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My mother is 89 and has not need prescription coverage until recently? In the past she always paid out of pocket for her meds but now needs more costly prescription medicines. She has dementia and on arisept and namenda. I understand that Medicare Part D companies will charge her a penalty since she did not have prescription coverage since 65 when she became eligible for medicare. Is 65 the starting age. she is now 89. That is 24 years of penalty? Can someone explain how the penalty works and how much it is going to cost in addition to joining a plan and paying for the prescriptions? Thanks!

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My understanding is that when it is time to review. October I think it is she can switch to an HMO AND GET PART d. However it does not cover the entire prescription.there is a coPay until she has reached 4,000 out of pocket unless her income is low enough and assets not including a home then she could get the 4,000 covered by state assistance without having full Medicaid. At least that is what my mom did Check with Medicare and your state assistance program. We are in Florida
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This is the first time that I have heard of a penalty under Medicare Part D, so will be interested to see what others have too say.

The only penalty I am aware of is under Medicaid. When applying for that program there is a review of finances for up to five years. Any money or property given as gifts or donations will be scrutinized. The penalty is equal to the gifted amount.
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There is an expert you can consult for free. Healthcare Connect show on Doctor Radio out of Langone Medical Center at NYU. The show airs live Thursdays 12-2 EST on satellite radio serius XM channel 110.
You can also go to the website and email your question just as you stated it here (very clearly stated). They will get back to you at no charge. I have my own question for you; will those two medications make a difference in your moms quality of life. Good luck.
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https://www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html offers a good explanation of the penalty imposed if a person was eligible for Medicare but did not sign up for Part D coverage: "Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($34.10 in 2016) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium." See the examples at the link above.
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According to the government website in the above post yes she will have a stiff monthly penalty for not signing up when she first qualified at age 65. The calculation will give u an idea of the amount which will be around $100 a month if my math is correct. Now does your mom perhaps qualify for medicaid? If so she could apply for that as her secondary insurance. So many people do not know about the penalities for medicare part C and D and get caught. We just had this happen to a sibling of mine, he was healthy took no meds thought I dont need that ins, then boom he had heart blockage pacemaker the works. Now he will have to pay the penalty, thank goodness its only for a year of non coverage. I wish you the best and hope there is some way she can get around this. Let us know what happens as it will help to inform others.
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My father-in-law, a farmer, (Mr. Miser) thought the Medicare Advantage program wasn't paying for himself after he was on it for a year and decided to cancel his Medicare Advantage insurance. Fast forward a year. Discussing taxes with CPA/Attorney in rural, farming community. Mentioned f-i-l cancelled Medicare Advantage. CPA/Attorney reamed f-i-l for doing that. (LOL!!!)

I signed f-i-l up for Medicare Advantage program ASAP. We now have to pay a penalty of about $25.00/month for the rest of his life. Fast forward to now. now f-i-l is 88 years old, has Chronic Kidney Disease with Anemia Stage 5, dementia and a whole host of problems. One, just one, shot of Arenesp for CKD is $5000.00!!! He need this every month!!! Thank all the deities in heaven and everywhere else that he is back on his Medicare Advantage insurance, even with the penalty.

Bottom line.....get the insurance and pay the penalty if you have to. Better to sign up for it when you are first eligible. Your future self will thank you.
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the website mentioned by Reno above still seems to exist, but the most recent Q&A postings are dated in 2013.
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i was shocked when i called medicare to see what i should expect when i turn 65. i was told that i would have to pay for 20% of hospital and god knows what??? 20% of bills from hospital stays or anything else is astr0nomical!! anyway...i joined humana hmo...and hardly pay for anything!! i know this because my father takes 8 medications a day...both parents in and out of hospitals for last 10 years...and never paid for anything! go figure! but i always ask for generic drugs!!
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Your HMO participation more than likely includes Medicare. Please, Please stop dissing Medicare benefits because Medicare is there for a reason - as a safety net for millions of retirees who have little to no access via exceptionally expensive medical insurance programs. Your HMO is a secondary coverage, Medicare is the primary coverage. If your HMO provider's agent did not explain this to you, shame on them. If you have waived Medicare and decide at a later date to subscribe to Medicare you will be paying a penalty. So, lifeexperiences please contact Humana HMO to be assured that your medical coverage includes your Medicare.
Bonniepages, if a website has not been updated since 2013 you can probably know that the website has either been 1) acquired by another source or 2) the annual hosting fee is paid by automatic payments and is no longer in service.
Open enrollment for Medicare is generally mid-October through early December. Generally, there are numerous workshops conducted by Blue Cross, United Health, AARP, Humana depending upon what state you live.
I have a cousin who presumed at the time she was 65 and was on no medications that she didn't need Medicare Part D. Was she in for a surprise when 6 years later she need Medicare Part D. She is a widow living on a limited income - not good.
I began at 62 going to workshops at my credit union on Social Security benefits as well as local Medicare workshops. I decided at 65 to participate with the AARP program, AARP Medicare Complete. At present, for the basic monthly Medicare cost of $105 plus $29, my basic medical health is covered as well as prescription drugs which are generally generics. So, if you are in general good health, I would recommend this plan. I'm awaiting my annual in-home visit from the plan and then will receive a gift card to Wal-mart which I give to someone else because I don't shop Wal-mart.
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According to the radio show, when you email them, they do respond to all emails. Possibly they stopped posting Q&A. They really are remarkable. Mix agree with the one poster that a $25/month penalty is nothing. Think of all the premiums which were never paid in the first place
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i will have medicare...BUT...with the HMO...you pay almost nothing...without HMO you pay 20% of everything!
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I have medicare and a supplement that I got a month before I turned 65. The first day of the month that I turned 65 it kicked in. Yes, I have to pay for both, but well worth it. Get the supplement, it is worth it. I don't know anything about the penalty.
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The Part D penalty goes back to the inception of Part D, which was May 2006. So your mother has approximately 120 months of penalty, or about "double" what she would be paying (120% of the average premium in her area) if she had had a plan all along.

First, remember that your mom has "saved" money all these years by not having a Part D plan, so hopefully that makes the penalty a bit easier to swallow. In addition, depending on her financial situation, she may not be subject to the penalty. Her medical condition qualifies her for Home and Community-Based care through Medicaid.

You can see information on Part D and the penalties, In addition, a SHIP counselor at your local senior center can assist. If your state has a State Pharmaceutical Assistance program, she may be eligible to enroll immediately (also true if she is relatively low-income.)

I would do a lot of investigation before enrolling a dementia patient in an HMO. I would want to make sure that they had a full complement of specialists that she needed. Again, a Medicaid Waiver program may be her best choice.
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You should work with a reputable insurance agent on this question.
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Go to medicare.gov. It will answer all of your questions.
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My Mother has dementia and possibly the onset of schizophrenia. She has military insurance along with medicare. Should I continue to take her to a private/state hospital or transfer to the military hospital. They used to live in a different state and now she currently lives with me since my dad passed away 3 months ago.
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I just read a comment: "will those two meds make a difference in your quality of life?" Excellent point to ponder when one must make decisions along the bumpy path of health issues. This also includes surgical procedures.
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