Due to $198.40 that takes my mom over the limit for social security's low income subsidy, she now has to spend thousands of dollars for her drugs. Prior to this whole Med Pt. D thing, I was able to get her drugs from the pharmecutical companies or through a state run program at little or no cost -- all of which have changed their policies since the inception of Med Pt. D. I asked the Med Pt. D rep if they took into consideration a person's cost of living when they determined whether or not one was eligible for the subsidy. I was told no. I don't get it. There are months where approx. 50% of her monthly income goes toward healthcare. That doesn't leave a whole lot left for living given her financial situation. I help her out as well. What irks me is that she's in what Med Pt. D and the state have referred to as a doughnut. How the heck do I fill the hole in the doughnut? I've tried calling Medicaid, but all I get is a busy signal. I question whether or not she'll qualify for any assistance there given the runaround she's getting w/Med Pt. D. Working through this maze appears to be a real talent that I've yet to comprehend. If anyone has any suggestions about maneuvering through the waters of Med Pt. D, or any other social programs, I'd love to hear about it. Thanks. I'm off to buy a lottery ticket.

Didier, my 1st reaction is to call your congressman[woman] and ask for help: 2nd.Start plowing into the Medicare D Supplimental ins. programs and their formularies to see if you can get her drugs cheaper that way. 3rd. Can you get rid of the $198.40 that takes her over the limit?

Hi Jam,

Thanks for the feedback. My first thought was getting rid of that 198.40. I just don't know how. After my dad's death, my mom started receiving a portion of his SS benefits. The extra money was helpful, but that's what brought her over the threshold so to speak. After speaking w/the Dept. of Human Services today, they suggested I apply for assistance. Hopefully that will work out. I didn't even think about a Part D Supplement, great idea. I'll look into that. Thanks again!

Dedier, I hooked up to AARP's Medicare Rx Plan when I turned 65 in Jan.of this year. It is saving me money [but that will depend on what drugs your Mom is taking.] If it will save you time, you can send me her list of prescriptions and I will look them up in the AARP formulary and tell you what they will cost her. Then you can plug in the premium and see if it is worth it. [and you will have aarp to compare to another ins. co. Amy

Mom has AARP too. They cover the drug, albeit a limited quantity - which is a whole other issue I'm working on, but it's a really, really expensive med. As a result, she can get it for a reduced price once. Then she has to pay hundreds of dollars for it until she spends something like $3600 out of pocket until she is able to get it less expensive again. It's strange. This friggin disease. First it damn near kills her, now the after effects linger and the combative drugs can be a financial strangler when purchased on an outpatient basis. Fortunately there may be some help through Medicaid. I've got the forms ready to go. Thanks for your help, Amy. I really appreciate it. I hope you're doing well.
Best wishes,
D

After reading your last post, I would strongly recommend that you send your experience with all of this to your Senator and Congressman and to your State Insurance Commission. I would also send a copy to AARP. They keep sending me questionaires on the new Drug plan, so tell them what is happening with your Mom. Takes alot of time and energy-I know, but if you get a victory, it's worth it. I just scored a major one with John's new Ins Co. by getting them to pay for his feeding tube nutrition. It took a month of phone calls and not backing down. Good Luck. Amy

In the state of Illinois, we have a program entitled "Illinois Cares RX". Eligible low income seniors can register to get help with their drug costs and their Medicare Part D premiums. Go to the Illinois state website http://www.illinoiscaresrx.com for the eligibility requirements and to enroll. In my Mom's case, Illinois pays her Part D premiums, she has no deductible and she pays $5 for name brand and $2 for generic drugs (30 day supply). The state covers costs up to $1750 per year. Then there is a cost sharing plan which, along with Part D keeps her costs low. She is on 10 prescription drugs with a monthly retail price of more than $500. Her monthly costs, at the end of the benefit year when cost sharing kicks in are around $100.

Diagnosed 7/03 with Stage 3 Tonsil SCC/2 positive nodes. 7 wks radiation -- 2 rounds chemo (cisplatin) -- 5 months feeding tube. Still cancer free.

Thanks Amy, those are good ideas. Catwoman, I've got my mom signed up with illinoiscaresrx, and although they pay the part D premium, her deductible a couple of weeks back for one of her meds was over $200. I told the pharmacist I thought she was suppose to get the drug for no more than $5, but evidently because of the quantity that she is taking, she is responsible for a really hefty deductible. I'm working any angle I'm able to in order to try to get her some assistance. Its been a test of patience and persistence in order to get accurate information from either agency. When the out of pocket costs get to a point that it's simply not feasible for an individual to live, some agency should get the idea of the predicament she's in. Last year, or perhaps it was 2004, her out of pocket drug costs were more than she received from Social Security for the entire year. At that point i sought out the help of Bridges to Access and the State of Illinois. Having seen both parents struggle with the costs of meds really scares the heck out of me. I sure hope I'm able to put together a retirement that can help me out in the event that I require extensive healthcare. Gotta love the commercials that try to sell people on saving for retiremet so they can go fishing and travelling and golfing. Heck, that is so far from my family's reality, it is honestly making me think I need to get much more aggressive with planning for the unknown. I have a relative who claims he went through a million bucks while his wife was battling breast cancer. It's absolutely frightening on so many fronts, Of course, I never thought about the money during my parents illness until it became a reality when they were outpatients. Hopefully now though the system will get ironed out so that it can benefit my mom a little better than it has been. I try to make light of it, but it's just an added nusiance in dealing with everything else. Someone told me we aren't given more than we can handle. Ah, BS. This is akin to being dropped into a helluva wave and doing whatever you can to keep your head above the water. Perhaps the lifesaver will come in the form of a letter from Medicaid...or a really big lottery win. Either one would make me equally happy. The proceeds of lotto would be divided amongst OCF, ALCASE and families in need of help. I was hoping a failure to diagnose lawsuit I was pursuing was going to help fund the three things I mentioned, but sadly that never materialized. Sorry.

D- Call the Drug company whose med was over $200.00 on the deductible and tell them the situation. Maybe they will do something. It's an exhausting fight, but keep trying. Amy

Didier,
I read this week (and I can't remember where) that several of the Pharma companies that were giving discounts on meds to seniors prior to Part D kicking in, have seen the huge deductables and have extended the reduced pricing. I remember that one of the companies was Astra-Zeneca, and I think GSK might have been one of the others. Check the web sites of the drug companies you were getting a discount from. They may have extended the discounts.

Good Health,

Chuck

D,
Another source I came across is a Pharma website for the Partnership for Prescription Assistance. It is supposed to be a site where info from some 475 programs are all under one roof, and by filling out their questionare you can determine eligibility for assistance, and apply. The website is www.pparx.org

Let me know if this is of any help.

Chuck

Cool, thanks for the info. My pursuit of any further assistance from Med Pt. D and Social Security has fallen on deaf ears. Although we have an appt. scheduled w/Medicaid, I'm not too hopeful. Because mom makes a tad bit more than the threshold of 14 some odd thousand dollars per year in SS benefits, she apparently doesn't qualify for additional help even though her out of pocket health care costs are running about 500/mo. I laugh in disgust at the system. I've met perfectly healthy people in their 20s who have figured out how to scam the system to the point that they get housing vouchers, food stamps and free med benefits, yet a 74 year old stage 4 cancer survivor who needs assistance is SOL. What a crazy world.