Medicare

[Dpjinx]

Met with our advisor yesterday. My husband is retiring this summer and we will both change to Medicare with a supplement My advisor did some checking and told me Medicare would not cover my meds cuz they're so expensive. Has anyone faced this? Any advice would be appreciated. Hope all are having a great day I'm off for a road trip with my friend today 😁😁😁😁😁. Have a good one. Dpjinx

[Jesmcd2 CommunityAmbassador]

Hi Dpjinx lm so sorry about your issues with your insurance. I have never run into this personally, but pretty sure MSAA and NMSA have, and would be happy to answer you questions☺

mymsaa.org

[phone] ext. 154

Or

nationalmssociety.org

Jes🌠

[erash in reply to Jesmcd2]

I'm doing some volunteer work at our local NMSS center, and spent last Monday afternoon troubleshooting things like this for people. Call MSAA or NMSS and hopefully they can assist u to find the resources.

[RobertCalifornia]

Talk to the company that makes your MS medicine. They maybe able to find you help. I will go on Medicare in October. I use Copaxone and they said to call them just before going on Medicare. I currently have a zero copay with them which goes away when I go on Medicare. They said to try the NMSS to see if they had any ideas.

[CalfeeChick CommunityAmbassador]

HI, agree with other posts. Check with drug manufacturer, they sometime will provide at reduced or no cost. So far I'm only on Gabapentin which is a very low co-pay for me. I take Celebrex for arthritis and Pfizer has been awesome helping with the cost of Celebrex. As far as insurance are concerned, we get Medicare supplemental insurance through AARP and I am very happy with them, we have UHC for healthcare, Humana for RX and VSP eyecare. I did hours of research prior to deciding on these and it was worth the time. What is great is I was able to select different amount of coverage for us as husband as VA coverage for allot of his care.

[cheshcat in reply to CalfeeChick]

My mom also has her supplemental insurance through AARP. We picked the highest level of coverage for her because of her auto immune diesease. She has no co pays and gets no bills, even with hospital stays. She does have a medication co-pay but it's low. With Medicare and AARP she pays right around $300ish a month. They also pay half her gym membership.

[CalfeeChick CommunityAmbassador in reply to cheshcat]

We also are entitled to gym membership, but only at select gyms. We pay out of our pocket for our gym and get a big discount by paying annually. It works for us.

[Dpjinx in reply to CalfeeChick]

I was told that if I'm on Medicare I can't participate in drug assistance ?????

[CalfeeChick CommunityAmbassador in reply to Dpjinx]

It is my understanding that if you have Medicare "D" coverage, then you would not qualify for drug company assistance. I don't have the D coverage because I started Medicare at age 50 and didn't get the D coverage at that time because I still had rx coverage from prior employer.. I didn't find out I should of taken out the D coverage regardless until I was 65, and by then it was too expensive for me.. I sure hope you find some help. Best to you.

[Eleyne92]

Dpjinx , have you gotten your problem resolved? Medicare parts A and B don't cover much ( any?) drugs. That's what Part D coverage is for. Did your advisor discuss that with you?

When I went on Medicare, my agent wasn't able to help me with the Part D stuff, but it's all online. There are many companies for Part D coverage, and almost all of them cover all of the MS drugs. Still not cheap, but it helps lot. You can find more information on MyMedicare.gov .

[Dpjinx in reply to Eleyne92]

Not resolved yet. I'll be doing further research today Will let all know what I find out

[itasara in reply to Eleyne92]

That's why we chose advantage plan with drug coverage. Once you no longer have other coverage it is imperative to get medicare drug coverage otherwise there's a penalty from the date you should have started it and that penalty never goes a way. Some advisor should have told you so. I may be wrong bu you can probably still get part D but you'll pat a penalty every year dating back. 😂😟

[Lakiee]

Lakiee....I have Medicare parts A & B....Then I applied for Medicade D which pays for all my Meds.

[itasara in reply to Lakiee]

Maybe I do need to look into Medicare rather than an advantage medicare plan. I’d like the advantage plan because except for one year we’ve had zero cost to pay for it, not counting Medicare B which comes automatically out of Social Security. The advantage plan includes part D. However I don’t get free medication. I pay about $6000 a year for Copaxone. Is it because some of you have a low income that you get free medication on your Medicare plan? My plan and my husband who is also on an advantage plan Pretty much pays for medications and tests and doctors visits except for the co-pay. Co-pay is anywhere from $15-$50 and medication as I said if it’s not generic does cost money.It is big business the way I see it.

[Lakiee]

Lakiee-After I was approved for both parts A & B.... then I was told I was eligible for Medicade part D for all my Meds.

I think some one told me @ the Medicare office that I need to go apply more Medicade part D. I was 65 and approved.

So maybe age, has something to do with it, and with this MS and health problems I was approved.

You may want to check into it, I don't know your personal circumstances and age....

Good luck as they don't make things easy!

Hugsss !

Dee

[Dpjinx in reply to Lakiee]

I need to go to SSN office for something else and I'll be asking about it. I'm 66 & have RRMS. Have had it 3 years. Have tried 2 meds with no success 😕 Something my body doesn't like & I react to it 😬

[itasara]

I've been on medicare three years since my husband went part time. It was a change from having the wonderful insurance he had from work. We choose an advantage plan which includes pharmacy. My MS meds are covered but copay is still hefty.I had one major difficulty when Copaxone came out with 3x/wk and ins. didn't want to pay for it. I fought back as did others and three mos later it was included. Choosing a policy that has your medication in its formulary is important. I still pay a lot out of pocket. The first of the year I have to pay the deductible upfront for the first medication I order. Even if it is not an expensive med I still have to pay the deductible first- no matter what the drug is. I really object to this policy.The retail prices are high ( probably artificially) so unless I pay the deductible upfront I don't get the lower price of the drug. It is a lose- lose proposition.. And until you spend a certain amount and get into the donut hole you pay more. Then it is a less and supposedly after spending enough you get out of the "hole" and most of the cost is paid for til end of year. That doesn't seem to have happened with me.. The drug companies can help out but one has to qualify I am pretty sure.