Community Chat

[winamac1]

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@itiswhatitis wrote:

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!

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I know for a fact to be eligible for Low Income Subsidy you do NOT have to qualify for Medicaid.  

I have to call on cases for the biologic I "sell" weekly.  That is definitely not the case...usually they are Medicare Part D--over 65.  I'm not sure if dual eligibles are also part of it, but it's certainly not stand alone Medicaid.

There is NOTHING in the website definition that says anything about requirement of Medicaid:

Here is the definition:

Eligible beneficiaries who have limited income may qualify for a government program that helps pay for Medicare Part D prescription drug costs. Medicare beneficiaries receiving the low-income subsidy (LIS) get assistance in paying for their Part D monthly premium, annual deductible, coinsurance, and copayments.

[winamac1]

See below:

If you are Medicaid, you AUTOMATICALLY get the help.

That is not low income subsidy:

https://secure.ssa.gov/i1020/start

[3suwm5]

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@Blahblahvampemer wrote:

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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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Actors and athletes make so much because they have a specialized talent, and with most, the earning period is very short.  If you do something that generates untold millions, you should get a decent share.

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They have gifts they can improve on, to become a very specialized commodity, my DH does too.  His area is very specialized, few in the world, but he won't make millions in his whole life time.  His talents, protect the entire country's citizens; I'd say that generates the term 'priceless'. MO  It isn't anybody's fault, it's just the value system in this country. When we know the details/facts, we can elaborate on the subject, when we just follow what we read in the loids or the nonsense we hear on the 'idiot box' as my DM would say; facts become very cloudy.MO

[itiswhatitis]

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@winamac1 wrote:

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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!!!

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Thank you ma'am!  LOL.

[3suwm5]

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@Lila Belle wrote:
Check out what those exact same super expensive and reasonably -priced drugs offered in the US cost in Europe.

It's really not all that complex.

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I wonder if wages have anything to do with it?  Just asking.

[itiswhatitis]

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@winamac1 wrote:

See below:

If you are Medicaid, you AUTOMATICALLY get the help.

That is not low income subsidy:

https://secure.ssa.gov/i1020/start

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Got it now, @winamac1.  Thank you.

[3suwm5]

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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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Of course, it's called paying your share and someone elses.

[3suwm5]

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@hyacinth003 wrote:

My husband just switched from private insurance to Medicare.

So, we've purchased Medicare and prescription drug supplements.

The drugs that we paid one amount for now cost more!  Very same medications he took for years and paid a certain amount for went up with that change.

Based on what company your prescription drug card is from is what the pharmacy charges you.  Same drug - different price charged.

Now we are trying to understand a whole new system of health care costs.

Hyacinth

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Not surprised!!!  Thought this was all going to get soooooo much better.

[3suwm5]

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@winamac1 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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You don't have to be facetious.  I didn't say "free drugs for every drug or for everyone".  I stated that MANY of the branded, expensive biologics are being sold by major companies (not generic drugs), and they do offer free programs.  I was only trying to help some who may not have known about the many programs offered!

I've dealt with this for years, and I do know that with the product I carry, many Medicare patients won't call the support teams back to even get screened for the free drug program.  So, yes...some should take personal responsibility to SEE if, perhaps, the product they are on...if it's a branded drug, offers assistance.

I also don't know about compounded drugs.  They may not offer the programs the Big Pharma branded products do.

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You know it is 5 o'clock somewhere.  Did you say no Zinfandel??  How about something stronger????  You are too funny!!!

[3suwm5]

Who thought things were going tobe  better??  The cost issue has to be dealt with, if you ask me.MO

If everyone wants to work for free or almost free, things will become much cheaper.  Don't plan on any research though.IMHO