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Thread: Unreasonable Medicare Part D drug costs

  1. #1

    Unreasonable Medicare Part D drug costs

    OMG, I just got off the phone with Medicare and I am in disbelief. I am currently on Medicaid via AHCCCS in Arizona. My insurance policy is also through Mercy Care. I pay no out of pocket for anything. No co-pays for Dr's, Rx's, hospital stays, DME or anything. My insurance changes by default to Medicare in October of 09. Although I am early with checking into what I should expect would happen, I was told that Medicare would cover 80% of my doctor visits and hospital stays and I would be forced to choose and Rx drug plan through Medicare. I called them this morning, shared with her all of my prescription drugs I was taking and I couldn't believe what she came back with. She said the best plan for me was through something called "Medicare Rx Rewards Standard." She indicated that I would have a monthly premium of $18.60 just to be part of the plan which I think is greedy. In addition she indicated that I would have a yearly deductible of $290.00. Lastly, she said that my monthly amount I would need to pay for my prescriptions would be $254.00. I just about fell to the floor. I do not have that kind of money. I am lost for words with disgust how these drug companies are so filled with greed and have no respect for us, the patients.

    Any feedback on this is greatly appreciated!

    Mike

  2. #2
    Look at Mercy Care Advantage.

    ETA: Call ABIL in the morning.
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  3. #3
    Senior Member DaleB's Avatar
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    If you don't have that kind of $ I would think you'd still be MediCAID eligible. Dually eligible, at least (both CARE and CAID). I'd ask about this, if I were you. If you have Walgreens pharmacies in your area, check into Wellcare Part D. My Wellcare Part D plan is $29.00/month premium, zero co-pay for my meds. I don't take much, just the usual suspects: Gabapentin, Baclofen, and Oxybutin. (I'm weaning off Oxybutin, though, in favor of Botox for bladder).
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  4. #4
    Senior Member smokey's Avatar
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    Michael, I'm on Medicare and purchased a BC/BS plan to cover the 20% gap Medicare does not pay. This particular plan includes prescription drug coverage and it costs me $5700/year or $110/week. There is a quarterly deductible for hospitalization ($1200), continuous prescription co-pay ($15 per prescription), annual deduction for medical care ($200) and there are plenty of things they don't cover at all and I pay out of pocket. Medicare coverage gets worse every year and more expensive. They will bury you with paperwork and coverage denials. If you can somehow stay on Medicaid...do it.

  5. #5
    JenJen,

    who is ABIL?? There is so much info and terminology that I don't, at this early stage have a clue.

    Mike

  6. #6
    If you have any drug from pfizer you can contact them get a application and see where it goes. I am going to be lucky enough for this yr it looks like to get my Lyrica free from them.

  7. #7
    http://ssl4.benefitscheckup.org/befo...2&subset_id=49

    You can check this link for some help. Also go to www.medicare.gov and you can be sure she was looking at the right plan. Look for info about part D plans and you can enter all of your drugs to see what they came up with. I believe you can apply for the QMB or extra help there also.
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  8. #8
    That's terrible. If you are on Medicaid it should pay for your premium . But come to think of it, my sister and her husband was having to pay all of their monthly insurance plan so I told them to call the Social Security office and explain to them what was happening and the SS office got them on SSI which gave them Medicaid. So that pay their premiums.
    Their co pay for their meds are like 1 to 3:00$ each.
    So start with the Social Security office and explain to them that you can't afford all of this.
    They will know what to do.
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  9. #9
    Senior Member Josh A's Avatar
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    michael,

    i had the same scare when medicare took over the numbers read to me were outrageous. this is what happened w/ me being on medicaid as well. medicaid picked up the difference. i live in illinois n all states are different. talk to your contact or case worker w/ arizona medicaid. also check into a plan called ''prescription solutions'' w/ medicare drops the copays of meds significantly [1.05, 2.10, 4.0]. i didn't even need a part d w/ this combo......hope this helps.
    Many Blessings,
    Josh


    So we can say with confidence, The Lord is my helper, so I will have no fear. What can mere people do to me?" Hebrew13:6

  10. #10
    Hi,

    Sorry, I hope you find a better way.

    The above suggestions are good ones. Folks on this site are very resourceful, so check out their options. If you have a social worker at all, you could contact them to help with this.

    AAD

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