Part D - Lose PAP

Jul 4, 2019

  1. somarco
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    somarco GA Medicare Expert

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    New client, T65 in August. No insurance for 10 years. Using PAP for one or more med's.

    Have not discussed med's in detail. Most of the initial consult was acclamating her to Medicare options.

    She mentioned the PAP in passing.

    Many PAP's will drop you from the subsidy once you obtain drug coverage. This makes me wonder if going without D is a good thing or not. Will know more once I have a list of her med's and can compare what she pays now with the coupon vs under Part D.

    I have always advised clients to secure drug plan coverage but this could be a completely different scenario.

    Have any of you encountered a similar situation and if so, did you advise going without D?
     
    somarco, Jul 4, 2019
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  2. Northeast Agent
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    Northeast Agent Guru

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    I'm assuming there's no SPAP available in your State when she turns 65, or she doesn't qualify based on income? What about Extra Help?

    I'd never advise against getting a Part D, as she'll most likely need other drugs someday.
     
  3. Fisher
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    Fisher Guru

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    I have plenty of clients receiving PAP while on Part D coverage. Just have to call the PAP and ask them what their guidelines are for that situation. Some programs will not allow it but my experience has been that the majority do.
     
    Fisher, Jul 4, 2019
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  4. Fisher
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    Fisher Guru

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    And yeah, advising against Part D coverage would be a big fat NO in my book. Worst case, lay out her options and let her decide. If she chooses to forego Rx coverage make damn sure you document that with her signature attached.

    But I'm sure you're aware of that.
     
    Fisher, Jul 4, 2019
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  5. DS4
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    And what if your client is prescribed an Rx not covered by PAP?
     
    DS4, Jul 4, 2019
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  6. somarco
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    somarco GA Medicare Expert

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    The other issue is income.

    Many of my clients earn too much to qualify.
     
    somarco, Jul 5, 2019
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  7. somarco
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    somarco GA Medicare Expert

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    Never said this was an easy decision. I don't have her med list yet so have not run a Medicare report. Once I have more information we will have a chance to discuss.

    I have never told a client not to buy a drug plan. If they decide to opt out that is their decision. I always make sure my butt is covered with a follow up email, explaining again why that may be a poor choice and what the implications are in passing up the chance.
     
    somarco, Jul 5, 2019
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  8. TwoCents
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    For what it's worth some PAPs are creditable to avoid the Part D LEP. SeniorCare in Wisconsin is an example.
     
  9. somarco
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    somarco GA Medicare Expert

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    Good to know.

    How do you find out which ARE creditable and which are not? Ask them?
     
    somarco, Jul 5, 2019
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  10. Fisher
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    Fisher Guru

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    SeniorCare in WI is a state PAP. I was under the impression we were talking about manufacturer PAPs. If not, my bad.
     
    Fisher, Jul 5, 2019
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