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    TGIF*****7/22/2016 ******Roll Call....New members too.
    avatar
    dollbug posted:
    TGIF****and a good Friday to each of you. MiMi in NC. It is gonna be a hot week-end.....with the heat index being over 100*....can you believe it? WELL.....I do hope this is short lived. Cooler weather has to be close. Funny as it seems that I can never be satisfied with the weather....it is always too hot, too cold....never just right. I think I missed spring time this year....so I am hoping for a longer fall. Time will tell.


    Welcome to any new members who have joined or to those also who just might be lurking.....I am sure you will find some good info here on this support site. Hopefully things will soon improve and we will not be faced with so many issues. (it sure took a long time for someone to finally address the issues - but hopefully someone knows and are trying to work on them).


    I am feeling better now. After several days of lower back pain....I think I am on the mend. I go next week for a ultrasound of the kidneys....I still do not know IF I have passed the stone OR it is just laying low. I can tell though that something is different. I am thankful.


    Not much going on today in my corner of the world. DH has taken off today and is helping his brother in law with some repairs at their lake house. I sure hope they are both careful. They are both getting older and should not be climbing on top of houses these days. I think there is a leak though which needs to be fixed. DH will be another year older tomorrow.
    Only 2 years to go for retirement....IF he decide to. Lots of things to consider and so much to figure out. This is not a good time with so much going on.


    OK...have a great Friday and remember to pace.....drink lots of water and try to stay cool.




    MiMi



    PRAY FOR PEACE and leave the rest to GOD....MAY GOD BLESS AND GUIDE AMERICA....

     
    avatar
    maggiethedoglover responded:
    OMG. I typed for a good 15 minutes and left for 5 minutes to eat and my post was completely gone. Let me try again.
    When you have Medicare, it only covers about 80% of your costs, except when you are in the donut hole Stage IV and then you pay through the nose.

    You can get a traditional supplemental plan like Humana or a number of others and they help if you are hospitalized or have huge doctor bills. For Humana, they have 2 plans, one at $80.75.mo which has a $2180 overall deductible and a $1288 hospital deductible before it covers anything and then picks up the 20% of part A and part B Medicare (doctors and hospitals), not covered by Medicare. Humana's other regular supplemental plan is called Healthy Living and costs $194.31/mo plus a rider of $29.59/mo. I forgot why you need that rider. With this plan, you have a 0% deductible for parts A and B. Neither of these plans pay anything toward prescription drugs.

    Humana also has a Medicare Advantage plan called Humana Gold Plus. This plan costs $31/mo per person and covers prescriptions only. This is the plan I have.

    There are 4 stages. In stage one which lasts until you have paid $360, you pay $6 for "Preferred Generic drugs", $15 for "regular generic drug"s, $47 for "Preferred Brand drugs" and 100% for all other drugs.

    Stage II which ends when the maximum prescription costs paid by you and your plan reach $3310, you pay the same for the first 3 categories of drugs, but there is a fourth category called "Non-Preferred Brand drugs" where you pay $100/mo. There is also a 5th category called Specialty drugs where you pay 25% (Lyrica is in this category).

    Stage III is the coverage gap (AKA donut hole). You stay in this stage until your out of pocket costs for the year reach $4850. The first 4 categories are the same co-pays. Category 5 moves from just "Specialty drugs" to "Preferred Specialty drugs" Lyrica is no longer in this category. It has moved to "all other brand drugs" and you pay 45%. "All other generic drugs", you pay 58%. those percentages that you pay move down each year until the year 2020 when you are paying only 25% for "all other specialty drugs" I don't know what the generic drugs cost You can thank President Obama for the cost reduction.I'm not sure, but I think the $4850 also decreases somewhat each year until 2020.

    Stage IV is Catastrophic Coverage. In this stage, you pay %5 or $2.95, whichever is greater for "Preferred Generic drugs" and 5% or $7.40, whichever is greater, for all other drugs.

    At the present time, I'm in Stage 3, the donut hole. Lyrica (120 capsules) is $310.82, no matter if it is 100 mg or 150 mg. 60 pills would be $155.41.120 Tramadol is $6.84. I didn't ask about my statin or my anti-depressant because every question took 10 minutes to answer and my head was already spinning.

    The bad news is that you cannot have both type of plans, even if you're willing to pay for them. You must choose either a regular supplemental plan that costs more and helps with doctor and hospital bills or a Medicare Advantage plan that helps with prescription costs. I must also tell you that some Advantage plans are free but pay slightly differently. For example, the plan that AARP endorses is free. I can't remember why I didn't choose that one. It had Silver Sneakers just like Humana gold. I use that to go to the YWCA and take water exercise classes. My favorite is called Aqua Zumba

    I hope some of this helps you decide. Good luck.

    Soft hugs to all of my fibro family friends. Enjoy the weekend.

    Love, maggie.

    Life is a shipwreck but we must not forget to sing in the lifeboats - Voltaire
     
    avatar
    katmandulou responded:
    Fabulous Friday is upon us again!!!!!


    It's hot. And humid. Mom would call it "very close" out. It feels like I'm swimming. LOL We're supposed to get t-storms later, and I hope the humid goes away.


    The FB page has been open for three weeks, and we have only 7 members. If you'd like to socialize in a safe and secure way, look for Louise Cote and tell me "Mimi sent me". You will NOT find the page - it's secret. Nothing can be shared across Facebook. Now THAT's secure!


    Mimi, I'm glad you're feeling better. Sometimes it just takes time for things to work out.


    Maggie, hi! You're giving really good advice on the whole Medicare thing. I'm my Mom's healthcare proxy, and every once in a while I get bogged down in the details. Dad made good arrangements, and I've changed very little since he passed. I'm glad the nursing home will help me out.


    To everyone I've missed - Hi! I might not get in over the weekend, so anyone who wants to copy-and-paste Mimi's Roll Call from WMD to FB is welcome to it.


    Wishing you all the best day - and the best weekend - YOU can possibly have!
    Lou


    PS - I miss having bold and italic in FB.
     
    avatar
    maggiethedoglover replied to katmandulou's response:
    Are you all moving to facebook? Can I join you?

    maggie

    Life is a shipwreck but we must not forget to sing in the lifeboats - Voltaire
     
    avatar
    dollbug replied to maggiethedoglover's response:
    Hi Maggie.....and thanks so much for the info....I am going to copy and past your reply so that I will have this.


    There is another FB site which has been set up. I am yet to find it....I hope you will be able to locate it.


    Take care.






    MiMi
    PRAY FOR PEACE and leave the rest to GOD....MAY GOD BLESS AND GUIDE AMERICA....



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