Most experienced Social Workers know this and will get you set up with this program as soon as you go on Medicare. However, many don’t which means you need to find this yourself. I hope I saved you some hunting time.
After three years on private pay or commercial insurance, you must transition to Medicare. You can do so prior to that but the dialysis facilities won’t encourage the move because commercial insurance pays much more than than Medicare. In your self-interest, you might want to consider it for the benefit of the Extra Help program which will help considerably to make your medications much more affordable (if you qualify).
When I was at “The Center from Hell”, I was asked to sign a form wherein I “opted out” from Medicare. The facility wanted me to stay on private pay insurance so they would get paid more for my dialysis. The problem was my insurance had huge deductibles and co-pays leaving me paying several hundred dollars a month for dialysis and medications. It was the cost for medications that was the larger share on my monthly cost. I was bleeding money. When I left that center, the first thing the new Social Worker did was get me on Medicare and Extra Help. Finally I was able to afford my medications!
It works like this: Medicare Part D and, in some cases, Part B will pay 80 percent of your medications leaving you responsible for the remaining 20%. In some cases, that can mean several hundred dollar per month for which you are responsible. If you have living on a low income, even an extra hundred a month is too much. Extra Help contributes to pay the twenty percent not paid by Medicare.
(Even after a kidney transplant, I still use Extra Help because I turned 65 while on dialysis for nearly ten years. That’s REALLY helpful because my meds would be about $3000/month!)
So, if you qualify, Extra Help can allow you to save a considerable amount on medications.
Check it out… https://www.ssa.gov/benefits/medicare/prescriptionhelp/
That website also has some valuable information about other Medicare and Social Security programs. Start clickin’ them links! Enjoy.
I hope this was helpful.
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