Medicare coverage and Insur craziness :(

carly23

New member
So I hve a few questions about this medicare situation?..I recently and still do have a problem with filling my pulmozyme script. and dont know what to do <img src="i/expressions/face-icon-small-sad.gif" border="0"> now let me explain my insurance set up. ok Ive always had Cigna have had for years now through my dads employer(Texas Instruments) and then Ive been getting Medicaid through the state as my income from SSDI is low enough but they havent said when but my medicaid is fixing to go as i cant have three insurances and i have medicare now...Then i became Medicare eligible after bein on SSDI for two years in May of this year!I was told to take it as if i declined it id face a penalty and have a world of problems with coverage?So i took it well then they start taking 110$ a mnth out of my check for the premium cost?well I only get 705$ a mnth so since they been doin that i now get 595$!Only to find out that I qualify for QMB meanin the state wil pay my premium!So now that is takin 90-120 days to get in process and il get a back pay wenever it goes through but in the mean time its really bad i cant do nothing!<img src="i/expressions/face-icon-small-sad.gif" border="0"> Completely broke!Thankfully i moved back home with my dad and im not on my own i would not be able to live!So anyways I get my pulmozyme script and need to fill it bear in mind in the past my private insur had coverd it and medicaid there was no question.But i go to refill pulmozyme and all three insurances declined it???Its not out of refills and not expired..so now im not sure what to do they all gave reasons to why they wont cover it my private insur was because i have medicare part d.medicaid said no because of medicare part d.and medicare said no because of cigna.so im like what the heck <img src="i/expressions/face-icon-small-sad.gif" border="0">!i always thought that medicare on the script side would be first as its cheaper copays but only to find out that cigna has to go first as my dads work has over 100 employees!so cigna is frst then medicare but all along my pharmacist i believe has jus been billing medicare?and i was told that if the board people found out i could be in alot of trouble but i was never told this??and anywhere iv ever gone theyve al known and got the cigna medicaid and medicare insur stuff from me so i dont know but i still have not got my pulmozyme script because i dont know what to do any help please <img src="i/expressions/face-icon-small-sad.gif" border="0"> thanks
 

carly23

New member
So I hve a few questions about this medicare situation?..I recently and still do have a problem with filling my pulmozyme script. and dont know what to do <img src="i/expressions/face-icon-small-sad.gif" border="0"> now let me explain my insurance set up. ok Ive always had Cigna have had for years now through my dads employer(Texas Instruments) and then Ive been getting Medicaid through the state as my income from SSDI is low enough but they havent said when but my medicaid is fixing to go as i cant have three insurances and i have medicare now...Then i became Medicare eligible after bein on SSDI for two years in May of this year!I was told to take it as if i declined it id face a penalty and have a world of problems with coverage?So i took it well then they start taking 110$ a mnth out of my check for the premium cost?well I only get 705$ a mnth so since they been doin that i now get 595$!Only to find out that I qualify for QMB meanin the state wil pay my premium!So now that is takin 90-120 days to get in process and il get a back pay wenever it goes through but in the mean time its really bad i cant do nothing!<img src="i/expressions/face-icon-small-sad.gif" border="0"> Completely broke!Thankfully i moved back home with my dad and im not on my own i would not be able to live!So anyways I get my pulmozyme script and need to fill it bear in mind in the past my private insur had coverd it and medicaid there was no question.But i go to refill pulmozyme and all three insurances declined it???Its not out of refills and not expired..so now im not sure what to do they all gave reasons to why they wont cover it my private insur was because i have medicare part d.medicaid said no because of medicare part d.and medicare said no because of cigna.so im like what the heck <img src="i/expressions/face-icon-small-sad.gif" border="0">!i always thought that medicare on the script side would be first as its cheaper copays but only to find out that cigna has to go first as my dads work has over 100 employees!so cigna is frst then medicare but all along my pharmacist i believe has jus been billing medicare?and i was told that if the board people found out i could be in alot of trouble but i was never told this??and anywhere iv ever gone theyve al known and got the cigna medicaid and medicare insur stuff from me so i dont know but i still have not got my pulmozyme script because i dont know what to do any help please <img src="i/expressions/face-icon-small-sad.gif" border="0"> thanks
 

carly23

New member
So I hve a few questions about this medicare situation?..I recently and still do have a problem with filling my pulmozyme script. and dont know what to do <img src="i/expressions/face-icon-small-sad.gif" border="0"> now let me explain my insurance set up. ok Ive always had Cigna have had for years now through my dads employer(Texas Instruments) and then Ive been getting Medicaid through the state as my income from SSDI is low enough but they havent said when but my medicaid is fixing to go as i cant have three insurances and i have medicare now...Then i became Medicare eligible after bein on SSDI for two years in May of this year!I was told to take it as if i declined it id face a penalty and have a world of problems with coverage?So i took it well then they start taking 110$ a mnth out of my check for the premium cost?well I only get 705$ a mnth so since they been doin that i now get 595$!Only to find out that I qualify for QMB meanin the state wil pay my premium!So now that is takin 90-120 days to get in process and il get a back pay wenever it goes through but in the mean time its really bad i cant do nothing!<img src="i/expressions/face-icon-small-sad.gif" border="0"> Completely broke!Thankfully i moved back home with my dad and im not on my own i would not be able to live!So anyways I get my pulmozyme script and need to fill it bear in mind in the past my private insur had coverd it and medicaid there was no question.But i go to refill pulmozyme and all three insurances declined it???Its not out of refills and not expired..so now im not sure what to do they all gave reasons to why they wont cover it my private insur was because i have medicare part d.medicaid said no because of medicare part d.and medicare said no because of cigna.so im like what the heck <img src="i/expressions/face-icon-small-sad.gif" border="0">!i always thought that medicare on the script side would be first as its cheaper copays but only to find out that cigna has to go first as my dads work has over 100 employees!so cigna is frst then medicare but all along my pharmacist i believe has jus been billing medicare?and i was told that if the board people found out i could be in alot of trouble but i was never told this??and anywhere iv ever gone theyve al known and got the cigna medicaid and medicare insur stuff from me so i dont know but i still have not got my pulmozyme script because i dont know what to do any help please <img src="i/expressions/face-icon-small-sad.gif" border="0"> thanks
 
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