Medicare choices

[scaredwifetx]

Thank Laurie. I now have a better understanding and think that MA is the best option. My New companies insurance is way to expensive to add Steve and has very high out of pocket expenses. His doctor is at the Texas Neurology and I am certain they take Medicare. It would be nice if he could keep his current primary are doctor but he no longer goes to him anyway. As far as prescriptions the only one he is taking at this tie is prostate meds which I think are fully covered.

My mother has AARP Medicare complete by United Health Care and it seems to be pretty good.

Thank you Laurie for helping me so much. I am very nervous about making the right choice for him and our pocketbook,

 

[KimT]

One of the things that helped me figure out this whole mess was to contact an independent insurance broker to find all the options available to me in my "zone" in Florida. We are one of the least progressive states but I cannot afford to move to another state. The independent broker gave me many options, hoping I would select one other than Blue Cross because they don't farm their marketing out to brokers. I work for a State College so I had three options upon getting approved for Medicare (which will start February 1.) The first was to jump in the retirees "Advantage Plan" with the college. It is a good plan but part of the University/College Florida Consortium and cost $299. I found many other advantage plans cheaper and just as rich (lower co-pays/deductibles.) I ended up driving to Winter Park (closest Florida Blue Cross customer service center) and speaking to a representative in person. Meanwhile, the broker was sending me information from many companies, including Part D Drug plans. I was torn between Aetna and Florida Blue cross for a Medicare Supplement but did a financial analysis on both companies and, in my opinion, Aetna has the potential to raise premiums more because of their recent acquisitions of companies carrying large debt. Just my opinion. I was familiar with Florida Blue so I decided to go with Florida Blue. I found a Part D supplement for $25 a month for drugs. There are co-pays but I have about a year's stash of my drugs, thanks to my doctors and cutting back on the dose of a few. I will still end up paying $600 for the Supplement and Part D but I have Plan G (which has the same coverage as F except you pay the Medicare B co-pay) For some strange reason, being 60 costs me less for Plan G than Plan F and it is triple the amount per year as the Part B deductible. So I ended up with Plan G.

Now I'm waiting for final confirmation from both the drug company and Florida Blue that I am accepted.

When you get approved for Medicare coverage, COBRA will force you to use Medicare as the primary.

I wish there were a Federal law that standardized everything but each State has its own set of rules to some degree. For example, Minnesota makes Mayo Clinic participate in Medicare. Florida does not. That doesn't mean I have to stop going to Mayo but it means that I need to be careful about what supplement I have and even be prepared to make calls to my carrier or pay the bill before reimbursement.

It's a crying shame that we have to spend what time we have on these matters.

I guess what I started out trying to tell you is that contacting an independent agent (look at the ads online when you google medicare supplement or medigap or advantage) she/he will give you lots of valuable help at no charge and fast.

 

[KimT]

Just another thought and that is if you already have all the DME you need, a MA plan is what I'd be looking at first.

 

[scaredwifetx]

Thanks Kim, the info was very helpful.

 

[lgelb]

Just a reminder that Steve's Trilogy rental is under a different plan (the Cigna COBRA plan) so they will take it back unless the DME remains the same and they update the payor. And actually, Vince, I should have mentioned that as a possibility in your case. That would be the goal.

So the DME, Deb, is another thing to look at network-wise.

In re brokers, having worked in managed care, I'm wary of who's comped how/tied into what network(s). Networks have "fire sales," in effect, like everyone else, using incentive comp as broker bait. That's why I prefer to see the plans all in one place, on line, and be able to use filters and sort order to narrow the field. I'm glad you found a good broker, Kim, but as you know, not all are.

 

[scaredwifetx]

Thanks Laurie. The Trilogy was my greatest worry. I guess if they take it , Medicare will approve a bi-pap

 

[nebrhahe53]

It sounds like Florida, as backward as it is, is more progressive than Texas when it comes to medigap plans. Only plan A is offered here, and it's a joke. They might as well offer nothing, which is what about half the states do.
Again, this is for people under 65.
We were told by a Medicare representative that it is actually illegal to use a cobra plan as secondary when you have Medicare.
With any of the advantage plans you have to be careful as they are allowed to take providers off the plan in the middle of the year even though you aren't allowed to change providers like that.

 

[KimT]

It sounds like Florida, as backward as it is, is more progressive than Texas when it comes to medigap plans. Only plan A is offered here, and it's a joke. They might as well offer nothing, which is what about half the states do.
Again, this is for people under 65.
We were told by a Medicare representative that it is actually illegal to use a cobra plan as secondary when you have Medicare.
With any of the advantage plans you have to be careful as they are allowed to take providers off the plan in the middle of the year even though you aren't allowed to change providers like that.

It's such a mess. In New York State they are not allowed age discrimination so people under 65 pay the same as 65 and over for Medigap. I've discussed much of this with my friend who is a neurologist and it's just as hard for the providers as it is for us.