I am going to loose my Cobra soon and my wife will be getting Medicare in a few months. She finally made it thru the 2 year waiting period. Under my current insurance we pay about $95.00 for a 90 day supply of Nemenda and pay $110.00 for Aricept 90 day supply on Medco. What can I expect the cost to be under Medicare?
It's the same for Plan D for Namenda. I think all the 3rd tier of drugs are right around $100 in all the Plan Ds. Generics are from 0 to maybe $10. The difference is probably how much the INSURANCE, not the meds, cost.
On medicare Part D, the prescription coverage, there is a "donut hole". After you and the insurance company have paid a certain amount (I forget how much), you then pay the full amount until you have paid a certain amount. Then the insurance starts helping again. I just filled my wife's Namenda prescription and found she is in the donut hole. Last month, for a one month supply, we paid $28. Today, for a one month supply, we paid $250.
marsh you will be coming out of the donut hole before the end of this year so try and remember at that time refill everything possible in December for 3 months before January 1. Your cost will be very little after you come out of the hole.
lmohr, if it is anything like last year, we won't be out of the donut hole until December. I'll have to get a change in the prescription for the Namenda, since it is only for 1 month at a time.
With medicare Part D (the prescription part) there is NO way around the donut hole. That was built into the law by our "wonderful" legislature (sorry, Joan, is this too political?).
For the F supplement we pay $585 per person every three months. I looked at several plans and they all seemed about the same.
Marsh means NO way - i.e., you can't buy supplemental insurance to help with it. And the cost that YOU pay for the drugs is NOT the cost that is figured in getting to the donut hole, for example, you pay $99 for 3 months of namenda under Part D, but the cost is "really" $750, and you fall into the donut hole at $2700. At the end of March my husband was at $1434 total costs, of which we had paid $315. And this is with ONLY namenda being non-generic.
The total of what we co-pay, plus what Ins. and Medicaid are paying for Dh's meds is running between $875--1100 per month, depending on how the refills fall. He's been in the donut hole since last month. When he comes out, our co-pays will drop to zero. This includes a total of 11 Rxs, most generic. However, this doesn't include the OTChe takes, of which there's a muti-vitamin and fiber therapy caplets.
No wonder so many seniors either take only half their meds, none at all or eat dog food. That is more than many peoples Social Security checks. That alone would factor in whether to treat or not.
My sister is so blessed in that her husband was civil service and had Kaiser. She still is able to keep it after his death at about $100 a month. She doesn't have to worry about the high Rx cost - she pays whatever the Kaiser co-pay is, which I think is $8.00 generic and $20 for name brand.
If your income is low, you may qualify for help with paying the fee for the medicare drug plan, and for your prescriptions. Your deductible might be less, too. Some people don’t have a donut hole if they get this help. I think you apply through the social security administration.
low income people are generally on medicaid, not medicare. There is a difference. Medicare is for people over the age of 65, or disabled. Medicaid is for the poor of any age. On medicaid most drugs are covered in full.
On medicaid drugs are covered with very small copays. Generics--$1.10 per 1 month fill;$3.20 for tier 2. Also, some may require extra paperwork from the Dr. if he wants you to have a certain drug--not just a matter of Name or generic. Sometimes they push to use a different drug which is cheaper, and does a similar job.
Under the Social Security Administration, there is a Medicare Prescription Drug Assistance program. This is for people whose incomes are not low enough to qualify for Medicaid, but who cannot afford all their prescriptions even with their Medicare drug plan. You have to apply for this benefit separately from Social Security or Social Security Disability.
My husband is under 62 and on Social Security Disability (because of EOAD). He has been on Medicare for several years, and on the Prescription Drug Assistance program for several years, also. Our income is not low enough to qualify for Medicaid, but we qualify for this program.
I thought this information might help someone else who is having trouble affording all the meds our loved ones are usually taking. I haven't seen a lot of publicity about this assistance program, so it's possible not everyone knows about it.
For low income/resources people there is SSI (Supplemental Security Insurance) that is administered by SSA. One has to also be either age 65 or disabled. If one qualifies for SSI in most states Welfare pays the medicare premium and also puts you on medicaid. (At least that was the way it was when I retired from SSA 10 years ago. I doubt that much has changed). With SSI there may be some variation to the State Buy In for Medicare and for Medicaid and one would need to check with their local SSA and Public Assistance office.
Before enrolling in the Part D Prescription Drug Program (with BC/BS) several years ago, I worked the numbers and concluded that the program would be pretty much a wash for me with annual prescription drug expenses of something less than $1500 per year, but could be quite worthwhile for my wife with annual drug expenses in the $7000 range. I can't find that analysis now, but in checking some of the backup for our 2008 income tax return, I see that each of us paid $546 in premiums for the coverage we chose, in return for which BC/BS paid $798 on my behalf and $2100 on my wife's behalf -- virtually all of which was in the Initial Coverage Period. I believe about $170 of my wife's expenses were above the donut hole threshold, with BC/BS paying $160 and her paying just less than $10.
I must be in the .01%, since we have been declined twice so far by ssi....But luckily the entire cost of this is covered by phranquecare....everything is covered 100%, including all the meds....but not sure how long I can maintain this coverage....
This is probably a complete no-no, but G is no longer using Namenda and we have TONS of the stuff I hate to just toss. Totally up for grabs! My e-mail is posted if anyone isinterested in freebies.
Check with your pharmacy. I recently took some BP meds that I no longer use to my pharmacy. The pharmacist said she would give them to someone who can't afford them. BTW I am on different BP meds now.
A component of qualifying for SSI is household income. It is to bring Soc. Security income up to a level in relation to the poverty level (I don't know the %). It can also be awarded to someone who has no work record base to get Soc. Sec. They look at the whole household income in figuring it. If your LO has enough work credits, and is too young to retire, apply for Soc. Sec. Disability. If old enolugh to retire, file for Soc. Sec. A wife who hasn't worked, can draw based on her husband's record. Soc. Sec. or Soc. Sec. Disability will get your LO into Medicare.
After reading kathi337's comment, I also have 2or 3 boxes of Excelon patches that will never get used....If anyone wants them, just email me...and after you sign all the legal releases, and hire 6 attorneys to prove that I am not dealing in drugs or another narcotic substances...I hear that college students are now buying or stealing excelon patches so they can wear them the day before the final exams......interesting...
There are several who post here who are having financial problems. I don't know if they might be able to use these medicines or not. Seems a shame for them to go to waste as expensive as they are. It was good of Kathi337 and Phranque to offer them. Hope someone can use them.
On another site a woman and I were able to swap drugs at a great saving to both of us. Probably not legal but who cares. We're all in this mess together. Just hope Joan doesn't get into trouble for permitting drug trafficking.
Our eye Dr. will do this with unexpired meds. From those who can't use to those who can. He just verifies that the person recieving actually has an Rx.
there is an article on today.msnbc.msn about if generic drugs are really the same as real brands.. it said about 90% of the factories producing parts of generics are overseas. and that we cant be sure we are getting the original 'drug formula' submitted to FTD to begin manufacturing of the original. very concerning. i have noticed that the generic prilosec just doesnt seem to be as good as the real prilosec. much more burping it etc for DH. i am thinking of razadyne, and or AD 'generics' . might want to rethink using them if insurance isnt an issue with pay. some insurances wont pay unless dr specifies original version and even then will allow the pharmacy to sub a generic. you may want to read the article if you have been using them to cust rx costs .. divvi
I have noticed sometimes his galantamine is generic and other times name brand. Must depend on what kind of deal the government is getting at the time. I just am glad no matter what, they are always $8 through the VA. I considered going to Wal-mart for their $4 but the VA has been good to us and want to stay with them. When money becomes more of a factor, which may not be long, I may check on that option.
For what its worth, my understanding is that a generic must be the same chemistry for the active ingredients, but can be different in the inactive ones, which may affect different people in different ways.
Yeah, and my understanding is that melamine isn't supposed to be a component of dry milk, but the Chinese factories put it in there to save money.
I no longer buy food that has been made in China. Trader Joe's used to get a lot of their food from there, but they've announced that they are "phasing it out" because of safety concerns. Sounds like we can't trust generic drugs made there now. :-(
And watch foods from Mexico, Brazil and other countries. WE have no idea what chemicals are used or safety. They shut the irrigation off in the valley in California due to a tine minnow. All the groves and fields are drying up. A lot of vegetables and fruits are being lost which will have to be made up with foreign food. Just think - if someone get sick from salmonella, there will be no way to trace like with home grown veggies.
We are both in the Doughnut hole with PDP. I am looking in to going back to a previous Pharmacy in Canada. Anybody else have experience using Canada during the black out period??? My DW and I are both into the HOLE and it is going to cost me over $6000 for Drugs before we get into the Catostrophic stage for the rest of the year. They seem to have Generic drugs for Namenda, Aricept, Plavix, Lipitor, HyZar, etc. I have sent an email to our IM Dr. to see what she can shed on this subject. bill
Does any of the AD drugs fall into the $4 Rx that Wal-mart, Fred Meyer (Kroger/Smith's), I think Walgreen's and others are offering. Sure would be great if they are.
I love a good sense of humor, Shanteuse. Between your Brownie Bites and Jules' strawberry & rhubarb pie, I'm getting the urge to make the cherry pie I bought 2 cans of pie filling for a few months ago. Yumm!
oooh, Shanteuse...try this. Berries are in season...any and all kinds work. Fresh berries in a bowl...top with a quality Vanilla Ice Cream (Preferably Blue Belle Homemade Vanilla) that has about 3 + big blubs of Amaretto stirred into it. You will believe you have died and gone to heaven... I mix the ice cream and Amaretto together till it's soft like a whipped cream consistancy..and keep it in the freezer till ready to put on top of the berries. I love it on raspberries...but blueberries run a close second. Yummy.
I bow to your experience, Marsh. I love blueberries but a teensy little carton about 1-1/2 inches thick costs almost $4.00 (1/2 cup or so...) mmmmm..amaretto ice cream on blueberries.... WOW!
Go to CostCo. You can get a huge bag of frozen wild blueberries for nine bucks. We're talking pounds here, not ounces. I just pour out a nice bowl of them, let them thaw a few minutes (maybe 5 minutes), and then eat them like ice cream. They're great.
I am sure we have a Cosco in our part of Houston, but I haven't found one. We have Sams - I know. I'm going to look for the bags of frozen blueberries. Aren't they supposed to enhance one's memory? I NEED them for sure.
I use Canada all the time to keep out of the doughnut hole. I get Lipitor for the same price as our co-pay here and I see that I can get 100 Seroquel for less than our co-pay. It is easy and they mail it for $5.00. If they are good enough for the Canadians they are good enough for me.
Here's the one I use: Can America 888-254-3015 I have been very pleased with them. You can decide which country your drugs come from. My actually came from the USA and much cheaper
I would be happy to share the Canadian website. I don't know how to do a link so here goes. http://www.crossborderpharmacy.com/pl_home.html There telephone number is 1-888-626-0696. They have a short health questionaire to fill out and you need a prescription from your doctor. It takes a little time to get it set up, but after that it is very simple. I have been using them for about 6 years without any trouble. I have had more grief from my mail order pharmacy through Mc.