Medicare Part D

[Rerun]

I did search for this but it won't let you have just 1 character in a search like Medicare Part D. 

This is not for me but this older lady that sits by me at dialysis who doesn't have a computer.

She wants to know if you need Part D.  She has private insurance where a copay is $6 but says she has reached the maximum??  I don't have Part D and I do fine.

I looked in my Medicare Booklet and it talks about A and B but not D.

Do any of you have Medicare Part D and if so what does it do for you and how much are the premiums?

Thanks~

[dwcrawford]

Medicare Part D is the RX Drug Program.  Whether she should have it or not depends on how much she spends, etc.  Also does she have supplements, etc.   Anyway, it is the drug program.

[okarol]

I found this http://www.medicare.org/index.php/medicare-basics/1-latest/22-medicare-part-d-plan-comparisons
I know Jenna has Part D but not sure what the premium is.

[dwcrawford]

You do not pay Medicare.  You pay the issuing  company (some HMOs cover it) their specific charge for a specific plan.  You have to (if you want to save money) project your costs and consider the "donut hole"....The medicare 2010 will list all the options which vary from state to state.

[Rerun]

I know Medicare Advantage which is issued by private insurance companies is not available to Dialysis folks.

Thanks for the help people!       

[Zach]

I know Medicare Advantage which is issued by private insurance companies is not available to Dialysis folks.

Thanks for the help people!       

My Part D is run by a private insurance firm: Caremark.
I pay $26.10 a month in premiums and about $33.75 per month of Sensipar-30 mg x 2/day.
The full retail cost would be $685.60 per month.

Annual deductible is about $300.00

That all rises with the 2010 premium increase.

[Chris]

Like dw said, it's for Rx. The trick part is choosing the provider for Part D, which depends on your state. Each one listed for that state has a different coverage plan to choose from and diferent drug tier groups (charges for medications) that are based on plans, income, and insurance level. It can get confusing Each one will tell you who they cover to get prescriptions from or mail order pharmacies to use for 3 month supplies. Since I have Medicare A & B, I get Part D also and just pay the $96 a month fee, but when it comes to the drug program choosen, they also have a monthly charge to be involved on top of a co-pay for the medication. If income is low enough, then you are elgible for assistance and not pay or pay a reduced fee to be in the program. Since I qualify for Medicaid also due to Disabily Income only, I do not pay a monthly service fe. However, for each medication my cost ranges from free, $1.10, $3.20 (name brand), reduced cost medication, and full price because of the group I joined. If I want better coverage of prescriptions covered in a tier group, then I would pay an additional fee per month to have more drug coverage on top of th prescription charge. For example a prescription I pay $23. 97 now for (reduced cost), I would pay $1.10 for if I pid the additional monthly fee which varies depending on the insurance and income you have. It gets tricky, but you can call each provider before signing up to go over cost that may not be understod from the Medicare website.

[Malibu]

Do any of the Part D or supplemental insurances pay for medications in the 'donut hole'?  I don't guess Part D pays for any in the donut hole...so I guess the questions is do any of the supplemental insurances pay for medications in the donut hole? 

[glitter]

There is a program for financial need through Social Security that pays for drugs with no doughnut hole.

[dwcrawford]

There are part D programs that don't have a donut hole.  They are rather expensive.  There is also a part D (the one I have from United) that doesn't have co pays or donut hole for generic drugs (yet the cost counts toward the donut hole for the brand names).  That are policies that do most anything you need but cost more or less.  As I said initially, it is rather complicated.  I put all the number in a spreadsheet (along with projections) prior to making a decision.  Keep in mind however that I am half Jewish, half Scotish and half cheap.

[Malibu]

Ha Ha Ha -- Oh Dan...... I needed that laugh about now!

The dialysis clinic said we are going to need to get supplemental asap! after MM is approved for Medicare.  My problem is....I don't know which medications he will be taking yet....and I don't know about future medical procedures so I am uncertain how I would go about choosing a supplemental.  I think this is where the social worker at the clinic comes in?  Or perhaps an insurance person versed in all things kidney.

[dwcrawford]

Malibu, the state of Texas gives you 35 per month toward a supplemental policy but not the HMO ones.  It is not income dependent either.  All get it.  Check your state. 

Of course you can't project your drugs now.  After dialysis started this year my medications went way down.  I'd recommend you get a rather standard policy with decent co pays for the first year.  You can always change part D at the end of each year.  If your state gives the 35 that will pay almost all of a standard policy.

Make one phone call to any provider and you'll start getting mailings from all of them.  It is pretty competitive.  Good Luck.