Old 07-09-2018, 02:01 PM #1 (permalink)
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Default Medicare Question

ISO some medicare help here. My husband is newly diagnosed and being seen at the John Hopkins Clinic. At our appointment last week, it was suggested we go ahead and get the medicare paperwork in and started. My husband is very early stages and only has some weakening in his hands and arms, otherwise he at full strength and still working. We have Federal Blue Cross Blue Shield as primary insurance and will continue to have that through the duration.

Any thoughts or suggestions on which Medicare plan to start with? We are also waiting for guidance from the clinic but thought i'd through it out to this group for any thoughts or opinions.

Thanks!
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Old 07-09-2018, 02:09 PM #2 (permalink)
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Default Re: Medicare Question

Medicare goes with ssdi unless he is 65 now. If working no ssdi yet so no medicare. Unless being fed employee changes something but I don’t think so?
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Old 07-09-2018, 02:16 PM #3 (permalink)
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Default Re: Medicare Question

When you apply for Social Security Disability, the wait is five months. It is automatic for ALS. You will get SSDI and Medicare, Part A and B at the end of the five-month wait.

I had very good company insurance and planned to keep it. However, after checking on the payments for durable medical equipment, they didn't cover the full 20% that Medicare does not pay. I ended up getting Supplement G (same as F except it has a small deductible each year but the reduced premium more than made up for it.) Every Plan G and every Plan F are the same. I chose Florida Blue because I already had Blue Cross in Florida and I was familiar with the site and looked at the premium increase histories.

You can Google the various companies in Virginia to compare prices but I would first check to see if your Federal Blue Cross will cover durable medical equipment co-pays.
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Old 07-09-2018, 02:29 PM #4 (permalink)
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Default Re: Medicare Question

I recommend meeting with a health insurance agent or broker. They know what the best plans are in your area and will see what Part D plan works best with your meds and anticipated meds.

It may be that your current insurance plan could become your supplemental or secondary insurance. Again, the agent or broker will know what’s best for you.

I used an insurance broker. That way, they weren’t tied to a specific insurance carrier. They presented me with several options.

I ended up with Medicare parts A and B, a plan F supplement, and a plan D for meds.

When I applied for social security disability, the Medicare A and B came with it. I had to select the plans D and F. Also, my SSD and Medicare kicked in retroactively because they determined I was disabled starting 7 months before I applied. The 5 month wait started from that retroactive date, so I ended up having Medicare and receiving disability benefits for 2 months prior to when I applied.
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Old 07-09-2018, 04:07 PM #5 (permalink)
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Default Re: Medicare Question

Nikki - I thought the same thing but the clinic was under the impression that was no longer the case. Guess we'll find out as my husband is only 53.
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Old 07-09-2018, 04:12 PM #6 (permalink)
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Default Re: Medicare Question

If that is true let us know please.
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Old 07-09-2018, 04:44 PM #7 (permalink)
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Default Re: Medicare Question

Chiming in to say that for my husband, Brian, we went with original medicare parts A&B, D for drugs and then supplement G. That got us a total of 100% coverage for DMEs. Where I live best I could get with an advantage plan was 50% coverage on DME, 80% on everything else. Plus with the original and supplement you are not tied to a Network.
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Old 07-09-2018, 05:27 PM #8 (permalink)
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Default Re: Medicare Question

The moment you get a diagnosis of "probable ALS", do this:


Ask your doc to write a simple letter saying you have ALS, and call the SS 800 number. Ask them for an appt at your local SS office (or just apply over the phone). At the SS office, give them your ltr, remind the clerk that ALS is a special case, requiring the SS to follow expedited procedures according to the TERI program for terminal illness, the Compassionate Allowances program, and send the application expeditiously, flagged for the Disability Determination Service as TERI.



If you are impoverished or close to it, you can also get SS to expedite a claim for "Supplemental" Security Income under the Presumptive Disability Program for Quick Disability Determination.


When you are accepted for Social Security, you'll also be given Medicare A (hospitals and such) and the opportunity to buy Medicare B (doctors and such) for about $105 per month.



My memory may be faulty, but I remember we got accepted really, really quickly, without any delay. Maybe I'm just special.
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Old 07-09-2018, 08:10 PM #9 (permalink)
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Default Re: Medicare Question

Mike,
When I applied I got accepted in two weeks. I put a cover sheet on my application with big red letters TERI.
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Old 07-10-2018, 01:31 AM #10 (permalink)
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Default Re: Medicare Question

Quote:
Originally Posted by KimT View Post
I got accepted in two weeks.

YOU'RE special, too!
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