Social Security approved my sister for help with her Part D prescriptions!

[Samurai_Writer]

As some of you know, my sister has severe schitzophrenia and is an uncontrolled diabetic. She's been on SSDI for 20 years. Before Part D went into effect, most of her drugs were paid for by the pharma companies through their charity plans. However, all the pharma companies are getting rid of these plans with the advent of Part D.

My sister gets $1000 a month in Social Security. The total cost of her drugs is $1300 per month. If she couldn't get help paying for them, when she reached the 'gap', she would have to pay the entire $1300 for several months before reaching the 'catastrophic' category. Her drug costs (out of her own pocket) would have been over $6000 per year under Part D -- 1/2 of her SSDI for the year.

Social Security has a program where they will pay the deductible AND pay for the entire costs of the meds during the 'gap' period. I applied for her a couple of weeks ago, and just found out that she was APPROVED. It's such a relief to know she will be able to get her meds.

If anyone is interested in looking into this program, go to http://www.socialsecurity.gov/prescriptionhelp/ . There are some restrictions, of course. You need to have a limited income and be on social security or SSDI.

[Cleita]

1. That's good to know if you get stuck without your meds.n/t

[elfin]

2. Social Security is still filled with professionals

who help you get what you are entitled to. I was amazed at the help I got after my husband died. They checked every detail to my benefit and got me a "death after disability" payment which I had never heard about. It really helped.

Bush etal are probably making this more difficult now - depends on who you get on the phone. Just keep trying is my advice to those who come up empty. Making an appointment to go in person and finding someone who is aroud 50 or thereabouts is probably the best strategy for those having problems.

[rowdyjesus]

4. Investigate your benefits

I thought SS was helpful when my husband died, and they did quickly set up benefits for my one child of 16. I found out only through a cousin that I could get widow's benefits at age 60...something SS didn't tell me, and truly, I didn't think it would happen...but it sure did. I would not have known to even ask, for nothing in the annual statements told me about this. I tell everyone in this situation to check it out, and none of my friends had known about this before. Medicare and prescription drug benefits don't apply till later, but that SS check can prove invaluable.

[juajen]

5. Do you mind explaining the "death after disability"payment

My husband is disabled and I would like to know.

[elfin]

6. sorry for the late answer

forgot to check my bookmarks for a while.

My husband had a heart attack and a stroke and died 11 months after the incidents disabled him. I think the rule is that you get a portion (3/4?) of what would be the monthly payment if he were on Social Security for each month beyond 6 months that he lived after the disabling incident. He was not on Social Security at the time, but nevertheless I was eleigible to receive one month's payment. A LOT of paperwork - copies of med records and long application to fill out, but got it.

The Soc. sec rep was very helpful, but only said it was worth it to try and didn't guarantee the payment.

I was told about it when I went in to get the $250 death benefit and register as a widow to get on the books for the time when I would be eligible to collect on his social security which would be greater than mine.

I don't know if it applies when someone is already disabled and then dies from something else.

[charlyvi]

7. It's not a death after disability payment. It's for disability paid after

the person has died. You can file a disability claim on behalf of someone who has died; if the claim is approved, the surviving spouse can receive the payment the disabled number holder would have received after the five full month waiting period. In other words, if the person had been disabled for, say, eight full months before they actually died, the surviving spouse could receive a payment for three months--the three months the deceased number holder was due. It is the full 100% of the payment minus attorney's fees, if any. The attorney can charge, in most cases, up to 25% of the retro payment due the beneficiary. It does not apply, by definition, to number holders already receiving their own disability payments.

[Sgent]

3. The program

will also subsidize premiums (up to the average premium in your area) for the health plan.

[pinto]

8. Great to hear that. Kudos to your sis for her perseverance.

Is Medicaid picking up the deductible? And the "gap" period?

Again, that's great to hear.

[Samurai_Writer]

9. No, Social Security is

She's not on Medicaid, she's on Medicare and SSDI. And it was my mom's and mine perserverance, but thanks. :)

[pinto]

10. Kudos to you and your mom.

:thumbsup:

[DarkmoonIkonoklast]

11. Way to GO, Bella!

:toast: :yourock:
MMMissed ya, darlin'! :hug: :loveya: