posted
Effective June 1, 2016, patients who are on Medicare with a Part D prescription drug plan will lose coverage of their medications and have to pay out of pocket unless they are prescribed by a health care provider who participates in Medicare. None of the top LLMDs participate in Medicare. For those of you faced with losing drug coverage, what will you do?
Posts: 18 | From MA | Registered: Jun 2009
| IP: Logged |
TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
If the participating provider has opted out with medicare the prescriptions will be covered. They must file the paperwork with medicare. My guess is that most LLMD's are already opted out or would be willing to do so.
To find the .pdf where this is outlined go to google and enter the string mln matters se1434
posted
Hi TerryK and thank you so much for replying:
This is what I thought, too, but I spoke earlier with my Part D provider (Blue MedicareRX) who told me that the doctor must be enrolled in Medicare. And when I spoke with Medicare directly a few days ago, she told me that the doctor had to be enrolled in Part D and could be enrolled in Part D only. ...
Can you tell me the source of your information? Because I would really like you to be right!
EDIT: Oh, so sorry, I see now that you told me what to search. Doing that now.
Suzanne
-------------------- Suzanne who no longer lives in northeast ohio Posts: 18 | From MA | Registered: Jun 2009
| IP: Logged |
<< Together, these rules require virtually all physicians and other eligible professionals, including dentists, who write prescriptions for Part D drugs to be enrolled in an approved status or to have a valid opt-out affidavit on file for their prescriptions to be coverable under Part D, except in very limited circumstances. >>
-------------------- Suzanne who no longer lives in northeast ohio Posts: 18 | From MA | Registered: Jun 2009
| IP: Logged |
TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
You are welcome.
In my experience it is not unusual to get incorrect answers from medicare or an insurance company. Makes it very hard to make decisions.
Posts: 6286 | From Oregon | Registered: Jan 2006
| IP: Logged |
posted
I was once told to call three times and hope that the answer that I got 2 of the 3 times was correct.
-------------------- Suzanne who no longer lives in northeast ohio Posts: 18 | From MA | Registered: Jun 2009
| IP: Logged |
susank
Frequent Contributor (1K+ posts)
Member # 22150
posted
I am hoping to see a doctor that does not take insurance. For her to be able to prescribe things that my Medicare Advantage plan would cover - she said she needs to be registered with Medicare. Something called PECOS? I am waiting for her to complete her paperwork. I assume this is for Parts B and D.
-------------------- Pos.Bb culture 2012 Labcorp - no bands ever Igenex - Neg. 4 times With overall bands: IGM 18,28,41,66 IND: 23-25,34,39 IGG 41,58 IND: 39 Bart H IGG 40 Posts: 1613 | From Texas | Registered: Aug 2009
| IP: Logged |
posted
I'm sorry, I don't know much about Medicare Advantage plans, but I thought that doctors have to be registered for Part C for that. But it is possible that she just needs to enroll for Part D.
-------------------- Suzanne who no longer lives in northeast ohio Posts: 18 | From MA | Registered: Jun 2009
| IP: Logged |
The Lyme Disease Network is a non-profit organization funded by individual donations. If you would like to support the Network and the LymeNet system of Web services, please send your donations to:
The
Lyme Disease Network of New Jersey 907 Pebble Creek Court,
Pennington,
NJ08534USA http://www.lymenet.org/