Medicare options?

[clicker]

I'm going to pull my hair out!

I've reached my 24 months of social security disability, and now I get to put all my Medicare options into a hat, shake it up, close my eyes, and hope for the best.

Or at least that's how it feels.

Does anyone on Medicare have any suggestions? Part A, B, & D? Gap insurance? Part C instead?

Why can't this all be simple?

[maximumlite]

The first thing you need to do is to get the insurance guy that sells the different types of Medicare insurance and find a plan that works for you. I live in MI and took the one that just takes what soc Sec takes out of your check automatically, Than it depends on what Med you take so you want to discuss that with him. For me Medicare only pays 2/3 or 66% so on my Rebif that left me with a $989 copay on my part.
So when I started I got 2 shipments in one month and that was basically $6000 so I jumped over the doughnut hole right to catastrophic so my regular scripts were $2.50 or 5% whichever was more so my insurance guy said not to buy part D as it would save me nothing, that has been my only gift from MS so far. I don't know if you take a DMD or not but if you get help like I do the amount paid by chronic disease funding counts towards what my share of my copay is.
So the best thing is to find an honest insurance salesman and yes medicare is a nightmare. I was given the choice of Rebif or Copaxone and then there were the step up drugs after that and Part A that is supposed to cover infusions like TY are'nt cover'd at all, so now that you are even more confused wellcome to the world of medicare,
They also have what is called extra help depending on what you make where they will help with premiums. It is a cruel process and I wish you luck and keep posting questions as there is someone that has been there
Good Luck

[Lexie]

I retire in 2 years and will be 63. just dread having to deal with this. I have always been so efficient with paper work all my life and now it is a major effort on my part even to call the doctor and write my appointments down. Plus my attention span is very short especially when you have to hear ten recording with what buttons to push on the phone before getting a real person.

[onlyairfare]

Your local Area Agency on Aging (AAA) probably can help you. You can also call 1-800-MEDICARE who can either help you decide, or refer you to the local AAA. If you are a member of AARP, they may have good advice, though you should be aware that they have an exclusive alliance with United Health Care, and may be motivated to encourage you to purchase those products.

Sometimes your local pharmacist can advise you on Medicare drug plans (either Part D or the various Medicare Advantage health plans that include drug coverage), since they usually deal with all of them. The Medicare website also has a tool where you list your area code and what drugs you take, and it well then tell you which plan is best for you in terms of pricing and formulary.

Arizona and Florida have large elderly/retired populations and they are very competitive markets, so there are many plans offered. Good to have lots of options, hard to make complicated decisions.

[wkikta]

You choose a Plan that has your Doctors. You get A, it is free, you will want B since that covers your Doctors, a little over $110. For Medications you want D, even with the Donut Hole it is manageable, and there is the Brand Discount now, covers 50% in the Hole. If you want no Out Of Pocket Expenses a C will help, but the Monthly Premium is high. I have a D plan with no Premium, Blue Cross, does have a High Deductible though, still much lower than a Premium would be.

[JudySz]

good luck. I got mine too and it sounded very confusing. I am lucky, all I need is part A cause my dh still works and I am on his plan.

JudySz

[Spydre]

Obviously, you want Part and Part B - that's your hospitalization and your doctor coverage. Part D is pretty much a requirement as well - generally they can pull the premium for that out of your SS check. Depending on your income, you may qualify for extra help, or if your income is low enough for Medicaid, you can get Medicaid to pick up your copays and premium (the SLMB program). That's how I get my coverage. Because of the cost of the Copaxone, I was beyond the donut hole two months into the year - and luckily Medicaid picked up my donut hole as well. Most of my prescriptions are free because I've passed the donut hole, and Medicaid picks up the copays, but sometimes I do have a smallish copay - like my copay for Copaxone was $3.30 (if I didn't have the Medicaid coverage it would have been $734).

[DianeD]

So hard, I agree.

I have Medicare and Medicare B & D.

I also have private insurance which we pay for. We lost our private in the GM debacle (not going there now).

As retirees, my dh and I could tear our respective hair out too (though dh doesn't have any....he'd have to work on chest hair!). It's a lot of work.

Here's my take. Do get Medicare, with the B & D.

Look up what each provides. I would not deal with Medicare at all in any form, BUT rare is the person (particularly those of us with pre-existing disease) who can afford their own private care!

Anyway, do, (as another poster suggested) speak to your insurance rep). There are all kinds of considerations. Some doctors only take certain type of Medicare.

I didn't think they had the right to do that, but they do.

They almost all hate Medicare because while there costs to provide treatment goes up, Medicare pays less and less.

So...ASK QUESTIONS. The insurance companies do have the right and the ability to look at your private (ha) medical records. So you can't hide anything.

Some insurance companies will not cover DMD's. A few will.

My current insurance company is going to raise my rates by $30.00. This happens every year to one degree or another. I will be paying about $175.00 a month for mine, plus my Medicare.

DH has no disease process going on and he pays less.

He also has LTC insurance, but I can't get it. Here is how our agent put it.

More or less....'well, you don't qualify for any of the good plans which include home care, BUT you can get a plan'.

Duh..of course the LTC plan would be lousy and I'd pay more for it. Thanks, I'll just move to a tent in the yard!

Take a breath, seek out qualified help. Do your best.

ASK QUESTIONS (and write down the responses or ask for it on paper from the agent). Also, if you have time write your congressman; be specific, don't whine.

I'll be thinking of you. Good Luck.

Diane

[Mamabug]

What did you do the previous 24 months, prior to qualifying for Medicare?

I was on my spouse's policy, that we purchase through his employer.

I became eligible for Medicare in November. However, I decided to only take the free Part A, and provide SSA with the requested documentation to confirm that I already had other coverage. (That is important, so that you don't get charged a higher rate if you add Part B at a later date.) I have remained on my husband's policy, because it provided better coverage, for the money, than Medicare did. And, no doughnut holes.

If you don't currently have adequate coverage, you'll need to research Medicare's various options and choose what is best for you.

~ Faith

[Lendi]

I have to agree, this was the hardest part of all the paperwork I've done for medications SSDI etc. I did go through an insurance agent who helped me a lot. I now have Part A, Part B and D. Tysabri goes through Part B because it can't be done at home. Part D isn't bad, less than $15 a month although I can't say it's the best at paying before the donut hole. Still, it's about as good as I had when I was on DH's insurance and the other part is better.