Medicare: I've hit the age when I must give... - Cure Parkinson's

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Medicare

Beckey profile image
29 Replies

I've hit the age when I must give up my Obamacare, and must find a Medicare Advantage program and a stand-alone drug plan. I'm in California, U.S. Suggestions, anyone?

Thanks, all.

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Beckey profile image
Beckey
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29 Replies
MBAnderson profile image
MBAnderson

Can't help you with Medicare, but I've gotten up to 85% off drugs with GoodRx.

Express Scripts, POB 66562, St. Louis, MO

daffodil48 profile image
daffodil48

we are with AARP United Health Care. AARP have plans to choose from.

park_bear profile image
park_bear

Straight Medicare better than Advantage. An Advantage plan tried to stick a friend of mine with a $19k ER bill and they didn't do all that much for her in the ER. Medicare won't do that.

For part D you want to find a plan that has as many of your meds as possible in their formulary.

Bailey_Texas profile image
Bailey_Texas

I have an Aetna advantage plan PPO that i like it cost me $50 a month plus my medicare $134 premium. It seems to be a good one.

I have been told supplement plans are better because it covers you any where in the US. Where a advantage plan is limited to only Doctors who are enrolled with the PPO OR THE HMO.

I can not get a supplement plan because i am only 64 you must be 65 to get one. I get Medicare because i have been disabled for 2 years. I will get a supplement plan neat year.

LostinHeadSpace profile image
LostinHeadSpace

Are you in SoCal or NorCal? I went to one Parkinson's support meeting, and they had an eldercare attorney there just talking through the importance of setting up things in the right order to quality for Medical later when it really mattered for long term care. The attorney was William Remery, out of Pasadena or Glendale. I walked away convinced that the cost of meeting with a specialist would be worth the money.

parkie13 profile image
parkie13 in reply to LostinHeadSpace

The government gives you only one year and one chance to accept that kind of Medicare. The Medicare that's going to give you a long-term assisted care if you are disabled as it happens in Parkinson's. I am a year older than my husband and he was still working so I was on his insurance. Nobody told me about it before. By the time I had to choose it was too late more than a year went by. We do have an advantage plan, and it has worked out well.

LostinHeadSpace profile image
LostinHeadSpace in reply to parkie13

That seems like some crucial information! One year from what starting point? Losing the insurance? Becoming officially disabled?

parkie13 profile image
parkie13 in reply to LostinHeadSpace

At 65 when you start your Medicare you have to start paying for it. You have a whole year to make a decision on what kind of Medicare you want to subscribe to. So I was still paying for the Medicare while being on my husband's insurance for a whole year. I was paying the minimum that everybody has to pay and I did not choose a plan at that time.

Lionore profile image
Lionore in reply to parkie13

There may be some confusion. At 65 almost every one can have Medicare Part A which is free and covers 80% of hospital bills, but if you can get good affordable coverage through a spouse’s employer or your job if you are still working you can safely delay enrolling in Medicare Part B and D until your employer based insurance is no longer available. When you do enroll in B and D which you pay for you must get a letter from the employer documenting continuous coverage to avoid a penalty.

Traditional Medicare plus a supplement is usually best since you don’t have to use in network doctors and hospitals but supplemental policies are expensive so many people go with advantage plans which have lower premiums but high copays if you incur hospitalization. None of these cover long term care in a nursing home or assisted living, only short term skilled rehab. Medicare Advantage plans are stingier with rehab days and in home skilled care such as visiting nurses or physical therapists.

parkie13 profile image
parkie13 in reply to Lionore

Hi Lionore, I have been racking my brain trying to remember how it all went. I even asked my husband and he does not remember. The only thing is I would have picked a different plan, the one that had care in a facility if you get disabled , let's say because of an illness and because I let a year elapse I was prohibited from doing it. I appreciate your explanation . Mary

LostinHeadSpace profile image
LostinHeadSpace in reply to parkie13

Thanks for your reply! We've got a ways to go to get to 65. I suspect we'll be dealing with care issues before retirement.

rhyspeace12 profile image
rhyspeace12

Where are you in California? We have a wonderful plan called Golden State that is affiliated with Medicare. It costs nothing, and a specialist is only $5. It is an HMO but we have very good doctors. It is in San Luis Obispo County and a few other ones. I'm not quite sure how it works, but i believe the plan pays a certain amount for each participant a year and the care comes from that. My husbands'care has been wonderful. It was $4 a month last year and this year it dropped to none. The price of the general practitioner dropped from $5 to nothing and the specialist from $15 to $5.

Beckey profile image
Beckey in reply to rhyspeace12

That sounds terrific! I'm in San Francisco.

rhyspeace12 profile image
rhyspeace12 in reply to Beckey

Rats, it is in central CA.

rhyspeace12 profile image
rhyspeace12

Drugs are part of the plan and more reasonable than when i was with Blue Shield supplements.

beckina profile image
beckina

Look into AARP...United Health supplement and RX. They have a zero copay prescription program

Rosabellazita profile image
Rosabellazita

Medicare and humana gold . i pay 0. Virginia.

grower profile image
grower

So grateful here in NZ we don't have to worry about healthcare insurance, sounds awfully complicated and expensive!

Donzim profile image
Donzim

We have had Mutual of Omaha very successfully for years. They pay everything Medicare will pay but the overage.

jackedmonston profile image
jackedmonston

Original Medicare is more flexible with no limits on whom you can see, but you have more decisions. Should you get a supplement to pay deductibles? Which level of supplement? I started without one and found that deductibles added up to less than premium would have been. You also have to choose which Part D plan is best for you. I have choice of 41 plans from 23 companies. The good news is that you can go to Medicare.gov and type in the drugs you take. It will then list all the plans available to you in order by out of pocket costs (including premiums). In my case, out of pocket costs ranged from $3,000 on cheapest plan to $11,000 on most expensive. Same drugs.

Beckey profile image
Beckey in reply to jackedmonston

Thanks!

Bailey_Texas profile image
Bailey_Texas in reply to Beckey

I get my meds cheaper using Goodrx than my insurance.

RobertoOcana profile image
RobertoOcana

I moved out of California

RobertoOcana profile image
RobertoOcana

I moved out of California

Waiyanwong1964 profile image
Waiyanwong1964

You can join Kasei advantage. It will include the drug plan. You don’t have to buy Part D for your med. kaiser also makes it easier to see the specialist.

arwenmark profile image
arwenmark

remember that if you did not take Part B when you got Medicare, you have another chance to take it when you turn 65 without any penalties.

Lionore profile image
Lionore

I wish it wasn’t so far complicated! Where you live, what meds you take, all are considerations and every year may be different. I have a really good prescription plan but brand name drugs are still expensive. I have to push back from my neurologist who pushes the newer meds, does he get some benefit from prescribing them? Probably but he is otherwise great. Anyone with PD or any chronic condition should seek out unbiased opinions before choosing a plan.

Beckey profile image
Beckey

Thanks hugely, all! Very valuable advice, very much appreciated.

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