[krzyk101]

I am not really sure if this will end up being a thread or not since i just got a big warning full of codes in my original attempt to make this thread?

Anyway, I am on Social Security Disability and am on State Medicaid which is currently paying my prescription drugs as of now. I am under no choice of my own being switched to a new 'program' of prescription drugs through the new program of Medicare since I am not totally on Medicaid and recieve both Medicare part A and B along with State Medicaid.

I know that I have until December the 31st to 'Choose' a Medicare drug program to take over my prescription drug coverage as the new 'program' of Medicare is going into effect on Jan 1, 2006 and State Medicaid will no longer provide me with prescription drug coverage. Well, it will I believe I am told still provide me with coverage on the Benzodiazapam Drug Class which the Medicare program will not cover being the Generic Valium I have taken for the last 13 years.

I am to 'Choose' a plan now, only no plan or even any type or details of such plan exist in my knowlege for me to even 'choose' from or not been provided to me. I have a Case Manager through Community Mental Health who agrees with me that it is difficult to 'choose' the plan that best fits my needs, as they will choose one for me if I do not choose one before December 31, 2005, until I can make the Decision.

At this point, I have no detailed plan to even choose from, yet it is made to sound as if I even have choices. I am totally in the dark recieving conflicting 'mailings' and 'brocures' from the US Government and the State Government over what the Heck my Darn options are. I am in one letter even told one has already been chosen for me and I should be hearing more about this in the month of October. I have recieved nothing other than litature on different vague wording and vague details all the while supposed to not worry even though I am going to be covered by the convience of this program from Medicare. I am thinking now I am told by the State Medcaid Worker to do something on the lines of Medicare part D?

Ia m already mentally, physically and emotinally confused on a daily basis and now this. Total change over coming in less than 60 days in which I still have no detailed, or concrete spelled out in terms which do not simply ramble in circles worse than I do in my own impaired verbal communication or lack of skills.

I take 21 prescription medications and have not a clue to what will be covered other than knowing now Valium is not covered at all by Medicare Prescription Program regardless. I have no idea about the other's, the Miralax, the Luvox, the Morphine Sulfate, the Lasix, the and the list goes on recently diagnosed with OCD to my lovely list of diagnosis' and now all this total chaos of a program supposed to benifit me, only stressing me into the most feared of by me of all : UNCERTAINTY nothing to reassure me of what the Hell is going on with any one and being shifted from place to place being ran in circles over how or what meds will be covered beside my Valium which Is not yet I know not how to apply for the State who says they will pay the Valium which the Medicare will not, Unfortionatally one of my personalitys has hidden the letter from the Medicaid office telling me they will pay for my Valium ( I do believe there was at one time such a letter in exsistance in other possibility's the letter itself is merely a delusion one way or the other this is all driving me over the edge) Thanks to the modern day political decisions for my best interests which I find to be doing the total opposite.

Only in the good ole' USA am I so lucky to have this great option. I am not Lucky to have Medicare as I am on Disabity and PAID for this Benifit which is being disabled no way in my opinion a form of Luck. Also, I am on Medicaid as I live so far below poverty level that I qualify for being disabled and poor. So I am not LUCKY to have medicaid either. I would gladly exchange it all in for a healthy mind, body and state of which I am not Chronically Disabled and be a productive member of society.

I am not sorry for anything I Have said as it is how I feel and I am supposed to be honest with my feelings. Regardless, I am having my resourses available to me cut left and right unoticed by the general public or sugar coated. No Front page news headlines when earlier this year my co-payment for generic prescriptions went up in a 500% increase, per prescription as to say.... forget it I am too opressed and tired to even go on about this.

Treat the condition and in the same hand make the person who is supposed to be 'best interest' looked out for only worry more and go further insane from their help.

END

[jennie]

hopefully your case manager keeps working with you on this. if not, there are other programs out there to help pay for prescription meds. the programs are called "patient assistance programs" and many drug companies offer such. a good starting point for more info is: http://psychcentral.com/resources/Me...cine_Programs/

[Monty_girl]

krzykris,
Medicare part D is the new prescription part of medicare. Like part A & B. Many states are automatically switching people over to Part D if they have Medicare/Medicaid already. I know here in Ky they are sending out a list for the people to choose which plan to go with.
I work with seniors and what I've been telling most of them is to talk with their pharmacy and see which plans they will be taking. Not all pharmacies will take every plan. There are a list of plans in the back of the MEDICARE AND YOU HANDBOOK. You should of gotten your new book for 2006. The plans are listed in the back of that. Another place to go for information is www.medicare.org You can put in your information in and it will pop up the plans that will work best for you. You can also call 1-800-MEDICARE. Just know that you might be on the phone on hold for awhile. But have the names of your drugs and doses already to tell them.
People can also get help with paying their monthly portion of their Medicare part D. You can file for help if you are low income by calling SS and getting an application to fill out. But it could be fasting to go to www.socialsecurity.gov and file online. But for anyone with medicaid SS more then likely have already done this part since the state already has a list of those people who have medicaid. Medicare part D is about clear as mud right now. There are still bugs they are trying to work out of the system.
krzykris, just PM me if you have a question, I'll try and find an answer for you.
Monty

[krzyk101]

Thank you Jennie and Monty for the advice and the website addresses, I will look into them and hope to find some more specific answers on this. Thanks again for the time you have taken to help me with this.

Sincerely,
Kris

[Fuzzybear]

Paws crossed for you! (((((((((((((((((((((Kris)))))))))))))))))))))))

[dottie]

Hi. I am on Medicare and Medicaid spend-down. If you don't choose, I believe that the Govt will automatically enroll you in a plan that will go like this: 0 monthly premium, 0 for enrollment, & between 2-5 dollars for co-pay per RX..However...those on Medicaid will stay on a seperate program...from the medicare.

Hope I have this right. I personally think it's crazy to require me to pay any co-pays as I pay medicaid $520 per month for health coverage. Spend- down my kiester.

AAAAAARRGGGGGGG!!

[wisewoman]

I think it is different state to state but here are the things I know across the board. SSA should have and did send out a questionaire within the last few months asking low income people about their assets and any additional income. This was to determine if the individual is eligible to have the gov subsidize the part d. The companies being offered each have formularies. This is a list of meds it covers. Some people go to the medicare part d website and look at the formularies and see which one best fits their needs with the drugs they take. Then they have more info about which program to sign up for.

Okay, in my state if you fit into a certain low income profile you get your part D paid and keep the previous insurance you had. Some pay a monthly premium to the state and drugs are free, and some pay a $1-$3 co-pay for each script. It is okay if you are low income to let the state auto-enroll you as they are going to go for the most cost effective program.

It is still very confusing. Initially I was told that they would not cover benzos or morphine type drugs. I have seen both on some of the formularies. Hope this helps.

My guess is Kris you don't have to make a choice and you will be okay. It is the middle income people who will suffer with this program. Good luck.

[TheAngryPatient]

The government bureacrats just LOVE to make things complicated don't they? This prescription deal has been a problem.

On the other hand - Medicare plus private insurance and 100% coverage can be like a smoking gun because then you get over doctored and over prescribed. We are an over-medicated society in our opinion.

We recently cut prescrption meds from 17 pills down to 5 and what a difference in overall improvement of health and psyche. Best thing we ever did was find a D.O. naturist.

EVERYBODY talks about the lack of medical and prescription coverage and proper medical care.. We should be grateful we have such "great" coverage right? Not really.

When you get incarcerated in the hospital like the poor retired veteran in TheAngryPatient.com - you can hardly get checked out because the patient's too adequate med insurance foots the hospital bottom line. Uninsureds surely aren't going to foot that huge bill. We never would've believed it till we lived it.

This is not a popular position today but......sometimes I think we need to be more like socialized medicine. It works fantastically in certain countries.

we now live in fear of having to check into a hospital because we fear we will never get out before we get doctored to death too.

[krzyk101]

Thank you for the hugs ((((((((Fuzzy))))))) and wishing you a belated birthday wish, hope you had a nice birthday. Hugs again, take care
KKris

[krzyk101]

I can say I did not have to make a choice in programs, while still waiting for the detailed insurance prescription information for a total new program which I know no specific information about other than that it has been chosen, I will have no choice in doing anthing about it, and no I am not ok with this. I am though used to the choices being made for me as it is a standard thing being under poverty level to not make choices on your own or be informed as I am a welfare recipient, and as you said the middle income people who will suffer. I believe we all suffer, only being on welfare, it is just a given to comply with suffering which goes hand and hand.

Yes, the middle income will be effected by this, yet I would not used the term of them suffering more than someone on welfare. Maybe just have to give up on some luxury items for it. It is quality of life which is really the important issue. I know that in healthcare the entire resourses made available to a person is much more limited in services and the options slide down lower and less options the lower the income level is. We all suffer in one way or another.

Have a Great Day