Heath and Well being of Seniors forum: Medicare donut hole questions

 
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Views: 49, Replies: 28 » Jump to the end
Imagejimsned2
Feb 26, 2010 7:18 AM CST
Name: Jim
South Florida
I've read and looked into what is called the medicare donut hole, but still don't understand if they are talking about a yearly limit before you start paying for 100% of your medications, or are they talking about a life time limit. For instance, if I and my insurance plan pay $2000.00 this year for medications, do I start over next year with zero, and am able to spend another $2000.00 without reaching this donut hole they talk about? Or, does everyone at some time reach the donut hole because over the years everyone will have spent the minimum at some time or another. I hope my question can be understood, I find it very confusing. Sticking tongue out
"we don't pay taxes, only little people pay taxes" Leona Helmsley

ImageSugarweed
Feb 26, 2010 9:07 PM CST
Name: Sidney, Zone 9A and 9B
Okeechobee, Fl
Giving Audubon Sanct. Tours Soon.
Jim,
Yes you start over every year and insurance pays the first $2,000.
I'm not sure how much you have to pay after that before the insurance pays for your Rx again.
Smiling
The difference between adventure and adversity is attitude. Be positive, be happy.
Imagejimsned2
Feb 27, 2010 6:14 AM CST
Name: Jim
South Florida
Thank you oh so much, it's a simple answer to a simple question, but the medicare info is written in such gobbledygook I just couldn't understand it.
"we don't pay taxes, only little people pay taxes" Leona Helmsley

Imageshirley
Mar 4, 2010 6:17 PM CST
Name: shirleyt thompson
Pearl River, Louisiana
Beginners At Art
I never did understand that either. It never seemed to hurt us. Generic type drugs were covered all the way through. The liquid nitro was very expensive and not covered but the nitro pills were mostly covered. We paid 25 dollars for those. That added up because he needed so many the last couple months. I was happy to pay for those. He needed them bad. shirleyt
shirleyt
wanna be artist bad
visit me at Beginners At ART



[url=http://cubits.orgshirleytBeginnersAtArt]


























shirleyt
Beginners At Art


Imagejimsned2
Mar 5, 2010 9:07 AM CST
Name: Jim
South Florida
Wow, $25.00 for Nitro? I go through a few scripts a year myself and have never had to pay a cent! Mine are pill form not liquid so maybe that's the difference? I'm still thinking that it's only because Florida is a haven for retirees, and we form a voting block that helps us with lower cost and better coverage plans, but, that's just my thoughts. I'd like to know if any retirees find that between they're doctor and they're different specialists there is a lot of waste because of duplication of tests. I think that in this electronic age a lot could be saved if any doctor could just type in your social security number and get a read out of the latest tests or imaging you've had done so they don't duplicate it and cost the insurance company unnecessary charges which in turn raises the costs of insurance so they can continue to make they're unholy profits.
"we don't pay taxes, only little people pay taxes" Leona Helmsley

ImageSugarweed
Mar 5, 2010 9:32 AM CST
Name: Sidney, Zone 9A and 9B
Okeechobee, Fl
Giving Audubon Sanct. Tours Soon.
I've been thinking that besides a SS#, each person will have an undisclosed pin # and could download all records on a flash drive. Then give the flash drive to the Dr.
Just thinking of how to do it where the whole world doesn't have access to something that's illegal for Doctors to disclose.
Rolling my eyes.

The difference between adventure and adversity is attitude. Be positive, be happy.
Imagesunfarm
Apr 29, 2010 12:34 PM CST
Name: Sally
East Central Kentucky
Jim, One of the things the recent healthcare reform bill passed and signed into law was supposed to do was reduce and eventually eliminate the dreaded donut hole. I think it is a phased-in fix that doesn't happen immediately. I still can't how people surveyed both before and after the bill passed answered the question of whether they were for or against its provisions. The bill was very complex--requiring several reams of paper just to print, and not even the legislators voting on it knew what was in it. The provisions changed right up to the day of the vote and there was so much misinformation floating around it was impossible for any layperson to make a meaningful study and weigh its pros and cons. AARP had the most clear summaries and explanantions IMHO, but all organizations and political groups put their own spin on it.
Living sustainably comes with learning to see the world in a new way.
Imagejimsned2
Apr 29, 2010 2:55 PM CST
Name: Jim
South Florida
Yea, that donut hole thing had me scaird, but thanks to the folks on this thread I better understand it now. I'm just glad to learn that it re-news every year, so I don't think I'll reach it; but then again, who knows.
"we don't pay taxes, only little people pay taxes" Leona Helmsley

Imagesunfarm
Apr 29, 2010 5:57 PM CST
Name: Sally
East Central Kentucky
We can't know what we will face in the way of health problems and the costs that will be required to address them. The whole business is scary and even attempts to preplan are not always successful. When my late MIL fell and broke her pelvis and had to go to a nursing home, we were unpleasantly surprised by the length of her stay and how little of the cost was covered by Medicare and her "excellent" private insurance. The nursing home was over $5k per month; that was more than 4 years ago when she passed away after nearly 3 years there.
We bought long term care insurance for ourselves which was more affordable the younger we were, though it was not inexpensive. We told our grown children that it was our Christmas gift to them. If you are poor enough you may qualify for government assistance; if you are wealthy you may be able to afford expensive care, but if you are somewhere in the middle (like we are) you can be devastated by the need for long term care.
Living sustainably comes with learning to see the world in a new way.
Imagejimsned2
Apr 30, 2010 6:19 AM CST
Name: Jim
South Florida
I just wanted to make a quick post to tell you I agree with you. I also very much agree with your post on "booming into senior hood" and wanted to comment but decided it would get into politics and so I refrained. It's sad about your MIL, but in truth I believe I'd rather be dead then to be in one of those places, maybe I will change my mind if ever the time comes. Our health care system is in a sad state of affairs though I am quite happy with what I have. I've posted before about a guy who I rented a room to, he was 51 years old with no insurance. He was diagnosed with colon cancer two weeks after I was diagnosed with the same thing. He had no insurance because he was between jobs! I got all the radiation therapy and Chemo I needed and lived to tell the tale. Bob,( the one without insurance) was discharged and told they only were obligated to "stabilize" him and he didn't get treatment. two months later he was dead. I don't think he deserved that, but, hey, if your not rich and/or don't have insurance your life isn't worth diddly! Yea, it's a sad state of affairs.
"we don't pay taxes, only little people pay taxes" Leona Helmsley

Imagesunfarm
Apr 30, 2010 9:03 AM CST
Name: Sally
East Central Kentucky
Jim , I hope I am not being too political by expressing my views, at least not partisan, because I think all the politicians and legislators have dropped the ball for quite a few years. It is just not one party or the other that has failed to step up and do what's right for the country. They all lack courage and many of them have agendas hidden from their constituents because of obligations to financial backers.

Not all nursing homes, personal care homes, or assisted living facilities are terrible places. Many are quite nice, though there are often problems in keeping qualified staff even with the best of them. I think all of us would prefer to live out our days in our own homes, but the alternatives are not all dreadful.
Living sustainably comes with learning to see the world in a new way.
Imagewcgypsy
Jun 17, 2010 8:18 PM CST
Name: Sherry
Crescent City, Ca.
I'm sure happy that you guys are discussing all of this re: Medicare. I'll be there in another year and a half and will have to figure it all out by then...lol...
Regarding being able to afford the care, a friend of my Mom's was from Scotland and her father died there of cancer. She was so upset because she was sure that if he'd been in the U.S. he'd still be alive, but....as my Mom told her, "Only if he could afford the care."
ImageSugarweed
Jun 17, 2010 9:40 PM CST
Name: Sidney, Zone 9A and 9B
Okeechobee, Fl
Giving Audubon Sanct. Tours Soon.
I am going to get some info posted here about seniors and the new health care bill, as soon as life slows down enough for me to do that.
Honest Injun!.... I am part Native American, so I can say that.
Big Grin
Sidney
The difference between adventure and adversity is attitude. Be positive, be happy.
Imagejimsned2
Jun 18, 2010 6:27 AM CST
Name: Jim
South Florida
Looking forward to your post Sidney, just please don't write it in gobbledygook! I no longer trust ARRP and have quit any association with them. To my mind they are just another large corp influenced by big money.I get much more reliable info from other seniors on a more personal level.
"we don't pay taxes, only little people pay taxes" Leona Helmsley

ImageSugarweed
Jun 18, 2010 11:14 AM CST
Name: Sidney, Zone 9A and 9B
Okeechobee, Fl
Giving Audubon Sanct. Tours Soon.
Being a union lady all my info comes from a retired union members association.
The AARP hired a republican high-up back in '02 or '03 as CEO. A cousin included me and so I like the discounts traveling.
I haven't trusted them ever since.
They send too much paper and sell memb. information.
For sometime they sent my things to Mr. S...McC...
After that I got begging letters addressed to Mr. S McC...
They finally changed it to Mrs S McC.... also wrong as McCollum is my maiden name.
(Yes, he's my cousin and I wouldn't vote for him for dog catcher!!!)
The info will truly be from non-profit.
The first thing they told me was if a ins co has to buy me dinner to get me to buy their supplemental, they are making more $$$s than a really good plan that cares about the patient.
Sidney
The difference between adventure and adversity is attitude. Be positive, be happy.
Imagejimsned2
Jun 18, 2010 1:00 PM CST
Name: Jim
South Florida
I found that you can get the same discounts if you belong to AAA or any number of groups that aren't in the business of misleading seniors.
"we don't pay taxes, only little people pay taxes" Leona Helmsley

ImageSugarweed
Jun 19, 2010 7:30 AM CST
Name: Sidney, Zone 9A and 9B
Okeechobee, Fl
Giving Audubon Sanct. Tours Soon.
My membership was a free one this year and I won't re-up.
I totally agree. In my last few years I found just my drivers license gave me all the discount I needed.
AAA left me stranded for 4 hrs once. I won't do them either.
Glad I stay at home more.
Sidney
The difference between adventure and adversity is attitude. Be positive, be happy.
Imagejimsned2
Jun 19, 2010 8:22 AM CST
Name: Jim
South Florida
Some one on another thread was concerned that Medicare was going to cut back on what they pay doctors, this morning I find that in reality Medicare is giving them 2and 1/2% more! It's very difficult to get past the scare tactics and figure out what is actually going on.
"we don't pay taxes, only little people pay taxes" Leona Helmsley

rtl850nomore
Jun 19, 2010 10:50 AM CST
Name: Jayne
Glendale/Parks Az
Twas me that was concerned. And, a headline in my morning paper reads "Medicare pay for doctors to be cut 21%. Inaction by congress may lead some doctors to drop patients." Further, "Doctors who treat Medicare patients will see their pay cut by 21.3% after Congress failed to approve a fix to the government insurance program for the elderly and disabled. The Senate on Friday passed legislation that aims to delay the pay cuts until the end of November, but the House will not vote on the payment fix until next week. Lawmakers did not act before the agency that oversees Medicare ordered Friday that claims submitted this month by doctors, nurse practitioners, therapists and others be paid at the lower rate."
The reason most people fail instead of succeed is because they give up what they want most for what they want at the moment.
Imagejimsned2
Jun 19, 2010 2:17 PM CST
Name: Jim
South Florida
The bill passed by the Senate delays the cuts until the end of November — after congressional elections — when lawmakers hope the political climate is better for passing a more permanent, and expensive, solution.

The bill would also increase payments to providers by 2.2 percent. The legislation, which costs about $6.5 billion, is paid for with a series of health care and pension changes that both Democrats and Republicans agreed to.

The Senate approved the measure by voice vote Friday after failing the night before to pass a larger package that included the funds.

As far as I can tell, your right about the delay in payments, and that the doctors or medical profession will be paid from last month at a lower rate, but, I believe that as of last night they will get a two and a half percent increase from now until November when our politicians "hope" to pass a better bill. The above first two paragraphs are cut and pasted from the Sun Sentinel in Ft. Lauderdale.
"we don't pay taxes, only little people pay taxes" Leona Helmsley

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