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    Medicare, under age 65 feedback

    Hello, looking for feedback from others that have gone through similar situations.

    I am currently on SSDI and I will be getting on Medicare early next year. I am currently insured through Cobra. Because I am under 65 years old my options with getting a supplement medigap plan is limited. Although the plans are state specific (I live in Maryland). I’m looking for any information on what people did in regards to a supplement plan (i.e. Medigap/ advantage) if under the age of 65. I’m looking for good coverage that’s as close as possible to Medigap plan G.

    #2
    I hope you receive some helpful responses soon. Although I receive Medicare Part A free, I have remained on my husband's employer's health insurance so i have so experience with with medicare supplements or medigap.

    I hope you can find a plan that works for you.

    I wonder if the NMSS in your area would be able to give you some helpful advice?
    ~ Faith
    MSWorld Volunteer -- Moderator since JUN2012
    (now a Mimibug)

    Symptoms began in JAN02
    - Dx with RRMS in OCT03, following 21 months of limbo, ruling out lots of other dx, and some "probable stroke" and "probable CNS" dx for awhile.
    - In 2008, I was back in limbo briefly, then re-dx w/ MS: JUL08
    .

    - Betaseron NOV03-AUG08; Copaxone20 SEPT08-APR15; Copaxone40 APR15-present
    - Began receiving SSDI / LTD NOV08. Not employed. I volunteer in my church and community.

    Comment


      #3
      I am under 65 and was 'moved' to Medicare after 2 years on SSDI. I always selected a PPO thru my employer.

      After reviewing the available Advantage plans for my state...
      I first tried an HMO plan but was unhappy with how limited the doctor network was and the referral process anytime I needed anything. I was trying to fit my current doctors and level of care into a plan but failed miserably.
      At the next open enrollment I switched to a PPO and paid a small premium but I was happy again.
      Then at the end of 2019 the provider terminated the plan so I had to find a new plan, so I switched to an HMO since there were no other PPO plans available. So far it seems to be ok since my main doctors accept it.
      (yes, based on my previous employer coverage I am a little bit spoiled!)

      I did spend hours researching all the different plans.

      FYI I never looked closely at the Medigap plans mainly due to the cost vs. the coverage I need.

      Comment


        #4
        Since the plans vary by state my experience in Georgia may not be relevant. I had Humana, high deductible plan F before I was 65. The premium was less because of the $2300 deductible. I did not have a lot of claims so that worked.

        I was on Tecfidera which was covered under Medicare part D.

        Be sure to re-visit your selection when you turn 65. You have 6 months to change Medigap plans without medical questions. In Georgia the premium drops drastically for 65 and over, but it’s not automatic.

        Comment


          #5
          Hi, I live in NY, am 60 years old and went on part A medicare after I was declared disabled in1998. I got part B after my husband retired.

          I went with original Medicare because I wanted to be able to keep or go to any doctor that accepts medicare without a referral. I also got a supplemental plan G that would cover the 20 percent part B costs that Medicare doesn't cover. I did this because I have a baclofen pump and was afraid of out of pocket costs for pump refills or if I needed a new pump.

          It gives me some peace of mind but it isn't cheap. $144.60 is taken out of my ss each month to cover my part B premium. Which everyone has to pay. Another $34.80 is taken out for my silver script drug plan. My United health supplemental medigap plan costs another $153 a month.

          I don't think you have to pay any thing for part A Medicare if you've worked and paid Medicare taxes for 30 quarters.

          I often wonder if the supplemental plan is worth it. I still have to pay my yearly deductible. But it did cover $6000 out of pocket costs when I had my pump replaced!

          Good luck with your decision!

          Comment


            #6
            I am just going thru this. My husband retired at 60, and with it, we get 5 years health care. However, since I was on SSDI, they are moving me into their private Medicare advantage 65 plan. I am 57, so I am trying to make sure I do the right thing now to make sure no penalty 5 years from now when I am 62.

            In Pennsylvania, insurers are not required to offer Medicare supplemental plans to those under 65. For advantage plans, they can also charge more, knowing full well that the only reason you are on Medicare under 65 is that you are disabled.

            So in 5 years, my options are to see if I can buy into my husband's insurer advantage plan(doubt they will allow it), pay a higher premium on a public advantage plan, or drop the advantage plan and keep only original Medicare part A & B and then at 65, enroll in a supplemental plan.

            The choices really stink.
            Kathy
            DX 01/06, currently on Tysabri

            Comment


              #7
              Thanks for all the replies. The choices are very limited.

              In case it can help anyone else; each state has a State Health Insurance Assistance Program (SHIP) That you can call for assistance with options in your state. I have called them and they’re very helpful. You call and leave a message and they call you back in a couple days.

              I also learned from them that there is a SNP (special needs plan) that we can possibly utilize as a chronic condition with MS, but I’m not sure what it provides. Sounds like some advantage plans include FNP and others don’t. Might be worth looking into.

              Comment


                #8
                My first gut reaction to this question is forget it. I could never find anything no matter how high a premium I was willing to pay.

                I got by by negotiating with doctors, hospitals etc to accept the 80% as payment in full. Usually if you ask for a hardship application and your income is sufficiently low they will waive the copay. Disabled under 65 are exactly the kind of people they like to help.
                There are also charities can help with specific things but they have gone unfounded lately.

                You could get a Medicare Advantage Plan. They sound like really good deals but you can’t choose your own doctor and it is a giant HMO.

                Turning 65 and having the opportunity to buy a supplement was like a dream.

                Comment


                  #9
                  Originally posted by palmtree View Post

                  You could get a Medicare Advantage Plan. They sound like really good deals but you can’t choose your own doctor and it is a giant HMO.

                  Turning 65 and having the opportunity to buy a supplement was like a dream.
                  Hi palmtree.

                  Not sure if state specific, but here, they offer a PPO Medicare advantage in addition to the HMO. So on the PPO, you can choose doctors and don't need referrals. But like normal insurance, you have to see if in network or out of network to make sure to minimize cost.

                  Glad you were able to get a supplement at 65.
                  Kathy
                  DX 01/06, currently on Tysabri

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