Ok, I FINALLY got my son on disability and now I need to find drug plan and 2ndary medicaid ins. Anyone from Florida provide advise? I need to know what is the better plan for someone with sz and cover all of these meds. Apparently, I need to act super fast.
We got help figuring out insurance from the provider that gives my daughter her injections monthly. They had a very helpful finance dept staff. We only have one drug to worry about.
Thanks, but my son is on 7 different meds (they aren’t working), but I am trying to figure things out. All the medicaids don’t really cover mental issues. This is so hard. Don’t want to make the wrong choices.
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My wife could get Medicaid in New Jersey, but not in Florida. One thing to remember, when you get the policy in place, you need to make sure they are actually billing it. My wife had coverage from her dad’s workplace insurance, but she also had medicaid. Over a year later we discovered a demand for $90,000 for two hospital stays. It turned out neither insurer had paid an outstanding bill, and they were just bouncing it to each other. Eventually we got them written off with the charity aid option. Basically a lot of these big bills are outrageous, and they give the hospitals a backdoor to write them off and avoid legal confrontations, it seems.
Thank You, I will try to remember your advice.
Tippy,
If your son can get on Medicare, there’s a program called “Extra Help” that pays for the majority of the cost of his prescriptions. The prescription program is official known as WellCare Classic (PDP).
Galaga
Thank you for this information! I sent in the request. Hope it doesn’t take 3 years for it to go through like it did for the disability!!
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The Extra Help that @Galaga mentioned will also pay for the monthly cost of Medicare (once they qualify for Medicare - what date did they give for start of disability?) Extra help also pays for the difference in Medicare approved charges - if Medicare pays 80% Extra help will pick up the other 20%.
Oh! I didn’t know that! My son’s card said he was Medicare part A and B eligible 2/2024 even though we just got the notification a few weeks ago. I sent in the application last week for extra help. Sure hope I hear from them soon. So with the Extra Help, does he need to get the 2ndary medicaid? Also, with the Extra Help will I have to pay first and then send in the bills for reimbursement?
If his application for Extra Help gets him QMB - Qualified Medicare Beneficiary - you will still need a prescription drug plan. Like @Galaga mentioned, Well Care Classic is one of the options. I liked Well Care Classic because they were easy to work with, had Mike’s prescriptions and their monthly cost was -0-. You will have to pay for the prescription drug plan you choose, you can have the money for that taken directly out of his disability check. You will also have to pay the drug co-pays.
Extra Help picks up Medicare premiums, deductibles, coinsurance and copays. You don’t have to pay and wait to be reimbursed. The doctors and hospitals will charge Medicaid directly for it themselves. You will not receive a bill. If they make an error and charge you of something Medicare didn’t approve without your permission, you don’t have to pay it, they make that very clear on their statements.
Did he get SSI also with SSDI? Usually if you receive SSI you will qualify for Extra Help.
Mike’s cancer treatments and all of the experimental trials were paid for 100% due to Medicare and his Extra Help QMB status.
He could get his therapy appointments paid for by medicaid. First their office would have to apply to Medicare, once turned down, the bills could be submitted to Medicaid for payment.