My mother is 89 and has not need prescription coverage until recently? In the past she always paid out of pocket for her meds but now needs more costly prescription medicines. She has dementia and on arisept and namenda. I understand that Medicare Part D companies will charge her a penalty since she did not have prescription coverage since 65 when she became eligible for medicare. Is 65 the starting age. she is now 89. That is 24 years of penalty? Can someone explain how the penalty works and how much it is going to cost in addition to joining a plan and paying for the prescriptions? Thanks!
First, remember that your mom has "saved" money all these years by not having a Part D plan, so hopefully that makes the penalty a bit easier to swallow. In addition, depending on her financial situation, she may not be subject to the penalty. Her medical condition qualifies her for Home and Community-Based care through Medicaid.
You can see information on Part D and the penalties, In addition, a SHIP counselor at your local senior center can assist. If your state has a State Pharmaceutical Assistance program, she may be eligible to enroll immediately (also true if she is relatively low-income.)
I would do a lot of investigation before enrolling a dementia patient in an HMO. I would want to make sure that they had a full complement of specialists that she needed. Again, a Medicaid Waiver program may be her best choice.
The only penalty I am aware of is under Medicaid. When applying for that program there is a review of finances for up to five years. Any money or property given as gifts or donations will be scrutinized. The penalty is equal to the gifted amount.
I signed f-i-l up for Medicare Advantage program ASAP. We now have to pay a penalty of about $25.00/month for the rest of his life. Fast forward to now. now f-i-l is 88 years old, has Chronic Kidney Disease with Anemia Stage 5, dementia and a whole host of problems. One, just one, shot of Arenesp for CKD is $5000.00!!! He need this every month!!! Thank all the deities in heaven and everywhere else that he is back on his Medicare Advantage insurance, even with the penalty.
Bottom line.....get the insurance and pay the penalty if you have to. Better to sign up for it when you are first eligible. Your future self will thank you.
You can also go to the website and email your question just as you stated it here (very clearly stated). They will get back to you at no charge. I have my own question for you; will those two medications make a difference in your moms quality of life. Good luck.
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