Which Medicare Part D Plan do you have? Are you happy with it (or as happy as you can be)? I am trying to help my 22 yo son with CF(CFRD?) choose the right plan. My head is spinning and my blood pressure rising. He starts on Medicare next month and still has not chosen his Part D plan. Oh great procrastination of youth! Now he has turned over this choice to his administrative assistant/secretary/chef/MOM.<br>From what I have been reading, none of the plans are as good as our state medicaid(NJ) which he has had for the past 2 years. From what I understand Medicaid will pickup as a secondary but not for medication, he will have to apply for a separate program for that. Why do they make it so difficult and confusing? Why do you have to submit the same info. to federal,state, county government agencies? Why can't they work together and give people the coverage they need and deserve?<br>(Climbing off soap box and putting it away-for now)<br>Any help or insight would be greatly appreciated.<br>Thanks,<br>Denise<br>
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Medicare Part D
- Thread starter imchatn
- Start date
Which Medicare Part D Plan do you have? Are you happy with it (or as happy as you can be)? I am trying to help my 22 yo son with CF(CFRD?) choose the right plan. My head is spinning and my blood pressure rising. He starts on Medicare next month and still has not chosen his Part D plan. Oh great procrastination of youth! Now he has turned over this choice to his administrative assistant/secretary/chef/MOM.<br>From what I have been reading, none of the plans are as good as our state medicaid(NJ) which he has had for the past 2 years. From what I understand Medicaid will pickup as a secondary but not for medication, he will have to apply for a separate program for that. Why do they make it so difficult and confusing? Why do you have to submit the same info. to federal,state, county government agencies? Why can't they work together and give people the coverage they need and deserve?<br>(Climbing off soap box and putting it away-for now)<br>Any help or insight would be greatly appreciated.<br>Thanks,<br>Denise<br>
Which Medicare Part D Plan do you have? Are you happy with it (or as happy as you can be)? I am trying to help my 22 yo son with CF(CFRD?) choose the right plan. My head is spinning and my blood pressure rising. He starts on Medicare next month and still has not chosen his Part D plan. Oh great procrastination of youth! Now he has turned over this choice to his administrative assistant/secretary/chef/MOM.<br>From what I have been reading, none of the plans are as good as our state medicaid(NJ) which he has had for the past 2 years. From what I understand Medicaid will pickup as a secondary but not for medication, he will have to apply for a separate program for that. Why do they make it so difficult and confusing? Why do you have to submit the same info. to federal,state, county government agencies? Why can't they work together and give people the coverage they need and deserve?<br>(Climbing off soap box and putting it away-for now)<br>Any help or insight would be greatly appreciated.<br>Thanks,<br>Denise<br>
Denise:
The plan that you pick will be directly related to the perscriptions that he takes and the out of pocket cost. Each "D" plan will deal with meds differently. Make a list of what he takes and compare that to the "formulary" for each plan. This will eliminate most plans. This is your first step.
Bill
The plan that you pick will be directly related to the perscriptions that he takes and the out of pocket cost. Each "D" plan will deal with meds differently. Make a list of what he takes and compare that to the "formulary" for each plan. This will eliminate most plans. This is your first step.
Bill
Denise:
The plan that you pick will be directly related to the perscriptions that he takes and the out of pocket cost. Each "D" plan will deal with meds differently. Make a list of what he takes and compare that to the "formulary" for each plan. This will eliminate most plans. This is your first step.
Bill
The plan that you pick will be directly related to the perscriptions that he takes and the out of pocket cost. Each "D" plan will deal with meds differently. Make a list of what he takes and compare that to the "formulary" for each plan. This will eliminate most plans. This is your first step.
Bill
Denise:
<br />
<br />The plan that you pick will be directly related to the perscriptions that he takes and the out of pocket cost. Each "D" plan will deal with meds differently. Make a list of what he takes and compare that to the "formulary" for each plan. This will eliminate most plans. This is your first step.
<br />
<br />Bill
<br />
<br />The plan that you pick will be directly related to the perscriptions that he takes and the out of pocket cost. Each "D" plan will deal with meds differently. Make a list of what he takes and compare that to the "formulary" for each plan. This will eliminate most plans. This is your first step.
<br />
<br />Bill
concernedmom
New member
<P>Have you checked out: ><A href="<A HREF="http://www.medicare.gov">http://www.medicare.gov</A>"><A HREF="http://www.medicare.gov">http://www.medicare.gov</A></A></A></A>? Also, you can rx coverage/cost/etc here: ><A href="<A HREF="https://www.medicare.gov/find-a-plan/questions/home.aspx">https://www.medicare.gov/find-a-plan/questions/home.aspx</A>"><A HREF="https://www.medicare.gov/find-a-plan/questions/home.aspx">https://www.medicare.gov/find-a-plan/questions/home.aspx</A></A></A></A></P>
<P> </P>
<P>Just to note: I have no experience with medicare part d & cf. My experience in picking medicare part d plans comes solely from helping my parents select their coverage each year. </P>
<P>Good luck. Part D coverage is a mess (& PITA!) </P>
<P> </P>
<P>Just to note: I have no experience with medicare part d & cf. My experience in picking medicare part d plans comes solely from helping my parents select their coverage each year. </P>
<P>Good luck. Part D coverage is a mess (& PITA!) </P>
concernedmom
New member
<P>Have you checked out: ><A href="<A HREF="http://www.medicare.gov">http://www.medicare.gov</A>"><A HREF="http://www.medicare.gov">http://www.medicare.gov</A></A></A></A>? Also, you can rx coverage/cost/etc here:><A href="<A HREF="https://www.medicare.gov/find-a-plan/questions/home.aspx">https://www.medicare.gov/find-a-plan/questions/home.aspx</A>"><A HREF="https://www.medicare.gov/find-a-plan/questions/home.aspx">https://www.medicare.gov/find-a-plan/questions/home.aspx</A></A></A></A></P>
<P></P>
<P>Just to note: I have no experience with medicare part d & cf. My experience in picking medicare part d plans comes solely from helping my parents select their coverage each year. </P>
<P>Good luck.Part Dcoverage is a mess (& PITA!)</P>
<P></P>
<P>Just to note: I have no experience with medicare part d & cf. My experience in picking medicare part d plans comes solely from helping my parents select their coverage each year. </P>
<P>Good luck.Part Dcoverage is a mess (& PITA!)</P>
concernedmom
New member
<P><BR>Have you checked out: ><A href="<A HREF="http://www.medicare.gov">http://www.medicare.gov</A>"><A HREF="http://www.medicare.gov">http://www.medicare.gov</A></A></A></A>? Also, you can rx coverage/cost/etc here:><A href="<A HREF="https://www.medicare.gov/find-a-plan/questions/home.aspx">https://www.medicare.gov/find-a-plan/questions/home.aspx</A>"><A HREF="https://www.medicare.gov/find-a-plan/questions/home.aspx">https://www.medicare.gov/find-a-plan/questions/home.aspx</A></A></A></A></P>
<P></P>
<P>Just to note: I have no experience with medicare part d & cf. My experience in picking medicare part d plans comes solely from helping my parents select their coverage each year. </P>
<P><BR>Good luck.Part Dcoverage is a mess (& PITA!)</P>
<P></P>
<P>Just to note: I have no experience with medicare part d & cf. My experience in picking medicare part d plans comes solely from helping my parents select their coverage each year. </P>
<P><BR>Good luck.Part Dcoverage is a mess (& PITA!)</P>
Thanks for your responses. I have already used the Medicare.gov site and I think we have narrowed it down to 3 plans. They all seem about the same (if the pricing given is correct) With all of them his out of pocket will be more than he receives from Social Security. Right now he is on state medicaid which covers all of his RX. His Medicaid is up for annual review, I am waiting on a call back from them. Some one there told me that medicaid will no longer cover RX once he is eligible for Medicare but if he is re-approved they will be his secondary insurance after Medicare Part A & B. After holding forever I finally spoke to someone with the program who provides subsidies for Medicare part D in our state and they said he is not eligible for that program if he is receiving medicaid!!! So I have spent most of the day on hold, being bounced from person to person or being cut off and I am more confused than I was before we started.
Thanks for your responses. I have already used the Medicare.gov site and I think we have narrowed it down to 3 plans. They all seem about the same (if the pricing given is correct) With all of them his out of pocket will be more than he receives from Social Security. Right now he is on state medicaid which covers all of his RX. His Medicaid is up for annual review, I am waiting on a call back from them. Some one there told me that medicaid will no longer cover RX once he is eligible for Medicare but if he is re-approved they will be his secondary insurance after Medicare Part A & B. After holding forever I finally spoke to someone with the program who provides subsidies for Medicare part D in our state and they said he is not eligible for that program if he is receiving medicaid!!! So I have spent most of the day on hold, being bounced from person to person or being cut off and I am more confused than I was before we started.
Thanks for your responses. I have already used the Medicare.gov site and I think we have narrowed it down to 3 plans. They all seem about the same (if the pricing given is correct) With all of them his out of pocket will be more than he receives from Social Security. Right now he is on state medicaid which covers all of his RX. His Medicaid is up for annual review, I am waiting on a call back from them. Some one there told me that medicaid will no longer cover RX once he is eligible for Medicare but if he is re-approved they will be his secondary insurance after Medicare Part A & B. After holding forever I finally spoke to someone with the program who provides subsidies for Medicare part D in our state and they said he is not eligible for that program if he is receiving medicaid!!! So I have spent most of the day on hold, being bounced from person to person or being cut off and I am more confused than I was before we started.
Medicaid should kick in if he is still considered low income. It will remain his primary if he qualifies if I am not mistaken. I personally have Medco complete plan, it covers every generic through the doughnut hole (trust me, I have alot of generics that are still very expensive), 50% Brands once I hit the gap, which is usually done by Feb. It is a little more expensive than some of the plans, but well worth it in my case. I hope Medicaid can continue to help him, especially if he is needing home IV's. You have to be really creative to get IV's for home if you are strictly on Medicare like myself. Home IV therapy is not covered under medicare, I get around this by having my doc preorder the most common generic IV's that I am prescribed and have them stockpiled for when I need them. They generally take a few weeks to come in once ordered, hence the reason for pre ordering them.
Hopefully you will get some straight answers soon....kids, don't ya love them????
Jenn
Hopefully you will get some straight answers soon....kids, don't ya love them????
Jenn
Medicaid should kick in if he is still considered low income. It will remain his primary if he qualifies if I am not mistaken. I personally have Medco complete plan, it covers every generic through the doughnut hole (trust me, I have alot of generics that are still very expensive), 50% Brands once I hit the gap, which is usually done by Feb. It is a little more expensive than some of the plans, but well worth it in my case. I hope Medicaid can continue to help him, especially if he is needing home IV's. You have to be really creative to get IV's for home if you are strictly on Medicare like myself. Home IV therapy is not covered under medicare, I get around this by having my doc preorder the most common generic IV's that I am prescribed and have them stockpiled for when I need them. They generally take a few weeks to come in once ordered, hence the reason for pre ordering them.
Hopefully you will get some straight answers soon....kids, don't ya love them????
Jenn
Hopefully you will get some straight answers soon....kids, don't ya love them????
Jenn
Medicaid should kick in if he is still considered low income. It will remain his primary if he qualifies if I am not mistaken. I personally have Medco complete plan, it covers every generic through the doughnut hole (trust me, I have alot of generics that are still very expensive), 50% Brands once I hit the gap, which is usually done by Feb. It is a little more expensive than some of the plans, but well worth it in my case. I hope Medicaid can continue to help him, especially if he is needing home IV's. You have to be really creative to get IV's for home if you are strictly on Medicare like myself. Home IV therapy is not covered under medicare, I get around this by having my doc preorder the most common generic IV's that I am prescribed and have them stockpiled for when I need them. They generally take a few weeks to come in once ordered, hence the reason for pre ordering them.
<br />
<br />Hopefully you will get some straight answers soon....kids, don't ya love them????
<br />Jenn
<br />
<br />Hopefully you will get some straight answers soon....kids, don't ya love them????
<br />Jenn
Anything that is nebulized does fall under part B, not D. That is correct, duonebs, pulmozyme, TOBI etc are covered as part B. Know that every drug isn't covered, particularly Cayston...I am still waiting for that one to finally be covered under part B (it's just a slow process, it will eventually be covered, but you know how slow anything related to the gov't is). You are also right that it covers 80% with 20% remaining, which is picked up by the supplemental plan if you have one. I opted for a supplemental plan that covers the remaining 20%, worth every penny as I have the original Medicare coverage with part D and a supplemental. I would never be able to afford the 20% left otherwise. Hope this helps...
Jenn
Jenn
Anything that is nebulized does fall under part B, not D. That is correct, duonebs, pulmozyme, TOBI etc are covered as part B. Know that every drug isn't covered, particularly Cayston...I am still waiting for that one to finally be covered under part B (it's just a slow process, it will eventually be covered, but you know how slow anything related to the gov't is). You are also right that it covers 80% with 20% remaining, which is picked up by the supplemental plan if you have one. I opted for a supplemental plan that covers the remaining 20%, worth every penny as I have the original Medicare coverage with part D and a supplemental. I would never be able to afford the 20% left otherwise. Hope this helps...
Jenn
Jenn