do it.

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          #5
          JenJen,

          who is ABIL?? There is so much info and terminology that I don't, at this early stage have a clue.

          Mike

          Comment


            #6
            If you have any drug from pfizer you can contact them get a application and see where it goes. I am going to be lucky enough for this yr it looks like to get my Lyrica free from them.

            Comment


              #7
              http://ssl4.benefitscheckup.org/befo...2&subset_id=49

              You can check this link for some help. Also go to www.medicare.gov and you can be sure she was looking at the right plan. Look for info about part D plans and you can enter all of your drugs to see what they came up with. I believe you can apply for the QMB or extra help there also.
              If you can't handle me at my worst, then you sure as hell don't deserve me at my best.


              Sometimes it is easier to widen doors than it is to open minds.

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                #8
                That's terrible. If you are on Medicaid it should pay for your premium . But come to think of it, my sister and her husband was having to pay all of their monthly insurance plan so I told them to call the Social Security office and explain to them what was happening and the SS office got them on SSI which gave them Medicaid. So that pay their premiums.
                Their co pay for their meds are like 1 to 3:00$ each.
                So start with the Social Security office and explain to them that you can't afford all of this.
                They will know what to do.
                Mary
                I want to Rock you Gypsy soul and together we will flow into the Mystic.
                Van Morrison

                Comment


                  #9
                  michael,

                  i had the same scare when medicare took over the numbers read to me were outrageous. this is what happened w/ me being on medicaid as well. medicaid picked up the difference. i live in illinois n all states are different. talk to your contact or case worker w/ arizona medicaid. also check into a plan called ''prescription solutions'' w/ medicare drops the copays of meds significantly [1.05, 2.10, 4.0]. i didn't even need a part d w/ this combo......hope this helps.
                  Many Blessings,
                  Josh


                  So we can say with confidence, The Lord is my helper, so I will have no fear. What can mere people do to me?" Hebrew13:6

                  Comment


                    #10
                    Hi,

                    Sorry, I hope you find a better way.

                    The above suggestions are good ones. Folks on this site are very resourceful, so check out their options. If you have a social worker at all, you could contact them to help with this.

                    AAD
                    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                    Comment


                      #11
                      Your Mercy Care case manager should be able to help you with this and ABIL (The Arizona Bridge to Independent Living) can also make sure that you understand all your options. Knowledge is power, especially the ins and out of all the red tape that goes with being disabled.
                      My blog: Living Life at Butt Level

                      Ignite Phoenix #9 - Wheelchairs and Wisdom: Living Life at Butt Level

                      "I will not die an unlived life. I will not live in fear of falling or catching fire. I choose to inhabit my days, to allow my living to open me, to make me less afraid, more accessible, to loosen my heart until it becomes a wing, a torch, a promise. I choose to risk my significance; to live so that which comes to me as seed goes to the next as blossom and that which comes to me as blossom, goes on as fruit."

                      Dawna Markova Author of Open Mind.

                      Comment


                        #12
                        http://www.google.com/search?q=free+...edu&sitesearch=

                        Check out about the first 10 links. Make sure you have a list of your meds in both generic and brand name and google them for the brand name manufacturer like Pfizer, Glaxo-Kline, etc. Pull out your last year's tax form and medical bills to answer questions. It may seem like a lot but it's normally a one time thing and then your doctor will just need to update the need for a drug annually.
                        Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

                        Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

                        Comment


                          #13
                          Originally posted by addiesue View Post
                          http://ssl4.benefitscheckup.org/befo...2&subset_id=49

                          You can check this link for some help. Also go to www.medicare.gov and you can be sure she was looking at the right plan. Look for info about part D plans and you can enter all of your drugs to see what they came up with. I believe you can apply for the QMB or extra help there also.
                          I agree with Addiesue. Go to Medicare.gov, have your list of medications ( or vials) and compare the plans yourself. It is a pretty simple process and offers several options & plans. e.g higher co-pay, lower premium, etc. (The premium you were quoted sounds pretty low. It may cause a higher medication cost under that plan) good luck.

                          At Medicare.gov click on and plug info into:
                          "Compare Medicare Prescription Drug Plans"

                          Comment


                            #14
                            ABIL will also do some advocacy work for you if necessary. They also provide caregivers probably with the best training of all the agencies out here. My mom is a full-time caregiver through them right now and for days that she works I hire out-of-pocket, although a lot of days I'll have someone come over it and if she's off.
                            C-5/6, 7-9-2000
                            Scottsdale, AZ

                            Make the best out of today because yesterday is gone and tomorrow may never come. Nobody knows that better than those of us that have almost died from spinal cord injury.

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