POZ Community Forums
Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: denb45 on December 01, 2009, 10:15:36 pm
-
OK, so, it looks like I'm now at 75% level of Extra Help, according to SSDI, last yr. I was 100% when my State Medicaid paid for my Part, A, B and D Premiums, now, my state no longer pays this anymore, and as a result of this action, this has created a snow-ball-effect, meaning, I'll have to pay 15% of all Meds Plus a Monthly Premium on top of that, what this means is that all of my HIV+ Meds will end up being about $150
a month each (I have about 5 HIV+ Meds) so since I cannot pay for this due to my low income status I will be forced to go back on my States ADAP Program in 2010.....
The Good News, ADAP will cover all of my HIV+ Meds, at no cost to me, the bad news, all other Meds I'll have to pay the 15% price tag, if I keep the Medicare Part D, so, my State's ASO case workers says, I don't need Part D anymore, and that my State ADAP will fulfill that requirement of having medicare part D
does anyone here know if this is the case, right now I'm so confused, I can just spit ??? How in the hell can I loose medicare part D, this makes no since to me, anyone know what I should do about this?
-
Dennis, I don't know anything about this, sorry. I just wanted you to know that I think it sucks, and I hope something can be worked out somewhere.
-
Hi Dennis , I am afraid I cant help at all ether although I should be an expert after my dealings with medicaid in my state last year . I even hired a consultant to help sort it all out to no avail . I finally realized that in my case the best thing to do was to do the just wait and see approach . Good luck and please keep us posted . I might need more info myself one day soon .
-
Hey Dennis,
You already know I know nothing, but I'm sorry that your world is being changed.
I only like change that I initiate.
-
The answer is yes................ so far. I was talking to an HIV/AIDS advocate yesterday, that works the halls of congress, and he stated that so far, most states are still covering co-pay. This of course is very tenuous at this point as most states are dredging up all the spare change they can find, and HIV funding, while isolated to HIV by law, is still a very large temptation to many fiscal agents of the states.
So, if your case manager says that they will cover the co-pay; they are right at this point. I urge you to take care of this as soon as possible, because nothing in Ryan White is etched in stone until Washington brings down the hammer and forces the states to not fuck with our Congressionally blessed and approved funding.
-
The answer is yes................ so far. I was talking to an HIV/AIDS advocate yesterday, that works the halls of congress, and he stated that so far, most states are still covering co-pay. This of course is very tenuous at this point as most states are dredging up all the spare change they can find, and HIV funding, while isolated to HIV by law, is still a very large temptation to many fiscal agents of the states.
So, if your case manager says that they will cover the co-pay; they are right at this point. I urge you to take care of this as soon as possible, because nothing in Ryan White is etched in stone until Washington brings down the hammer and forces the states to not fuck with our Congressionally blessed and approved funding.
Thanks Moffie, I'm working on this as i type this, and I just got off the phone with my Part D Medicare provider to find out the cost of what I'll pay each month ( without ADAP)
Total Cost per month for HIV+ Meds (If I keep my Part D)
Norvir $161.05
Truvada $145.80
Aptivus $155. 13
Isentress $134.13
Total Part D Cost $596.11 per month ??? that's more than half of my SSDI income WTF? how can one eat and pay Rent like that, this is outrageous ??? so you see, keeping my Part D would bankrupt me, I'd be homeless, and living in my Car, if it weren't for ADAP ??? due to me being only 75% of extra help, and and not 100% like I was a yr ago, my Income hasn't changed, but, the cost of meds sure has, as you can see, I'll keep everyone posted, as to how this mess will play out ??? I was told that you CANNOT keep both Part D Medicare and ADAP too, so, I'm kinda confused here, as my State ADAP only covers HIV+ Meds, and doesn't cover ANY non-HIV+ Meds, so, I may be stuck with paying full price for the rest of my other non-HIV+ Meds that aren't covered by my states ADAP, if this is the case, I'll be in another financial deli ma............sigh ??? man this get's worse and worse doesn't it ???
-
We are forced to put up with a lot to maintain our health....hang in there.
-
We are forced to put up with a lot to maintain our health....hang in there.
Thank You, Joel, I think I'm gonna be ok next yr. in Jan 2010, so I'll update everyone on what happened when I saw my ASO-case worker today....... ;D
1st of all I would like to thank MARK, for all of the info he gave me on this problem over in the PM's Thank you MARK :-* :-* :-* you were spot-on ;D I will be getting and receiving Blue Cross/Blue Shield medicare-carve-out prescription drug coverage as of Jan, 1st 2010......this is paid for by the State of New Mexico NMMIP program, it's called different things in other States, but, medicare-carve-out is what you need, if you cannot afford your part D medicare drug coverage anymore, so, if this should happen to any one of you in others states, and you have medicare part's A and B, and you don't qualify for Medicaid any longer, this program meets those needs, so PLEASE contact your local-State ASO-office, if this should happen to you :D
I sure hope that congress doesn't cut any of the Ryan-White-HIV+ Programs, I 'm forever grateful of these programs, and would be in a world of hurt without them....... FIGHT, LOBBY, MARCH, and do whatever you can do to keep these programs going, they are there to help all of us ;)
-
Dennis,
I'm glad you got things figured out. That's great that NM has a program to help. I know when I contacted my ASO & different state agencies in Indiana they were of NO help what so ever. I'm still waiting for the official word from IL about my coverage but not only does the state have a program the county also has a program so I've been assured that I will get my meds without a hassle and only a minor co-pay.
Here's to 2010 being uneventful! :D
-
Dennis,
I'm glad you got things figured out. That's great that NM has a program to help. I know when I contacted my ASO & different state agencies in Indiana they were of NO help what so ever. I'm still waiting for the official word from IL about my coverage but not only does the state have a program the county also has a program so I've been assured that I will get my meds without a hassle and only a minor co-pay.
Here's to 2010 being uneventful! :D
I was a little worried, as I didn't have the $695 to $788 to pay for my meds under the part D medicare plan, so now I don't have to worry about this anymore ;D and, as for yourself and the State of IL. that's great news Andy :D sigh....the things we have to do to get our MEDS, and maintain our good health it's an Up-Hill-Battle isn't it.......
-
I was a little worried, as I didn't have the $695 to $788 to pay for my meds under the part D medicare plan, so now I don't have to worry about this anymore ;D and, as for yourself and the State of IL. that's great news Andy :D sigh....the things we have to do to get our MEDS, and maintain our good health it's an Up-Hill-Battle isn't it.......
Yes! Some days I really feel like ole Sisyphus!!! >:(
(http://bespokecashmere.files.wordpress.com/2009/05/sisyphus.jpg)
-
Yes! Some days I really feel like ole Sisyphus!!! >:(
(http://bespokecashmere.files.wordpress.com/2009/05/sisyphus.jpg)
all LTS are like Sisyphus, you just have to be that way to survive this disease for as long as we have ;)