Sent:	Wednesday, December 19, 2007 3:10 PM

Subject:	TX Support Group - Medicare & Meds
Attachments:	Client handout Part D 2008.doc

Hi All - 
I am passing along this info that I received from Phyllis.  She is working hard to get info out in a 
timely fashion - especially to those who need it most - as you will see in her email.  [And 
download her info attachment!  It will help clarify things.] 
We can look forward to a full presentation on our drug plan options at an upcoming support group 
If you need help ASAP, give Phyllis a call [212.305.6266], or call and introduce yourself to Jennifer 
Fojas [212.305.4340], who replaced Sophia  as our financial coordinator for transplant-related 
Take your time, ask questions, ask for help! 
Don't make any decisions when you're tired. 
~T, 12/19/07 
About the time we can make ends meet, somebody moves the ends!    ~ Herbert 

-----Original Message----- From: Phyllis Sachs <> To: Cc: Lucy Soto<>; Jennifer Fojas <> Sent: Wed, 19 Dec 2007 9:14 am Subject: Re: Support Group - Medicare & Meds Hi, Terry, The following information was forwarded to me so I am passing it on to you: Most people who are enrolled in Medicare Part D can only switch their drug plan between Nov. 15 and Dec. 31 each year. As we come to the end of that period, we’ve tried to prioritize which clients need help now and which may be able to wait until January. We wanted to share with you the order that makes sense to us. *Lower priority:* · People on* Extra Help*, the federal government subsidy that makes Part D significantly cheaper. You receive it automatically if you have* Medicaid* or a* Medicare Savings Program* and can also apply for it through Social Security. · These clients may change their drug plan once each month, with the new enrollment effective the following month. · People on* EPIC*. · EPIC has generally chosen a plan for these people based on their drug needs and pharmacy use. If someone’s Part D plan doesn’t cover a drug, EPIC will. · These people also may change their drug plan once each year in addition to the Nov.15 - Dec. 31 period. · People who are currently enrolled in* Medicare Advantage* plans with prescription drug coverage (MA-PDs). · These people may switch from their current MA-PD to a different MA-PD/ or/ to Original Medicare and a Prescription Drug Plan (PDP) from Jan. 1 to March 31, 2008. *High priority:* · People who* do not receive Extra Help and who are not eligible for EPIC*. · Note: EPIC does not have an asset test. Income limit is $35,000/yr for a single, $50,000/yr for a couple. · Unless extenuating circumstances apply, these people will not be able to change plans again until next November, with the new enrollment effective Jan. 1, 2009. Just because someone’s drug plan worked for him this year doesn’t mean it will next year. Our department has analyzed 2008 Part D plan choices for about 70 individual clients in the past several weeks. Of these, the majority will have to switch plans next year due to a premium increase; restrictions on their drugs; or changes in drug coverage (i.e. the plan covered one of their drugs in 2007 but will not in 2008, making it prohibitively expensive). I’ve attached a client-friendly notice that explains the transition into 2008 for Part D – feel free to pass it on and hand it out to people. Hope this is helpful. We are still working on a presentation re Medicare Part D for a Support Group Meeting. Stay tuned. Happy Holidays, Phyllis Sachs, LCSW wrote:

Hi Phyllis - Some people are asking questions about Medicare and medication coverage at the two year mark. More of us are coming up on that milestone, and need a review of our options for funding our immuno-suppressants. And a lot of pre-transplant folks are oblivious to the pitfalls of "routine" coverage. They are often caught unawares at a time when so many things seem overwhelming. Now that Sophia has left, we're not sure where to turn for general information. Perhaps an open date in January could be devoted to the kind of post-transplant expenses that are routine: additional travel, temporary housing, all those medications, lab visits, etc. [Even the costs for unusual things add up - like additional over-the- counter vitamin supplements, new walking shoes and bigger sweats/tees!] Some discussion of Medicare/Medicaid, EPIC, Part D plans, private insurance - as well as options provided directly by pharmaceutical companies, and various search services [like] could provide helpful information. Anything you can do to schedule such a support group session will be a real help, and a reassurance that things are manageable. Thanks! ~T, 11/28/07 Stan Terry Lopata > PO Box 497 Clinton NY 13323 315-853-3342 ---

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