Re: I have a Question About the Donut Hole

[Guest guest]

Hi Jane...I saw your picture when you were in TN. All the pictures show having a good time.

Donut Hole: I carry Regence BCBS Med-Advantage for a supplemental. They pay a percentage of all meds. Some are only $4, Some $10 for the generic. The 'major' meds, such as Cymbalta cost so much that even my co-pay is $40! Every month. I have many other meds as well and when my co pays reach a certain amount...I can't remember without digging out my policy...then I have to start paying 100% for ALL meds. Thus I'm in the 'donut hole'. Depending on how many months are left before a new year, I pay out of pocket. 2009 I hit the hole in Aug!

I personally am not aware of any ADDITIONAL insurance that will cover when you reach the max and have to pay 100%.

Other insurance may be different. There is Secure Horizon, Health Net and others, they differ a bit.

Call your carrier and ask questions. Usually they are good to give info. Or even call Medicare.

If you find something that takes over when you hit the hole let me know! lol

MamaSher; 71, IPF 3-2006, OR.Don't fret about tomorrow, God is already there!

I have a Question About the "Donut Hole"

Hi! I have a question that I need to ask about "The Donut Hole".

When Medicare is the primary insurance, what supplementary insurance does one get to help to take care of medication costs when one has entered "The Donut Hole" ????

Toodles

Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

[Guest guest]

I sure would like to know that too, Jane! I haven't found any.....

B

Barbara McD

PF--Sept 08; Sjogren's--Apr 09; Reynaud's--seems like forever

Beautiful Western NC

Attitude is everything.

To: Breathe-Support Sent: Sun, November 8, 2009 3:13:36 PMSubject: I have a Question About the "Donut Hole"

Hi! I have a question that I need to ask about "The Donut Hole".

When Medicare is the primary insurance, what supplementary insurance does one get to help to take care of medication costs when one has entered "The Donut Hole" ????

Toodles

Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

[Guest guest]

i think the donut hole comes from medicare rules

Pink Joyce R (IPF 3/06) IFA 5/09 Pennsylvania

Donate Life Listed 1/09 Inactive 4/09

www.transplantfund.org---

Subject: Re: I have a Question About the "Donut Hole"To: Breathe-Support Date: Sunday, November 8, 2009, 3:36 PM

Hi Jane...I saw your picture when you were in TN. All the pictures show having a good time.

Donut Hole: I carry Regence BCBS Med-Advantage for a supplemental. They pay a percentage of all meds. Some are only $4, Some $10 for the generic. The 'major' meds, such as Cymbalta cost so much that even my co-pay is $40! Every month. I have many other meds as well and when my co pays reach a certain amount...I can't remember without digging out my policy...then I have to start paying 100% for ALL meds. Thus I'm in the 'donut hole'. Depending on how many months are left before a new year, I pay out of pocket. 2009 I hit the hole in Aug!

I personally am not aware of any ADDITIONAL insurance that will cover when you reach the max and have to pay 100%.

Other insurance may be different. There is Secure Horizon, Health Net and others, they differ a bit.

Call your carrier and ask questions. Usually they are good to give info. Or even call Medicare.

If you find something that takes over when you hit the hole let me know! lol

MamaSher; 71, IPF 3-2006, OR.Don't fret about tomorrow, God is already there!

I have a Question About the "Donut Hole"

Hi! I have a question that I need to ask about "The Donut Hole".

When Medicare is the primary insurance, what supplementary insurance does one get to help to take care of medication costs when one has entered "The Donut Hole" ????

Toodles

Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

[Guest guest]

I have Blue Cross Security 65 plan C -- i think security 65 has about 8 plans -- 4 are offered in this area

that is for medicare part C

for prescription or medicare part D, i have Blue Rx -- also part of Highmark Blue Cross

the supplements vary by state

the givens are medicare Part A -- free to everyone who is eligible

Medicare Part B -- optional -- costs $90.-- plus per month -- comes out of social security check

parts C and D are optional

the donut hole is a medicare rule as far as i know -- i was in it by mid january-- catastrophic by mid february

some of my co pays are $2.40 for a 90 day supply, some of my co-pays are $100.-- plus for a 90 day supply

depends on brand name or generic if available, and there is a third level, don't remember what it is called -- they are the super expensive ones

but i would rather pay for those meds and hold off on the transplant

Pink Joyce R (IPF 3/06) IFA 5/09 Pennsylvania

Donate Life Listed 1/09 Inactive 4/09

www.transplantfund.org---

Subject: I have a Question About the "Donut Hole"To: Breathe-Support Date: Sunday, November 8, 2009, 3:13 PM

Hi! I have a question that I need to ask about "The Donut Hole".

When Medicare is the primary insurance, what supplementary insurance does one get to help to take care of medication costs when one has entered "The Donut Hole" ????

Toodles

Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

[Guest guest]

Jane/Barbara,

For those with limited income and resources, Medicare offers help to cover deductables, copays and the donut hole. You can call them at or here is a link: www.ssa.gov/prescriptionhelp/. If the link doesn't work from this email, copy and paste to your browser window. There is also a move afoot to eleminate the donut hole in the health care legislation, however most of its provisions, if passed, would not take effect for a while.

Other than help from Social Security, I am not aware of insurance that would cover the donut hole.

Jerry/Mississippi/54/IPF/dx April 05Who believes that hard times help us appreciate the good times even more.

[Guest guest]

Jane

Unless you have access to some supplement through your husband or

something, then there isn't one. There is no such thing as a gap policy

for the drugs. Now, if the health care bill were to pass as it's

currently written, you'll pay half priced during the donut hole, but

thats still speculative. Some get assistance through drug assistance

programs. Some medicare drug policies do pay for some generics during

that period but obviously its not generics that are your problem. I get

my Nexium off-shore to help. The donut hole is a real problem. Are you

just going on medicare?

>

>

> Hi! I have a question that I need to ask about " The Donut Hole " .

>

> When Medicare is the primary insurance, what supplementary insurance

> does one get to help to take care of medication costs when one has

> entered " The Donut Hole " ????

>

> Toodles

>

> Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

>

[Guest guest]

Thank you, mama sher for the info

Toodles!

Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

>

> Hi Jane...I saw your picture when you were in TN. All the pictures

show having a good time.

> Donut Hole: I carry Regence BCBS Med-Advantage for a supplemental.

They pay a percentage of all meds. Some are only $4, Some $10 for the

generic. The 'major' meds, such as Cymbalta cost so much that even my

co-pay is $40! Every month. I have many other meds as well and when my

co pays reach a certain amount...I can't remember without digging out my

policy...then I have to start paying 100% for ALL meds. Thus I'm in the

'donut hole'. Depending on how many months are left before a new year, I

pay out of pocket. 2009 I hit the hole in Aug!

> I personally am not aware of any ADDITIONAL insurance that will cover

when you reach the max and have to pay 100%.

> Other insurance may be different. There is Secure Horizon, Health Net

and others, they differ a bit.

> Call your carrier and ask questions. Usually they are good to give

info. Or even call Medicare.

> If you find something that takes over when you hit the hole let me

know! lol

> MamaSher; 71, IPF 3-2006, OR.

> Don't fret about tomorrow, God is already there!

> I have a Question About the " Donut Hole "

>

>

>

>

> Hi! I have a question that I need to ask about " The Donut Hole " .

>

> When Medicare is the primary insurance, what supplementary insurance

does one get to help to take care of medication costs when one has

entered " The Donut Hole " ????

>

> Toodles

>

> Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

>

[Guest guest]

Mama Sher,I know that a lot of pharm companies say that if you can't afford your meds, they can help. Have you tried that? KathySubject: Re: I have a Question About the "Donut Hole"To: Breathe-Support Date: Sunday, November 8, 2009, 12:36 PM

Hi Jane...I saw your picture when you were in TN. All the pictures show having a good time.

Donut Hole: I carry Regence BCBS Med-Advantage for a supplemental. They pay a percentage of all meds. Some are only $4, Some $10 for the generic. The 'major' meds, such as Cymbalta cost so much that even my co-pay is $40! Every month. I have many other meds as well and when my co pays reach a certain amount...I can't remember without digging out my policy...then I have to start paying 100% for ALL meds. Thus I'm in the 'donut hole'. Depending on how many months are left before a new year, I pay out of pocket. 2009 I hit the hole in Aug!

I personally am not aware of any ADDITIONAL insurance that will cover when you reach the max and have to pay 100%.

Other insurance may be different. There is Secure Horizon, Health Net and others, they differ a bit.

Call your carrier and ask questions. Usually they are good to give info. Or even call Medicare.

If you find something that takes over when you hit the hole let me know! lol

MamaSher; 71, IPF 3-2006, OR.Don't fret about tomorrow, God is already there!

I have a Question About the "Donut Hole"

Hi! I have a question that I need to ask about "The Donut Hole".

When Medicare is the primary insurance, what supplementary insurance does one get to help to take care of medication costs when one has entered "The Donut Hole" ????

Toodles

Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

[Guest guest]

i contacted both companies at issue last year == not poor enough for them

Pink Joyce R (IPF 3/06) IFA 5/09 Pennsylvania

Donate Life Listed 1/09 Inactive 4/09

www.transplantfund.org---

Subject: Re: I have a Question About the "Donut Hole"To: Breathe-Support Date: Tuesday, November 10, 2009, 1:29 AM

Have you contacted the mother ship-the actual pharmaceutical company. I'd get pushy if I had to. Bureaucracy is ridiculous.Kathy

From: Sher Bauman <bofus6 (AT) verizon (DOT) net>Subject: Re: I have a Question About the "Donut Hole"To: Breathe-Support@ yahoogroups. comDate: Sunday, November 8, 2009, 12:36 PM

Hi Jane...I saw your picture when you were in TN. All the pictures show having a good time.

Donut Hole: I carry Regence BCBS Med-Advantage for a supplemental. They pay a percentage of all meds. Some are only $4, Some $10 for the generic. The 'major' meds, such as Cymbalta cost so much that even my co-pay is $40! Every month. I have many other meds as well and when my co pays reach a certain amount...I can't remember without digging out my policy...then I have to start paying 100% for ALL meds. Thus I'm in the 'donut hole'. Depending on how many months are left before a new year, I pay out of pocket. 2009 I hit the hole in Aug!

I personally am not aware of any ADDITIONAL insurance that will cover when you reach the max and have to pay 100%.

Other insurance may be different. There is Secure Horizon, Health Net and others, they differ a bit.

Call your carrier and ask questions. Usually they are good to give info. Or even call Medicare.

If you find something that takes over when you hit the hole let me know! lol

MamaSher; 71, IPF 3-2006, OR.Don't fret about tomorrow, God is already there!

I have a Question About the "Donut Hole"

Hi! I have a question that I need to ask about "The Donut Hole".

When Medicare is the primary insurance, what supplementary insurance does one get to help to take care of medication costs when one has entered "The Donut Hole" ????

Toodles

Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

[Guest guest]



Kathy...yes, I did contact the 'mother-ship'...

MamaSher; 71, IPF 3-2006, OR.Don't fret about tomorrow, God is already there!

I have a Question About the "Donut Hole"

Hi! I have a question that I need to ask about "The Donut Hole".

When Medicare is the primary insurance, what supplementary insurance does one get to help to take care of medication costs when one has entered "The Donut Hole" ????

Toodles

Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl