News From SHINE!

Help!..My new Part D Plan doesn’t cover all my Medications!!”

If you have a new Medicare Part D plan and have just found out that your new plan does NOT cover a drug you have been taking, you should know about transition refills. Transition refills may give you temporary coverage (one-time, 30-day supply) for a drug that is not on your new plan’s formulary OR that has restrictions (prior authorization or step therapy).

It is important to understand that a transition refill is only a temporary solution. You need to call your doctor right away to talk about switching to a drug your plan does cover OR filing a request with your Part D plan for a "formulary exception" (which may or may not be approved).

A transition refill is not for new prescriptions. You can only get one if you were already taking the drug before you signed up for the plan. Also, a transition refill does NOT apply to drugs that Medicare doesn’t require Part D plans to cover (like Valium and Ativan).

If you are in the same plan as last year, you may still be able to get a transition refill if your plan removed a drug you had been taking in 2012 from its 20123 formulary, for reasons other than safety.

Not all pharmacists know about transition refills. Ask your pharmacist to call your Part D plan for special instructions.

5 Signs That Your Aging Parents May Need Help

Visiting your aging parents for the holidays after not having seen them for a while can be eye-opening. You might notice some changes – confusion when they’re relaying a story, less agility when they’re getting out of a chair – but there also could be some serious red flags that your parents might need the help of a caregiver or a different living situation.

Below you will find a list of things to look for. This was originally published by Safety Mom, and can be found here!

Change In Routine – Have they lost interest in social activities they used to engage in and/or have they distanced themselves from friends and/or family?

Poor Eating Habits – Check the refrigerator, is it well stocked or is it pretty bare with expired food? Are they eating regularly?

Not Managing Finances – Are there stacks of mail and bills unopened? Take a glance at their check book and bank statements to make sure they’re paying bills promptly, not bouncing check or overspending.

Disregard For Personal Hygiene – Is your mom the type that has always been perfectly dressed and groomed? Has she lost interest in her appearance? Does your dad seem rather disheveled? These could be signs of depression or another issue.

Frequent Injuries – Chances are your parents might not want you to know if they’ve slipped and fallen or injured themselves. Look for signs of bruises, a limp and/or that they’re favoring one arm over another. Check the house for fall hazards such as throw rugs, clutter on the floor – especially near stairs, slippery surfaces in the bathroom and poor lighting on staircases.

It’s hard to admit that your parents are getting older and need help but it’s important to take a realistic look at the situation.