I have met my 2 years now after getting my disability. So now they have me down for Medicare part A which is hospital. It is free.
I received a paper saying they have me down for part B which is medical for seeing a doctor. They have me set up for deducting monthly bill for this.
Now I am suppose to find a provider to get part D for prescription coverage, and that will be extra payment for that.
Can any of you offer me any advice on what I am doing, and what is the best way to go? I am in US, and in Tennessee.
I don't have any other coverage, so this will be it.
Thanks
susanep :)
Part A and Part B come out of everybody's check. It is your basic medical coverage. You have to have Part D for prescriptions. Call the 800 number for the healthcare assistance folks at Medicare. They can check your area and take a list of your current medicine and guide you to the best plan for you.
You will have to pay for prescriptions through medicare part B. You should also look if your state has any kind of plan. My friend in MN has coverage through a state plan for her medical, dentistry and meds and pay a lot less because of it.
You may want to check into paying another insurance company for your Rx's....like Cigna, for example.
You have to pay either way and you won't have problems with Cigna or others as far as falling into that doughnut hole of Medicare part D. I ended up changing my Mom's Rx coverage and it's not terribly expensive. Check out the exact coverage with Medicare part D.....see if they still have that doughnut hole and check other Rx coverage....you may be surprised.
I have Medicare/Blue Cross & Blue Shield. I hear many people have this, but I think your region can make a difference. You should be able to find something that will help. Lucy
This is the way it is in MN. You have the Medicare part A which is free. The part B fee is taken out of your social security check prior to depositing it in your account.
I get part D from BCBS for a fee and then a supplement from BCBS to pay what is owed after Medicare pays. If medicare doesn't pay then the supplement will not pay either. This is the way it is set up.
Part B pays for a very few medications that is why you need the part D to help pay for the rest. Do your research and remember that that cheaper isn't always better. There are some more modest priced policies out there that work quite well.
If it was me I would set up an appt with BCBS and get a good run down on the policies available and you will then have something to judge the other policies by. BCBS has some good coverage and at least a good explaination will help you with further decisions. A lot of the part D policies are similar. The laws in each state determine this I thnk. Good luck. IRish
I help with the Part D sign-ups for our county. If you are on A & B you are required to buy a Part D policy. There are many different companies offering them and some offer in one state and not another. If you go to www.medicare.gov website and click on the yellow box that says find drug and health plans. You can follow the steps and answer the questions including listing the drugs and doses that you take and it will tell you the policies in your state and which are the best deal for you considering what you take. You can even sign up for the policy from this site. Wish I were there to walk you through it. Hope this helps.
Thanks a lot everyone. You all have been a lot of help as you always are. :)
susanep :)
You have to pay for Medicare????? I had no idea! How much do they deduct?!!
Yes, Medicare is not free..they just had in increase..I think its 109.00 a month now? I have them as my primary, and BCBS Legacy plan as my secondary, I pay them around 122.00 a month, but they cover everything. I cant complain since I use this soooo much. Ive had no co-pays or anything..love it.
I have Wellcare Extra for my prescriptions..they have been ok. You can go to medicare.gov and get alot of info on which plans
might be right for you. You can put in your scripts and it will tell you what you will pay etc...very helpful. I used to have BCBS before and payed
85.00 a month and it was bad. I pay $34.00 a month now with Wellcare and all my generics are covered at 0 copay. Most of the them have the gap fcoverage stipulations etc.
Oh, I live in michigan.
Gursie
I have been through the gamut with Medicare and just changed my coverage this past Jan 1st.
I live in Mass and I have Medicare Parts A and B.
However Medicare Part B ONLY covers 80% of your costs and if you have medical bills like I do, that other 20% I have to pay is a lot of money.
So, I also have Part C which is a Medigap policy through Blue Cross/Blue Shield. It covers all the expenses of that remaining 20% except for $140 deductible per year and a $1,100 copay if I am hospitalized. I do have the option to change to a better quality Medigap policy through BCBS that would waive that $1,100 but the premium is a lot more so I am taking my chances, for now. All my other copays are covered for everything: doc visits, tests, labs, etc.
If you have Medicare Part B, you MUST sign up for a Part D prescription plan. I just changed to an Aetna plan.
My premiums are: Medicare Part B: $109?/month I forget.
Medigap plan: about $95/month
Part D Aetna: $34/month
It sounds like a lot and it is but it is cheaper than a lot of other Medicare options, like the one I had last year. It is also much cheaper than paying 20% of your bills. Imagine paying 20% of a hospital bill for a few days.
I would look into a medicare supplmental plan (Part C)
When you add the medicare cost (which is automatically subtracted from your monthly social security check) in the cost always sounds terrible. I don't even count the medicare cause I never see it in the first place.
The BCBS and part D can sound terrible also, but stop and think that it is about 160$ a month and if you didn't have insurance you would be paying a lot more out of pocket. With these autoimmune diseases the doctor bill and visits can really add up. We need to also learn to pick and choose what tests we will consent to take. Some of the doctors get carried away with ordering so many tests.
Having the health insurance really does help and remember that the health insurance cost is a tax deduction if it qualifies---who knows though with this Obamacare. The whole shootingmatch could burn to the ground cause we don't know the full extent of what Obamacare is going to cover. Good luck Susan and Good luck to all of us. Irish
Look for a Medicare Advantage plan. Some of them have no additional premium. Find a health insurance broker who specializes in Medicare and bring a list of your medications with you. They can help you find the most economical plan for your specific situation.
Sharon
Thanks again everyone, and yes irish we don't know what's to come.
susanep :) :)
You can also get information about Medicare D plans online - go to medicare.gov, and there is a link to compare plans. You can enter the drugs that you currently take, and your zip code, and get what plans are available in your area.
Some things to consider - if you travel (for example go south in the winter), make sure that you sign up with a plan that is not restricted to a few pharmacies in your area. Also look at the details of the plan - For example, in one plan that I was looking at, the cost was quite different depending on whether you had prescriptions filled at Walgreens or CVS. Luckily for me both were nearby, but it might matter for someone else.
Some are free, some are associated with a particular medical facility (such as Kaiser in California), some work anywhere in the US.
Because I had been told by my doctor about some possible treatments this year, I also put in the medicines for those, to get a sense of what they might cost under different plans.
I ended up doing a spreadsheet of all the info, because I found it pretty overwhelming.
But here's the good news - overall your costs are going to be less. Before Medicare, my medical costs (including insurance) were over 15K, this year, which had at least as many complicated medical stuff, my costs are going to be around 3K (which was the deductible in my old plan). So do your research, but don't panic - it's probably going to be better.
The Medicare Advantage plans are going to be phased out from what I understand, so I would avoid them. I have a friend with the medicare advantage and she has not had good luck with it at all and ended up changing to another plan. She had hospitalizations and ended up owing lots of money in medical bills that the advantage doesn't pay. Irish
The big problem I see with the Advantage plans is that doctors and hospitals do not have to accept them. In our area not one doctor nor does our hospital accept Medicare Advantage so you would end up paying that share out of pocket. Be careful when signing up to be sure that your doc, etc will accept these plans.
Yeah, I think my dad has medicare advantage, and he pays a tons of money in deductibles, etc. He has no choice, his school system pays
his premium every month.
I know with my BCBS plan, it has been a godsend so far. No doc co-pays..nothing. I think my 122.00 a month is a steal!!!
I wish I had the energy to help some of the seniors/disabled people go over this every year. Some are on the worst medical
plans, and they dont have to be. My mom used to have Mutual of Omaha and payed them $265.00 a month, for the same coverage
she now has with BCBS for $122.00 a month? its crazy!!!
You really have to do your homework on this. Word-of-mouth is always good..ask around?
Gursie