If I qualify for medicare under SSDI......what does carrying medicare as a secondary payer cover. We don't meet any low income guidelines and my husband's company would remain my primary insurance. What exactly does medicare pay for when they are secondary? I am curious whether they pay some of the co-pays for drugs under Part D and does your primary continue to pay for the drug cost??? Help with co-pays on drugs would be great....not holding my breath. Also, keep in mind that we do not meet any low-income guidelines.
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Medicare as Secondary Payer
- Thread starter Skye
- Start date
If I qualify for medicare under SSDI......what does carrying medicare as a secondary payer cover. We don't meet any low income guidelines and my husband's company would remain my primary insurance. What exactly does medicare pay for when they are secondary? I am curious whether they pay some of the co-pays for drugs under Part D and does your primary continue to pay for the drug cost??? Help with co-pays on drugs would be great....not holding my breath. Also, keep in mind that we do not meet any low-income guidelines.
If I qualify for medicare under SSDI......what does carrying medicare as a secondary payer cover. We don't meet any low income guidelines and my husband's company would remain my primary insurance. What exactly does medicare pay for when they are secondary? I am curious whether they pay some of the co-pays for drugs under Part D and does your primary continue to pay for the drug cost??? Help with co-pays on drugs would be great....not holding my breath. Also, keep in mind that we do not meet any low-income guidelines.
If I qualify for medicare under SSDI......what does carrying medicare as a secondary payer cover. We don't meet any low income guidelines and my husband's company would remain my primary insurance. What exactly does medicare pay for when they are secondary? I am curious whether they pay some of the co-pays for drugs under Part D and does your primary continue to pay for the drug cost??? Help with co-pays on drugs would be great....not holding my breath. Also, keep in mind that we do not meet any low-income guidelines.
If I qualify for medicare under SSDI......what does carrying medicare as a secondary payer cover. We don't meet any low income guidelines and my husband's company would remain my primary insurance. What exactly does medicare pay for when they are secondary? I am curious whether they pay some of the co-pays for drugs under Part D and does your primary continue to pay for the drug cost??? Help with co-pays on drugs would be great....not holding my breath. Also, keep in mind that we do not meet any low-income guidelines.
I have Medicare A&B, but not D. Medicare is my secondary insurance. They normally pick up the doctor's office co-pays and in the past the remainder of the balance due on my inhaled meds (Xopenex/Pulmicort) have been picked up by Medicare Part B. I say <i>in the past </i>because lately Medicare will not pick up my co-pays on these meds...something about effective April 1st they will only cover inhaled meds (or co-pays) for a COPD diagnosis?? This could be just in my state? but somehow I think it's across the board.
My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
I have Medicare A&B, but not D. Medicare is my secondary insurance. They normally pick up the doctor's office co-pays and in the past the remainder of the balance due on my inhaled meds (Xopenex/Pulmicort) have been picked up by Medicare Part B. I say <i>in the past </i>because lately Medicare will not pick up my co-pays on these meds...something about effective April 1st they will only cover inhaled meds (or co-pays) for a COPD diagnosis?? This could be just in my state? but somehow I think it's across the board.
My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
I have Medicare A&B, but not D. Medicare is my secondary insurance. They normally pick up the doctor's office co-pays and in the past the remainder of the balance due on my inhaled meds (Xopenex/Pulmicort) have been picked up by Medicare Part B. I say <i>in the past </i>because lately Medicare will not pick up my co-pays on these meds...something about effective April 1st they will only cover inhaled meds (or co-pays) for a COPD diagnosis?? This could be just in my state? but somehow I think it's across the board.
My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
I have Medicare A&B, but not D. Medicare is my secondary insurance. They normally pick up the doctor's office co-pays and in the past the remainder of the balance due on my inhaled meds (Xopenex/Pulmicort) have been picked up by Medicare Part B. I say <i>in the past </i>because lately Medicare will not pick up my co-pays on these meds...something about effective April 1st they will only cover inhaled meds (or co-pays) for a COPD diagnosis?? This could be just in my state? but somehow I think it's across the board.
My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
I have Medicare A&B, but not D. Medicare is my secondary insurance. They normally pick up the doctor's office co-pays and in the past the remainder of the balance due on my inhaled meds (Xopenex/Pulmicort) have been picked up by Medicare Part B. I say <i>in the past </i>because lately Medicare will not pick up my co-pays on these meds...something about effective April 1st they will only cover inhaled meds (or co-pays) for a COPD diagnosis?? This could be just in my state? but somehow I think it's across the board.
<br />
<br />My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
<br />
<br />As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
<br />
<br />
<br />
<br />My endocrinologist also said that effective July 1st they are cutting down on what they reimburse doctors too<img src="i/expressions/face-icon-small-mad.gif" border="0">.
<br />
<br />As for pills, I have to pay all of my co-pays on them since I didn't opt for the Part D coverage. If I could piggy-back a question here, for those of you that have Part D, if you don't mind my asking, how much is the premium a month & is it pretty good coverage? (you can PM me if you want).
<br />
<br />
rubyroselee
New member
I do not have Medicare, although I do some billing for patients with Medicare as secondary. From what I have noticed they pay the office copays but not the medication coinsurance.
And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
rubyroselee
New member
I do not have Medicare, although I do some billing for patients with Medicare as secondary. From what I have noticed they pay the office copays but not the medication coinsurance.
And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
rubyroselee
New member
I do not have Medicare, although I do some billing for patients with Medicare as secondary. From what I have noticed they pay the office copays but not the medication coinsurance.
And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
rubyroselee
New member
I do not have Medicare, although I do some billing for patients with Medicare as secondary. From what I have noticed they pay the office copays but not the medication coinsurance.
And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
rubyroselee
New member
I do not have Medicare, although I do some billing for patients with Medicare as secondary. From what I have noticed they pay the office copays but not the medication coinsurance.
<br />
<br />And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
<br />
<br />And yes, Medicare has cut down on reimbursement rates, so they are now paying even less than they were paying before.
I have strictly Medicare for my health insurance and have to say that it is a pain! Lynda, Part D is tricky...I picked a plan that would at least cover my generics through the "doughnut hole"(coverage gap..after you as well as your insurance payouts has reached a limit of $2510, you reach this level. You then are usually responsible for 100% of prescription costs until you reach a total of $4050 and then you reach yet another stage, the catastrophic level...here is a link that describes this <a target=_blank class=ftalternatingbarlinklarge href="http://en.wikipedia.org/wiki/Medicare_Part_D">http://en.wikipedia.org/wiki/Medicare_Part_D</a> ), unfortunately it does not cover any IV meds or specialty stuff like that or brand names when I hit that stage. Home IV's are not covered at all through medicare...they would rather spend an exorbitant amount on inpatient hospitalizations than to cover the much less expensive home IV's. My doc thinks this is insane, so do I...I usually am camping out in the hospital for 3 weeks for my IV's.
Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a>
I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a>
I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
I have strictly Medicare for my health insurance and have to say that it is a pain! Lynda, Part D is tricky...I picked a plan that would at least cover my generics through the "doughnut hole"(coverage gap..after you as well as your insurance payouts has reached a limit of $2510, you reach this level. You then are usually responsible for 100% of prescription costs until you reach a total of $4050 and then you reach yet another stage, the catastrophic level...here is a link that describes this <a target=_blank class=ftalternatingbarlinklarge href="http://en.wikipedia.org/wiki/Medicare_Part_D">http://en.wikipedia.org/wiki/Medicare_Part_D</a> ), unfortunately it does not cover any IV meds or specialty stuff like that or brand names when I hit that stage. Home IV's are not covered at all through medicare...they would rather spend an exorbitant amount on inpatient hospitalizations than to cover the much less expensive home IV's. My doc thinks this is insane, so do I...I usually am camping out in the hospital for 3 weeks for my IV's.
Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a>
I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a>
I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
I have strictly Medicare for my health insurance and have to say that it is a pain! Lynda, Part D is tricky...I picked a plan that would at least cover my generics through the "doughnut hole"(coverage gap..after you as well as your insurance payouts has reached a limit of $2510, you reach this level. You then are usually responsible for 100% of prescription costs until you reach a total of $4050 and then you reach yet another stage, the catastrophic level...here is a link that describes this <a target=_blank class=ftalternatingbarlinklarge href="http://en.wikipedia.org/wiki/Medicare_Part_D">http://en.wikipedia.org/wiki/Medicare_Part_D</a> ), unfortunately it does not cover any IV meds or specialty stuff like that or brand names when I hit that stage. Home IV's are not covered at all through medicare...they would rather spend an exorbitant amount on inpatient hospitalizations than to cover the much less expensive home IV's. My doc thinks this is insane, so do I...I usually am camping out in the hospital for 3 weeks for my IV's.
Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a>
I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a>
I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
I have strictly Medicare for my health insurance and have to say that it is a pain! Lynda, Part D is tricky...I picked a plan that would at least cover my generics through the "doughnut hole"(coverage gap..after you as well as your insurance payouts has reached a limit of $2510, you reach this level. You then are usually responsible for 100% of prescription costs until you reach a total of $4050 and then you reach yet another stage, the catastrophic level...here is a link that describes this <a target=_blank class=ftalternatingbarlinklarge href="http://en.wikipedia.org/wiki/Medicare_Part_D">http://en.wikipedia.org/wiki/Medicare_Part_D</a> ), unfortunately it does not cover any IV meds or specialty stuff like that or brand names when I hit that stage. Home IV's are not covered at all through medicare...they would rather spend an exorbitant amount on inpatient hospitalizations than to cover the much less expensive home IV's. My doc thinks this is insane, so do I...I usually am camping out in the hospital for 3 weeks for my IV's.
Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a>
I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a>
I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
I have strictly Medicare for my health insurance and have to say that it is a pain! Lynda, Part D is tricky...I picked a plan that would at least cover my generics through the "doughnut hole"(coverage gap..after you as well as your insurance payouts has reached a limit of $2510, you reach this level. You then are usually responsible for 100% of prescription costs until you reach a total of $4050 and then you reach yet another stage, the catastrophic level...here is a link that describes this <a target=_blank class=ftalternatingbarlinklarge href="http://en.wikipedia.org/wiki/Medicare_Part_D">http://en.wikipedia.org/wiki/Medicare_Part_D</a> ), unfortunately it does not cover any IV meds or specialty stuff like that or brand names when I hit that stage. Home IV's are not covered at all through medicare...they would rather spend an exorbitant amount on inpatient hospitalizations than to cover the much less expensive home IV's. My doc thinks this is insane, so do I...I usually am camping out in the hospital for 3 weeks for my IV's.
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<br />Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a><br />
<br />I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
<br />
<br />Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
<br />
<br />
<br />Okay..back to the prescription coverage...Part B covers all of my nebbed meds such as TOBI, HTS , pulmicort, pulmozyme and Xopenex because they are delivered through a DME or durable medical device (the nebulizer). All of my other meds...my enzymes, insulin, pain meds, GERD stuff etc falls under my part D insurance. I try to get the generic as they are always covered. Some stuff can't be gotten in generic so I usually have to either pay for it or have my doctor get samples for me (she has saved me thousands in med costs!). As far as how much the part D plans cost, they vary depending on what coverage you want. The choices available depend on where you live and could be many. When I signed up for my insurance, there were something like 30 other choices!! Crazy and confusing...I settled on Humana complete and will probably change that once my enrollment period opens up again as they are getting expensive!. When this program first started out, Humana covered everything throughout doughnut hole even...after a few years, that coverage went down to brands, specialty and generics until the doughnut hole period, after that, only generics. Here is a link that better describes the part D insurance and how to find a plan along with costs: <a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/MedicareReform/drugbenefit.asp
">http://www.medicare.gov/MedicareReform/drugbenefit.asp
</a><br />
<br />I hope this helps...again, Medicare is nuts and can be confusing. I am grateful to have any coverage but wish that Medicare wasn't my primary, just so many hoops to jump through! Skye...In your case, your medicare would be secondary to your husband's insurance. Whatever isn't covered under your hubby's insurance would be submitted to medicare I would think. Your prescriptions would be covered under your husband's insurance...again, just guessing.
<br />
<br />Sorry for the novel...hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">
<br />