Have the healthcare changes started - Page 2 - Big Big Forums

nelda · 10-19-2009, 02:00 PM

Is the med coverage on the Medicare Advantage plans controlled by the plans or by Medicare?

Are you also in Texas? My neighbor has that same ins, and just last week she told me one of her specialists is no longer a provider. She said she's called 15 other doctors that were listed in her provider's book and all said they are no longer taking Humana. She said she asked why and was told "because Humana doesn't want to pay for prescriptions". She has mentioned to me before that her insurance wouldn't pay for a couple of meds she needed.

I also have a Medicare Advantage, but I have a different one. I don't take any meds on a regular basis, so I don't know if any prescription coverage has changed on the plan I have now. Last year I had a Humana PPO for part of the year when I first became eligible, but I dropped it because of unacceptable changes that were going into effect on their PPO this past January.

shadowcats · 10-19-2009, 03:38 PM

[quote=jasmine;96217885]gotta love that huge list of $4 prescriptions at walmart!!

ive been on them for over 6 years now , and almost every grocery store and all the walmart s that have the 4 dollars script plans have the generic ones on their list. so tell her to ask for a script . and fill it off the plan,
as for the other pill , cant help you there i gave up smoking years ago cold turkey,,,,,,,,,,,,
good luck.

DrGrin · 10-19-2009, 08:37 PM

Quote:

Originally Posted by hblueeyes

Again they will no longer cover thyroid. She could pay out of pocket $11. But she will not. Chantix was covered but they no longer cover it if you are over 65 years old.

I wonder if they changed in anticipation of the healthcare changes. Like the financial industry is doing making rates variable and charging for credit cards that used to be free in lieu of the new rules to take affect next year.

Me

It would be a dangerous thing for her to suddenly stop the armour thyroid. She needs to pay the $11 out of pocket and keep taking it. $11 is a small price to pay to keep from having all the health issues that will come back if she stops taking it.

gmyers · 10-19-2009, 08:49 PM

If they're saying she's too old to get it can the doctor still give her a prescription for it?

buglebe · 10-20-2009, 01:22 AM

Quote:

Originally Posted by hblueeyes

Again they will no longer cover thyroid. She could pay out of pocket $11. But she will not. Chantix was covered but they no longer cover it if you are over 65 years old.

I wonder if they changed in anticipation of the healthcare changes. Like the financial industry is doing making rates variable and charging for credit cards that used to be free in lieu of the new rules to take affect next year.

Me

Many insurance companies refuse to pay for the Armour. But if she refused to take thyroid meds because she just won't pay for it , please pay for it for her. Read about hypothroidism and you will see her need to keep taking it. At 65, you need all the thinking power you can get.

hblueeyes · 10-20-2009, 03:10 AM

Her meds are covered by Humana Gold. Which is paid for by her medicare. They used to cover Armour but no longer do and use another med. However, because of the diligence of her doctor and the phamacy,CVS, she got her meds today for free and I was surprised to see it was Armour. They said it should last for about a year. We shall see.

I did check walmart after the op mentioned it and that would have been the route we would have taken if all else failed.

My mother is cheap and refuses to pay for certain meds. If she got it free once she will rarely pay unless it is pain meds. I told her what the consequences were if she stopped taking them and she did not care or seemed at all concerned. She is 81 and I am not about to try and change her. She is so set in her ways and change for her is hard. As for paying it for her, NO WAY!. We pay for everything and she has loads in the bank, owns stock that pays nice dividends, has US savings bonds out the wazoo. Money is not her problem.

Me

sunniekiss · 10-20-2009, 12:12 PM

Geez I honestly do not know how you tolerate it with your Mom. She has the money to pay for her medication but won't. You have more patence than I do for sure.
My Mom also has Hummana & they cover her thyroid meds but she does have a co-pay.

cathych · 10-21-2009, 10:45 AM

Quote:

Originally Posted by hblueeyes

I wonder because my mother, who is 81 years old was told after 2 1/2 years of her current health plan, that she is too old for thyroid meds and chantix to stop smoking. They said that older than 65 is the cutoff. Excuse me, but she has been over 65 for 16 years. The state paid unril 2 1/2 years ago when she opted in to Humana Gold and they have been providing it. Now suddenly, she is too old for hormones for her hypothyroidism or to quit smoking with meds.

Me

well, I hate to be a wet blanket here; but it sounds like your mom has her mind made up, and there is nothing that you can do about it. If she is stubborn and will not get her meds because at one time she got them free, well, that is just going to have to be her problem. I can identify with you because my mom is 80 and stubborn as heck about some things, and I worry about her also. But, short of buying her meds yourself, there is really nothing you can do. If she has been taking meds for hypothroidsim, if she goes off them she will feel bad. Maybe this is the wake up call she needs to get back on her meds. Things are tough all over dollar wise. I also have medicare, but am on my dh's work insurance because it does not cover pills.