A lesson on Medicare

[t34gib]

Today I learned a lesson on Medicare. It is a government run program and they do everything they can to prove it cannot work. I am so disgusted. My medicare kicked in on June 1st and I was told I had to have a prescription drug plan so I hit the internet and got one. I got the same one my husband has from Humana. Now, I understand that knowing what I know now, I should have checked into things further, but they make it so frustratingly incomprehensible that you just take the easy route.
I am being cared for and attend the Mayo Clinic ALS clinics in Jacksonville Florida. I have an appointment next week and was asked to verify that my insurance will cover it. Come to find out they don't. Mayo is not a provider for Humana which now I find out is not just my prescription drug plan but is my medicare provider. Also, I cannot cancel it until January. So now I have an insurance plan that I have to pay for that I cannot use. On top of that the only drug I take is one that is not covered by any insurance company because it is not FDA approved. So here I am, disabled, with insurance i can't use because I signed up for a prescription drug plan that I did not need. You gotta love it. After the fact I was told I should have purchased a suplemental policy. Thanks for the info.
You know all the bastards in Washington have all their needs taken care of no matter what they are and they are the ones who set up all this crap with all this underlying bullshit that makes it impossible to understand. I don't care if they are republican or democrats, they are all just a bunch of asses who have control issues. I wash my hands of the whole system. I won't pay the premiums although i know they will eventually have them deducted from my disability check. But maybe by then I will be gone and not have to worry about it. The hell with the whole thing. I am done with it all.
Sorry, just had to vent. Won't bother anymore.

 

[hopingforthebest]

Dear Nancy

So sorry that all this insurance nonsense is so frustrating and complicated.

When my husband was diagnosed with ALS, his ALS physician suggested that for his "CARE ISSUES" he prescribe Hospice for him. I'm getting a little ahead of myself. We had applied to social security for disability for my husband and it took 6 months and with that he was also given Medicare at age 57. To make a long story short. Hospice came and nurse evaluation, listed meds, if any, that he was on and the Hospice pharmacy paid for everything. We never had to go to a pharmacy etc. Don't know if this will help you but assume that all states might be the same, so you can look into it.

Hope I was some help and will be checking back on your posts to see how you make out.

Also, so sorry that you have to go through this and will keep you in my prayers Nancy.

Patty

 

[kelly]

Nancy....we also did the same thing with the supplemental prescription plan. Big waste of money as we hit the donut hole within two months with the rilutek. I just recently learned that we should have purchased a supplemental insurance rather than medicare advantage plan. To be honest...I am still totally confused. Amazes me that my hubby and I both have our Masters Degree and had such difficulty navigating the whle medicare process. Do not give up....keep yelling..hollering...keep venting..we are here for you.

 

[indigosd]

Nancy and Kelly, I soul agree and totally understand your anger and frustration. You are so correct that not one of the Politicians is suffering! Could you possibly contact one of your senators and ask them to help you? I "think" that you are allowed to cancel the supplemental in 30 days after you purchased it and you have 90 days after Medicare begins to chose a supplemental. I think that is correct. I did not purchase a drug plan. Web is not taking Rilutek so it is possible for us to pay for his few medications. I did buy a supplemental part "?" that covers our 20% that Medicare [or as I so fondly call that organization Med I DON"Tcare] demands be paid and everything else that is not covered by them. So far it has worked wonderfully. Our supplemental is from Physicians Mutual. Having ALS is compounded by all this other BULLS$$T!
hugs to you.

 

[brooksea]

This article explains Medicare Sup and Medicare Adv.

According to the article's writer, you can cancel your advantage plan and go on straight Medicare! (I know you can't get another "insurance" plan, til Jan as you stated) I'm sure Mayo takes straight Medicare! That way you won't be paying needless premiums for nothing!

My husband had a problem with his Advantage plan, as they did not renew in our area and failed to inform the members. Surprise, Surprise when we went to the clinic. So he was on straight Medicare.

Medicare Supplements and Medicare Advantage Plans Are Not the Same Thing

"When an individual is enrolled in the plan they do not lose their Medicare. They are entitled to cancel their Medicare Advantage plan, and the next month, they can go back to original Medicare. While enrolled in Medicare Advantage, they will have to use the insurance card provided by the Medicare Advantage plan instead of their Medicare card."

Hope that helps!

PS: For those that live in GA -

The Gov recently signed a bill that mandates insurance companies to allow Medicare Supplemental to disabled under 65. Previously we were unable to get this coverage unless you were 65 or older in the state of GA. However, who knows what the premiums would be and if a co-pay with Medicare Advantage would eventually be better than monthly premiums for supplemental ins plus their coverage dis-allowances. This bill will take affect 11/01/2010.

 

[tdamess]

the socila securtiy told me a trick to call our local elderly service chapter and they will help with what plan you need , they know what is covered so they sit with you and help you figure it out ... i got the aarp plan i like them , my son also has it and i learned when i call the part d pricption coverge and you tell them that this is the med you need and you can change that upgrade i believe .. they can also tell you if you are elgiable for federal asst in paying for it a lot of people dont know about ... mass has its own but there is a federal one .. hope this helps