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Author Topic: Major Issue with Medicare Part D for 2009  (Read 3020 times)

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Offline atxpozguy

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  • Posts: 63
  • POZ+ 30 year milestone reached for Austin man
    • It's Your Vehicle & Money
Major Issue with Medicare Part D for 2009
« on: January 13, 2009, 11:07:25 AM »
Yesterday, I stopped by my neighborhood CVS to pickup to four medication refills, as I have done in 2008. This time (2009) was a major shocker when the copays for the HIV Meds were $223.22 - 30 day supply of Lexiva and $184.73 - 30 day supply of Truveda.  :o

In total shock, I was like is this for real and the pharmacist suggested I call my insurance company, which is AARP or United Health Care.

I find out after speaking with a AARP representative, that Medicare moved all the HIV meds to Tier 4, as in 2008, they were in Tier 3. Tier 4 drugs require a 15% copay. As I told the lady of AARP, I just cannot afford to pay that much money, one because I don't have and two, if I am unable to get my HIV meds, I could die in 6 months if not sooner.  :'(

After getting off the phone with the insurance company, I called my clinic and was told that the Texas HIV Medication Program has a special program just for Medicare beneficiaries that will pay the copays of the HIV meds. Well that some good news, as this afternoon, I will meet with a social worker to complete an application for this extra help with expense, after I give blood for quarterly lab work.

But, it's not a done deal until I receive an acceptance letter from the State.

Although, I was told by my clinic, they would make sure I get my HIV meds.

For others who have yet to learn about this Medicare Part D for 2009 extra copay expenses, I suggest you check with your pharmacies about the copay cost before your supply of medication run out.  ::)
30 years poz with no expiration date

atxlovingqueer@gay.com
atxniceguy@gmail.com

Diagnosed HIV 1983
Diagnosed AIDS 2001

As of Jan 17, 2012: VL <20k CD4 183  28.5%

Offline aztecan

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  • Posts: 5,384
  • 29 years positive, 56 years a pain in the butt
Re: Major Issue with Medicare Part D for 2009
« Reply #1 on: January 13, 2009, 11:41:44 PM »
Hey Atxpozguy,

Thanks for the info. Many of the Part D plans changed this year and caught a lot of people off guard.

Basically, Part D sucks.

HUGS,

Mark

"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline Miss Philicia

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Re: Major Issue with Medicare Part D for 2009
« Reply #2 on: January 14, 2009, 01:36:18 AM »
I had no issues with my new Part D coverage doday at the pharmacy.
"Iíve slept with enough men to know that Iím not gay"

Offline kajnjewel

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  • Posts: 71
  • Living Life with a Passion!
Re: Major Issue with Medicare Part D for 2009
« Reply #3 on: January 14, 2009, 10:45:31 AM »
ATXPozGuy:

You may need to change carriers.  I was contacted by my provider (Humana) and was informed that my payments would go up and suggested other carriers.  I did some research and went with another one.  I had no problems in changing pharmacies and when I picked up my meds earlier this month I had no problems and did not have to pay anything.
When you were born, you cried and the world rejoiced; live your life in such a manner that when you die, the world will cry and you will rejoice!

Offline BT65

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Re: Major Issue with Medicare Part D for 2009
« Reply #4 on: January 14, 2009, 10:57:06 AM »
I've had no problems so far.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Online Andy Velez

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Re: Major Issue with Medicare Part D for 2009
« Reply #5 on: January 14, 2009, 11:04:09 AM »
This is another ill-begotten legacy from the Bush years. I only just read that Obama is planning to have it dumped.

Part D was always just another giveaway to the insurance companies. And healthcare in this country will never be everything it needs to be until we get insurance companies and profit-making out of the equation. Single payer healthcare is coming and it's actually going to cost everyone less than this current, ill-begotten system.

Hang in there but it ain't easy.

I was on a conference call last night about this issue. We're looking for organizational partners to work together in making sure the Obama administration and his Secty of Health know how crucial and urgent the needs are of those living with HIV (and other challenging health situations) and how addressing those needs meaningfully must be built into the healthcare changes. Stay tuned.

Cheers.

« Last Edit: January 14, 2009, 11:14:37 AM by Andy Velez »
Andy Velez

Offline Miss Philicia

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Re: Major Issue with Medicare Part D for 2009
« Reply #6 on: January 14, 2009, 04:48:26 PM »
I had no problems yesterday when picked up my news meds, and I changed over to a new Med-D plan for 2009.  Pennsylvania pays for whatever the Med-D plans doesn't pay as our secondary insurance.  I think this is a state-by-state thing, mostly due to higher local taxes.
"Iíve slept with enough men to know that Iím not gay"

Offline aztecan

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Re: Major Issue with Medicare Part D for 2009
« Reply #7 on: January 14, 2009, 11:49:56 PM »
I had no problems yesterday when picked up my news meds, and I changed over to a new Med-D plan for 2009.  Pennsylvania pays for whatever the Med-D plans doesn't pay as our secondary insurance.  I think this is a state-by-state thing, mostly due to higher local taxes.

Yes, you're right. It does happen state by state and, unfortunately, I live in a relatively poor, rural state. Wait, its not unfortunate I live here. I love it here. But it is unfortunate that there isn't always enough money to pay for services, etc.

Here people simply fall into the doughnut hole and are never heard of again, unless they are lucky enough to be able to switch to another plan.

HUGS,

Mark

« Last Edit: January 15, 2009, 10:49:53 AM by aztecan »
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline Robert

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Re: Major Issue with Medicare Part D for 2009
« Reply #8 on: January 15, 2009, 12:25:56 AM »
I'm also on ADAP and the state picks up the tab. Believe me, I'm real greatful but I'm just not sure what is new cost is and that's not necessarily a good thing. I think that as part of our appreciation for ADAP it's important that we know just how much is costs and how much the increase is and how much the pharmaceuticals are making off us.

Andy....you are so right about Part 'D' being nothing but a giveaway to the pharmaceuticals.  I guess their boondoggle on Norvir was just too short term.

robert 
..........

Offline caregiver2008

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Re: Major Issue with Medicare Part D for 2009
« Reply #9 on: January 18, 2009, 12:07:25 PM »
Hey atxpozguy,

If you live in Dallas area, contact Aids Arms who can refer you to Resource Center who pays co-pays up to $750 per month.  There is an income limit for eligibility.

My hubby didn't qualify for ADAP but he qualified for Resource Center.  They pay his $585 copays for HIV meds, so our only out of pocket is his non-HIV meds which is about $485 per month.

Aids Arms has been a life saver for us!  They provide financial and emotional support.  Our case worker is awesome and always looking for ways to help us!


Offline Miss Philicia

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Re: Major Issue with Medicare Part D for 2009
« Reply #10 on: January 18, 2009, 02:54:11 PM »
Yes, you're right. It does happen state by state and, unfortunately, I live in a relatively poor, rural state. Wait, its not unfortunate I live here. I love it here. But it is unfortunate that there isn't always enough money to pay for services, etc.

Here people simply fall into the doughnut hole and are never heard of again, unless they are lucky enough to be able to switch to another plan.

HUGS,

Mark



Hmmm.... sounds like a rather high price to pay for all that lovely tumbleweed, Tasmanian Devils and iconic sandstone buttes!

I'll take Philadelphia's sky high murder rate and free HIV meds any day!  Plus we have red brick buildings everywhere.

(also helps that we had an HIV+ gay man running the state ADAP up until last year :))))
« Last Edit: January 18, 2009, 02:55:56 PM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline atxpozguy

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  • POZ+ 30 year milestone reached for Austin man
    • It's Your Vehicle & Money
Re: Major Issue with Medicare Part D for 2009
« Reply #11 on: January 24, 2009, 02:34:03 PM »
 :) I can finally rest easy, as I received a letter today, from the Texas HIV Medication Program administered by the State of Texas. The contents of the letter stated, the state will pay all co-pays for the medications I am currently taking. Sure makes my for less stress not worrying about getting refills.

Although, I wouldn't mind taking med holiday for 6 months, but my doctor said no way, because I might not bounce that so quickly and become severely ill.
30 years poz with no expiration date

atxlovingqueer@gay.com
atxniceguy@gmail.com

Diagnosed HIV 1983
Diagnosed AIDS 2001

As of Jan 17, 2012: VL <20k CD4 183  28.5%

Offline AlanBama

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  • Posts: 3,604
  • Alabama: the 'other' 3rd World Country!
Re: Major Issue with Medicare Part D for 2009
« Reply #12 on: February 06, 2009, 10:59:15 PM »
I'm glad you are able to get your meds, tx.   The State of AL will be furnishing mine again this year; it's February, and I'm already in the donut hole.  >:(

Last year, Blue Cross/Blue Shield offered us generic med coverage while in the donut hole; this year, NO coverage whatsoever.  It's very discouraging.   I did manage to jump in for a refill on my Flomax and my Ultrase in January, with $35 copay for each.   Now, I'll be reliant on Birmingham AIDS Outreach to help me with those two meds.


"Welcome to Alabama.  Please set your watches back six years".   ;D
"Remember my sentimental friend that a heart is not judged by how much you love, but by how much you are loved by others." - The Wizard of Oz

 


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