Thread: Dropped Medicare
09-23-2010, 12:16 PM #1
I had to drop Medicare because after the payments I had nothing for co-pays. I was given PT but to get to it was more more PT than the exercises given during the sessions. I bought an elliptical and I do stretches and some yoga. Okay, let me get to the point, I was told that if I re-signed up for Medicare I would pay more each month for it. I have not seen a Doctor in over two years but have monitored my symptoms and adjusted to my disabilities. I chose not to take medication. Will I be forced to pay more even though i am not using it?Positive Possibilities
09-23-2010, 04:31 PM #2Registered Member
- Join Date
- Aug 2010
- Brooklyn NY
That may be a question only someone at the medicare office can answer. The thing is you have a diagnosis, whether you use the services regularly or not, you still have MS. Maybe someone at the NMSS could help answer your questions.
09-23-2010, 10:31 PM #3
I was in a fog this morning and was not thinking clearly. With the new rule to have medical coverage I was wondering if I could wait it out until 65 and sign up again or will they make me pay a penalty for everymonth I wait. I am 62 now. I know you cannot answer that for me but thank you for bringing me to snity and I will go where the answers are. Thanks again for enen answering.Positive Possibilities
09-23-2010, 11:36 PM #4.
- Join Date
- Mar 2009
- California, USA
Ditto about contacting Medicare with your question, because only a Medicare representative can answer the question as it applies specifically to you. There are several considerations that you might not be taking into account.
For example, if you couldn't/can't afford copays, did/do you qualify for SSI or Medicaid? If so, Medicaid might be able to cover some or all of your Part B premiums and copays. You haven't said anything about Medicaid or other insurance. But if you had/have other coverage, Medicare copays would probably not even be an issue.
Normally, there is a penalty if someone doesn't sign up for Part B when first eligible. Whether that penalty applies to dropping Part B coverage and then restarting it, someone at Medicare is best qualified to tell you. But it's important to note that, if you qualify for Medicaid, the penalty might not apply if Medicaid pays your Part B premiums. If you do end up having to pay a penalty, try not to let yourself get sucked into the trap of trying to rationalize the Medicare rules. The rule won't be changed for you just because you don't think it's fair, and stewing about it is a nonproductive waste of your time and energy.
Another thing that really jumps out of your post is that you might not be fully appreciating why Medicare (or even Medicaid) coverage is a good idea. It seems like you're thinking of Medicare as "MS insurance," and since you're not actively treating MS, you can get by without insurance.
Medicare is [I]health[/I] insurance, and it pays to have it to cover the unexpected. What do you plan to do if you come down with, say, pneumonia and require hospitalization and lengthy follow-up care? You might not be taking medications now and don't think you need Part D medication coverage, but you might change your mind about that when you realize that you can't [I]breathe[/I] without medication.
What do you plan to do if you're injured in a car wreck and need lengthy follow-up care? Once you're out of the hospital, the doctors are going to need to be paid [I]somehow[/I].
The point of paying into an insurance pool is not that you take out what you pay in, but that you take a calculated risk to be able to benefit from pooled money even if it [I]exceeds[/I] what you pay in. And a serious accident or illness is guaranteed to get you more benefit than you pay in.
Hopefully this gives you a bit more perspective on looking into whether you might qualify for SSI and/or Medicaid before you make any decisions about Medicare, and why it's important to get information about your re-enrollment directly from Medicare.
09-25-2010, 12:46 PM #5
I don't qualify for anything else. My income is too high. I have debt that I refuse to write off because I created it . I helped my daughter set up a home for her and my granddaughter. At the time I saw myself being able to do it in a fewe years when this hit me hard. I will follow the advice given. I've had more than one near miss by a person on cell phone when I'm trying to cross a street.Positive Possibilities
09-30-2010, 01:38 PM #6Registered Member
- Join Date
- Sep 2010
OMG Call them!
Hi! I had to jump in here. The rules have changed a bit. If you don't have any kind of other coverage then there is a penalty for each year you wait. You will pay an additional 10% for each year that you don't take medicare. So, let's say you are 63 and you wait 2 years. Then you will have to pay an additional 20% if you wait the full 24 months. So, instead of paying $110.50, you would be paying $132.60 a month.
My husband is having to decide this right now as he just qualified for disability. I have MS and am on disability already. I did not take Medicare, Part B but at that time if you had other insurance which you were keeping (which we were) then they "froze" your rate. Now, I think that has changed. If he doesn't take it now it will continue to go up by 10% every year.
Redwings makes really great points and I completely agree with him/her. I think you need to take it and start taking care of yourself! I studied the options for the supplemental insurance and medigap and they are not good for any of us under the age of 65. They are GREAT for people 65 and over. Paying additional if you are under 65 gets you nothing in addition, at least in the state of TX. If you go on the Medicare website, you can check to see what coverage you would/could get in your state and what the cost would be.
I was ALWAYS healthy, always exercised and then I got a late diagnosis of MS and it has completely wrecked my health! I do yoga and pilates. Any type of aerobic exercise makes me so hot that I get sick too quickly, so I have been sticking with those two things mostly.
I feel like you must be in a similar position to where we are. Debt that we caused ourselves...drowning in it but paying it off, because we caused it. With two of us, it is probably a bit easier.
If you are alone, you should look possibly into your state assistance programs. Most shot programs do offer "scholarships" for people who can't afford medication. I take copaxone and Shared Solutions or Teva Neuroscience pays for my copay of that medication so that I can afford it.
I don't know when you were diagnosed, but it would be worth looking into to try to slow down any further progression.
Also, what about applying for Social Security Disabilty? Have you yet? If not, you should!
Hang in there, you are not alone!
10-01-2010, 04:16 PM #7
I am on SSDI. I would not be able to live if I did not have it. I had Medicare but dropped it two years ago because i could not afford to pay them AND get glasses (about $400 a pair) and pay a co-pay for Doctor's visits. I am on no medication and will not take any (personal choice). This is what I do for my care: I have changed my eating to all organic, gluten-free, soy-free, and dairy-free. I bought myself an elpitical to exercise. I do Yoga and stretches. I "walk" as much as I can as best as I can. I have not been ill otherwise (thank God) . This is what the money is used for. If I pay Medicare, that will take money from nutrious food that keeps me well.
I am not "cured" and still have a lot of the problems others are having but this is how I choose to handle it. I use meditation when it gets really bad.
Paying for Medicare will do me more harm than good.
I have to make that decision soon because it will be two years in January. I am 62.Positive Possibilities
10-02-2010, 01:19 PM #8Registered Member
- Join Date
- May 2008
If you are cutting it that close financially, do you qualify for Medicaid?
10-02-2010, 10:01 PM #9.
- Join Date
- Mar 2009
- California, USA
Have you thought about re-enrolling in Medicare through one of the Medicare HMO plans (not one with extra option$ like dental)? A lot of people pass up HMOs because they don't want to be restricted to the HMO's panel of doctors. But that might not be as big a concern for you since you aren't going to the doctor anyway. Medicare HMO plans often offer some extras that straight Medicare doesn't, like low-cost drugs (up to the donut hole). You'd have Part B coverage for an accident or unexpected illness and might get the advantage of some things being covered that were a factor in why you had to drop Medicare. In other words, some things might be included in the cost of Medicare Part B instead of you having to pay for them separately in lieu of Part B.
Don't forget that eating well and exercising can't prevent you from being hit by a bus. I've never had to make a claim on my earthquake insurance, either, but I have no intention of dropping it. The consequences of not having it far outweigh any other good I could get from spending the money on something else.
10-03-2010, 04:43 PM #10Registered Member
- Join Date
- Sep 2010
Good for you
I think all of the things you are doing are really admirable. Good, healthy food costs a LOT! We are trying to eat healthy also and it isn't cheap!! Fresh fruits and vegetables and if you go organic....!! Anyway, believe me I understand the dilemma!
So, if you are 62, if you wait til you are 65, as it is now you will pay an additional 30%. However, if you don't take it now it will be hard to tell if will even be available later. That is sort of what we are wondering about. OR, if the rule will change again and the percentage will go up even more in the coming years. It's sort of a craps shoot. We don't do very well at gambling so we are leaning toward signing up now and just taking plain medicare with nothing else. That will freeze it at the price we have and we would probably be "grandfathered in" if there was a reduction in who would get this type of insurance. Then when we are 65we would sign up for one of the additional policies that help pay for all of the holes that aren't covered in the current medicare for people under 65. Anyway, that's what we are thinking. Just thought I'd share where we are currently leaning.
One other thing, there are groups that might help with glasses, like your local Lions Club...just a thought. I'm in the same boat for a hearing aid that I need and can't afford! I contacted Sertoma but have not heard back yet.
Good luck to you!
10-03-2010, 04:59 PM #11
You get it!
I will contact my office this month as it is almost two years since I dropped it. Maybe it will be 10% or 20% but it beats 50% if I wait until I am 65. The two years have been profitable to me. My health and outlook has not been better. Thank you.Positive Possibilities
10-29-2010, 03:00 PM #12
My DH and I retired early; 58. My Dh didn't go on Medicare until 65, so i don't understand the 62 issue?
I also started on Medicare at 65.
I hate it by the way.
We have Part A and B, plus D.
It costs ea of us $110. for A and B. Then we got the Medicare Supplimental (D) and that costs us each even more.
We retired with BC/BS and expect that would be our major insurance with Medicare secondary. While we had that things were good.
Then all 'salaried/non-union' employees of our (major) company were dumped from health care.....
So even though our retirement was planned out carefully it changed.
I have found Medicare to be a very onerous process. They cover things very poorly and even with a secondary insurance (D) they are not beloved by docs and hospitals, so you feel very 'second class'.
The coverage is actually downright insulting and if everyone were on Medicare I think Docs would find another career. You cannot run an office and pay your staff on Medicare payments.
Also, I just got a booklet of Formularies from our Part D.
They want everyone on Generics and even if you are long time on a non-generic drug you will be told you must cover it yourself or go through an onerous appeal.
Since there is no Generic for our DMD's they do cover them to an extent.
It's a very stressful situation for everyone!You cannot dream yourself into a character; you must hammer and forge yourself one.
10-31-2010, 04:07 PM #13
I don't have to sign up!
I started this thread and am happy to say that they cannot MAKE me sign up.
I would have to wait(?) until January and then pay a penalty each month of 20%. I dropped Medicare 2 years ago. I would pay the fee PLUS the penalty from January to June WITH NO COVERAGE. In July, I would be covered. I would continue to pay the penalty until whenever...OR I could wait to 65 and I would be offered to join again. This is what I opted to do.
If I could not afford Medicare why would I pay more for it and then not be covered or have the money to do what I needed to do?
The amount of $122 is over half of my food budget for the month. I prefer to continue eating my way to the best health I can obtain inspite of MS.
Thank you all for your input.Positive Possibilities
12-08-2010, 01:11 PM #14
It was my understanding you could not go on medicare until you are 65 which I will be in May of next year. My whole life has changed since the government started the healthcare fiasco. My insurance and co-pays doubled the 1st of the year. I had to change my whole way of living, get rid of medications I could no longer afford, eat differently etc., In other words I have no money left to do anything except barely exist.
I am trying to pay off my debt which wasn't a lot before all the changes but now well you see what I mean. Now I may be dropped by the insurance company and am waiting for the other shoe to drop. My situation is much like Diane D.'s.
I am terrified that I will have nothing to live on and even lose my car. Some mornings like today I wake and burst into tears. It is bad enough having MS without the added stress of monitary issues. Thanks for listening. I sometimes feel there is no point it talking aboutall this because there is nothing I can do to change it. I wish I could just accept it and live. I feel like I should be able to get over myself!
12-08-2010, 01:53 PM #15
There is Hope!
If you have been on disability for two years, you can sign up for Medicare is my understanding.
I am not, nor was I 65 when I got on Medicare. After two years of SSDI, I was offered Medicare. Contact them, I wish you well.....Positive Possibilities