I am losing my supplemental Medicare insurance, because the insurer decided not to sign up again.
Has anyone found a good supplemental plan which covers more than 66% of Trelstar ADT shots? The insurance I am losing covered 75% of a $2600 cost. The best I have found to replace it is 66% of 2900+ dollars.
Was it supplemental, or Medicare Advantage? Shots are 80% covered by Part B and the supplemental plan covers the remaining 20% . I have Anthem/Blue Cross Part F that picks up the full 20%. They got rid of Part F (it is grandfathered for me). The Part G plans in some states that replace it have a deductible of $2,490 in 2022 before Medicare covers the shots.
It is a plan called Inter Valley Health Plan and is a Advantage plan. I have paid a 25 % co-pay of $566.51 co-pay every 3 months for nearly 18 months. Plan paid $193.65, Medicare Coverage Gap paid $1505.85. I’m in California. I don’t know if that has anything to do with it.
Suggest you look into medicare (A&B)+supplemental vs.man advantage plan. It gives you the freedom to see any doctor. The downside is that you would need a separate drug plan. I think there is penalty for switching or a waiting period for coverage. The people at CMS (federal govt agency) or the Calif. Dept of Aging -- they are usually very good at explaining all that.
aging.ca.gov/Programs_and_S...
From what I’ve read (extensively), if you initially choose a Medicare Advantage plan, then you have one year to change to a supplemental plan without penalty. After that you are subject to insurance underwriting. And that’s not going to happen with stage 4 cancer. Of course, OP needs to check with an independent experienced advisor for detailed guidance.
which supplemental plan do you have? If you have F or G there should be little out of pocket. F isn’t available unless you are grandfathered in. If you don’t have F or G, but a lower supplemental, you should consider switching to a supplemental G plan during open enrollment. The premiums are a little more expensive, but should have no or little out of pocket expense.
I am assuming you are not on an Advantage Plan.
I am on supplemental F, with united healthcare through AARP, and have not had any out of pocket expenses.
If you have an Advantage Plan you need to check with various insurance companies that offer advantage plans and see what your out of pocket expenses will be. Main carriers like UHC and Blue Cross all offer advantage plans
Thanks guys. I do have an advantage plan so I will be digging deeper into other insurers.
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