Hi Everyone,

Hope all is doing well.Can anyone tell me when your get Medical D do you need any other insurance?
I was fully favored but haven't received any money yet.Still waiting of course.But I should receive Medical D benefits in August this year.How do you know what to do when the booklet comes.It sounds confusing.

Thank you Mary

Let me ask a different way,I have Golden Rule for insurance right now when Medicare D kicks in can I drop my insurance thats costing me over $600.00 a month?

Thanks Mary

Let me ask a different way,I have Golden Rule for insurance right now when Medicare D kicks in can I drop my insurance thats costing me over $600.00 a month?

Thanks Mary

You have to apply for it....Since you did not apply for it by Dec.31, 06 your going to face a penalty....You need to search what your states supplemental or advantage plus plans are...

When you received you disablity you were automatically enrolled in Part A and B ONLY....it's up to you to enroll in Part D....

You need to do a google search on Part D and your state...

Thanks Sam,

I didn't recieve my letter so I don't know when Medicare D will start.Can I drop my insurance when A & B start or do I need to keep?

Thanks again Mary

Hey Mary I had posted that answer in your health insurance thread....It's really up to you on what you are comfortable with...I really explained how I did it, so the long answer is in your health insurance thread....

Your welcome.....:)

Mary
Wanted to jump in here because I beleive you will not be penalized for not picking your Medicare Part D plan prior to Dec 31,2006. You have not recieved your info from SS yet regarding any of your Medicare and SS payments. When you are first approved the Dec31, rule does not apply to you, it is only when are already enrolled that you have till Dec 31 to change your plan.
Also check with your current health insurance and talk with the people at Medicare, they can help guide you through this step. There are programs in each state with different plans to meet each individual persons needs. Some you keep Medicare and supplement it with an insurance plan designed for those special needs you may require and based on your income.
Best yet is to call Medicare and ask them the whens and why's. I hear it happens alot with people that go for the hearing and aren't approved on first try.
Medicare can be slow to get everything out.

Hi Mary------My husband spent almost 4 years waiting to be approved so he got his medicare at the same time since it was more than the 30 month wait. He called medicare several times as he has rec'd his backpay and his first check but no paperwork explaining anything. The december 31st date was waived as he ws not approved until Feb. '07. He called AARP which is one of the Co. in our state that supplies supplemental health coverage and RX. they were the nicest and most helpful people. Though out income is below the limits for him to get extra aid we have a few $$$$ in the back and that will make him ineligible for the waiver of premiums. I dorpped him from my Co. plan and saved roughly $550. With the AArp coverage added he has good coverage and a RX plan. Youshould be able to print a list of insurance co. that supplement medicare in your state by going on the Medicare website. Best of luck.


ICC

They pay half of everything in Medicare and your drug coverage is tremendous ..at first you are buying part of the price of meds and than it goes down to like five bucks ...

dont take a second insurance ..they will prob kick you off D ..because they will think you have enough money to take care of oneself ..
although when I move to MASS I will have mass health automatically and medicare part D for nine months ...because I will be finally working ..
SSDI plans to give me eight months after being hired as a librarian to test out whether I can work to my full potential ..otherwise I stay on SSDI ..which I definately do not plan on doing ...

but good luck hun
I dont even read the books ... so bad
I pretty much know the rules through and through ..
I have gone to hand surgery and they have payed almost all of it ...

good for you for getting it ..its helpful
as far as a dentist ...medicare is not taken by most dentists.... and neither are glasses ...checkups for glasses ... they only pay for one pap a year ..unless you need something more advanced ... they dont pay for pregnancy tests at the gyn ...those are around fifty dollars
I have pcos .. poly cystic ovary disease too ...so ... thats why I know about the gyn

but good luck
and take care of yourself

always
natalie jo

Hi: I would definitely talk to Medicare, or make an appt with HiCap to have them explain your MC coverage, whether or not you want to buy a Secondary Insurance (Medigap policy) and how the Part D rx plan works. Or you have a 3rd option of waiting until open enrollment and applying for an HMO, which "could" give you medical, dental, optical, hearing, and rx coverage. MC doesn't pay what HMO's do and if you choose a HMO with rx coverage you no longer qualify for Part D rx coverage.

MC will not discontinue your Part D rx coverage unless you have coverage somewhere else. I have a Medigap policy through BC and it *doesn't* cover prescriptions so I qualify for MC Part D. These Part D policies are hard to understand, so get some help... You really need to understand how it works, what they pay, and "when" the coverage gap/donut hole starts, because once you reach that point, you pay full price on most rx's until you reach the end of the coverage gap. Some co's offer coverage during the coverage gap, but there aren't that many and you pay more for this.

An example of what I pay throughout the year, on Part D, would be:

$5.00 on generics (ins pays the difference)
$30.00 preferred brands(")
$60.00 non preferred brands(")
25% of retail on specialty meds (like injectables) (ins pays the difference)

These prices apply, on my plan, *until* you reach the coverage gap/donut hole which starts at $2400.00 out of pocket expense for both you and the insurance.
All copay prices "vary" by insurance co. but the figures above are very similar to most plans. So when you reach the $2400.00 out of pocket amount spent, you then have to pay full price on rx's until you reach $3850.00.
~~~~~~~~~

During coverage gap I pay:

$5.00 on generics (because I pay for a more expensive plan)
100% of retail on *all* brand name drugs.
A lot of people have to pay for generics as well during this time "if" they don't purchase a more expensive plan that covers generics during the coverage gap.

~~~~~~~~~~

After out of pocket expenses reach $3850.00 I pay:


2-5% of retail on all rx's (brand or generic)

(Out of pocket means the combo of what you spend and the ins. co) So if you pay $5.00 and the ins pays $100.00 (example) you add both figures for all rx's to figure your total out of pocket expense.


Make sure you check each ins co's formulary before purchasing a plan to see if you rx's are covered. Each co has a different list of what they cover so this is real important, as well as what their copay price, and plan cost is.

Good luck:wave: