November 07, 2024
Column

‘Fedicare’ questions, answers

Q: What is Fedicare, Part D?

A: Fedicare, Part D, supplants prescription drug coverage previously included under Fedicare, Part C, which now covers some other things (SOT). Enrollment in Part D is optional, yet failure to enroll during the window-of-opportunity sign-up period (WOOSUP) may result in disturbingly indifferent service (DIS) from participating pharmacists (PP).

Q: How do I know if I qualify for coverage?

A: Unenrolled eligibles (UE) or enrolled ineligibles (EI) qualify for prescription drug coverage under Fedicare, Part D, if their annual income does not exceed a certain fluctuating sum (CFS) and they are able to cut their own toenails. Any applicant who does not match either the UE or the EI eligibility profile may petition for second-chance consideration (SCC) on condition that the application includes a licensed cryptanalyst’s notarized note, not stapled to the form, swearing that the applicant can now decipher Fedicare, Part D publications without assistance.

Q: What, exactly, is SCC?

A: SCC is a fill-in option available to those applicants whose score on the eligibility profile (EP) is lower than it would be were they not eligible for the option to begin with. Not all petitioners will qualify for SCC even if it seems clear to them that they do. All rejected ineligible petitioners (RIP) may fill out Fedicare, Form R, and wander uncovered within the program (TP) for a period of not less than three years, after which they may apply for freedom from full freight (FFFF) if not by then residents of Canada.

Q: Is there as deductible in Fedicare, Part D?

A: Yes. The terms of prescription drug covered under TP require that all participants, during the initial period (IP) of any pharmaceutical fiscal year (PFY), herein defined as the period between the vernal equinox and noontime on Columbus Day, must kick in an out-of-pocket subsidy (OOPS) for the full cost of each prescription until the IP deductible of $174.99 is satisfied, after which something else happens.

Q: How does the SEH provision work?

A: SEH, variously termed All Hell Breaking Loose (AHBL), stipulates that drug costs accruing beyond the deductible but still only mildly exorbitant are jointly the obligation of the enrolled member (EM) and TP in a buddy system (BS) until said costs reach the ridiculous level (TRL). At that point, the EM enters what TP calls “The Black Hole of Calcutta” and switches from BS to an all-by-my-onesies payment status (ABMOPS) until either bankruptcy or automobile repossession, whichever occurs first, triggers Tsunami Coverage (TC).

Q: What is TC?

A: TC, or The Windfall, takes over all but a few dollars of the cost of each prescription for the period remaining in the PFY, providing that the EM is living under a leaking roof, and can prove it, and does not enjoy an income exceeding a daily average of $1.50 from redeemable containers.

Q: Does Fedicare, Part D, provide umbrella coverage?

A: No. Umbrellas are not covered under this plan.

Charles Packard teaches Latin and writing at Watershed Community School in Rockland.


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