Medicare....AKA Headache time!!

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phrannie51
phrannie51 Member Posts: 4,716
edited June 2015 in Head and Neck Cancer #1

Spent two hours this morning in a seminar about Medicare.....then another hour this afternoon with an advisor from my old insurance hashing it over again....Trying to figure out what to do for my only free enrollment is killing me (like I cannot be denied no matter what my health has been).....I'd be just as uncomfortable sitting at a table in Las Vegas Laughing.....gambling with my future. 

I'm right in the middle....three years out of treatment....my health is good, but this is remission, not "cure".....not for two more years....So I know I can't be the only person ever in this predicament....like go for lesser coverage and pray that I get through the next two years without anything cropping up....or....pay more monthly, and be covered no matter what happens...

Anybody else going on Medicare this year?  I know a few are already on it.....what plan did you choose with our "history"?

p

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  • hwt
    hwt Member Posts: 2,328 Member
    #2
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    Medicare

    I will turn 65 next January so not far behind you. My experience with my husband's Medicare claims was good. We had a good backup with BCBS. Our supplement was thru the utility company he retired from. When it comes time for me to make the decision you are facing, I will chose the higher premium for better peace of mind. My Mom also had BCBS thru my Stepdad's Retirement from the government and her coverage between the two was excellent. I can't imagine adding the stress of out of pocket expenses to an already difficult medical situation. Of course, we all hope that need doesn't arise but for me, personally, I can't  afford to take the risk. What my husband had was medicare A and B with our BCBS supplement. Our prescription coverage was thru the BCBS..

  • Hondo
    Hondo Member Posts: 6,636 Member
    #3
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    P

     

     

     

    I had to get on Obamacare care because I am no longer working, you talk about something that sucks is having this stuff. I been trying to see my doctors but can’t unless I have a referral from my PCP Primary Care Physician. No one wants to do anything and I am stuck in the middle, right now my PEG tube is leaking and braking and I can’t get to see the doctor to get another until this who does what is fixed. Sorry I don’t mean to vent it is just hell trying to do anything when someone else is making a decision for you that has never seen you. Also one of my doctor prescribes Lyrica 50mg for me 4 times a day but someone at Obamacare said no we will only approved 3 a day; they know nothing about me or my problems but they have the power to overrule my doctor? I can't believe that

     

    It sucks but this is what we have to try and live with.

     

    On the good side I did get approved for SSD with no problems, they took one look at my health records and approved it within a month. I must wait 5 months to get my first payment but that is no problem.

     

    Hope you get what you need

     

    Tim

     

  • donfoo
    donfoo Member Posts: 1,771 Member
    #4
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    knowing you....

    Jackie,

    If the incremental premium is affordable, then why not get more coverage and sleep better. You can change it later during open enrollment from what I understand. Naturally, our crew would bankrupt the insurance companies given our potential to run up some very big bills, so you know you are getting far more coverage than what they would generally offer, probably a big zero.

     

    bye don

  • Hondo
    Hondo Member Posts: 6,636 Member
    #5
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    donfoo said:

    knowing you....

    Jackie,

    If the incremental premium is affordable, then why not get more coverage and sleep better. You can change it later during open enrollment from what I understand. Naturally, our crew would bankrupt the insurance companies given our potential to run up some very big bills, so you know you are getting far more coverage than what they would generally offer, probably a big zero.

     

    bye don

    insurance

    You are right normally I would not have been able to find insurance coverage with all my health problems. I finely got to see the doctor; he had an angle working for him who gave me a lot of help in getting all the paper work going. He gave me a prescription so I could get the PEG tube I wanted, it will be here on Monday and I have him scheduled to put it in on Wednesday. Nothing worse than having a broken PEG tube.

     

    Life is so goooooooooood

  • phrannie51
    phrannie51 Member Posts: 4,716
    #6
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    I figured out what I want....

    had to let it bubble around in my head for a few days....It's been 3 or 4 days and I haven't changed my mind...a good sign that I've settled on one plan that will fit me.  Always a chance that I will change in a couple of years....but for now, the one I chose seems to fit.  What a relief!

    Don....you make me laugh Laughing. 

    p

  • KTeacher
    KTeacher Member Posts: 1,103
    #7
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    April 1st

    I went on it April 1st.  We pay for the best possible because I continue to have medical issues.  I prefer to pay monthly rather than huge co-pay because of weekly chemo or PET scans every 3 months.  A good thing is that I don't seem to need pre-approval like I always did with BCBS.  Hondo, I think that you are younger than I am but because I had to retire on disability, I qualified for Medicare earlier.  I did have to wait 2years to get on the program.  I think if I had fought it with a lawyer it might have been sooner.

  • Ladylacy
    Ladylacy Member Posts: 773 Member
    #8
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    Medicare

    Be careful with Medicare Advantage Programs is all I can say.  When my husband went on Medicare, we put him on a Medicare Advantage Plan thinking we could change it when I went on Medicare and could afford the higher supplemental plans.  Well when that time came, found out that unless all Medicare Advantage Plans in your area went out, you have to stick with that plan something we weren't told about in the beginning.  So when he was diagnosed with cancer, we had a co-pay for everything and I mean everything.  Yes the premiums are lower, but the co-pays, if you get sicks are something else.  I on the other hand took a supplemental plan for which I pay dearly but I have no co-pays (unless Congress changes that).  Now don't get me wrong the MAPs are a lot cheaper and the majority of them are not HMO's so you can still see whatever doctor you want as long as they take it.  No referrals needed either.  

    Since my husband was diagnosed we have paid out of pocket a good bit each year until he went on hospice because that is covered by Medicare and we have no co-pays.  Another bad thing is that many doctors, unless you are an established patient, are not taking new Medicare or MAP patients, thank you Obamacare.

    Sad thing is that many people think if you are on Medicare you don't pay any premiums.  What a laugh, regardless you pay a premium for Plan B, supplemental plan or MAP, and prescription drugs.

    Sharon

     

     

  • Duggie88
    Duggie88 Member Posts: 760 Member
    #9
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    P

    You're too young for that medicare stuff. But you are old enough for the Vagas thing. I could fly out and meet you at the craps table in about 10 hours and we can work on our retirement plans. I love gambling with the kids inheritance.

    The cure is just 2 short years away your doing great Phrannie.

          Jeff

  • phrannie51
    phrannie51 Member Posts: 4,716
    #10
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    Duggie88 said:

    P

    You're too young for that medicare stuff. But you are old enough for the Vagas thing. I could fly out and meet you at the craps table in about 10 hours and we can work on our retirement plans. I love gambling with the kids inheritance.

    The cure is just 2 short years away your doing great Phrannie.

          Jeff

    LOL Jeff....

    I wish I was too young for medicare....but alas....the big 65 is looming in September.  I'd blow on your dice at the table for luck, but a gambler, I'm not.....thank gawd I avoided at least one vice in my life Laughing.

    I decided to do the high deductable Plan F....there are two plan F's, one is the cadalac of plans....the other the high deductable is the same except there is a $2180 out of pocket.  The differenc in cost is about $80 a month.  Medicare pays 80%, I pay 20% until that out of pocket is matched.  If nothing goes wrong, I only pay $50 a month plus $30 for presciptions (plus the $104 they take out of my SS check....total of $184 a month)....and go to my 6 appointments per year (4 ENT and 2 Oncology)....If something did happen, I can come up with a couple thousand....and be on the same cadalac plan F as those paying a total of $284 a month. 

    I'm gambling a little bit, but not anything like an Advantage plan.....where $25.00 a month covers both meds and appointments with co-pays.....and have a $6700 out pocket hanging over my head.  Advantage plans are for people who have had no health problems.

    When my two years are up, and all is well.....I can always go to the Advantage plan if I want....

    So....small gamble, lower monthly costs....and faith that I'll get through the next two years with nothing happening!!

    p

  • jim and i
    jim and i Member Posts: 1,788 Member
    #11
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    Hondo said:

    P

     

     

     

    I had to get on Obamacare care because I am no longer working, you talk about something that sucks is having this stuff. I been trying to see my doctors but can’t unless I have a referral from my PCP Primary Care Physician. No one wants to do anything and I am stuck in the middle, right now my PEG tube is leaking and braking and I can’t get to see the doctor to get another until this who does what is fixed. Sorry I don’t mean to vent it is just hell trying to do anything when someone else is making a decision for you that has never seen you. Also one of my doctor prescribes Lyrica 50mg for me 4 times a day but someone at Obamacare said no we will only approved 3 a day; they know nothing about me or my problems but they have the power to overrule my doctor? I can't believe that

     

    It sucks but this is what we have to try and live with.

     

    On the good side I did get approved for SSD with no problems, they took one look at my health records and approved it within a month. I must wait 5 months to get my first payment but that is no problem.

     

    Hope you get what you need

     

    Tim

     

    Tim, it is not Obamacare it

    Tim, it is not Obamacare it is an HMO. I went with a PPO because you do not need referals. Jim was on Medicare and chose a PPO, all he paid through treatment was $16 because he also had the states "Share of Cost" It is worth paying higher copays not to have to have PC approvals.

    Debbie

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