This just in from a caring reader:

Hi, Karyn.  It is J. Adams in Kentucky again….just read your article on “YOU HAD BETTER SHOP AROUND”.  You are absolutely correct in that generics do not have to be charged against your $2,830 you get in drug benefits before you hit the “dreaded donut hole” in 2010.  In fact, even though most pharmacies will ask for your medicare number, you must DECLINE this and end any possibility the pharmacy can charge your Part D plan.  I use Krogers and get a 30 day supply of generics for $4 each.  In the beginning they asked for my Medicare number and Social Security Number.  I SIMPLY DECLINED AND TOLD THEM I’D BE PAYING FOR MY GENERICS MYSELF. No problem from them after that!  I also told them they had no need for that information.

Please feel free to pass this tip onto your other people with these questions  Please tell your people there are other ways they can verify who you are.  Kroger uses my date of birth and the last 4 digits of my telephone number. It works just fine!

THANK YOU SO MUCH FOR SHARING THAT GREAT TIP, J. in Kentucky

I am not yet on Medicare, but every time I go into a pharmacy I check to see what kind of programs they have for Medicare beneficiaries.  Yesterday at CVS I saw a plan where they have over 400 generic drugs for $9.99 for a 90 day supply.  I know that Walgreens, Wal-Mart, Costco, Sam’s Club and many other places have these plans as well. You may ask, “but why should I do this when my co-pay is cheaper than that?”  Even though your co-pay is $4, your drug plan dings you $20, $30 or $40 dollars or more because it is the RETAIL PRICES that count toward your donut hole amount of $2,700.  This pushes you closer and closer into the donut hole.  DON’T BUY YOUR GENERICS ON YOUR DRUG PLAN!  SAVE YOUR $2,700 FOR BRANDS YOU MUST HAVE THAT ARE MORE EXPENSIVE.

I also asked the pharmacist if they made claims on your Part D drug plans when you had this program and he told me absolutely NOT!  The reason I asked them that is I have recieved many emails from readers telling me their pharmacist said it was against the law if they didn’t file a claim.  This is a downright LIE! They just get a higher re-embursement if they file a claim.  If your pharmacist tells you this, give him/her my number and I’ll report them to Medicare or you can do so yourself at 800-633-4227.

Many of you are now in the “DREADED DONUT HOLE”.  Please know that if you begin 2010 by using these generic programs instead of using your Part D plan on your generics you will stay OUT of the donut hole months longer next year!

ONE MORE THING: Read your monthly drug plan statements like it was your bank statement.  See what claims have been charged to you to push you further and further towards the donut hole.  Many people report duplicate claims.

YOU MUST SHOP AROUND! Even on my own meds, I found huge differences in prices from one pharmacy to the next on the same exact medication.  One medications was $127.00 at one pharmacy and $67.00 at another pharmacy.  Don’t just pay them, tell them you can get it cheaper down the street.  Shop around and find the best price either locally or online.  When you are in the DREADED DONUT HOLE, YOU CAN’T BE FAITHFUL AND USE YOUR PART D PLAN, YOU MUST GET YOUR MEDICATIONS ANYWHERE YOU CAN FIND THEM CHEAPER NOT USING YOUR DRUG PLAN!  YOUR PART D DRUG PLAN IS NOT FAITHFUL TO YOU!

If you know you will get to the 95% coverage, then you must use your drug plan through the donut hole….but if you fall in, never to get out for the year….just act like you don’t even have a Drug Plan, except you must continue to pay the premiums or be penalized.

I know I sound like a broken record, but I’m still getting so much email on this subject!  Hope this helps.

THOUGHT FOR THE DAY:  Your Integrity Will Affect Your Destiny; Don’t Leave Home Without It!

As I was sitting in my doctor’s office yesterday I picked up a WEBMD magazine.  You can go to their website at www.WebMD.com.  I found an article about how one of the best things for our hearts is LAUGHTER!  Not that we can all go and throw our Lipitor down the toilet, but just think about these few ideas:

1. Every day your heart beats about 100,000 times, sending 2,000 gallons of blood surging through your body.  All this blood feeds our organs and tissues, so we better take care of it by eating healthy, taking at least 3,000mg’s of Omega 3’s per day and doing some kind of exercise that gets our heart rate up.

2. A good belly laugh can send 20% more blood flowing through your entire body!  Now who knew that?  One study found that when people watched a funny movie their blood flow increased.  That is why laughter is the perfect antidote to stress.  When you laugh, the lining of your blood vessel walls relaxes and expands and this excersises your heart muscle making it stronger.  So, find ways to make yourself laugh every day…..read jokes online, watch a funny movie or stand-up comedian.  There are too many stressful things to watch on TV.  One of these is your local news and all the arguing talking heads.  Who wants to spend their evening listening to people argue?  Many people do and this contributes to YOUR STRESS! Watch old re-runs of Andy Griffith instead of Hannity or listening to all the horrible news stories, over and over again, that you can’t do anything about anyway.

I read one study about how the media causes stress in the elderly. Many times all they have to entertain themselves is the BOOB TUBE or TV and the more news stories and talking heads they watched the more afraid, stressed, worried about the future and plain out paranoid they became.  Stress causes your immune system not to function properly which can cause sickness of many kinds.  It increases your blood pressure.  Choose what you watch as carefully as you choose other components of your health care.

3. A man’s heart weighs about 10 ounces, while a woman’s heart weights about 8 ounces.  Not only is a woman’s heart smaller than a man’s, but the signs that its in trouble are a lot less obvious.  Women have different symptoms of  a heart attack than men, such as nausea, indigestion and shoulder aches, rather than the hallmark chest pain.

I KNOW THERE ARE LOTS OF MEDICATIONS PEOPLE TAKE FOR HEART PROBLEMS THAT CANNOT BE REPLACED BY LAUGHTER, OMEGA 3′S OR ANYTHING ELSE, SO PLEASE, EVEN IF YOU ARE IN THE “DREADED DONUT HOLE” THIS TIME OF YEAR, DO NOT STOP TAKING YOUR NEEDED MEDICATIONS.  IF YOU FIND THAT YOU ABSOLUTELY CANNOT AFFORD TO BUY THEM ANYMORE, PLEASE CALL YOUR LOCAL SOCIAL SECURITY OFFICE AND TELL THEM YOU NEED TO APPLY FOR MEDICARE PART D LIMITED INCOME SUBSIDY PROGRAM.  IF YOU QUALIFY YOU WILL NOT HAVE A DONUT HOLE!  DO THIS TODAY.  IF YOU HAVE ANY QUESTIONS ABOUT DOING THIS, PLEASE WRITE ME AND I’LL GET BACK TO YOU ASAP! YOU MAY EVEN CONTACT THE DRUG MANUFACTURER.  MANY TIMES THEIR INCOME LIMITS ARE HIGHER AND YOU CAN GET HUGE DISCOUNTS DIRECTLY FROM THEM.

Thought for the Day: Some Doctors Say That Cheerful People Resist Disease Better Than Grumpy Ones.  The Surly Bird Catches The Germ.

I have been getting many questions about DISCOUNT DRUG CARDS.  I have written other blogs warning you about some of them and to never pay a fee to recieve a discount.

There are some NEW cards circulating all across the country from reputable organizations that anyone that is paying retail for their medications or in the “donut hole” should definately check out!!

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Please call your local United Way office, your local County or City Health Clinics, and also check with many of your local pharmacies.  Some cards will give you a better discount than others.

Just be sure that you never pay a FEE! If someone asks you to pay for a discount card, you can be sure it is not one that is regulated by a reputable organization.

The discount cards I have had news reports about are located in Austin, Texas; Gastonia, North Carolina and Brevard County, Florida.  These cards are issued by non-profit organizations such as United Way and others.  Check in your local area to see if a discount card is available for you!

QUESTION:

My mother has only a few hundred dollars left before she will go into the donut hole.  Do you know of any other kind of insurance we can get to cover her drugs during this time?  I don’t think she will be able to afford to pay for them when she has to pay full price.  What can I do to help her?

ANSWER:

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I have not heard of any kind of insurance product that will cover drugs during the “donut hole”.  It is a shame that your mother may not be able to pay for her medications.  There are several things you can do.

1. Contact the manufacturer of that particular drug and ask them if they have any “free help” programs.  Many times they do help people with low incomes.

2. Find out if you qualify for the “extra help” programs through Social Security.  If you qualify, you will not have a donut hole on your Part D Plan.

3. IF YOU KNOW THAT YOU WILL NOT REACH THE OTHER SIDE OF THE DONUT HOLE TO THE 95% COVERAGE, YOU MUST BEGIN TO COMPARE PRICES.  YOU NEED TO SHOP ANYWHERE YOU CAN TO GET YOUR MEDICATIONS AT A LOWER PRICE.  DO NOT USE YOUR DRUG PLAN CARD!  YOU WILL STILL HAVE TO PAY YOUR PREMIUMS TO YOUR DRUG PLAN, BUT CERTAINLY YOU CAN FIND BETTER PRICES FOR YOUR DRUGS!

4. Next year, at the beginning of your plan for 2009, try to buy all your generics and lower priced medication at large retailers that have $4 generics.  This will leave more in the pot to pay for your very expensive medications, thereby extending the time it takes you to reach the dreaded “donut hole”.

If any of my readers knows of an insurance plan to cover the “donut hole”, please CONTACT ME ASAP, so we can check it out. contact divx

Until then, we must make the most of our drug plans and save as much as possible!

For those of you who have hit the dreaded “DONUT HOLE” or the coverage gap that is built in to the Medicare Part D drug benefit, watch the prices of your generics! Many plans inflate prices for generic drugs during that time.  Some of these prices are far higher than widely available retail prices.

When you first join your drug plan you are paying the lower co-pay amounts, but when you fall into the “donut hole” and still present your drug card to the pharmacy, the drug plan still regulates the prices you pay.

IF YOU HAVE BEEN READING MY OTHER BLOGS ABOUT DONUT HOLE SAVING HINTS, I HAVE TOLD YOU TO STOP USING YOUR DRUG CARD DURING THE DONUT HOLE IF YOU ARE VERY SURE YOU WILL NOT REACH THE OTHER SIDE TO THE 95% BENEFIT.

How do you know if you are a victim of this scam?

1.  If the price indicated by your plan, as listed on the Medicare website, for a common generic drug is 2 to 3 times the prices charged by other Part D plans, you may be a redneck….I mean victim.  Just checking to see if you are listening!!!

2.  If the drug prices on your monthly statement for drugs purchased at the phamacy are much higher than the retial price available from your neighborhood pharmacy, you may be a victim.

3.  If your montly statement shows mail-order prices (not co-payments) that are higher than the price charged at your neighborhood pharmacy, you may be a victim.

Please look at your statement!  Call a pharmacy that you do not use and ask them for their price on your generic medication.  If you are paying more than that……..you CAN BUY YOUR DRUGS WHERE YOU FIND THEM CHEAPER WITHOUT USING YOUR DRUG PLAN!!!!!  Check around, shop everywhere!

You will still be required to pay your montly premium to your drug plan, but there is no need to pay higher prices for your medications!!

Congress is working on cracking down on this practice, but it won’t be implemented until 2010.  In the meantime, don’t be fooled into paying higher prices.

At My Part D USA we hope to educate you on the many ways you can save more money on prescriptions!

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As we have mentioned before, there will be no National Drug Plan available in 2008 that will cover brand name drugs during the dreaded “donut hole”!

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However, there will be plans that cover GENERICS during the “donut hole”.

You must pay attention to how the drug plan intends to cover them, because the quality of coverage

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will be different on each plan.

The are using the terms….

ALL GENERICS - all generics on their formulary

SOME GENERICS - they have a list of generics they will cover

PREFERRED GENERICS - they have a list of preferred generics they would have you use before covering any others

Before you enroll on a plan that covers generics during the “donut hole” you need to check and see if your medications are on the list. The premiums on these plans are higher, so before you select one, make sure you can actually get your prescriptions on that plan.

When you go to our webiste, on the comparison page, we will have a box named MORE INFO, you can click on this box to see if your drugs will be covered during the “donut hole” on that particular plan you have selected.

Please don’t just assume that your medications will be covered if the plan says they will cover generics during the “donut hole”.

It has been annouced that there are NO plans available for the 2008 coverage year that will include brands during the “donut hole”. We have recieved many calls asking what plan will give more help next year. Unfortunately, there will not be a national plan available.

Last year we had Sierra RX, but they took themselves off the marketplace for 2008. The first year Humana had a plan with brands covered during the donut hole with a premium around $85. Last year many people did not get a comparison and did not realize that Humana has discontinued that coverage and were stuck paying a higher premiun with only generics being covered in the “donut hole”.

That is why we strongly advise you to get a comparison each and every year so that you will not be suprised when your plan changes.

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Begining November 15 to December 31st you can go to www.MyPartDusa.com and get a live comparison and also enroll in the plan you choose to be best for you. Enrolling has never been easier! If you need to speak to a personal consultant with any questions or help to navigate the site, please call toll free 866-752-1795.

Remember the LIVE COMPARISONS WILL ONLY BE ACTIVE NOVEMBER 15TH TO DECEMBER 31ST 2007.