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part B, D plan to sign up for HELP
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Anyone here in Medicare / Medicaid?
I have been receiving Medicaid since August, now that I'm eligible for Medicare (am receiving part A only as we speak) I can no longer get my medicine now they said, so I am having trouble deciding what part D plan to sign up for. does anyone have any suggestions? because I am so lost, and so frustrated. All I know is, prescriptions I get at Walmart (Imuran, Toprol XL, Flagyl, and Lunesta is all I take) If my doctors accept part B, then thats all I need to get for medical coverage, right? then for prescriptions I just need to get what walmart accepts. I see signs at walmart for "Humana" all the time, so Humana is probably a good choice for prescriptions right? so if I signed up for just prescription only, my doctors would accept part B, and that would be ok right? I mean, I am so confused, is anyone here on Medicare who can help me figure this stuff out? or does anyone know where I can go for help besides the medicare.gov site, because that site only confuses me more. Most doctors offices accept part B anymore here in the US though right? I don't plan on having anymore surgeries or ER visits for quite some time now, so in that case if I don't have anymore surgeries or hospital stays, part B would be enough for doctor visit coverage right? I can always have blood work drawn for imuran at my doctors office, I think my family physician and GI and Therapist accept part B, I would think that would be ok, but I don't know I am so confused. Why do they have to make this so confusing? :( I don't know how much Humana is going to be either, I don't understand what the cheapest way to go is I guess. All I get on Social Security Disability is $700 a month, thats all I'm living on right now, so I can't afford to make a bad decision on this. Posted on 12/15/07, 12:12 pm |
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apparently nobody else has a clue either, hehe.
oh well. ya know who I feel sorry for, are people with severe mental illnesses, and retired individuals, who have no choice but to figure all this out... cuz it is very confusing to say the least. 
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well, let me ask you guys this much at least,
do any of you have part B medical coverage? or is it better to go with a part D plan that covers both medical and prescription drugs? that alone would help me out a great deal
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I have Humana and it is really good. I have had another part D prescription plan and it wasn't good at all. I was paying almost the full price for my prescriptions. With Humana I'm paying almost nothing. I think it has to do with the kind of prescriptions your taking to so I would call Humana and see what they say. For me, they are the best.
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Most doctors accept part B coverage. I think it pays about 80% after deductable, and I forget how much that is. Human is something like 20 dollars a month but you may qualify for extra help. You can check out the extra help application on medicare.gov I think.
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I found a website called My Part D USA and a blog. The address is http://blog.MyPartDusa.com or www.MyPartDusa.com. You can get a comparison of Part d plans to see which one will cover your meds at the lowest prices. They also help you get on "extra help" programs through SS that could pay for your premium and you would have no donut hole. It sounds to me like you would qualify for that help. They have a toll free number too on the website you could call. I have tried to call Medicare, but you always get a busy signal and it is hard to get help. Hope you get help. Let us know if you go there and what happens.
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I have been medicare for a year now...
What I did I called and talked to a senior linkage line... and she explained alot to me and help me find a plan that fit in my needs... There is alot of plans out there.. and it is confusing... I would find out if you have a service like that... I help me alot
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I also got Humana, so far so good. Now WalMart has a list of medicents you can get 30 day supply for $4.00 my doctor changed some of mine that I could get them, before I got insurance
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Because you have Medicare and Medicaid, you are a "dual eligible". Your local medicaid office should have helped you get signed up for Part B, for which your state will pay the premium. They will also sign you up for a drug plan unless you choose one. The state will also pay you premium for Part D.
Also, because you are on Medicaid your co-payment for your prescriptions should be $1 or $2, So don't worry about where you shop for your drugs. Your local Medicaid office should help you and you probably have a case worker who can guide you through this. There should also be a local council on aging that could help you. Are you in or near a big city? Humana has good plans with very good premiums. - but you don't have to pay the premium for your part D plan. You will want the middle plan which is called the Enhanced plan. Your Mediaid counselor should help you pick a plan to be sure your drugs are on this "formulary" which is the list of drugs the plan covers. One more thing about Medicaid. When you go to the doctor you can only go to doctors who accept are in the Medicaid system. Not all doctors want to deal with Medicaid and Medicare paying the bills. Actually, if you have Medicare Part A and Part B, Medicare pays the bills and then Medicaid pays the 20% and deductibles in your Medicare coverage. I live in Arizona and I work with Medicare and Medicaid as an insurance agent. If you need more help post your question and I'll check this site regularly.
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Even if you are getting extra assistance for your drugs you need to make sure the Drug Plan you choose will have no premium. The Humana Enhanced plan is good, but they are not on the government list to have NO PREMIUM. There are several difference plans out there this year that are to be used for "extra help" beneficiaries. The Humana Standard plan is one of them. If you go with Enhanced you will still pay some premium. SilverScript also has one that you would pay not premium. So just be careful about that. Also, if your income is low enough you may not have to pay the 96.40 for your Part B. Call SS or go to their website to apply for this. It sounds to me like you would qualify, not only for "extra help" for your drugs, but for the Part B help.
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I'm in this same position right now. Thank you all for the links and helpful info. I'm trying to get out from under medicaids thumb too. I just want to be able to a little work when I'm able to, without losing my insurance coverage.
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