Would God Honor this divorce????

Kutless · #1 06-22-2007, 09:07 AM

I had an elderly lady in my office yesterday desparate for help. She is on 2 different kinds of insulin. They are the expensive ones, obviously. Lantus and Novolog/pen to be exact. She just happens to be in the "GAP" or as they were calling it last year "DONUT HOLE" Isn't medicare wonderful?

Here med's are costing her well over $1000 per month. Because of her husbands VA pension and the sum of there SS check they are just a couple hundred $ above the federal poverty guidlines. Yes, just around $200.

Since she is a Med Part D. eligible she does not qualify for any of the Pharmaceutical Assistant programs. If she wasn't Part D eligible even though she was over the $ limit PAP's would still review her case. And if I submitted Dr or Hosp bills they would more than likely help.

Whats the solution? She needs her insulin but can't afford it or get help. The solution, from her mouth is divorce. By doing this it would decrease her income to the point of eligibility. Yeah she's probably going to lie about her household size, but can you blame her?

Thanks alot George Bush.

Theresa · #2 06-22-2007, 09:11 AM

I heard something about this here just last week about older folks facing divorce in order to afford medication. They interviewed someone at Medicare who said they had never heard of such a dilemma and said the participants need to contact them before they make a drastic decision b/c there might be something else they can do....

could have been a bunch of smoke and mirrors, but Medicare was "suprised"

Kutless · #3 06-22-2007, 09:13 AM

Quote:

Originally Posted by Theresa

I heard something about this here just last week about older folks facing divorce in order to afford medication. They interviewed someone at Medicare who said they had never heard of such a dilemma and said the participants need to contact them before they make a drastic decision b/c there might be something else they can do....

could have been a bunch of smoke and mirrors, but Medicare was "suprised"

Do you know much about this Part D coverage? Why is there a gap in coverage to begin with ?

Theresa · #4 06-22-2007, 09:16 AM

Quote:

Originally Posted by Kutless

Do you know much about this Part D coverage? Why is there a gap in coverage to begin with ?

its been over a year since I read up on it, let me look at my stuff and see if I undertood all that...

I remember when I was going through all this with my parents, reading all this mess - I got so mad - who helps those little old folks with no one to help them make life decisions? So many "advocates" are not looking out for their best interest and these precious folks are getting royally snowed!!

I got so upset thinking about it...

Anyway, let me look at my stuff and ask my mom, I'm sure she remembers.

BoredOutOfMyMind · #5 06-22-2007, 09:36 AM

Quote:

Originally Posted by Kutless

Thanks alot George Bush.

Is that really the fault of George Bush?

I don't think so. There are prescription plans where there is NO Donut Hole. My wife has one. And she takes Lantis with Opticlik inserts. I pay $200 a month for her scripts.

Kutless · #6 06-22-2007, 09:42 AM

Quote:

Originally Posted by BoredOutOfMyMind

Is that really the fault of George Bush?

I don't think so. There are prescription plans where there is NO Donut Hole. My wife has one. And she takes Lantis with Opticlik inserts. I pay $200 a month for her scripts.

My bored friend, the GB reference was to get a rise. And no, how could I blame him all by himself.

I'm very intersted in your wifes plan. I need knowledge. I just put a call into the Dept. of Public Aid so that I could be helped to understand.

But I really do think that the ball was dropped in the formation of this Plan D. There is no help out there for our elderly, or should I say very little. I honestly think this poor lady thinks that divorce is an option.

What s even more sad is that I get tons of people in my office who need med assistance who have been denied from the state dept because they don't have a child.

Now what does that promote?

BoredOutOfMyMind · #7 06-22-2007, 11:41 AM

Quote:

Originally Posted by Kutless

My bored friend, the GB reference was to get a rise. And no, how could I blame him all by himself.

I'm very intersted in your wifes plan. I need knowledge. I just put a call into the Dept. of Public Aid so that I could be helped to understand.

But I really do think that the ball was dropped in the formation of this Plan D. There is no help out there for our elderly, or should I say very little. I honestly think this poor lady thinks that divorce is an option.

What s even more sad is that I get tons of people in my office who need med assistance who have been denied from the state dept because they don't have a child.

Now what does that promote?

Bro, I would not vote for this man running on his record again. I hold no small distain for BIG Government. I know that the social security system is bankrupt and that means millions who have depended only on BIG Government to support them are headed to be in the same peril as this woman.

The donut is not understood by many seniors. In traditional medical plans you pay a deductible- 100 % sometimes up to a certain dollar amount, then you pay a percentage to another dollar amount. You then have 100% coverage after paying a certain capped amount. My deductible now is $3000. My max out of pocket is $3600.

In Medicare, you pay a 120 deductible. You do not pay again for the first $2500. You then pay 100% of the amount above $2501 and up to $5000 where again the plan pays again. Supplements pay this "donut hole gap" and sometimes differ from company to company and state to state.

My inlaws I believe have theirs through AARP. They had to research many plans to find one with "donut hole" coverage.