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Mompoplake Asked January 2020

My parents both have insurance, are they still eligible for Medicare/ Medicaid? Their pharmaceutical cost are expensive. How do I access care?

Abradford244 Jan 2020
You would need to contact social security regarding Medicare and your local social services regarding Medicaid. Medicaid is based on income

JoAnn29 Jan 2020
I would hope your parents are already on Medicare. If not, there will be a penalty for not taking it at 65.

Insurances are very confusing. You need to understand straight Medicare with a supplemental vs Medicare Advantages.

Where I live our Office of Aging can help you understand what is the difference and help u find a policy that fits ur parents needs. They maybe able to help u find aides.

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tevincolorado Jan 2020
Get them on Medicare and get them a supplement, probably Plan g. Then get them Part D drug plan. Humana or Wellcare. If they are low income then medicaid.
Abradford244 Jan 2020
I am a medicare specialist, I would recommend plan D not G, G is more expensive
97yroldmom Jan 2020
Top Tier Drugs are terribly expensive and sometimes it seems like if a person could only be on Medicare they would have it made. Not so.
Part D of Medicare outlines the rules for pharmacy. There are many plans available. They are not all the same price.

There’s something called “extra help” through Medicare for help with drugs. I’m sure it won’t be easy to qualify for the help but take a look.
Here is a link.

https://www.ssa.gov/benefits/medicare/prescriptionhelp/

A word of caution. Insurance can be very confusing. There are tv ads that make it seem like all you have to do is switch to one of the Medicare Advantage Plans and all will be well. It’s very discouraging to see Medicare aged celebrities masquerading as our friends advertising things like reverse mortgages and insurance plans that aren’t what they seem. Make sure you dig deep before making any changes to your parents plans. . It’s very easy to go from original Medicare to an advantage plan but not so easy to switch back when you realize with health issues you would have done better on original Medicare. Just mentioning this in case you look into that. I’m sure those plans work for some people.

I would suggest you get a complete list of your parents drugs from their pharmacy. This print out will show when they got the drugs, dosage, doctor and price paid.
Be aware that what was paid last year may not be the same for 2020. But it will give you an idea of what they are taking. In fact drug plans went up for 2020.
Discuss with your parents doctors the importance of each drug if a decision has to be made to cutback on one or the other. Sometimes doctors have samples that can help stretch the budget.

There may be combo drugs that are less expensive than the two separate drugs. And oddly enough sometimes the two sep drugs can sometimes be cheaper than the combo drug.

You can look online at the drug Plan website or in your formulary book to check the prices on what your parents will pay this year.

There are online programs that can compare the different drug plans. Be sure to enter all drugs your parents take.

Most companies offer a lower premium plan but you will have a larger deductible. Or higher premiums and lower deductible. I chose the one with higher deductible and lower premium for myself because I take no maintenance meds and seldom need a prescription filled.

Also you can try the drug discount cards. Occasionally they are quite a bit less than the insurance price. GoodRx is an example.

Mail-order is usually slightly less than the pharmacy price.
Some people get their meds from Canada.
If your parents are eligible for Medicaid in their state then they will pay the lowest price. This generally means your parents are indigent or very low income in order to qualify.
You can call the Area Agency on Aging for the County where they live and discuss services that might be available to help your parents or their caretakers in other areas if not prescription drugs.

The best plan for those of us who are able is to exercise and eat a healthy diet. Drink plenty of water. Keep a healthy weight. Sleep well and stay away from doctors and meds. Some meds are truly life saving. Some not so much.
Oh and sometimes you can contact the drug company and ask for help.
I hope this information is helpful. Remember to read the mail that comes in from the insurance company as the rules change from time to time.
cherokeegrrl54 Jan 2020
Excellent information. Like you, it makes me so angry about all these tv ads It makes the elders think those programs are so great. But they’re really not. I just went on medicare in December. I chose straight medicare and a supplemental plan. And of course, part d. Thats what will work best for me and my budget...
worriedinCali Jan 2020
Your profile indicates your mom is 84? How do you know she isn’t already on Medicare? As far as Medicaid eligibility, it’s income based. If your parents are in the same state as you then we have medi-cal which is our version of Medicaid. If their income is above the limit for Medi-cal, look in to a prescription drug plan.

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