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WHAT TO DO THRU COVERAGE GAPS
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Ms. Understood
    Nashville
    Joined: Nov 2005
    Posts: 5
    
Post Date: 11/15/2005 9:32:19 PM
I am trying to decide what plan is best for my father. He is 75 owns a home and property but has no real monthly income. He has assets with no money, but because of his assets he is not considered in the poverty level. They say that Silverscript would be the best for him. He really doesn't spend a whole lot on medications, but he will make it to the coverage gap. He is already in jeporady during the deductible. He is currently enrolled in HealthSpring and they are changing their plan. I see that now they have a deductible, that is not something that we were expecting. My inital question was again what can a participant do during coverage gaps to get over the hump.

THANKS~ KETURAH
SeaOtter
    ARkansas
    Joined: Dec 2005
    Posts: 3
Post Date: 12/3/2005 8:32:53 PM
Dads like him are prety tough problems for the kids! {Said with a grin, as I'm 70+!} This is a type of planning for the future that should really be done with an attorney to help out. That said, I'll go out on a limb for you and recommend that Dad get rid of his property. Then he could qualify for all sorts of things in 2 or 3 years. He might also choose a Reverse Mortgage to take some of his equity out as monthly payments, bringing his income up to allow him to pay for a good plan. This is getting into Estate Planning, but that is really what you must face. Good luck. Dads are special, love them while they are here!
vtpharm
    Joined: Nov 2005
    Posts: 87
Post Date: 12/4/2005 2:10:36 AM
Careful about the Medicaid Look back period. Many states are considering expanding this to FIVE YEARS, meaning he would not qualify for Medicaid until he is 80. So I partly agree with SeaOtter, but he needs to be extra careful about giving or selling things for less than they are worth, and the temptation would be there with having all that cash from the sale of the property to help out children and grandchildren. Seeking the advice of an attorney seems to be sound advice, but I am not sure he will be able to become poor enough on paper to get Medicaid assistance in a timely fashion.
l55centaur
    Washington
    Joined: Jan 2006
    Posts: 1
Post Date: 1/24/2006 10:42:07 AM
Go to www.nase.org and checkout the Association RX Card or the Advantage RX Card. No deductibles, most pharmacies are on the list except ma and pa's (you can probably get them nominated), substantial discounts, no $ limits, and the cost is $10/mo for a membership to the NASE and $4/month for the Advantage RX card or $13.95 for the Association RX Card. I would try both cards out to see what works best for the scripts he is taking, then cancel one of them. The costs are tax deductible as the NASE (National Association for the Self-Employed) is a non-profit organization. I am in Washington State and a field service rep for the NASE. I plan on talking to seniors and show them an alternative to the confusing new
Medicare Part D plans. Hope this helps.
SeaOtter
    ARkansas
    Joined: Dec 2005
    Posts: 3
Post Date: 1/24/2006 1:17:00 PM
I mentioned a Reverse Mortgage. It is a rather unusual thing, but our local banks and attorneys are using it to deal with situations such as your Dad's. Another idea is to sell the property and invest the money in an annuity, with monthly payout and remainder to a beneficiary. A third idea is to sell the property, but reserve a life estate in it. That is: sell it, but continue to live there as long as he is able.
Annuities are not considered part of an estate at death. I don't know how Medicaid treats them.
Anyway, the idea is to create income, rather than qualifying for Medicaid, so plan a course of action on that basis. Whatever you decide, be sure that a trusted financial planner and attorney review things before you do something regrettable.
xladlk
    Joined: Oct 2006
    Posts: 2
Post Date: 10/17/2006 11:25:03 PM
If you can stand the higher premiums, there are plans available where you pay 5% for everything from Day 1 and there is no coverage gap. This is a good deal for us as we blew through the coverage gap in the first month of membership so will be going to one of these plans ourselves this next year.
medicaremama
    Oregon
    Joined: Dec 2006
    Posts: 1
Post Date: 12/4/2006 6:15:35 PM
Pay close attention to the Plans' formulary list because they vary quite a bit. If your father takes meds that are not listed on the plans formulary, he'll pay dearly. Also, there are many plans that will still cover generics through the coverage gap. If you go to www.medicare.gov and click on "Formulary Finder", you can list his medications, and it will search and show you which plans have ALL his meds on their formulary and which ones have SOME on their formulary. Most of the less expensive drugs are on everyones formulary, but when you start getting into the more expensive ones, you find some plans cover it and some don't. Also, you might try mail-order to save on maintenence meds. Postal Prescription Services is a thought. Their number is 1-800-552-6694, and they take almost any Medicare D plan. Also, they have a "discount plan" where you pay a one-time fee of $10 and you can order the meds at a discounted rate during the coverage gap.
 

 

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