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Floridajo & Joanne..& anyone who can help

lizper
lizper CSN Member Posts: 199
edited March 2014 in Ovarian Cancer #1
Ladies tks for previous answers, but now I'm all confused.. So Medicare pays 80% of what they authorize not of the whole bill??? Do you have to pay everuthing in the meantime before you get through all the paperwork?? Can you help me out with understanding what a supplemental plan is? Even though I'm American I`ve been in Mexico since I was 10 so I'm way out of knowledge of all these things. Thank you so so much!! Liz
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  • floridajo
    floridajo CSN Member Posts: 480
    #2
    Hi Lizper
    Believe me I know how confusing this is!!! OK she'll have to have Medicare part B,so apply for that first. They will send a booklet(a rather thick one)to give you all the info on what they pay for and won't pay for. Then you will need a supplement plan to pay alittle more of what Medicare doesn't cover. I wanted a medi-gap plan,which is much more money..but I wasn't approved as soon as they hear Cancer,they reject. A supplement works with Medicare,and you can't be turned down for it.In the booklet as well as on line they can give you some ideas of insurance companies who handle supplmental plans. I made my choice by selecting a plan that covered any Dr. and any hospital I went to. I also made my choice based on RX coverage (which is medicare part D) I got confused as well,so I also chose a plan that included RX too. I pay 2-$5.00 for my prescriptions. Also like I explained they might charge alot ofr thing but Medicare doesn't let them get away with that..this is something agreed upon between the Medicare and hospital or Dr.you use. Good luck,I'll be willing to help as much as I can. If you need more help e-mail me at jlockamy1@yahoo.com..OK???? ((((hugz)))>>~~~Joanne
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  • lizper
    lizper CSN Member Posts: 199
    #3
    floridajo said:

    Hi Lizper
    Believe me I know how confusing this is!!! OK she'll have to have Medicare part B,so apply for that first. They will send a booklet(a rather thick one)to give you all the info on what they pay for and won't pay for. Then you will need a supplement plan to pay alittle more of what Medicare doesn't cover. I wanted a medi-gap plan,which is much more money..but I wasn't approved as soon as they hear Cancer,they reject. A supplement works with Medicare,and you can't be turned down for it.In the booklet as well as on line they can give you some ideas of insurance companies who handle supplmental plans. I made my choice by selecting a plan that covered any Dr. and any hospital I went to. I also made my choice based on RX coverage (which is medicare part D) I got confused as well,so I also chose a plan that included RX too. I pay 2-$5.00 for my prescriptions. Also like I explained they might charge alot ofr thing but Medicare doesn't let them get away with that..this is something agreed upon between the Medicare and hospital or Dr.you use. Good luck,I'll be willing to help as much as I can. If you need more help e-mail me at jlockamy1@yahoo.com..OK???? ((((hugz)))>>~~~Joanne

    Joanne, tks again for your help. A big question though... does Medicare accept an already DX cancer Patient? Was exactly does Medicare Part D cover? Thks again Liz
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  • floridajo
    floridajo CSN Member Posts: 480
    #4
    lizper said:

    Joanne, tks again for your help. A big question though... does Medicare accept an already DX cancer Patient? Was exactly does Medicare Part D cover? Thks again Liz

    HI Lizper,
    Yes,Medicare has to accept a cancer patient!!!If she qualitfies for medicare Part B. If not then look into the state you'll be living in and check out the Medicaid program. Part D handles prescriptions. I believe that falls into the catogory of regular medicines...like meds she will take everyday. For me it's my pains meds,colestrol,Elavil and lasix, as well as steriods and nausea meds. But I have seen recently a RX list for a company called Secure Horizon that covered chemo meds like carbo,taxol and avastin, but you would need prior authorization. I should have questioned the man,but I forgot. Also it would only pay 80%,but you would not want to get her chemo that way..as there is a donut hole,,which is too complicated to talk about right now. You would want your Mom to have her chemo as an out patient clinic...so the chemo wouldn't be a part of her Part D claims. Remember to write me privately if you need me...good luck ((((hugz)))>>~~~Joanne
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