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Author Topic: Medicare, Prescription Coverage, Retirement  (Read 750 times)

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Offline didee

  • Member
  • Posts: 9
Medicare, Prescription Coverage, Retirement
« on: March 24, 2015, 08:57:05 PM »
Unfortunately I am one of those that has not been a saver in preparation of retirement, and then when diagnosed back in 1985 I felt like there was no reason to save.  It was a good excuse anyway :-)   Now here I am surviving this and having been blessed with decent health throughout the years am still able to work.  I work in the technical field which makes it easier physically, except for the stress which wears on me a lot lately.  I've worked full time all my life and am starting to 'dream' about not having to for a change, at least getting away from such a stressful job.  I have been checking on my financial status and one thing I'm curious about is how well Medicare and any supplement coverage for medicines pay for HIV medications.  The plan I chose at work this year I'm finding to be the wrong choice, so next year I'll be changing my plan in hopes that it pays better for medications.

With the cost of medications, I'm expecting to have to keep working for as long as I can to help pay for them until I turn 65 maybe?  Anyone else out there still working and starting to look into a possible 2nd less stressful career in order to continue on with health care until Medicare kicks in?  And those on Medicare, are you getting good coverage?  Just some concerns that have been kicking around in my head lately. 

Positive since 1985
CD4 675, VL 29

Offline mitch777

  • Member
  • Posts: 4,021
Re: Medicare, Prescription Coverage, Retirement
« Reply #1 on: March 25, 2015, 05:23:32 PM »
Hi Diane,

I'm not the best one here to answer your question regarding Medicare drug benefits but as I am about to (hopefully) be on disability soon I think this is how it works...

Once on Medicare you will need to also purchase Medicare Part D insurance. Make sure you find a plan that best covers your meds. The cost of this plan can vary but I believe most are between $100-200/ month.

Then there is the "donut hole". At some point you will need to pay for your meds on your own until you get through it and then your insurance will cover you from that point forward for the year. The donut hole is supposed to get smaller in the years to come I'm not sure what it is now but I'm guessing around $3000. Some one else here would know the exact amount but you could google it.

Correct me if I'm wrong here folks but if you are eligible for ADAP it will cover you through that donut hole period so there would be no out-of-pocket expenses on your part.

It's great to hear that you have been able to work through all of these years with decent health being diagnosed when you were! I had a productive working life for the first 23 years after being diagnosed in 1982 and while I miss it I can understand how stress can wear one out as we get older and in my case have had many medical problems (not all related to HIV).

I'm not sure how helpful I was but hopefully others with more direct knowledge of the system will chime in here.

Best of luck to you! Saving for retirement isn't easy for most people if you read the statistics and for us LTS... well, I get it.

...And a belated welcome to the forum.

Best wishes,
32 years hiv+ (oct. 2013) with a curtsy.

Offline OneTampa

  • Member
  • Posts: 2,444
  • "Butterflies are free."
Re: Medicare, Prescription Coverage, Retirement
« Reply #2 on: March 30, 2015, 08:35:27 PM »
I posted a thread about living with HIV and planning for retirement several years ago:



All definitely worth exploring.

"He is my oldest child. The shy and retiring one over there with the Haitian headdress serving pescaíto frito."

Offline deibster

  • Member
  • Posts: 158
Re: Medicare, Prescription Coverage, Retirement
« Reply #3 on: June 06, 2015, 03:24:31 AM »
Hi Didee,
It always helps to tell us what state you live in, either in your question or in your profile. In MA & NY you can earn or receive $58,000 per year and still be eligible for ADAP. The last time I checked, the income limit was lower in all of the other states.

In a few Republican run states like FL, NC & SC there is not only a lower income limit to get on ADAP, but also a waiting list many years long. In FL I think you have to wait for someone on ADAP to die, in order to be moved up the waiting list. It may be worthwhile to move to a different state when you stop working. BUT, you have to research that also. I live in MA and you are eligible for ADAP as soon as you sign a lease or rent a motel room to live here. I investigated moving to southern CA and you cannot even start the paperwork to get services from the ASO in Palm Springs until after you have lived there for a full month. Best of luck.
Hugs from Provincetown, Deibster
Poz since Dec 1992. Meds since 1995. Disability since 2005. Constantly fighting the Lipodystrophy 'beer gut.'

Prezista/Norvir, Epzicom, Cytomel, Prevacid, Coumadin, pravastatin, Fenofibrate, Remeron, Zoloft, Concerta, Flomax, Allegra180, Nasacort, Centrum, Flax Oil, Fish Oil

Offline aztecan

  • Member
  • Posts: 5,490
  • 29 years positive, 57 years a pain in the butt
Re: Medicare, Prescription Coverage, Retirement
« Reply #4 on: June 08, 2015, 11:16:44 AM »
Hi Didee,

We are pretty much in the same boat, you and I. I was diagnosed in 1985, was told I would'nt live long and, subsequently, never planned to grow old (or older).

I am still working, but I did switch careers about 10 years ago. I was in the news business, then became a medical case manager. I didn't do it necessarily by choice at the time, but am glad for the changes that have occurred.

As far as Medicare goes, I would look for a Medicare Advantage Plan, rather than just a Part D plan. Those types of plans typically will cover the infamous donut hole and also pay for the 20 percent that Medicare doesn't.

They are more expensive up front, meaning the premiums are greater. But the cost savings on the other end can be substantial if you have regular doctor visits, etc.

Just a thought.


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

Offline wolfter

  • Member
  • Posts: 5,185
Re: Medicare, Prescription Coverage, Retirement
« Reply #5 on: June 08, 2015, 02:25:32 PM »
I don't believe there are currently any states with an  ADAP waiting list? 
Being honest is not wronging others, continuing the dishonesty is.


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