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  • Medicare Drug Plan

    I've been seraching in the Archives for any information that was posted on the New Law which became effected in May. It pertains to the Elderly and their Medical Drug Coverage. Please correct me if there is any.

    Today, MAMA went to her doctors. She also went to her see her Pharmacist to get her monthly medications. He informed her that she no longer had any Drug Coverage from HMSA.

    Luckily, MAMA's Pharmacist knows her. He said she is not the only one this has happened to. He also advised her not to call HMSA to renew or get another Drug Plan. They would ask for a $250.00 upfront Fee. Instead, he gave her a print-out for me to read and a number to call.

    I did. The representative: professional, caring and made sure everything would be sent to MAMA ASAP. Medicare would be billed. She wouldn't have to pay anything upfront.

    The company's name is AARP Ph. 1-888-687-2277.

    What makes angry? I saw the announcement in the media. I did call Social Security and HMSA. Both said I didn't have to do anything. MAMA was covered. Can you imagine the horror we felt, thinking her needed medications were not covered?

    Who is to blame? The main thing is MAMA will recieve the Medical Drug Coverage she needs. What about the many who are wondering and worrying where to turn?

    Auntie Lynn
    Last edited by 1stwahine; June 15, 2006, 04:35 PM.
    Be AKAMAI ~ KOKUA Hawai`i!
    Philippians 4:13 --- I can do all things through Christ who strengthens me.

  • #2
    Re: Health Insurance...Kaiser or HMSA

    What happens if you have NO coverage, in Hawaii?
    http://thissmallfrenchtown.blogspot.com/
    http://thefrenchneighbor.blogspot.com/

    Comment


    • #3
      Re: Health Insurance...Kaiser or HMSA

      Originally posted by SusieMisajon
      What happens if you have NO coverage, in Hawaii?
      Susie, For the poor - they have Medicaid. For the rich - they can pay.

      For the middleclass and those like my MAMA...they have to pay their own coverage no matter what.

      Insurance covers the bulk. Still the cost of care, medications, etc., is quite expensive. My MAMA's last hospitilazation totaled over $22,000! We still are figuring out the balance that needs to be paid. That doesn't include her Physicians.

      Getting sick in Hawai'i without insurance coverage is certain DEATH.

      Auntie Lynn
      Be AKAMAI ~ KOKUA Hawai`i!
      Philippians 4:13 --- I can do all things through Christ who strengthens me.

      Comment


      • #4
        Re: Medicare Drug Plan

        It's funny when I first moved to Hawaii... everyone was telling me that if you get a job with the state... that they would cover your medical.

        Well as it turns out... I still have to pay 50% of my coverage and it comes straight from my paycheck

        I truly feel for those un-insured...

        I often wonder if that could be a reason why so many children here in Hawaii have poor teeth... the lack of Dental Coverage...etc.?

        Comment


        • #5
          Re: Medicare Drug Plan

          I think that my Mom is with Kaiser. When she turned 65, her insurance went up from about ten dollars, to a hundred.
          Originally posted by manoasurfer123
          It's funny when I first moved to Hawaii... everyone was telling me that if you get a job with the state... that they would cover your medical.

          Well as it turns out... I still have to pay 50% of my coverage and it comes straight from my paycheck

          I truly feel for those un-insured...

          I often wonder if that could be a reason why so many children here in Hawaii have poor teeth... the lack of Dental Coverage...etc.?
          I have four kids, from ages 8 to 15, and there is only one cavity between all of them. Dentists don't prevent tooth decay, but parents and brushing and flossing do.
          http://thissmallfrenchtown.blogspot.com/
          http://thefrenchneighbor.blogspot.com/

          Comment


          • #6
            Re: Medicare Drug Plan

            Expensive as it is, the laws surrounding medical coverage in Hawaii are unusually strict, to the point of being one of the key exhibits in any "anti-business" argument about our state. There may be a lot of uninsured people, and others struggling to pay their medical bills, but you're more likely to be insured in some way here than in many other places.

            As for poor teeth, fluoridation advocates will give you an earful on why they think that's a problem here. But that's a whole 'nother ball of wax.

            Aunty Lynn, I'm glad you were eventually able to get the help and information you need. I'm only moderately familiar with the new Medicare drug plan, but I know enough to say that it's been a nightmare of confusion, contradiction, and bureaucracy for just about everyone.

            Comment


            • #7
              Re: Health Insurance...Kaiser or HMSA

              Originally posted by 1stwahine
              Luckily, MAMA's Pharmacist knows her. He said she is not the only one this has happened to. He also advised her not to call HMSA to renew or get another Drug Plan. They would ask for a $250.00 upfront Fee. Instead, he gave her a print-out for me to read and a number to call.

              I did. The representative: professional, caring and made sure everything would be sent to MAMA ASAP. Medicare would be billed. She wouldn't have to pay anything upfront.

              The company's name is AARP Ph. 1-888-687-2277.

              Auntie Lynn
              Aloha Lynn,
              That is very odd about her HMSA not covering her meds. Medicare Part D went into effect on January 1, 2006 so if her HMSA was covering her medicines since January, she shouldn't have been dropped this month. Which HMSA plan does she have? Is it HMSA 65C+? Or retired federal plan? Individual plan? I would check with HMSA to see if there was a mistake made.

              If she is low income, she may be eligible for assistance with Medicare Part D premiums. For more info and to apply, go to https://s044a90.ssa.gov/apps6z/i1020/main.html.

              AARP is the American Association of Retired Persons and they have a Medicare Part D plan through United Health Care. There is a premium for this plan. You may also go to www.medicare.gov to check out ALL of the Medicare Part D plan options for Hawaii. The site can even tell you if the medicines your mother is on are covered (every plan is different), what the co-pays would be, and what her estimated annual out-of-pocket costs would be with each plan (they DO vary).

              Hope this info helps. Email me if you have any more questions.

              Mary

              Comment


              • #8
                Re: Medicare Drug Plan

                Originally posted by SusieMisajon
                [...]I have four kids, from ages 8 to 15, and there is only one cavity between all of them. Dentists don't prevent tooth decay, but parents and brushing and flossing do.
                Decay isn't the only cause of tooth problems.

                Comment


                • #9
                  Re: Medicare Drug Plan

                  Originally posted by tutusue
                  Decay isn't the only cause of tooth problems.
                  That's true...but good dental habits do help. I'm quite proud of my kids' teeth.
                  http://thissmallfrenchtown.blogspot.com/
                  http://thefrenchneighbor.blogspot.com/

                  Comment


                  • #10
                    Re: Health Insurance...Kaiser or HMSA

                    Originally posted by alohacandy
                    Aloha Lynn,
                    That is very odd about her HMSA not covering her meds. Medicare Part D went into effect on January 1, 2006 so if her HMSA was covering her medicines since January, she shouldn't have been dropped this month. Which HMSA plan does she have? Is it HMSA 65C+? Or retired federal plan? Individual plan? I would check with HMSA to see if there was a mistake made.

                    If she is low income, she may be eligible for assistance with Medicare Part D premiums. For more info and to apply, go to https://s044a90.ssa.gov/apps6z/i1020/main.html.

                    AARP is the American Association of Retired Persons and they have a Medicare Part D plan through United Health Care. There is a premium for this plan. You may also go to www.medicare.gov to check out ALL of the Medicare Part D plan options for Hawaii. The site can even tell you if the medicines your mother is on are covered (every plan is different), what the co-pays would be, and what her estimated annual out-of-pocket costs would be with each plan (they DO vary).


                    Mary
                    Hi Mary! Like I said earlier in my other post...I "did" call Social Security and HMSA. MAMA had HMSA 65C+. She paid her premiums. Real Estate as well a other "assets" prevents those who are on a fixed income to be eligible for Medicaid...even if it's only Funeral Plots that are owned.

                    Some Seniors go as far as transferring all thier "assets" to their beneficiaries before anything happens to them so they qualify for Medicaid Benefits and other State or Federal Assistance. It is a silent but common practice.

                    As far as AARP. Yes there is a Premium. However, unlike HMSA, there is no upfront fees to be paid. Medicare will be billed and thus, my MAMA will only have to pay the monthly dues. She is still covered by HMSA for her hospitilizations.

                    The New Law for Drug Plans took effect in late May. I read it in the Media and called. I thought everything was fine. I was wrong. My MAMA is not the only one who is being affected by this whole shabang!

                    Mahalo for the links. I'm sure someone can find them useful.

                    Auntie Lynn

                    btw: See you Saturday!
                    Last edited by 1stwahine; June 16, 2006, 01:25 AM.
                    Be AKAMAI ~ KOKUA Hawai`i!
                    Philippians 4:13 --- I can do all things through Christ who strengthens me.

                    Comment


                    • #11
                      Re: Health Insurance...Kaiser or HMSA

                      Originally posted by 1stwahine
                      Hi Mary! Like I said earlier in my other post...I "did" call Social Security and HMSA. MAMA had HMSA 65C+. She paid her premiums. Real Estate as well a other "assets" prevents those who are on a fixed income to be eligible for Medicaid...even if it's only Funeral Plots that are owned.
                      I wasn't referring to Medicaid when I mentioned Low Income Assistance. The program I was talking about is one that must be applied through from Social Security and they have a higher asset limitation than regular Medicaid. I have had several people that I work with become eligbile for this program that aren't eligible for Medicaid.[/QUOTE]
                      Originally posted by 1stwahine
                      As far as AARP. Yes there is a Premium. However, unlike HMSA, there is no upfront fees to be paid. Medicare will be billed and thus, my MAMA will only have to pay the monthly dues. She is still covered by HMSA for her hospitilizations.
                      Even though you called HMSA when you were first inquiring about whether she had the coverage, you should still call them now to see what went wrong.
                      Originally posted by 1stwahine
                      The New Law for Drug Plans took effect in late May. I read it in the Media and called. I thought everything was fine. I was wrong. My MAMA is not the only one who is being affected by this whole shabang!
                      The new law went into effect on January 1, 2006. The May deadline was for people to sign up for a plan who already hadn't and who don't want to pay a penalty. If she had prescription benefits under HMSA 65C+ in January, it should have continued. Again...the program did NOT go into effect in May....it went into effect in January. [/QUOTE]
                      Originally posted by 1stwahine
                      btw: See you Saturday!
                      I enjoyed see you again on Saturday and getting to meet Lucie too! ;-)

                      Comment


                      • #12
                        Re: Medicare Drug Plan

                        Update: MAMA finally got her medications. The difference? Very Big. Before she payed over $150.00 for medicines plus the $ 87.00 Premium to HMSA and $ 57.00 to Social Security.

                        Now she pays $89.00 to HMSA for Hospital and Emergency Coverage and $57.00 to Social Security. AARP collects the money for MAMA's medicine coverage directly from Social Security.

                        When MAMA went to pay for her monthly medications she was thrilled. Her bill ~ Six Dollars!!!

                        K-den. I going back moe moe. I stay sick too.

                        Aloha & Love

                        Auntie Lynn
                        Last edited by 1stwahine; July 24, 2006, 06:26 PM.
                        Be AKAMAI ~ KOKUA Hawai`i!
                        Philippians 4:13 --- I can do all things through Christ who strengthens me.

                        Comment


                        • #13
                          Re: Medicare Drug Plan

                          Medicare enrollment deadline: Six days
                          Seniors who want to participate in the Medicare Part D prescription drug program have until Sunday to enroll or possibly face higher prices. Medicare beneficiaries who already are enrolled and are satisfied with their Part D plan don't have to do anything, but those who want to sign up for the first time or change their current drug coverage must do so by the end-of-the-year deadline. The next enrollment period doesn't begin until Nov. 15, and officials warn that premiums and drug prices could rise by then.

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