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info on med help for medicare part D
Hello I'm hep C positive have liver cancer. Just finished olisio and sovaldi. Cleared while taking med and 6 weeks after and now its back. Anyway being on SS disability I now have to go to medicare part D for meds loosing the $7000 out of pocket max I paid on my current insurance. So now I find out that medicare part D has no out of pocket max and you pay $4500 and the 5% of monthly cost of meds. Well at over $30,000 a month this is way more than I can afford any suggestions?
I am not near as experienced with these medicare plans, but I am treating with Solvaldi and Olysio and I pay $3.60 for both for a 28 day script. My regular meds are always just 1.20 for each. Now I am paying nothing for my blood pressure after the hep c meds. The company was great helping me with getting the appeal in a week for the Olysio.Just needed doc to send more info to them. This stuff is all new to me, I have just got disability a few years ago. Good Luck to you and I hope u get the help you need soon.
It looks like there going to send me in for another tabe. Cemoembilization. My F plan covers the procedure but does it cover meds? Cemo, pain meds and antibiotics.
Thanks but the treatment drugs were talking about cost a $1000 each just over $28000.00 a month witch puts you into catastrophic and the donut hole.Witch is complicated and something I'm just learning about.
I have a great prescription supplement with my medicare disability. It is Humana through Walmart. You have to get your prescriptions at Walmart. Do you live close to a Walmart? Most everyone does. It comes out of my check and it has prescriptions for 2.00 then nothing after you meet the deductable.I go my tx meds for a small copay. I am very satisfied with it.
Thank you for the tips. Deb yes I'm seeing a therapist and doing much better. I've learned that you need patients and to try and live to the best of my ability under these circumstances lonely Ness is a big problem I had to move from the Bay area to Fresno where I don't know anyone except my support person and only see her a few times a month. As for the hospital I'm going to its CPMC San Francisco. I have Medicare A and B United Health Care part F and AARP medicare RX saver plus PDP part D. Its great to talk to all of you there are no support groups here in Fresno. Thanks, Michael
Hi wizard.....I'm in Cali, Ventura County. I'm not trying to be nosey but do you have any sort of depression or behavior health issues that relate to the HCV, etc then I suggest you get state aid. I have worked my whole life and as this disease progressed I became increasingly depressed and I'm not the person I used to be. I was so embarrassed by having to do this because I have always prided myself on being self sufficient. When I was diagnosed with HCV 2 yrs ago I have not had to pay for my medication. I have Medicare/Medi-Cal (medi-medi). Medi care pays 80% as you know and the other 20% is paid by medi-cal.". Just a thought
Best of Luck to You, Keep the Faith.....
Deb
Best of Luck to You, Keep the Faith.....
Deb
Since you are in California and may have access to these same plans although there may be differences because of where in cali we are.....
I have Anthem pre 65 Plan F Medicare Supplemental Plan and this year I changed my Plan D coverage to AARP MedicareRX Plans through United Heathcare. They were $10,000 cheaper than my former insurance plan and covered all of my post transplant meds which the other plan wasn't going to do this year (2014). We can change our Part D every year at open enrollment at the end of the year.
Can't remember when I last saw a hospital bill from UCSF.
Hector
I have Anthem pre 65 Plan F Medicare Supplemental Plan and this year I changed my Plan D coverage to AARP MedicareRX Plans through United Heathcare. They were $10,000 cheaper than my former insurance plan and covered all of my post transplant meds which the other plan wasn't going to do this year (2014). We can change our Part D every year at open enrollment at the end of the year.
Can't remember when I last saw a hospital bill from UCSF.
Hector
Can-do is right you are much better off with Original Medicare A, B, a supplemental Plan F (to cover all deductibles, co-pays, etc.) and a Part D drug coverage plan.
While drugs are expensive and you will take meds for the rest of your life. Just remember that the HCC treatments and everything around liver cancer is very expensive and of course transplant surgery and hospital stay is many hundreds of thousands of dollars so you want the maximum coverage possible.
I waited 4 years for my transplant and had HCC for 2 1/2 years during which time I had 8 different HCC treatments and currently treating with Sovaldi, Olysio and Ribavirin. Started Friday. So my medical costs are way over a $$million and still counting. Luckily while waiting I made very sure I had the best health care coverage I could get.
It is all doable but it does take work.
If you will be on SSDI and Medicare I highly recommend Allsup Medicare Advisor Plan Selection Service.
"We make it easy to evaluate your Medicare plan options. Allsup Medicare Advisor does the work for you and provides the most relevant and accurate information based on your specific requirements and preferences. You’ll receive one-on-one personal assistance from a Medicare specialist and also have secure access to online web features at your convenience.
Allsup Medicare Advisor is a trusted resource that offers:
• Personal assistance from a Medicare specialist who will research the Medicare options that best fit your specific needs.
• Education and knowledge to help you understand the complex issues of Medicare such as the “donut hole.”
• Information on the plans most likely to provide the coverage you need.
• Comparative analysis of coverage options available in your area.
• An easy-to-understand customized report that provides the details needed to evaluate your coverage options and make an informed decision.
• Enrollment assistance in most Medicare plans of your choice.
• Alerts about upcoming enrollment periods and the opportunity to re-examine your coverage options annually (available at an additional cost).
They help me choose my Part D Plan each year (plan coverage often changes each year) that covers all of my meds at the least cost to myself. My monthly payments. You should Chose a plan that covers all of your current meds as well of your transplant center's post transplant meds. Immunosuppressants meds can cost $1000-2000 per month. Valcyte to prevent CMV infection $3,000 per month retail so you want good health insurance coverage.
Allsup also helped me get my SSDI approval within a few months.
They have saved me at minimum tens of thousands of dollars plus a ton of stress which no one needs when they are waiting for transplant.
I see you are in Fresno. We here at UCSF liver transplant center see many folks from Fresno and the surrounding area. Today I was visiting a woman from Fresno who is waiting for her second transplant as her first liver transplant is failing after about 10 years. Hopefully see will be getting her transplant in the next few weeks and will be on her way back to health again.
If you need any more info let me know.
Hang in there.
Hector
San Francisco, CA
UCSF liver transplant # 2,999, November 16, 2013
While drugs are expensive and you will take meds for the rest of your life. Just remember that the HCC treatments and everything around liver cancer is very expensive and of course transplant surgery and hospital stay is many hundreds of thousands of dollars so you want the maximum coverage possible.
I waited 4 years for my transplant and had HCC for 2 1/2 years during which time I had 8 different HCC treatments and currently treating with Sovaldi, Olysio and Ribavirin. Started Friday. So my medical costs are way over a $$million and still counting. Luckily while waiting I made very sure I had the best health care coverage I could get.
It is all doable but it does take work.
If you will be on SSDI and Medicare I highly recommend Allsup Medicare Advisor Plan Selection Service.
"We make it easy to evaluate your Medicare plan options. Allsup Medicare Advisor does the work for you and provides the most relevant and accurate information based on your specific requirements and preferences. You’ll receive one-on-one personal assistance from a Medicare specialist and also have secure access to online web features at your convenience.
Allsup Medicare Advisor is a trusted resource that offers:
• Personal assistance from a Medicare specialist who will research the Medicare options that best fit your specific needs.
• Education and knowledge to help you understand the complex issues of Medicare such as the “donut hole.”
• Information on the plans most likely to provide the coverage you need.
• Comparative analysis of coverage options available in your area.
• An easy-to-understand customized report that provides the details needed to evaluate your coverage options and make an informed decision.
• Enrollment assistance in most Medicare plans of your choice.
• Alerts about upcoming enrollment periods and the opportunity to re-examine your coverage options annually (available at an additional cost).
They help me choose my Part D Plan each year (plan coverage often changes each year) that covers all of my meds at the least cost to myself. My monthly payments. You should Chose a plan that covers all of your current meds as well of your transplant center's post transplant meds. Immunosuppressants meds can cost $1000-2000 per month. Valcyte to prevent CMV infection $3,000 per month retail so you want good health insurance coverage.
Allsup also helped me get my SSDI approval within a few months.
They have saved me at minimum tens of thousands of dollars plus a ton of stress which no one needs when they are waiting for transplant.
I see you are in Fresno. We here at UCSF liver transplant center see many folks from Fresno and the surrounding area. Today I was visiting a woman from Fresno who is waiting for her second transplant as her first liver transplant is failing after about 10 years. Hopefully see will be getting her transplant in the next few weeks and will be on her way back to health again.
If you need any more info let me know.
Hang in there.
Hector
San Francisco, CA
UCSF liver transplant # 2,999, November 16, 2013
It seems you know more about the part D donut hole more than medicare. I'm already out of pocket $7000 max paid for my current insurance but have to give that up October 1st to continue getting disability. So it looks like I'll need to come up with the $4500 some how.So after donut hole is used what about the other drugs I may need?
Also would like to welcome you to the forum and to add there are several programs out there to help offset drug costs. Sorry to hear you are dealing with HCC. We have a member here that goes by Hector who has dealt with HCC and beat it. Had a Liver TP and is now about to start treatment for his Hep C. Any questions you might have there he will have the answer.
Wishing you the best.
Wishing you the best.
No that's not the case. Really you will now be better off.
2014 Medicare Part D donut hole. Once beneficiaries has paid for their annual deductible and they and their plans have reached the initial coverage limit by paying $2,850 on covered drugs, they will then enter the 2014 Medicare Part D donut hole. Within this coverage gap, beneficiaries are responsible for the full cost of their prescription drug coverage. In 2014, beneficiaries will continue to receive a 52.5% discount on covered brand-name drugs and will be responsible for paying a maximum of a 72% copayment for generic drugs. Please note that beneficiaries who get Extra Help paying for Part D costs will not enter the Part D donut hole.
After beneficiaries have spent a total of $4,550 on their prescription drugs in the donut hole, they will then enter the catastrophic coverage period, during which they are responsible for little to none of the costs of their medications.
http://www.planprescriber.com/medicare-part-d/2014-plans/
2014 Medicare Part D donut hole. Once beneficiaries has paid for their annual deductible and they and their plans have reached the initial coverage limit by paying $2,850 on covered drugs, they will then enter the 2014 Medicare Part D donut hole. Within this coverage gap, beneficiaries are responsible for the full cost of their prescription drug coverage. In 2014, beneficiaries will continue to receive a 52.5% discount on covered brand-name drugs and will be responsible for paying a maximum of a 72% copayment for generic drugs. Please note that beneficiaries who get Extra Help paying for Part D costs will not enter the Part D donut hole.
After beneficiaries have spent a total of $4,550 on their prescription drugs in the donut hole, they will then enter the catastrophic coverage period, during which they are responsible for little to none of the costs of their medications.
http://www.planprescriber.com/medicare-part-d/2014-plans/
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