My mom neglected to pay her Part D Medicare bill and has lost coverage, she has appealed the process, but what does she do in the meantime?

I know the horse is already out of the barn but after you get this corrected, have the premium automatically deducted each month from her account. That is how most people are doing this now. I hope she cooperated with you on this.

Contact a Social Worker who may be able to Guide you in this Matter. For now, Being it is just 30 days away and She may Win, She should already have those Meds she needs and If not, Dish out the money for now to Keep her Going.

See if her doctor has samples on hand. At least that is something. Some big pharmas will give people a break if they've erred as in the case of your mother.

Dear allesandra September 26, 2019

My response is related to the fact your mom did not pay her premium.
It's good that you have taken over the bills. I hope you get Part D reinstated. But if you do, I suggest you set up auto paying the premium from a checking or other account so that this doesn't happen again the future.

You also need to speak to her MD about meds she is on. MDs often get 6% of every NEW and EXPENSIVE drug they give patients. Most meds given for dementia have NO proven track record for helping at all. It is just the pharmaceutical companies being what they are (don't as) and MDs still a part of it all. Tell the MD that going forth Mom can only take Generics and if the drug is not old enough to have a generic equivalent it is not an option. Use Costco to check pricing as well. You need not be a member to use their pharmacy and they are often cheaper than others.

Heads up-I had the same thing happen; I didn't take it seriously because I don't use any prescription meds. Then I get a bill from Medicare saying that because I didn't have the Part D coverage I had to pay them a penalty for not having the coverage! (Who says the government is logical?) I don't know if you can get it reinstated with the minimum lapse in coverage, but try!!

Try GoodRx.com

GoodRX! I use it, even though I have Medicare part D, I chose the cheapest monthly plan. This plan has a large deductible and pays a bit less of the cost. I keep it just in case I have an emergency or an accident. For my regular meds, GoodRX works just as well (if not better!) than using the insurance.

Suggest you Call Medicare and get the phone number of the SHIP office in your mothers county for assistance and information about programs such as Extra Help that pay premiums, cap costs for medicines, and create A SEP for her on a quarterly basis . SHIP can also help you find the most affordable plan for 2020 and enroll her so the premium (plus penalty) comes out of her Social Security automatically every month. If she doesn't qualify for Extra Help, most states offer some kind of specific State Health Insurance Program (each state call s it something different)that allows members a one time enrollment outside of the annual October 15- December 7th Open Enrollment period. The income caps for these tend to be much higher than the federal programs. If you can get her into one of those federal or state programs for the rest of the year just remember coverage starts the first of following month. Any enrollment done during the annual Open Enrollment (October 15- December) 7th automatically starts January 1 of the following year so be sure to confirm start dates if enrolling her during this time frame. Another option is her doctor should be a able to direct you to the manufacturers of her meds and help get her into a PAP ( patient assistance program) to reduce the cost of her meds for the rest of the year. Unfortunately, Medicare Law states that after 63 continuous days without prescription coverage your mother faces a monthly penalty that will be charged for her lifetime. The penalty is calculated at 1% for each month not covered, times the current late enrollment base # established by medicare, times the number of months she did not have comparable coverage. The base # has been 33 cents for the past two years. So if she stopped paying a year ago Subtract 2 months for the allowed 63 days. 1% x 10 months x.33 =$3.30 This amount will be added to her monthly premium regardless of the prescription plan she chooses. Starting Oct 15 you can go to the plan finder on medicare.gov to evaluate her prescription plan options for 2020 and know exactly what her premium plus penalty will cost per month. Good Luck!

All of these answers are so great...just wanted to add that I was surprised at how many have dealt with learning their parent never signed up. Don't forget to check with the pharmaceutical manufacturer itself for a patient assistance program. Also you don't have to be a member of Costco to use the pharmacy...but you still need to do your homework and check the pricing. And lastly, especially with the drugs for dementia, if you're not seeing any obvious benefits, consider speaking with the MD about a drug "holiday" to see if there's any difference and weaning off or stopping.

Allesandra, please go to everyday cheapskate, everydaycheapskate.com, search prescription drugs and she has multiple resources for getting help with prescription drugs.

I'm sorry for your difficulties. Have you spoken to a social worker to find out if there are any agencies or organizations that will help your mother (and you)? Some pharmaceutical companies also offer discounts for people who need them (or so they say in their TV ads). If you don't have Power of Attorney for your mother's financial and medical affairs, talk to her about setting this up. Perhaps it is time for you to take over paying her bills. She may be grateful for the help.

I have mine taken out along with Medicare - my agent arranged this for me.

Everyone should have it taken automatically when they have the Medicare taken from their Social Security check.

I realize this is locking the barn door after the animals have escaped - but for the future and anyone else not knowing, have the monies taken out automatically.

If she has any expensive ones, order them from Canada. I order my husband’s Medication (1) from Canada. His urologist said that was fine. They are great! So nice and give discounts on top of the lower prices. No fees.

She will have to sign up again during the next enrollment period, which starts October 15th. A penalty fee will be added to her premium from now on, but it's better than having no coverage at all. I have to pay a penalty myself b/c of a paperwork error when I originally signed up.

My mom did the same thing and I called and told them the truth...you would think they have this happen all the time and would be more flexible. Anyway, long story short I had to apply for her again...I believe it was Jan 1 when it went back into coverage meanwhile, I told her doctor what happened and they provided samples for me of the most expensive drugs so that helped. I took over her bills then as well and I got to learn all about Medicare and coverages and referrals,etc. ask them if you can just reapply. Unfortunately, the renewal was more expensive after the lapse in coverage but still a huge help with prescriptions.

Have you checked if she is eligible for SS extra help for drug coverage?

Have you checked if she is eligible for SS extra help for drugs?

I have RXscript from united health, and they told me if you are late on a payment they will give you time to pay. They won't just cut you off. I don't know how behind she was, but there are many medicare RX insurance companies you can check into. Good luck

Contact your Congressman or Congresswoman. My husband had a similar situation because my employer gave us incorrect advice when we got married. At the time he was only 3 years away from going on Medicare and was going on my insurance. They had told us he would not need Part B as my insurance would be his entire supplemental insurance to Medicare. But I retired in that time and they never told me he would now need to sign up for Part B. Our wonderful Congressman straightened everything out for us. They are there for YOU, their constituent. Good luck!

We didn't realize that Mom didn't have prescription coverage, just a BCBS discount, until we tried to refill her meds earlier this year and learned BCBS had ceased the discount program. Instead of paying about $50 the bill was about $1600. We then compared different discount programs such as GoodRx and RxSaver and dropped the price back down to about $59 which covers 3 months of sertraline, donepezile, and memantine. Classic Alzheimers medications. Not all pharmacies play well with the quoted prices from the discount services. CVS and Walgreens come to mind, they charge way more than the estimated price. Kroger charges the quoted amount, so we moved everything there. I even switched to Kroger using RxSaver for my own meds because it's half the price of my own insurance covered rate. FYI the prices vary between discount programs and location and pharmacy so I suggest checking them all. The difference can be substantial.

Prescription coverage is mandatory since George W. Bush's time, and I believe they will increase her Medicare rates for non-compliance. There are a lot of supplemental insurance plans that also covers prescriptions which can suit her needs--some cost very little or even no cost but you have to use THEIR doctors because it is HMO. It's a lot cheaper to get these supplemental plans than pay for prescriptions. If she is ever in the hospital or even emergency room talk to a social worker.
Here is some information. There is also a medicare hotline they will answer any questions you have.
https://www.aarp.org/health/medicare-insurance/info-2018/medicare-made-easy.html

I'm assuming you've already looked at all these, but I thought I'd share this link just in case you haven't:
https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods#

If she's reinstated or when she is set with another Part D insurance company, check to see if they offer an "easy pay" option where they automatically withdraw the premium from her checking account. You would have to provide her checking account information to them. The Part D company should provide instructions on how to enroll. At least this would eliminate you having to worry and she won't have another lapse in coverage.

I hope this helps, it didn't say anything on the website about being limited to my state only.
https://www.goodrx.com/blog/save-on-medications-goodrx-gold-drug-savings-program/ (website).
GoodRx Gold currently has a special offer where you can get a free membership for 30 days. After that, monthly plans will cost $5.99 for individuals and $9.99 for families.
Please check with your pharmasist, who has likely dealt with coupon companies like this a lot.

Not all Medicare D is deducted from ur SS check. Mine is thru an employer.
How r Moms finances. She maybe able to get Medicaid or like my Mom, a State prescription plan like PADD in NJ.

Ask the doctor's office if they have any samples of your mother's medications.

Try and find a new provider. There are a multitude of prescription insurances.

In the mean time, see if she can use coupons from goodrx dot com. They helped me out when my rx was too expensive. You can see how much the drug is at each store they have a contract with and pick the cheapest or most convenient.

Why isn't she paying for her meds? Perhaps some one needs to take over her finances. My part D is deducted right from my SS check every month, so I do not get that either. Have it taken out direct to avoid this in the future. Also get a durable POA to avoid future problems.