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Government programs

(1-800-MEDICARE) Once you have read the information on their web site and the booklet you receive in the mail, call them to make sure you are signing up for the correct plan.   This is very confusing to most people.   I will be adding more info as I get it. http://www.medicare.gov/default.asp

Some key points to consider:
  • "If you are new to Medicare, you should consider your options for Medicare prescription drug coverage. You may sign up when you first become eligible for Medicare. If you do not sign up when you are first eligible, you may pay a penalty. If you currently have Medicare prescription drug coverage, you should review your coverage each year in the Fall. You might want to switch Medicare prescription drug plans if another plan better meets your needs. Generally, you can only switch plans from November 15 - December 31 of each year. In certain situations, you may be able to change plans at other times". For example:
    * if you move out of the service area of the plan you are in,
    * if you have both Medicare and Medicaid,
    * if you live in, or move into or out of an institution (like a nursing home),
    * if you have creditable prescription drug coverage and that coverage ends.
To start, check out the different programs which are available in your state.
http://www.medicare.gov/medicarereform/local-plans-2007.asp
  • If you already have prescription drug coverage through your Medicare private health plan or other insurance, check with your current plan to see if this coverage is changing.   Unless you have other drug coverage that is, on average, at least as good as standard Medicare prescription drug coverage, it’s important for you to join a Medicare prescription drug plan when you are first eligible.   For most people, joining when you are first eligible means you will pay a lower monthly premium than if you wait to join until later.
  • If you join, your costs will vary depending on which plan you choose.   In general, you pay a monthly premium (generally around $37 in 2006) and a yearly deductible (up to the first $250 in 2006).   You will also pay a share of your prescription drug costs, and your plan pays a share.  Medicare helps pay for drugs up to a limit ($2,400 in total) and once your total out-of-pocket costs for drugs reach $3,800, you pay 5% of the costs and Medicare pays 95% of the costs for the rest of the year.
  • If you get help from Medicaid in paying your Medicare premiums, receive Supplemental Security Income, or get full Medicaid benefits, you don't need to apply for extra help.   Medicare already knows you qualify for this help.   You will get a letter from Medicare in May or June telling you Medicare will help pay the cost of your Medicare prescription drugs.

I must now go unto Part "D" myself, so I have done some research into how to investigate which provider is best for you.

  • The option in which you do a "personallized search" was not performed because I did not wish to supply my SS number. I selected the "Learn More About Plans in Your Area" on the right, entered my state, and clicked "view plans".
  • The next page will be a page in which you'll be able to select the county that you reside in. This is necessary to find plans that service your area (and pharmacies).  
  • The next page will list the drug plans available in your area.
  • Now we are going to get into the "decision" process. Each plan has a few elements that are going to be the same. One is a premium which is paid every month and the "hole" in the plan. The hole is the dollar amount that you will have to pay for the drugs once you pass the $2,400 limit. This limit does not include the monthly premiums.
  • Premium cost, annual deductable, and medicine co-pay are the factors that must be taken into consideration. A low monthly premium does NOT mean you will pay less in the long run.
  • As an example: Provider "A" has a monthly premium of $20, an annual deductable of $0, BUT their co-pay for medicine is $57 for "prefered" drugs. Provider "B" has a $20 monthly premium, an annual co-pay of $250, BUT their co-pay for prefered medicine is only $30. In the long run, paying the annual deductable of Provider "B" maybe the best situation.
  • Determine the price range you are willing to pay (monthly premium) and click on one of the providers. This page will show the co-pay amounts for the different tiers of drugs, such as, the cost of their generics, prefered brands, non-prefered brands, etc.
  • Now click the button: "View plan formulary". You'll then be able to list the drugs you need. The information you receive will show if the provider carries the drug and what tier the drug falls under. Then check the plan details page for the co-pay amount for that drug.

Medicare Rights Center - Medicare Rights Center (MRC) is the largest independent source of health care information and assistance in the United States for people with Medicare. Founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care.
http://www.medicarerights.org/aboutmrcframeset.html

State pharmaceutical program information - As of 2006 at least 41 states have established or authorized some type of program to provide pharmaceutical coverage or assistance, primarily to low-income elderly or persons with disabilities who do not qualify for Medicaid. Most programs utilize state funds to subsidize a portion of the costs, usually for a defined population that meets enrollment criteria, but an increasing number use discounts or bulk purchasing approaches. Information on your state program can be found herehttp://www.ncsl.org/programs/health/drugaid.htm

Don't get scammed on a Medicare prescription drug plan.  It appears that con-artists are taking advantage of those in need. The AARP has a good article on the subject of prescription drug scams.
http://www.aarp.org/bulletin/consumer/medicare_scams.html

Problems Plague Rollout of New Medicare Drug Plan  - This article by Julie Rovner outlines some of the problems that have plagued the new plan. If you are on Medicare please read this article.
http://www.npr.org/templates/story/story.php?storyId=5148817



*Free or reduced prescription medications*

Express Scripts Specialty Distribution Services developed Rx Outreach to provide a safe, affordable, and easy way for people of all ages to get medicines they need. The program offers prescription medicines to uninsured individuals and families, as well as those who have limited prescription drug coverage. 
http://www.rxoutreach.com/Default.aspx?s=12

This site will help you contact participating drug manufacturers that can help supply you with free or reduced medications.   There is a brief questionnaire to fill out.   NO personal questions are asked. If you don't have internet access you can call for directory of participating pharmaceutical companies at: 800-762-4636   https://www.pparx.org/Intro.php

Here is a contact list of pharmaceutical companies that have programs to assist the elderly and the disabled with prescription drugs. These companies offer discount cards and programs to fund your prescriptions . Call and ask for information but make sure you understand how participating in one of these programs will affect other prescription assistance programs you are enrolled in.

  • GlaxoSmithKline's The Orange Card: (888) 672-6436
  • Eli Lilly's LillyAnswers Card: (877) 795-4559
  • Novartis' The CareCard: (866) 974-2273
  • Pfizer's The Share Card: (800) 459-4156
  • Abbott Laboratories
    AstraZeneca
    Aventis Pharmaceuticals
    Bristol-Myers Squibb Company
    GlaxoSmithKline
    Janssen
    Johnson and Johnson
    Ortho-McNeil's TogetherRx Card:

    (800) 865-7211 (to contact the companies listed above)
  • Xubex Pharmaceutical Services  "Xubex® offers assistance to qualified individuals for generic medications through its innovative program. A licensed pharmacist in the United States fills all prescriptions with the same medications available from your local pharmacy. There is no cost to join and no monthly fees."
    Xubex Pharmaceutical Services


The cost of medicine as we all know continues to skyrocket. I'm heavily burdened by this increase as you must be also. I'm going to continue to investigate the options available to all of us to lessen the cost. Please check back to find any new information I may have indexed. View this page or my quick links page for additional info I receive.










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