This summer Riverview Estates will be selling baked goods along the river. The bake sale will be held every Wednesday night beginning April 25th. We will start the sale on our front lawn at 5:30 p.m. and go until sold out or the sun starts to set. So come on down to the river, enjoy the Riverton Yacht Club sailboat races, a stroll along the river and some homemade baked goods. All monies raised will benefit the lives of the residents. 

Coverage restrictions are tools that Medicare Part D plans can use to limit the use of drugs on their formularies. A plan can deny coverage of drugs on its formulary that have any of these restrictions on them:

• Prior Authorization: This is when your plan requires that you ask for special permission before it will cover the drug.
• Quantity Limits: This is when your plan will only cover a certain amount of a prescription per month or per refill.
• Step Therapy: This is when the plan requires that you try a different drug on the formulary before the plan will cover the drug your doctor prescribed.

If your plan denies your medication because of coverage restrictions, you have a few options. 

 

First, check with your doctor to find out if a covered medication that doesn't have restrictions on it will work for you. If not, you have two choices. You can ask your doctor to help you meet the coverage restriction.  For example, the doctor could ask for prior authorization or submit proof that you have already taken the drug. This approach works best when you have a one-time prescription to fill.

 

If you will need to multiple refills of your medication, you or your doctor can make a formal written request to your plan to cover the medication without restriction. This is called requesting an exception. When you request and exception, you're asking your plan to make an exception to its normal rules and cover your drug without the restrictions.

 

You or your doctor can request an exception, but either way, you'll need a supporting letter from your doctor. The letter must specify what kind of exception you need. In your case, you should request that your plan override the coverage restriction on your drug. The doctor's letter should explain why you need the drug, the amount of the drug that you need and/or that other drugs on the formulary won't work as well for you or will harm you. In addition to the letter, you should send any medical records that support your request. For example, you may want to send medical histories or lab reports. Call your plan or look at your plan's web site or Evidence of Coverage booklet to find out where to send your request and your doctor's letter and whether you need to submit any other forms.

Keep proof, such as fax transmission reports or certified return receipts that show when you submitted your exception request. You will need it if your plan doesn't respond to your request on time. Plans must respond within 72 hours of getting your doctor's written statement. Their response is called a coverage determination. If it's an emergency, your doctor can file an expedited request, which plans must respond to within 24 hours. These are clock hours, not business hours. Your plan should send you its decision in writing, but if you don't hear from the plan in the proper timeframe, you should call the plan and ask for its decision.

If you receive a written denial from the plan that says it won't grant you an exception to the coverage restriction, the next step is to appeal.

 

This information is republished with permission from the Medicare Rights Center. For more info visit www.medicarerights.org.

For additional information please see www.medicareinteractive.org

Riverview Estates offers a support group for caregivers and family of those affected by Alzheimer's disease.  This is an informal group that meets the first Wednesday of every month at 6:30pm. This group is free and provides information about the disease process, support, and services that are available. Please join us. For more information please contact Jane Bohn at (856)829-2274 ext.113 or via email at jane@riverviewestates.org

 

5/1 AUXILIARY DAY LUNCHEON

5/1 RIVER-LINE RIDE

5/2 SING W/JOANNE BIVIANO

5/4 GIRLS AGAIN PRODUCTION

5/5 CERAMICS

5/7 ICE CREAM SOCIAL

5/8 SING W/THE MELODEERS

5/9 SPRING FLOWER ARRANGING

5/10 ADOPT A GRANDPARENT PROGRAM

5/12 MOTHER'S TEA

5/15 CATHOLIC MASS

5/15 BIRTHDAY PARTY

5/16 SING W/FRANKIE MUSUMICI

5/19 AUXILIARY SALE

5/19 FLOWER PLANTING

5/23 SING W/TOM DELMOORE

5/26 S.C.O.R.E. W/CHUCK SIKORA

5/29 ICE-CREAM OUTING

5/30 SING W/GLORIA TURK

"Daisy and Rosie love their house but the neighborhood is too busy.  Learn to take the bitter with the sweet." 

Meaning: To accept the bad things that happen along with the good

  

Origin: The famous English poet of the 14th century Geoffrey Chaucer first used this idea in one of his poems and many other writers have since adopted this phrase.  Of course, 'bitter" represents bad happenings and "sweet" stands for good.  Some people say that you have to take "the rough with the smooth", and that expression gets the message across just as effectively.