Community Chat

[itiswhatitis]

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@winamac1 wrote:

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@itiswhatitis wrote:

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@winamac1 wrote:

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@Cakers3 wrote:

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@hyacinth003 wrote:

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@JillyMarie wrote:

Wow.  This is great news.  Free drugs -- just call the pharms and you are good to go.  I will take personal responsibiity.  I'll let you know how it goes.  Thanks again @winamac1

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Nothing in this world is "free."  Someone pays for it. 

In the case of free drugs, the people who DO PAY will pay for those who get it for "free."

It is merely cost shifting.

Hyacinth

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@hyacinth003 @JillyMarie  Not all Pharma companies offer "free" meds. They may offer coupons one can take to a pharmacy to reduce out of pocket costs but the catch is that you must have insurance to use these coupons.

Cost shifting is a good way of putting it - "free" programs still cost others who may not be at poverty level but are still having to decide- meds/food/mortgage/-which is the priortiy for this month.

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You are exactly right--in order to use "co pay cards", one has to have insurance.

But, if one falls up to 135% of the Federal Poverty Level (and they are Medicare Part D), the government will give meds at a cost of 0 to $7.40 a month.  That's called the "Low Income Subsidy" or "Extra Help" Program.  One has to call Social Security to get screened for that program.

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@winamac1  Medicaid.  Meicaid picks up these costs.  Under ACA, not all States expanded Medicaid, but they may still be eligible so yes, this is a good idea.

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Medicaid is totally separate from Low Income Subsidy.  Low Income Subsidy is for Medicare Part D patients. 

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@winamac1 Not in my State.  In my state, those extra helps come from MEDICAID.  Not Medicaire.  I know three people who get it and it's not coming from the SSA or the Federal Government but rather, Medicaid.

[winamac1]

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@itiswhatitis wrote:

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@winamac1 wrote:

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@itiswhatitis wrote:

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@winamac1 wrote:

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@Cakers3 wrote:

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@hyacinth003 wrote:

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@JillyMarie wrote:

Wow.  This is great news.  Free drugs -- just call the pharms and you are good to go.  I will take personal responsibiity.  I'll let you know how it goes.  Thanks again @winamac1

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Nothing in this world is "free."  Someone pays for it. 

In the case of free drugs, the people who DO PAY will pay for those who get it for "free."

It is merely cost shifting.

Hyacinth

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@hyacinth003 @JillyMarie  Not all Pharma companies offer "free" meds. They may offer coupons one can take to a pharmacy to reduce out of pocket costs but the catch is that you must have insurance to use these coupons.

Cost shifting is a good way of putting it - "free" programs still cost others who may not be at poverty level but are still having to decide- meds/food/mortgage/-which is the priortiy for this month.

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You are exactly right--in order to use "co pay cards", one has to have insurance.

But, if one falls up to 135% of the Federal Poverty Level (and they are Medicare Part D), the government will give meds at a cost of 0 to $7.40 a month.  That's called the "Low Income Subsidy" or "Extra Help" Program.  One has to call Social Security to get screened for that program.

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@winamac1  Medicaid.  Meicaid picks up these costs.  Under ACA, not all States expanded Medicaid, but they may still be eligible so yes, this is a good idea.

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Medicaid is totally separate from Low Income Subsidy.  Low Income Subsidy is for Medicare Part D patients. 

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@winamac1 Not in my State.  In my state, those extra helps come from MEDICAID.  Not Medicaire.  I know three people who get it and it's not coming from the SSA or the Federal Government but rather, Medicaid.

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No...sorry...not the case from what I've been told.  I guess you can send me the link so I can learn something, but that's not what I've been trained on.  

Please send info.  Thanks

[itiswhatitis]

@winamac1, here's more info

https://q1medicare.com/PartD-Medicare-Medicaid-Extra-Help-LIS.php

[winamac1]

Thank you for the info, but Low Income Subsidy is different from Medicaid--they both have programs.

Low Income Subsidy is for Medicare.

The Medicare Part D Extra Help or Low-Income Subsidy (LIS) program helps people with limited financial resources pay for their Medicare Part D prescription drug coverage. For more information, you can read below and see Extra help paying for Medicare prescription drug coverage If you receive Medicare Part D Extra Help, you may pay a lower or no monthly premium, a lower or no initial deductible, have coverage in the Donut Hole or Coverage Gap, and pay very little for your prescription drugs that are covered by your Medicare Part D plan.

There is nothing in the definition, above, that I pulled off the site you sent me the link to or the sites I found that state that Low Income Subsidy is Medicaid.  It's a different program. 

ETA:  I bet you are thinking of "dual eligibles".    Medicare/Medicaid--dual eligibles

[itiswhatitis]

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@winamac1 wrote:

Thank you for the info, but Low Income Subsidy is different from Medicaid--they both have programs.

Low Income Subsidy is for Medicare.

The Medicare Part D Extra Help or Low-Income Subsidy (LIS) program helps people with limited financial resources pay for their Medicare Part D prescription drug coverage. For more information, you can read below and see Extra help paying for Medicare prescription drug coverage If you receive Medicare Part D Extra Help, you may pay a lower or no monthly premium, a lower or no initial deductible, have coverage in the Donut Hole or Coverage Gap, and pay very little for your prescription drugs that are covered by your Medicare Part D plan.

There is nothing in the definition, above, that I pulled off the site you sent me the link to or the sites I found that state that Low Income Subsidy is Medicaid.  It's a different program. 

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@winamac1, this is a little confusing because in order to qulalify for the LIS you must be eligible for Medicaid:

Medicare provides "extra help" to pay prescription drug costs for people who meet specific income and resources limits. Resources include your savings and stocks, but not your home or car. If you qualify, you will get help paying for your Medicare drug plan's monthly Premium , yearly Deductible , and prescription Copayments. In most cases, if you get extra help, you won't pay a premium. Check with your plan. If you qualify for extra help, you won't have a coverage gap (see What is a coverage gap?).

What If you didn't automatically qualify, but think you might qualify for extra help

Here's what to do:

1. Apply for extra help. Call Social Security at 1-800-772-1213, visit www.socialsecurity.gov on the web, or apply at your State Medical Assistance (Medicaid) office (see 1-800-MEDICARE Helpline). TTY users should call 1-800-325-0778. After you apply, you will get a letter in the mail letting you know if you qualify and what to do next. Even if you don't qualify, you should consider joining a drug plan.
2. Join a Medicare drug plan. If you apply and qualify for extra help, you can either join a plan on your own or let Medicare enroll you in a plan. Medicare will send you a letter letting you know what plan it will enroll you in and when your coverage begins. If Medicare enrolls you in a drug plan, you can switch plans at least once through the end of the calendar year. You can also switch plans one time between October 15 and December 7 in following years. Your coverage would begin January 1 of the following year.

This is a good discussion because it can be helpful for readers.

[itiswhatitis]

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@winamac1 wrote:

Thank you for the info, but Low Income Subsidy is different from Medicaid--they both have programs.

Low Income Subsidy is for Medicare.

The Medicare Part D Extra Help or Low-Income Subsidy (LIS) program helps people with limited financial resources pay for their Medicare Part D prescription drug coverage. For more information, you can read below and see Extra help paying for Medicare prescription drug coverage If you receive Medicare Part D Extra Help, you may pay a lower or no monthly premium, a lower or no initial deductible, have coverage in the Donut Hole or Coverage Gap, and pay very little for your prescription drugs that are covered by your Medicare Part D plan.

There is nothing in the definition, above, that I pulled off the site you sent me the link to or the sites I found that state that Low Income Subsidy is Medicaid.  It's a different program. 

ETA:  I bet you are thinking of "dual eligibles".    Medicare/Medicaid--dual eligibles

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@winamac1 I could be.  Does the LIS put your part B deductible back in your pocket?  (The 104.00).  I'm looking at it and you are likely right!  

[maestra]

buy the generic brand.

[maestra]

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@millieshops wrote:

It makes little sense.  But so many things don't make sense to me.

Why is it we think little of paying a Hollywood actor or a professional football player millions and millions, but we pay scientists and doctors who work quietly in the background developingpotentially life-saving devices and meds pretty ordinary incomes?

We seem to be happy paying a pre-school teacher we trust with our children a minimum wage while we pay a fashion designer princely sums.

I know some of the reasons, but sometimes I think our values are not anywhere near where we say they are -  not in a society where money is definitely the biggest indicator of value.

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You hit the nail on the head!! ITA.

[itiswhatitis]

https://www.medicare.gov/your-medicare-costs/help-paying-costs/save-on-drug-costs/save-on-drug-costs...

This is all I found about LIS.  Seems the LIS automatically qualifies you for Medicaid.  Low Income Subsidy.  Not necessarily dual coverage.  Dual coverage may be for those who are entitled to SSI and Medicaid or a combination of both, but not SSDI.

Anyway......Grrrrrrrrrr!

[winamac1]

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@itiswhatitis wrote:

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@winamac1 wrote:

Thank you for the info, but Low Income Subsidy is different from Medicaid--they both have programs.

Low Income Subsidy is for Medicare.

The Medicare Part D Extra Help or Low-Income Subsidy (LIS) program helps people with limited financial resources pay for their Medicare Part D prescription drug coverage. For more information, you can read below and see Extra help paying for Medicare prescription drug coverage If you receive Medicare Part D Extra Help, you may pay a lower or no monthly premium, a lower or no initial deductible, have coverage in the Donut Hole or Coverage Gap, and pay very little for your prescription drugs that are covered by your Medicare Part D plan.

There is nothing in the definition, above, that I pulled off the site you sent me the link to or the sites I found that state that Low Income Subsidy is Medicaid.  It's a different program. 

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@winamac1, this is a little confusing because in order to qulalify for the LIS you must be eligible for Medicaid:

Medicare provides "extra help" to pay prescription drug costs for people who meet specific income and resources limits. Resources include your savings and stocks, but not your home or car. If you qualify, you will get help paying for your Medicare drug plan's monthly Premium , yearly Deductible , and prescription Copayments. In most cases, if you get extra help, you won't pay a premium. Check with your plan. If you qualify for extra help, you won't have a coverage gap (see What is a coverage gap?).

What If you didn't automatically qualify, but think you might qualify for extra help

Here's what to do:

1. Apply for extra help. Call Social Security at 1-800-772-1213, visit www.socialsecurity.gov on the web, or apply at your State Medical Assistance (Medicaid) office (see 1-800-MEDICARE Helpline). TTY users should call 1-800-325-0778. After you apply, you will get a letter in the mail letting you know if you qualify and what to do next. Even if you don't qualify, you should consider joining a drug plan.
2. Join a Medicare drug plan. If you apply and qualify for extra help, you can either join a plan on your own or let Medicare enroll you in a plan. Medicare will send you a letter letting you know what plan it will enroll you in and when your coverage begins. If Medicare enrolls you in a drug plan, you can switch plans at least once through the end of the calendar year. You can also switch plans one time between October 15 and December 7 in following years. Your coverage would begin January 1 of the following year.

This is a good discussion because it can be helpful for readers.

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This is a good discussion.

Respectfully...no...to qualify for LIS, it is NOT necessary to be eligible for Medicaid.  That, I'm 100% sure of!!!