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Wed Dec 18, 2013, 03:57 PM

I'm playing with fire. Dropped Medicare Part D.

For years, I have had Medicare A & B. This year, now that I am 71, I decided to sign up for Part D. Thankfully I have been healthy and have not had need of prescription drugs. Who knows what will happen tomorrow. I decided to sign up for part D, just in case.

Like many, I survive on SS alone. I own my house but have very few other assets. I'd like to stay here until I'm pushing up daisies(as the phrase goes). Other options, like moving do not make $$ sense to me. I could try and sell this old place but buying something else would not only be complicated but would not offer me a better alternative.

Last Friday, I got the final notification regarding the cost of Part D. I have a penalty incurred from the day I turned 65 until Jan. 2014. Between the cost of Part D and the penalty, it would be another $1000.00 dollars out of my meager SS check each month.
If I used the benefit, after the first level, I would hit the 'donut hole' and would be paying full freight until I reached the ceiling. before Part D kicks in again.

Somehow, the math does not work for me. A thousand dollars a year, use it or not, then a vacant spot for another couple of thousand, then coverage again.
It may be a stupid move on my part but I canceled part D and will hopefully be healthy enough to keep going.

Another thousand from this SS check would bring me to a point where I could not meet my bills. No extras now, debt later. Because I own my house, I am not eligible for any assistance at all. I was told to appeal. Will not work. Doesn't count if you have any assets. Appeal is a no-go. I called for info and found that my assets do not allow me to qualify. I don't have lots of money, it is just that I am above the very low limit they require.

I guess Uncle Sam wants you to go totally broke before any relief is possible. I pay my Real Estate taxes and all my bills. It has reached the point where I am ready to have peanut butter and jelly every day. How far can any of us stretch a dollar?

I hope I stay healthy. My options otherwise are bleak. I will not wipe out all I have worked for to pay drug companies. I would rather call it quits than give both my late husband and my work to pay some big CEO his billion a year.
I know there must be thousands like me. There is no option but to go without because you have just a little too much on paper. No-one cares what you have in your wallet or checkbook.

Rant over, thanks for letting me vent.

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Response to Paper Roses (Original post)

Wed Dec 18, 2013, 04:10 PM

1. You've got it wrong. You don't hit any donut hole unless the part D insurance has paid out a certain

dollar figure and it would come bout half way (or farther) through the year, depending on what your meds cost. If you aren't taking any meds at all, you would never reach the donut hole in a year's time.
Mr. Shraby and I have never hit it. Our meds don't cost that much. Even when he had one that was over 200 dollars a month, he didn't hit it.
Edited to add. Mr. Shraby went from no meds one week to have to take three the next due to a stroke..one was the over 200 per month one.

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Response to Paper Roses (Original post)

Wed Dec 18, 2013, 04:42 PM

2. Look at this link. It gives good explanations of what you acutally have to pay.

Not everyone will enter the coverage gap. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. In 2013, once you and your plan have spent $2,970 on covered drugs (the combined amount plus your deductible), you're in the coverage gap. This amount may change each year. Also, people with Medicare who get Extra Help paying Part D costs won’t enter the coverage gap.

http://www.medicare.gov/part-d/costs/coverage-gap/part-d-coverage-gap.html

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Response to Paper Roses (Original post)

Wed Dec 18, 2013, 04:45 PM

3. Check back with Medicare to be sure all the info is correct. The late enrollment penalty -

It's figured at 1% of the "Part D base premium" (Medicare pegs that at $32.42) for each month you were uncovered after eligibility.

In your situation, 72 months. That should be a monthly penalty of $23. i.e. -

72 months uncovered (6 years).

72% x $32.42 = $23.42 penalty per month added to your monthly Part D premium.

There are examples at the Medicare Part D website -

http://www.medicare.gov/part-d/costs/part-d-costs.html

Encourage you to contact Medicare directly, though, to verify all costs and coverage options. They can clarify the donut hole situation with you as well (there are changes coming in 2014).

It pays to go back to the source and speak with a live, knowledgeable representative. Ask for clarification on everything. Persistence can work to your benefit.

Good luck.

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Response to Paper Roses (Original post)

Wed Dec 18, 2013, 04:55 PM

4. I don't think that is playing with fire

some of the Medicare part D and Part C I think are insurance company rip offs. Depending on the costs. They have people paying for this medigap insurance, what, $300 or $400 a month. Well, how many months are you gonna pay before you actually need it? Three years? Four years? After 4 years of paying $300 a month, you have paid $14,400. Are you gonna get that much in benefits?

I think it is very likely that people would be better off just saving that premium money and then having a nest egg to use in case of disaster. But they get scared into buying inusrance. Medicare part A already covers a lot in case of a disaster.

I also, so far in my life, have had very little use for prescription drugs.

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Response to hfojvt (Reply #4)

Wed Dec 18, 2013, 05:04 PM

5. If we hadn't had medigap insurance, we would have faced a huge problem with my husband's

rehab costs after his back surgery. He literally could not get off the second floor of the house. He had had insufficient rehab after his surgery and needed a full 3 weeks staying in a rehab facility. It allowed me time to do the necessary rehab on the house, making it handicap accessible for him when he returned. He had excellent care and it was all paid for, not just the 80%. When I saw the actual amount of what the 20% was in dollars I was flabbergasted. That was when I realized how being old is fraught with possible health problems that can be very costly indeed.

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Response to hfojvt (Reply #4)

Wed Dec 18, 2013, 05:47 PM

7. Part C is 'medigap' supplemental coverage. Part D is prescription coverage.

Two different things, just for clarity's sake. I think for most Medicare beneficiaries A, B and D is adequate. Everyone's situation differs, of course. For me A, B and D work.

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Response to Paper Roses (Original post)

Wed Dec 18, 2013, 05:11 PM

6. Because to a lot of people out there, any program assisting those with less is "charity" -

and the Conservitive sees Charity through a Calvianistic lens.

That mindset considers living in dignity is your personal responsibility that you should have to bankroll yourself - you don't need assistance now, if you already have a house (that you want to pass down to your children) or retirement set aside for later. You shouldn't need Social Security disability, or Medicaid, or Food Stamps unitl you sell your house, your valued family treasures, and divest yourself of anything that could be of financial benefit to you, even if it's an insurance plan, trust, or annuity that you might be setting up for your extreme old age or to pass on to your kids. You have to lose everything before you should ask for any help.

See, the simplistic view is that if you have anything that can take benefit you or your family in the future (even if you have no way to liquidate it for cash to survive on now), you obviously don't need the help , and are scamming the government if you are getting government insurance or another program.

To the conservitive Calvinist, the Government is supposed to be a service of last resort - Americans should to be starving-homeless-poor - their last asset gone and no church around to provide charity, before they should even think of getting aid on "the taxpayer dollar". That includes Medicaid or Food Stamps (or Social Security).
Getting help to live in dignity and some modicum of comfort? Getting back what you paid into early to ensure you don't have to sell your home, empty the trust fund your grandparents set up for future generations (including your own kids or grandkids) Get on with you, you were obviously careless or made the wrong choices, and you deserve everything bad that can be thrown your way. You must pay for your sins, before you can go begging for mercy and grace. That's the Calvinist way.

As if that $0.0000001 of every tax dollar that might go to any particular individual that gets monitary assistance from the government (pell grants, HUD, food stamps, etc...) means that the person getting assistance is clawing it out of the pockets of the upstanding citizens who are far more deserving of every penny they "earned".

Haele

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