Discussion in 'Fibromyalgia Main Forum' started by suzetal, Sep 28, 2006.

  1. suzetal

    suzetal New Member

    What is wrong with this picture.We beg for a script plan they give us one,that wont cover some of the meds. we need.

    Also depending on which plan you choose depends on when you have reached your GAP and than need to pay for the rest of the year.

    What about the people who can not afford this. Here we go again the poor will stop taking there medication cause they do not have the money to pay the high price of the meds.

    Just makes me MAD.And yes I have written my congressmen more than once.

    Sue.................My new post is towards the end Im UPSET............And Im sure you are also.
    [This Message was Edited on 10/07/2006]
    [This Message was Edited on 10/07/2006]
  2. 69mach1

    69mach1 New Member


    but it took some spending down etc. to make it work..

    can't have more than 3k in the bank..certain criteria's, and after my son turns 18 ir grduates..not sure which i can't have over 2k in the bank.

    i was at my local ssa office talking to woman she said she had a friend that kept money in a safe deposit box and the state took it out....50k is what she said..

  3. optimistic1

    optimistic1 New Member

    I am in the "Gap" already for this year so I have to pay full price for my meds until I reach some phenomenal amount and then if I need any others before the end of the year they will cost very little.

    What the Ins. companies didn't stress is that the amount of $$$ paid out each year is the TOTAL of what we and the Ins. Co. pay. This can add up very quickly if we take many meds. Any way you look at it, these plans sound wonderful but they really aren't.

    Sorry for being such a downer,

  4. Lana56

    Lana56 New Member

    They give you coverage and then it always has a catch.I won't be able to buy the meds when I reach the limit they pay for the year. lana56
  5. Cromwell

    Cromwell New Member

    WARNING. Anyone getting part D and only making the $5 extra cover payment, listen up. You have to re-apply now for this to stay in effect in 2007.

    Notices are being sent out. Fill out the paperwork NOW and get it back off, as you know they have to receive it early.

    Also, at any time any of the plans can suddenly stop providing a certain medication.

    Unless you were enrolled in Medicaid before, you will not automatically get the extra cover as they only applied it over to people they were switching from medicaid. People on PAP's were not switched to extra cover(where there is no cap either). Make absolutely sure you are getting extra cover if you are low income. Took me six weeks and many phone calls to sort this out last year for Dan snr.

    Love Anne
  6. Marta608

    Marta608 Member

    I went through that stress last year when I had to choose which plan to have. I was furious that it was so difficult! I'm not a stupid person but I felt as if I was by the time I was through.

    I'm not completely unhappy with the plan I selected but I still quit taking Crestor because it was $55 a month. Gimme a break!

    We need good health care, period. No one should have to choose between food and their meds. And no one should be made to feel stupid trying to figure out what to do. But we take it!

  7. Marta608

    Marta608 Member

    Some people only pay $5??

  8. suzetal

    suzetal New Member

    Now I'm on my own for my meds.I have 8 different scripts.

    Cymbalta alone is 598.00 a month.After I pay my Medicare my SSD check is 614.00 a month.

    Now tell me does this make any sense.

    They told me yesterday if I had chosen the plan with BCBS that was 156.00 a month I would be covered for all my generics with no cap.....................NOW why did they not tell me this when I was talking with them about a plan to give me extra heath coverage plus my script plan in the beginning.

    I'm no dummy and would have chosen the one that was 156.00 instead of the 79.00 that will not cover my meds anymore at all from now till January one 2007.

    So my total drug cost is 1038.80 and my pay is 614.00.

    Well before I started the meds I'm on now I was bed ridden so I guess Ill be back in bed till January thats when I will be covered again.

    THEY NEED TO DO SOMETHING>>>>>>>>>>>>No wonder so many take no meds. and some even live in the streets.

    Its nuts.
    Sorry Had to vent.

  9. suzetal

    suzetal New Member

    I received every month a letter letting me know what they spent on me and what I had left.

    Sorry I do not know about Medicaid .I do know Medicare only covers for medical no meds.

  10. 69mach1

    69mach1 New Member

    i get 890.00 a month and 462.00 for my son for my total benefit of ssdi..plus i get some child support...

    i qualify for the state to pay my medicare and the other plan of kaiser..which i am not satisfied w. plus i get medi-cal which will cover whatever medicare will not cover...i do not get chared the 88.00 month for the plan b nor do i pay for the plan d...

    so check t see if you state has some help for you....alot of people don't realize it..

  11. suzetal

    suzetal New Member

    Thank you so much ....But I am married and my husband makes to much LOL.......

    His pension is 2500.00 a month OK now car payment 450.00 heat 300.00 electricity 175.00 .Miss Ins for him car 200.00 .Plus he has credit card bills total of 75,000.00 from putting his ex through collage using CC..

    But the state says we make toooooo much money for any help.LOL what a joke .They do not count the CC dept if they did they would be no problem.

  12. atiledsner

    atiledsner New Member

    After 2 years I got disability.A whoping 297.00 a month, and i have to pay 88.40 for the medicare insurance out of this.

    my meds cost about 350.00 a month. I take zoloft,zertec.atenenol,prevesid.

    Am I understanding that with the BCBS at 156.oo a month that all meds would be covered?Even if I have to go to the doctor for other things would these meds be coverd too?

  13. atiledsner

    atiledsner New Member

  14. cjcookie

    cjcookie New Member

    qualify for extra help. I finally got mine approved. I pay $15.00 per month for my meds - no premium, no deductible. $15.00 is all I pay.
  15. Mikie

    Mikie Moderator

    That Part D sucks is because it was written by people who are supported by political donations from the insurance and pharmaceutical companies. We need to let our elected officials know how we feel about how we have been sold down the river on this plan.

    It would have been much better to have negotiated with the pharmaceutical companies for discounts for people on Medicare.

    I just pay cash and buy 90 day supplies for my meds at Costco. It's cheaper than using the crappy Pard D my HMO offers which restricts one to only a 30 day supply with high co-pays.

    Love, Mikie
  16. Cromwell

    Cromwell New Member

    To qualify for the $5 per scrip and no monthly fees your income has to fall below a certain level. If you qualified for Medicaid before then you should be getting the $5 scrips and no fee.

    We earn about $23,000 per year for family of three ( and BTW Wakemeup you do NOT count anything you get for your son-just what you get for yourself).

    We did not apply for Medicaid as they would not allow us to have more than $1,000 in our bank account(which we needed to have at certain times of the month for bills-it did not stay in there!!!)so we used PAP and got free scrips before and the Cap for them was $34,600 per year for family of three.

    I think social security automatically sent out what is called "extra Cover" to anyone getting Medicaid before. Also there is no cut off you get it for a whole year no matter what the real charges are.

    I hope this helps. I would say call them now and tell them about you wanting to sign up and how you were never informed before. You could get something back as it is illegal not to let you have extra help if you qualify.

    Love Anne
  17. suzetal

    suzetal New Member

    Yes if you buy the plan from BCBS for 156.00 a month for Bluechip for Medicare plus.That includes your part D as long as your scripts are generic you are covered and only pay your co-pay.

    So when January comes around I'm switching to that one instead of the 79.00 one that has a cap.I have to pay something like 3800.00 out of pocket till January.

    You must remember that it starts over every year once you meet your cap its up to you to pay all your meds.( Full Price ) thats nuts my cymbalta alone is 598.00.

    My list at full price.

    Vicoden 9.60 no big deal.
    Ambien 105.81 yes big deal will not take.
    Lovastatin no big deal will get 17.86
    Carpisoprodol 11.41 no biggie
    Evista 87.43 will not take till January
    oxycodone 125.60 will no longer take till January
    And nueontrin 65.69 will no longer take till January.

    Just so you will all know the combo of cymbalta and nueontrin is what got me out of bed.I am not pain free but at least I am out of bed.

    So if I pay for my drugs I can not pay for my Medicare.So what happens if I need surgery ( Witch I do on my Back) also have some heart test next week. And maybe a hospital stay.

    So I have decided to skip the meds wind up back to being bedridden till after the holidays.

    This post that I have just written I have sent to my congressmen Governor and Mayor And also Bush. I will send once a week till I die....or they come up with a REAL PLAN to help the disabled elderly and children in this country.


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