Archive for February, 2009

Dreaded Donut Hole Begin Saving Strategies EARLY in 2009

As you all know, many people who hit the “dreaded donut hole” STOP taking their needed medications because they cannot afford to pay the full retail price.  Have you ever heard the saying “SURVIVAL OF THE FITTEST”?  It seems to me the drug and insurance companies are changing this old saying to “SURVIVAL OF THE RICHEST”!!!

Please read my other blogs about drug savings tips and donut hole help on the left side of this blog.

THOUGHT FOR THE DAY:

To the world you may be only one person, but to one person you may be the world!

Please write to me, Karyn Blake, here at My Part D USA’s blog at kblake@MyPartDusa.org. Or you can email this article to a friend.

Published by mypartdusa on February 5, 2009 in Uncategorized.

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More Q and A from Readers About Medicare Part D

QUESTION: I was told I could save more money on my drugs by using mail order.  How do I get the forms to get them that way?

ANSWER: Yes, many times you can save more money on your tier 2 or tier 3 drugs by using mail order.  It would depend on which drug plan you joined.  All you would need to do is contact the customer service number of your drug plan and ask them to help you get it started.  Also, ask them the prices to see how much you would save.  REMEMBER: IF YOU WILL BUY YOUR GENERICS OFF YOUR PART D DRUG PLAN AT WALMART OR OTHER LARGE RETAILERS FOR $4, YOU SHOULD DO THAT INSTEAD OF GETTING THEM BY MAIL ORDER.  THIS WILL KEEP YOU OUT OF THE “DREADED DONUT HOLE” LONGER EACH YEAR.  IF YOU WILL GET TO THE CATASTROPHIC COVERAGE OF 95%, HOWEVER, YOU JUST NEED TO APPLY ALL YOUR PURCHACES TO YOUR DRUG PLAN TO GET THERE ASAP!

QUESTION:

How will I know when I am getting close to falling into the “dreaded donut hole”?  Also, how can I see if my generics are being filed to my Part D plan or not?

ANSEWR:

You should be getting regular statements from your Part D drug plan telling you how much has been applied to your $2,700 limit before going into the donut hole.  You should also get a list of every purchase you have made for the month so you can see if the pharmacy actually DID NOT file a claim for your medications as you requested.  PLEASE READ THESE STATEMENTS CAREFULLY! Many times they can make errors and charge you for purchases you did not make and that could put you in the donut hole long before you should be, so READ, CHECK, STUDY your statements!  BE LARGE AND IN CHARGE of your own insurance claims and don’t “just assume” the drug plan will never make a mistake.  Remember the old joke:  When you ASSUME you make an ass out of u and me.

QUESTION: I am a Social Worker for a hematologist in Florida.  We have come across many issues with our patients’ that have Medicare and also have a supplemental insurance to cover the extra 20% that traditional Medicare does not cover.  It seems that in the past few months our patients’ supplemental insurance has now become their primary coverage.  They are having difficulties getting their medications paid for.  Our patients are confused about their plans as well as we are, (the nurses and myself).  I was wondering if there was some sort of educational meeting we could attend to be able to better inform our patients on what questions are to be asked when looking for the right supplemental insurance?

ANSWER: That is a great question and the answer is hidden between the lines.  Your patients have joined Medicare Advantage Plans not knowing that Medicare does not pay the claims anymore, but the actual insurance company does.  If your patient is on Medicare Parts A & B, Medicare would always be primary to pay the 80% of claims.  The Medigap/Medicare Supplement would pay the other 20%.  They would then get a stand alone drug plan to cover medications.

When your patient joins a Medicare Advantage Plan, they no longer have the same coverage or send claims to Medicare.  They would have a plan that also includes a drug plan from the same company.  Many times these drug plans are inferior, as I have said before.  Many doctors and hospitals do not accept this form of payment and will not take these insurance plans.  We can help get your patients back on Traditional Medicare combined with a Medigap plan and a stand alone drug plan that will cover all medications, just call our toll free number to speak with a Consultant that can also educate you on the differences between plans and taking away any confusion you may have.  Just read our TESTIMONIES on the right hand side to see how we have helped educate many, many people all over the USA.  Also, please read all my catagories on the left hand side where I go into much detail regarding many issues you need to know about.  I would also recommend that you go to Medicare.gov and read the many pages of info they have online as well.

Please be aware that we can help your patients apply for “extra help” programs to pay for their needed medications if they cannot afford them.  There are plans available that many folks still do not know about.  Just let me know how I can help!

THANK YOU FOR WRITING IN WITH ALL YOUR QUESTIONS!!!  I hope I helped you better understand these issues.

THOUGHT FOR THE DAY:

PEOPLE WILL BE HAPPIER FOR YOUR SUCCESS IF YOU LET IT BE THEIR OWN DISCOVERY!

Please write to me, Karyn Blake, here at My Part D USA’s blog at kblake@MyPartDusa.org. Or you can email this article to a friend.

Published by mypartdusa on February 3, 2009 in Where do I go for HELP with Part D or Medicare Issues?.

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REMEMBER THE MEDICARE RIGHTS CENTER!

THIS TIME OF YEAR MANY OF YOU HAVE DISCOVERED DIFFICULTIES ASSOCIATED WITH YOUR PART D PLANS.  YOU MAY BE FINDING OUT THAT YOUR DOCTOR OR HOSPITAL DOES NOT ACCEPT THE TERMS OF PAYMENT FROM YOUR MEDICARE ADVANTAGE PLAN.  MAYBE YOUR DRUG PLAN IS NOT COVERING A DRUG FOR YOU THAN IS NEEDED AND YOU CANNOT TAKE A SUBSTITUTE.  IF YOU HAVE GONE THROUGH THE USUAL CHANNELS, SUCH AS CALLING YOUR PART D DRUG PLAN TO GET INSTRUCTIONS OR HAVING YOUR DOCTOR FILL OUT THE PROPER FORMS FOR AN APPEAL, CONTACTING MEDICARE TO ISSUE A FORMAL COMPLAINT, BUT STILL NOTHING IS BEING DONE TO HELP YOU, GO TO THE MEDICARE RIGHTS CENTER. 

WWW.MEDICARERIGHTS.ORG   – 800-333-4114

THEY CAN GET THE BALL ROLLING IN YOUR DIRECTION AND HELP YOU GET THE PROBLEM SOLVED.  MANY TIMES PEOPLE USE THEIR FREE LAWYERS TO CONTACT THE DRUG PLANS OR MEDICARE ON YOUR BEHALF.

PLEASE CONTACT ME IF YOU HAVE ANY QUESTIONS OR IF YOU WANT TO SHARE YOUR EXPERIENCES WITH OTHERS. 

THOUGHT FOR THE DAY:   GET IN THE DRIVER’S SEAT – DON’T BE A PASSENGER IN YOUR OWN LIFE!

KARYN

Please write to me, Karyn Blake, here at My Part D USA’s blog at kblake@MyPartDusa.org. Or you can email this article to a friend.

Published by mypartdusa on February 2, 2009 in Where do I go for HELP with Part D or Medicare Issues?.

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