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If you are considering getting Mom Medicaid fot health, this is a question you need to ask a Medicaid caseworker. I am in NJ and my nephew gets vision, dental and prescriptions. He has been disabled since birth.
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Reply to JoAnn29
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Is your LO in facility care? I see you posted under Assisted Living. Not all states accept Medicaid for ALF. Without more info just trying to give you heads up on red flags.

In my DH aunts case they do pay for prescriptions except for the times they don’t. 🧐


I’m assuming you may be looking at the new price of the Part D drug plan?
It was a shock for me when I saw it but since she’s on Medicaid it will be adjusted.

Or maybe you are filling out a Medicaid application and wondering whether to list the drug plans?
My attorney advised me to keep her Part B, Supplement and Part D. The premium for the Part D comes out of her SS along with Part B. The supplement is deducted from her bank account but is allowed for along with her monthly Personal Needs Allowance (PNA).
The rest of her SS goes as her share of cost. So, it isn’t costing YOU, it is part of the benefit of Medicaid, of course that’s IF your state accepts it.

Or you might in the future have a LO on hospice and this question comes up again?
In which case, Medicare pays for meds received through hospice compensation. Since it comes out of their profit, you may find them less than willing to provide meds that you want your LO to receive. You keep the plan and they are covered just in case. I’ve had the facility not go along with the hospice on who should pay for what. While they fussed, I picked up the prescription.

Or you might be wanting a drug for your LO that the NH pharmacy can’t get easily and you know with LO drug plan you can go pick it up at the drug store?
Has happened more than once for DH aunt.

Or you might wonder what would happen if your LO came off Medicaid?
How would you get their meds then?

Because the pharmacy the NH uses is out of network for my LO insurance, they applied for extra credit from Medicare and her meds are zero when I have picked them up. When her SS statement came in I see that the premium for her Part D was reduced to $2.20 from last year when it was $6.60 and $20+ the year before. If she weren’t on Medicaid it would now be over $40.

There is a lot wrong on the surface for this appearance of overpayment for insurance premiums but you nor I wrote the rules. We just have to manage the best we can within them for the benefit of our loved ones.

I imagine most people don’t keep it. That was advice aunt paid for and I’m glad I followed it.

Now this is my personal experience. She has been on Medicare for 2+ yrs.
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Reply to 97yroldmom
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In OH, Yes.

They even changed it to one company handling all requests. Gainwell.
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Reply to cover9339
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In my state (MN) the answer is yes in my MIL's case. My hubs is her PoA. We manage her Medicaid application and paperwork. She' not had to pay for anything, but then against, she hasn't required much either. She's on meds for thyroid, depression, and OTC pain (acetaminophen and ibuprofen). Can't speak to anything more than that.
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Reply to Geaton777
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Because Medicaid varies so much state to state I think it would be difficult for us to answer this for your own particular situation. I think also that as is the case with most insurance, some scripts must be written for generics and there are certain drugs that may be unproven and/or very expensive while still in patent protection that may not be covered.
I would discuss this with your pharmacy and they should be able to better inform you, or to inform you as to how to obtain the information you need.

Good luck!
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Reply to AlvaDeer
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