Grandpa is on Medicare. He has fallen into the doughnut hole with his meds. They’re covering a smaller % because he hit $ limit. Coverage will reset when he hits catastrophic or Jan. 1. He’s on 6 meds. Some are now $100+ more.
Is he a veteran??
I've been there. It's moronic.
And is why I don't trust govt people when it comes to money, costs, accounting...
Many pharmaceutical companies have a patient assistance program for donut holes at end of year, and deductibles at the beginning of the year.
Those saved me tens of thousands on my chemo meds.
I’l have to check into it.
He may have to switch to Medicaid
Have him go to Costco for prescriptions. Three years ago I fell into the donut hole so switched to Costco. Most Rx's were about $10.00 for 90 days.
Please explain to me why someone else should be forced to pay for Grandpa’s meds.
No one is asking for anyone else to pay for his medicine. He’s worked since he left home at the age of 13. He’s paid taxes and paid into the system. Why shouldn’t Medicare cover part of his health care?
Because that is someone else paying for his healthcare. Otherwise let’s abolish Medicare, have Grandpa save his Medicare taxes in the bank, then let him use his own saved funds to pay for his meds.
We both know that wouldn’t work.
How is him taking utilizing a system that he paid into for for nearly 50 years having someone else pay for his healthcare?
Do I need to spell this out? Because he’s paid pennies on the dollar.
If I pay you $10 a month for six years will you buy me a Ferrari? Why not?!!?? I paid for it!!
So what is your solution?
How about we let people provide for themselves, and free up the massively over-regulated healthcare market so that prices drop and they can do so?
Charity cases will always exist. My solution to them is easy: Charity.
And I would also eliminate any unnecessary overpriced meds from his list. If he’s not getting his money’s worth, the pitch it or switch to a cheaper alternative. I just realized that this situation wasn’t just a hypothetical. What are some of his costlier meds?
It’s crazy!!! I recommend checking to see if your state or county has a senior RX program! It completely saved me with my dad and grandfather!
It’s called a prescription assistance program
He’s only in the doughnut hole for 2 months. I don’t know if it would help for that short amount of time or not.
Even if it doesn’t this year, it might for next...
It’s going to get worse
Obamacare is closing the donut hole. Should be completely closed in 2020, but gradually until then. (Before Obamacare, you’d pay 100% while in the donut hole instead of the 51% this year.) No one at Marco Rubio’s office could tell me if the closing would continue under any of the repeal plans this year, though it was clear that the means to pay for it were being ended. They had no clue what they were signing onto.
My dad is on medicare also. He has had quadruple bypass and is on over 6 meds. None of which cost him more than $8..... he is 87 and been on medicare for over 20 years and has never fallen into a "donut hole"....
He’s obviously on all generic medications. (Lucky!) It’s the EXPENSIVE brand name meds that will get you in the donut hole. Also, there was no donut hole prior to the Part D coverage starting in 2006.
My grandpa is 87 and has had bypass surgery as well. I had called last month to get a few of his prescriptions refilled last month. He always s wants to know the price. One was significantly higher. I asked the pharmacist why. She had me call the insurance company. That’s when they told me about the doughnut hole. (I haven’t had insurance in almost 15 years, so all of this is new to me.) So, he’s definitely in it.
The more expensive brand names may have patient assistance programs (though some do not help people with a Medicare Part D plans). Check on needymeds.com
Let me know if you have other questions. I do this for a living.
I believe he does have a Part D.
From what you’ve said, I can guarantee he has a part d.
Otherwise, to have medication coverage with Medicare, people usually have Tricare for Life, obtain them through the VA, or have a secondary insurance (usually through a union retirement deal).
The donut hole is unavoidable once you hit $3700 combined insurance & out of pocket payout. The previously mentioned patient assistance programs are usually the only way to help with the large bill.
I believe he has Anthem. He’s not a veteran. He gets a pension, but no insurance from there.
I think the Anthem is probably his supplemental insurance & not the part d, but I can’t be sure. It all changes state to state. Anthem may provide a part d where he lives. It doesn’t really matter. Part d’s really aren’t very different from each other.
Why not make something really confusing for elderly & disabled people, right? Of course, I might have to find a different job then.
That’s the game they play.
The ACA ended the donut hole.
No it didn’t. He’s in it right now.
See my comment above. It explains Obamacare & the donut hole.
Thanks smartfart. I didn’t realize it was gradual. All these efforts to repeal sure are hurting people. It’s very sad that crap like this happens in America. The money they want to bloat the military budget with should help these people. I wonder if calling the manufacturer for help paying would be a possibility?
He’s only in the doughnut hole for about 2 months.
Please see my comments in other threads in this and the other poll.
This seems to be a pretty good explanation of the donut hole & how it is gradually closing:
Still, calling the manufacturer for help paying for his medication could help. I have done that and save $25 a month on one of my prescriptions.