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Does anyone in here know of consequences for not signing up for plan D

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Imagevision Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Mar-08-06 12:45 AM
Original message
Does anyone in here know of consequences for not signing up for plan D
for Bush's Drug plan fiasco/rip off!!
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carpetbagger Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Mar-08-06 12:55 AM
Response to Original message
1. A later buy-in has some penalties associated with it.
I don't have the numbers, though. It could just be that the assumption, and thus the rates, are based on a 75 yo costing more than a 65yo.
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Dr Ron Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Mar-08-06 01:03 AM
Response to Original message
2. Costs more if join later
Unless someone is already in a health plan, if they try to join the Medicare plan after May there is a 1% per month penalty. In addition, the premium may go up every year and those joining later pay the higher premium plus the penalty.

Another consideration is that there is a limited time frame where you can join. If someone doesn't join before May (possibly because they aren't currently on much medications) and then is diagnosed with a condition requiring expensive medications in July, they will have to pay for the rest of the year until they can join in January. (Due to these penalties, I'm advising patients with limited medication costs to wait until closer to May, and then get the cheapest plan they can with higher out of pocket expenses, so at least they have some coverage, and can change to a more comprehensive plan in a future year if needed).

Before people get outraged, while there are many problems with the plan, it makes sense to have some penalties for joining late. Think of it as an insurance policy. If only the sick join, then expenses are higher for every one. It is better if you can get everyone, incuding healthier people to join, in order to reduce cost per person.

This assumes that everything works well with initiating the plan. Considering how overly complicated this is, there is also a valid argument to give people more time to figure it out before instituting the penalties.
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Wordie Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Mar-08-06 01:34 AM
Response to Reply #2
4. Are there any plans in the works to simply scrap it and try again?
Edited on Wed Mar-08-06 01:37 AM by Wordie
It seems to me I've read that's been suggested, although I don't know how serious a proposal it is, or whether anyone is giving it any serious consideration. Given how confusing the plan is, I think that might be a good idea.

Another question I have is how does one choose which plan to select without a crystal ball that can predict all the unknowns of one's health in the future? As I understand it, the different plans all have different lists of drugs. If you sign up for a plan in May, but then catch something, or develop some new condition in July, and the drug you need isn't on the list of the plan you chose, what do you do then? Do you have to pay full price? Wait until the open enrollment period rolls around again so you can switch plans (I understand you can only do this once a year)? Just go without?

This is a plan that works great for the drug companies, apparently, but not so hot for the people who actually need it. Although, the one possible postitive outcome is that perhaps it will be so clearly a huge fiasco, that it will bring us one step closer to universal health care.
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Dr Ron Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Mar-08-06 01:51 AM
Response to Reply #4
5. Changes proposed by Democrats
Democrats have proposed changes, but I doubt that any major changes will be passed as long as the Republicans controll Congress.

If people research the programs, most likely they choose based upon the medications they are now on as there is no way to know what will be needed in the future.

It is rarely an absolute case of medications being covered or not being covered. Typically a plan will have a few tiers of drugs, with some having lower copays, and others having much higher--I've seen many with $60/month copays. There may also be some that aren't covered.

If drugs aren't covered at all it is generally because of only covering certain drugs in a class. Often if a drug is not covered there is an alternative that isn't.

Some plans will grandfather in people who are on a medication which isn't normally on their formulary.

It is also possible to obtain prior authorization to get some drugs covered which normally aren't on the formulary.

Maybe the mess will bring us closer to a single payer plan if people see this as a mess. There is also the possibility that the right wing noise machine will spin this as a failure of Medicare to attempt to create a backlash against government run health plans. Hopefully people will see that the problem is the hybrid nature of having multiple insurance companies involved rather than having the prescription plan be part of the main Medicare program.
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LastLiberal in PalmSprings Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Mar-08-06 01:25 AM
Response to Original message
3. Death.
A long, lingering, painful death due to the unavailability of affordable drugs, either at home under Plan D or overseas (Canadian drugs are being intercepted by Customs). This time will be spent contemplating the question, "Why the f*ck did I vote Republican?"
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roguevalley Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Mar-08-06 03:21 AM
Response to Reply #3
6. my mom and dad are covered by my mom's aetna plan from her
PERS pension. Does she need to join this &^%$# or is she cool?
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Dr Ron Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Mar-08-06 12:36 PM
Response to Reply #6
7. Depends if a credible plan
If someone is in plan which meets the minimum requirement of the Medicare plan they can continue in their current plan. They should have received a letter saying that their plan qualifies as a credible plan. It is important that they have this letter. Should their plan ever be shut down, or for some other reason they decide to change to the Medicare plan, they can change to Medicare Part D without penalty if they have the letter proving that they have been in a credible plan.
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roguevalley Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Mar-08-06 03:25 PM
Response to Reply #7
8. thanks!
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oneold1-4u Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-14-06 09:54 AM
Response to Original message
9. Realize please!
If one is on SS, SSI. or other minimum disability it would be very hard for any medical care costs beyond your control to be taken from you. Just sign up for anything "this fiasco bunch" has created and they will be able to claim what ever they want before you see your check!
"Blind trust" of over half the nation, got us into this horrible mess. They are walking to the bank on that "trust" and you may never need a bank any more!
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Imagevision Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Apr-15-06 11:56 PM
Response to Original message
10. Just received Medicare letter stating if I didn't sign up; " Medicare
would choose a medicare prescription drug plan for me" -- I was deemed disabled almost 3 years agond the meds I use aren't covered by drug companies and/or the Insurance-co-payments exceed what the meds would for a year because they would deduct the Ins. plan $35.00 from monthly check.

Anyone else receive an altimatum letter?
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