Medicare help

[bldblu_2]

As we approach the 2 year mark I understand my husband will be enrolled in Medicare. Is anyone else here have this? Do you have A, B or both? What about a drug plan and a supplement. Any help would be appreciated. He is not yet 65. He is on disability.

[Redtexa5]

I am on disability and Medicare and you are right to ask for some help, there are some ins and outs to it and it is somewhat different for people disabled and under 65 than for 65 year olds. Feel free to PM me as the subject is long and complicated I would be happy to talk to you and share what I know.

[skypup]

PM me if you want. I went on Medicare last April. It's confusing at first, but I found an agent who really helped me. She's in Utah and I'm in Texas, but she can underwrite for any state and any company. I have no personal reason for telling you about her, just that she was incredible for me.

[LeighB]

I just helped my dad through this. Unfortunately, he did not signup on time and had to go through a 6 month waiting period.

Yes, sign up for both A and B. A covers only in-patient, B covers out-patient. You need both A and B before you can get supplemental coverage for prescriptions. As for the other medicare options, it depends on what you need. We found going through AARP to be a better deal.

[Redtexa5]

We found going through AARP to be a better deal.

This is what I mean by it being different for people under 65 and disabled when they are on Medicare. The only options you have when you are disabled and under 65 or advantage plans and part D plans you can't get Medi-Gap coverage like you get through AARP.

[orcasres]

My mother is 84 and when she moved out here with us last year I went through all of her Medicare plans. She was using AARP for both Part D and for her Medigap insurance (supplement for Part B). The Medigap is ok, but she was paying way too much for Part D. The trick with Part D is that the out of pocket costs vary widely based on the actual drugs that you take. I got her to switch to a different plan and she is paying a few hundred less as a result out of pocket. I think we could possibly do better with the Medigap as well, but she is very comfortable with her plan since she pays no deductible or copays and the predictability of it is comforting to her.

So one piece of advice I can give is make sure that you have a list of all of the prescriptions that need to be covered and you examine the Part D plans by comparing that list with their formulary (list of drugs that they cover and their respective copays).

Good luck, Lois

[mstults]

I will be eligible for Medicare sometime next year due to disability. I'm not sure I want it and not sure I can decline if I don't want it. I have what I consider good individual policy now with Blue Cross. They grandfathered so they aren't affected by obamacare. At age 51 I pay 20% until I pay 4,000 per year. Then it pays 100% after that except,for meds. It always pays 80% of meds. I have a 15.00 copay for each Dr visit no matter the specialty. For this I pay nearly 330.00. Can I get the same or better coverage with Medicare and supplements for a comparable price. And do I have the option to keep it? I'll be talking to Blue Cross as the time nears. I'm not even sure of the dat Medicare becomes effective. I was approved in June and received my first check in November 2012 after the 5 month waiting time. Which do they use?

[skypup]

The only options you have when you are disabled and under 65 or advantage plans and part D plans you can't get Medi-Gap coverage like you get through AARP.

No, no, no, this isn't true. I'm 57 and have a good Plan A Medigap plan!!!

[skypup]

I will be eligible for Medicare sometime next year due to disability. I'm not sure I want it and not sure I can decline if I don't want it. I have what I consider good individual policy now with Blue Cross. They grandfathered so they aren't affected by obamacare. At age 51 I pay 20% until I pay 4,000 per year. Then it pays 100% after that except,for meds. It always pays 80% of meds. I have a 15.00 copay for each Dr visit no matter the specialty. For this I pay nearly 330.00. Can I get the same or better coverage with Medicare and supplements for a comparable price. And do I have the option to keep it? I'll be talking to Blue Cross as the time nears. I'm not even sure of the dat Medicare becomes effective. I was approved in June and received my first check in November 2012 after the 5 month waiting time. Which do they use?

For comparison: Medicare = $105/mo; medigap Plan A = $172/mo; Rx = $25/mo ==> $302 total. I pay $147 deductible for major medical per year and then all is 100% covered. Hospitalization has an $1100 (or so) deductible for each "instance" (meaning separate issues, not readmits for related stuff). Rx's cost me a little each time, usually about $6-7, although some non-generics might be much higher, but I haven't run into that yet. Chemo is covered under Part B, so is subject only to that $147 deductible. So basically I pay $300 a month and less than $200 for everything else per year, although that would change if I had to go in the hospital.

I had a good BCBS plan and was afraid to go on Medicare, but BCBS was costing me $400/mo plus another $3600/yr in deductibles, so $700/mo. I took the Medicare plunge with trepidation, but have been really impressed with Medicare. It is a really well run program and nothing has been challenged, not even when the MDA doc wanted to run another CT only 3 weeks after my previous one and 2 weeks after a PET.

Btw, they use two years from when you receive your first check as the date you become eligible for Medicare.

Hope this helps...

Oh, and I forgot to mention that my BCBS policy made me tell them if I became eligible for Medicare. I don't think I would have been able to keep it. But it was an individual policy and I think group policies are different.

[bldblu_2]

Thank you all for your answers. So it is 2 years from the date you get your first check, not the date of disability?

[skypup]

Yes

[mstults]

Thanks for clearing up a lot of questions skypup. I have almost exactly another year left. Medicare sounds better or comparable. The 1100.00 is all that bothers me. I have a hard time dealing with uncertainties. Guess I don't make a good cancer patient. I have not been hospitalized since resection almost 18 months ago but as the disease progresses I would expect the likelihood of that to change. I have a huge abdominal hernia I'd love to have fixed but onc won't talk about it I expect that Blue cross will have some plans to offer me to use as supplements or medigap. But I will check all options. I expect as time goes on this thread will be very active. Thanks again.

[skypup]

The 1100.00 is all that bothers me. I have a hard time dealing with uncertainties.

Yea, me, too. The way I looked at that was if I am saving $400 every month, then I could go in the hospital every three months and still break even. Since I figured I had a bit of time before I would have to frequent the hospital very often, each month I save puts me ahead in the game. But it is a bit of a crapshoot on this stuff. There are medigap plans that cover that $1100, but they were more costly than I was willing to pay.

[bldblu_2]

I am already starting to feel better about this. I just hope that my personal premium goes down on myself and my daughter once he is off the policy. If it stays the same and then goes up at renewal because of the ACA I don't know what we will do. I am just glad the hub will be covered no matter what.

[PGLGreg]

Before I retired in 2010 I had healthcare insurance through my work, and when I switched to Medicare, I didn't notice any difference. I had supplemental insurance previously, and I still do. There are probably some differences of detail, but I haven't had any reason to look at details. The change to Obamacare has also been a non-event here in Hawaii, since we already had something approaching universal coverage, already. Premiums are about the same.