How does Genetically Handicapped Persons Program work?

C

CaliSally

New member
I have Medicare (A & B only) and GHPP. You are correct to opt out of the part D portion. I get all my rx's from mail-order pharm, and all of my drugs have been covered, and I've never had to pay out of pocket for anything. The only exception is when I walk an rx in to the local pharm. They don't know how to deal with GHPP and it's a pain to explain, so I just don't do it. Instead, I make sure that all docs call my rx's into the mail order pharm. (I only have this problem when I've seen a dentist or non-cf doc and the rx's they might hand me.)

GHPP will pick up the balance that your other insurance(s) don't cover, except if you have a co-pay. All other insurances are billed first and what remains is paid by GHPP, though this may take months, it will be paid. GHPP does NOT pick up "co-pays" by other insurance carries (if you have Ins through a spouse or work).

Bottom line, GHPP will cover the 20% that remains after Medicare.
 
C

CaliSally

New member
I have Medicare (A & B only) and GHPP. You are correct to opt out of the part D portion. I get all my rx's from mail-order pharm, and all of my drugs have been covered, and I've never had to pay out of pocket for anything. The only exception is when I walk an rx in to the local pharm. They don't know how to deal with GHPP and it's a pain to explain, so I just don't do it. Instead, I make sure that all docs call my rx's into the mail order pharm. (I only have this problem when I've seen a dentist or non-cf doc and the rx's they might hand me.)

GHPP will pick up the balance that your other insurance(s) don't cover, except if you have a co-pay. All other insurances are billed first and what remains is paid by GHPP, though this may take months, it will be paid. GHPP does NOT pick up "co-pays" by other insurance carries (if you have Ins through a spouse or work).

Bottom line, GHPP will cover the 20% that remains after Medicare.
 
C

CaliSally

New member
I have Medicare (A & B only) and GHPP. You are correct to opt out of the part D portion. I get all my rx's from mail-order pharm, and all of my drugs have been covered, and I've never had to pay out of pocket for anything. The only exception is when I walk an rx in to the local pharm. They don't know how to deal with GHPP and it's a pain to explain, so I just don't do it. Instead, I make sure that all docs call my rx's into the mail order pharm. (I only have this problem when I've seen a dentist or non-cf doc and the rx's they might hand me.)

GHPP will pick up the balance that your other insurance(s) don't cover, except if you have a co-pay. All other insurances are billed first and what remains is paid by GHPP, though this may take months, it will be paid. GHPP does NOT pick up "co-pays" by other insurance carries (if you have Ins through a spouse or work).

Bottom line, GHPP will cover the 20% that remains after Medicare.
 
C

CaliSally

New member
I have Medicare (A & B only) and GHPP. You are correct to opt out of the part D portion. I get all my rx's from mail-order pharm, and all of my drugs have been covered, and I've never had to pay out of pocket for anything. The only exception is when I walk an rx in to the local pharm. They don't know how to deal with GHPP and it's a pain to explain, so I just don't do it. Instead, I make sure that all docs call my rx's into the mail order pharm. (I only have this problem when I've seen a dentist or non-cf doc and the rx's they might hand me.)

GHPP will pick up the balance that your other insurance(s) don't cover, except if you have a co-pay. All other insurances are billed first and what remains is paid by GHPP, though this may take months, it will be paid. GHPP does NOT pick up "co-pays" by other insurance carries (if you have Ins through a spouse or work).

Bottom line, GHPP will cover the 20% that remains after Medicare.
 
C

CaliSally

New member
I have Medicare (A & B only) and GHPP. You are correct to opt out of the part D portion. I get all my rx's from mail-order pharm, and all of my drugs have been covered, and I've never had to pay out of pocket for anything. The only exception is when I walk an rx in to the local pharm. They don't know how to deal with GHPP and it's a pain to explain, so I just don't do it. Instead, I make sure that all docs call my rx's into the mail order pharm. (I only have this problem when I've seen a dentist or non-cf doc and the rx's they might hand me.)
<br />
<br />GHPP will pick up the balance that your other insurance(s) don't cover, except if you have a co-pay. All other insurances are billed first and what remains is paid by GHPP, though this may take months, it will be paid. GHPP does NOT pick up "co-pays" by other insurance carries (if you have Ins through a spouse or work).
<br />
<br />Bottom line, GHPP will cover the 20% that remains after Medicare.
 
B

BSJCA

New member
CaliSally, just want to confirm I understand you. Are you saying that GHPP will cover an Rx written by doctors that accept Medicare but would not accept GHPP? I go to the CF center for all CF problems, but I go to a different medical group for all other problems, and I have a lot! This medical group accepts Medicare but not GHPP. So, what do you think, would GHPP cover those Rx's?

I'm thinking of getting medigap because the high quality medical group I see does take medicare. And also, GHPP only covers you in California except for emergency visits in other states.

What a conundrum GHPP is.
 
B

BSJCA

New member
CaliSally, just want to confirm I understand you. Are you saying that GHPP will cover an Rx written by doctors that accept Medicare but would not accept GHPP? I go to the CF center for all CF problems, but I go to a different medical group for all other problems, and I have a lot! This medical group accepts Medicare but not GHPP. So, what do you think, would GHPP cover those Rx's?

I'm thinking of getting medigap because the high quality medical group I see does take medicare. And also, GHPP only covers you in California except for emergency visits in other states.

What a conundrum GHPP is.
 
B

BSJCA

New member
CaliSally, just want to confirm I understand you. Are you saying that GHPP will cover an Rx written by doctors that accept Medicare but would not accept GHPP? I go to the CF center for all CF problems, but I go to a different medical group for all other problems, and I have a lot! This medical group accepts Medicare but not GHPP. So, what do you think, would GHPP cover those Rx's?

I'm thinking of getting medigap because the high quality medical group I see does take medicare. And also, GHPP only covers you in California except for emergency visits in other states.

What a conundrum GHPP is.
 
B

BSJCA

New member
CaliSally, just want to confirm I understand you. Are you saying that GHPP will cover an Rx written by doctors that accept Medicare but would not accept GHPP? I go to the CF center for all CF problems, but I go to a different medical group for all other problems, and I have a lot! This medical group accepts Medicare but not GHPP. So, what do you think, would GHPP cover those Rx's?

I'm thinking of getting medigap because the high quality medical group I see does take medicare. And also, GHPP only covers you in California except for emergency visits in other states.

What a conundrum GHPP is.
 
B

BSJCA

New member
CaliSally, just want to confirm I understand you. Are you saying that GHPP will cover an Rx written by doctors that accept Medicare but would not accept GHPP? I go to the CF center for all CF problems, but I go to a different medical group for all other problems, and I have a lot! This medical group accepts Medicare but not GHPP. So, what do you think, would GHPP cover those Rx's?
<br />
<br />I'm thinking of getting medigap because the high quality medical group I see does take medicare. And also, GHPP only covers you in California except for emergency visits in other states.
<br />
<br />What a conundrum GHPP is.
 
C

CaliSally

New member
If your other problems are a result of your CF (especially if your CF doc referred you), it should be covered. My Authorization states: "all referrals by the selected care center (scc) team to any specialist within the scc's affiliated medical center" (providing that doctor acceepts GHPP.)

There have been times when I've had the non-cf doc call call the Rx to my CF doc, who can then call in the Rx to the pharm, so then it's covered. If the CF doc feels it's really not their position and doesn't want to take responsibility, that's a different story.

What are your other types of problems? GHPP does cover female issues, dental, and psychosocial services.

A fill-in-the-gap type coverage would be a good idea, as long as there isn't a deductible. That's why I opted out of the Medicare part D - the deductible was $500, that I just couldn't afford. I've had no problems or issues by doing this.
 
C

CaliSally

New member
If your other problems are a result of your CF (especially if your CF doc referred you), it should be covered. My Authorization states: "all referrals by the selected care center (scc) team to any specialist within the scc's affiliated medical center" (providing that doctor acceepts GHPP.)

There have been times when I've had the non-cf doc call call the Rx to my CF doc, who can then call in the Rx to the pharm, so then it's covered. If the CF doc feels it's really not their position and doesn't want to take responsibility, that's a different story.

What are your other types of problems? GHPP does cover female issues, dental, and psychosocial services.

A fill-in-the-gap type coverage would be a good idea, as long as there isn't a deductible. That's why I opted out of the Medicare part D - the deductible was $500, that I just couldn't afford. I've had no problems or issues by doing this.
 
C

CaliSally

New member
If your other problems are a result of your CF (especially if your CF doc referred you), it should be covered. My Authorization states: "all referrals by the selected care center (scc) team to any specialist within the scc's affiliated medical center" (providing that doctor acceepts GHPP.)

There have been times when I've had the non-cf doc call call the Rx to my CF doc, who can then call in the Rx to the pharm, so then it's covered. If the CF doc feels it's really not their position and doesn't want to take responsibility, that's a different story.

What are your other types of problems? GHPP does cover female issues, dental, and psychosocial services.

A fill-in-the-gap type coverage would be a good idea, as long as there isn't a deductible. That's why I opted out of the Medicare part D - the deductible was $500, that I just couldn't afford. I've had no problems or issues by doing this.
 
C

CaliSally

New member
If your other problems are a result of your CF (especially if your CF doc referred you), it should be covered. My Authorization states: "all referrals by the selected care center (scc) team to any specialist within the scc's affiliated medical center" (providing that doctor acceepts GHPP.)

There have been times when I've had the non-cf doc call call the Rx to my CF doc, who can then call in the Rx to the pharm, so then it's covered. If the CF doc feels it's really not their position and doesn't want to take responsibility, that's a different story.

What are your other types of problems? GHPP does cover female issues, dental, and psychosocial services.

A fill-in-the-gap type coverage would be a good idea, as long as there isn't a deductible. That's why I opted out of the Medicare part D - the deductible was $500, that I just couldn't afford. I've had no problems or issues by doing this.
 
C

CaliSally

New member
If your other problems are a result of your CF (especially if your CF doc referred you), it should be covered. My Authorization states: "all referrals by the selected care center (scc) team to any specialist within the scc's affiliated medical center" (providing that doctor acceepts GHPP.)
<br />
<br />There have been times when I've had the non-cf doc call call the Rx to my CF doc, who can then call in the Rx to the pharm, so then it's covered. If the CF doc feels it's really not their position and doesn't want to take responsibility, that's a different story.
<br />
<br />What are your other types of problems? GHPP does cover female issues, dental, and psychosocial services.
<br />
<br />A fill-in-the-gap type coverage would be a good idea, as long as there isn't a deductible. That's why I opted out of the Medicare part D - the deductible was $500, that I just couldn't afford. I've had no problems or issues by doing this.
 
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