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Mom only has MediCare only right now. Need help in paying prescription costs it does not cover. She is insulin dependent. Where do I start? Mom is just moving into an ALF.

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Call AARP THEY HAVE A COUPLE. ASK. IF EITHER OF THEM KICK IN IMMEDIATELY. OR A WAITING PERIOD.
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I just wanted to suggest that you be careful and get an insurance agent that can help you. I got a plan for my mother that I was told was a secondary insurance only to find out that it was considered a primary and all of her benefits that she was receiving through Medicare, including her much needed inhome nursing care, were not available to her and her "new primary" insurance did not cover them. It was jumping through hoops to get that insurance canceled and get her all set up with Medicare programs again. I would suggest Medigap for any procedures not covered by Medicare, including medications. Any good insurance agency should be able to help you get set up with them. That is the route we are using now.
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Humana has a good pharmacy plan.
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Llamalover47 I wasn't sure where Tattochick was from. Social Security will provide the SHIP number for the area the inquirer is from. But thank you for your thorough contact information for Florida.
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Varuna I believe it is illegal these days to drop a patient because of the cost of treatment.
Be careful with United healthcare too because they won't treat a pre existing condition for the first six months. I know it is illegal for them to refuse to cover someone but don't know the legality of making you wait 6 months for treatment. The main benefit of United healthcare is that you can consult any provider anywhere in the country without incurring extra expenses. BCBS has a preferred network and if you go outside that you pay an extra co-pay. In the main I believe all plans allow you to consult any Dr who accepts Medicare but you may have to pay bigger co-pays out of network
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Nancynurse: I already provided the OP the SHIP phone number...see the above.
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Tatoochick: Below is the information that Nancynurse was referring to---

Florida SHIP Website:
floridashine
Program Name: SHINE (Serving Health Insurance Needs of Elders)
About: SHINE is Florida’s state health insurance assistance program for elder Floridians. SHINE provides educational materials and free unbiased insurance counseling to Florida elders, caregivers and family members. The goal is to help elders understand and receive the health insurance coverage they need through Medicare, Medicaid, Prescription Assistance, Long-Term Care Planning & Insurance, and other health care issues. Contact SHINE if you have questions by dialing the Elder Helpline at 1-800-963-5337.
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So you're looking for Medicare Supplemental insurance?
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GraceNBCC You no idea of the amount of training that the HIICAP/SHIP volunteers and coordinators must go though. I admit sometimes things do get forgotten or missed but don't blanket saying we don't know what we are doing. We have meetings and monthly teleconference calls. Yearly all day programs for volunteers and multiday programs for coordinators. Also we are required to be certified on a yearly bases. I would rather deal with someone who has gone though this training than deal with the shister insurance sales people that come around. We work very hard to make sure we provide everyone with unbiased assistance and all the help they need. Oh and I have been DBL for 10 years and got into this to help people negotiate the complex Medicare rules.
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Pls use UNITED HEALTH INS AS SECONDARY CARRIER. NOT BLUE CROSS TERRIBLE THEY DROPPED ME because my IV medicarion cost too much. If she is not in any secondary ins she can sign up for it now. Call medicaid ask them. Or AARP but if u go through them you have to join AARP.
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Forgot two things on documents. You will need copies of Medicaid card, but bring original to any agencies & tell them you made a copy. You will need a Social Security Benefits letter that is less than 30 days old! You can get this at no cost online or calling the automated SS #, or wait in petson at your local office 😞.
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First apply to State Medicaid. Why? If they help pay for Medicare Part B (doctors) premium, that is one of the automatic quialifiers for SS Extra Help! Extra Help will also pay ablout $39 toward the Premium for Part D ( Drug coverage) & it pays most of the copay. Ex: $3, $5, $9 instread of up to $95 a month.
Gather all income & asset papers in one place and make a bunch of copies of each, plus SS card, DL or State photo ID, and get multiple original copies of her birth certificate. Many peograms require a certified copy, not a photocopy. This will make filling out all the forms go much faster!!!
Chunckiemonkey gave you the key site for Pharmacy Assistance Plans. Note: Each manufacturer has their own paperwork & rules. Ask the pharmacy she uses to sit with you and make a list of her Rx, dose, qty. & Manufacturer. You can Do this anytime of the year. They will ask about other insurance or help you get, so do things like Brand Name expensive drugs first. They dont help with generics or older brand names, but on the company site there will be a link to brands they cover.
Some State Medicaid programs now have HMO type programs. If your Moms income is more than 125% of the poverty level, they have what is called a spend down.

I was told I was just over the limit for a lot of programs, but because just one medication was $800 a month, I qualified. The money I spent on co-pays for RX & doctors goes to my spend down, but you have to kerp sending them (State Medicaid) copies of your paid bill & Rx reciepts. NEVER give them originals!!!
Center on Aging & SHIP ( Senior/State Health Insurance Programs) can help, but I found many only know one prpgram and in researching Plan D ( drugs) they only go by list of Rx your Mom is on now. You can go online at home and do the same thing. Then do another search with just the most expensive, to see what needs prior authorization ( which is hard to get these days if there is a cheap form, older drug ...more side effects). Also see if drugs from two different companies are available.

Ex: For Osteoperosis there is Drug A or B. Many doctors now actually suugest alternating every few years because ome is slightly better for hips & the other for the rest of your bones. The list and cost of recommended Plan D programs was completely different. Companies either cover A or B or neither. So it could be they dont cover the auto injector pen ( which you might get from the Drug Company for a year or two, and taking that one item off the list gives you different Plan D programs and costs! The people trained to help you pick a Plan D do not know this!!! Been there, done that!

Final note: Programs max. income limits tend to run from 100-150% of poverty level, or 100-150% of median income for your county. Many workers are so ised to working with poverty level or under, they dont know about the 125% & 150% limits!!! Again, been there, done that. Hope my 8 years experience since becoming disabled helps you.
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First of all, how long has Mom been on Medicare without a Part D? I ask because there is a penalty for not signing up for a Part D plan when she signed up for Medicare. In Alabama, it is a percentage (don't remember how much) for every month since she first signed up for Medicare PLUS the premium. In my case, my Aunt is 96, never had prescription coverage and now that she needs it, a Part D plan is cost prohibitive. Also, if you want to check with the drug companies, do so before you get the Part D coverage. When we tried to get help for my Mom most of the companies would not help her during "the gap" because she had insurance, even though the insurance didn't cover her medications from about August to the end of the year. Just the fact that she had insurance kept her from qualifying.
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You need to contact your local "Hiicap" or "Ship" office. Call your local Social Security office and they can give you the number. These offices help people deal with Medicare and find insurance that best suits their needs based on the medications they take. They are not biased by any specific insurance company. They also can check to see if your Mother is eligible for EXTRA HELP or Low Income subsidy. These are programs that pay for Part D insurance and depending on income the Medicare premium and also lower the cost of the copay for the medications. She also may be eligible for the Elderly State medication program which will help pay for medications and limit out of pocket expense. This is all very complicated and these programs are funded by Medicare just to help folks with these issues. I volunteer at our local Office for the Aging doing this exact program. She should get in touch with them as soon as possible and may not have to wait for Open Enrollment to get help. Generally Open Enrollment is Oct. 15th to Dec. 7th each year and allows you to change insurance or enroll if you don't have coverage for the beginning of the next year. If she is eligible for one of the other programs I mentioned she won't need to wait and can get coverage that will start the 1st of the month after enrolling. Good luck with this. I know it is confusing and frustrating, so I urge you to avail yourself of one of these programs.
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Check with the AL to see what pharmacy they use if they will be managing her meds. Then go to that pharmacy and ask them to review her meds and suggest a Part D plan that will be best for her. Not all pharmacies participate with all plans, so be sure to get one that works with the pharmacy you will be using.
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Your mom will need a supplement to pick up where medicare leaves off, it will pay the balance of what medicare doesnt pay. Then you will need the part d plan, thats important for meds.
Have your pharmacist run her neds and tell you which woukd work best.
I have been taking care of my mom for 10 years so all this medical has a learning curve. Premiums will be according to age, plus if she didnt sign up for part d when she turned 65 there will be a penalty.
I switched my mom(91) to atena insurance for part d cause it was cheaper and no detuctable.
Good luck, like someone said, every state is different so check with your area aging association!
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Try the pharmaceutical assistance programs or manufacturing assistance. Look at needymeds.org. The best resource is your State Health Insurance Assistance program. When she enrolls in a Prescription Drug Plan, she is not changing her Medicare... she is only changing the drug plan. Open enrollment for next year's drug plans is 10/15 - 12/7, and your SHIP can assist you in that regard.
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United Health Care compare pricing with others
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Also, I believe that if your mother moves into ALF, she may be able to change her part d as often as needed, I know you can in the NH and on Medicaid, but you may want to confirm that.
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You can apply for Medicaid. If accepted, they could pay for her part b premium Also, go to the SSA website and apply for an Low income subsidy 'LIS', which would help pay her part D premium and some of her meds.
In the meanwhile, if your mom has expensive drugs, go to each manufacturer's website and see if they have a patient assistance program, to offer low cost or free medications.
Also, you can check needymeds They can sometimes help.

Good luck!
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Blue Cross is one carrier that offers a "stand alone" RX plan.
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Open enrollment starts in October. She should start receiving advertising in the mail. I might suggest going to AARP website or ask around your area to find a specialist in Medicare insurance. I know a few people in my area but the operate in a state specific areas. I would call your local area on aging the will most likely be able to direct you.
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I am not looking to change her MediCare just find a secondary issurance.
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The time to change is during open enrollment in November, and changes do not take effect until January 1.
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