immunosuppressant drugs

[Okralove]

I’m having trouble understanding which type of insurance should cover the 20% for immunosuppressant drugs that Medicare does not cover post transplant. I have Medicare A&B supplemental medical insurance that states no prescription coverage. Also a D drug plan. My understanding was that the Medical part of our supplemental should cover this. Being told by insurance not so because I’m not in the hospital and picking them up at a pharmacy. Any help is greatly appreciated.

[Jayhawker]

I’m just about to shift from my work insurance as I retire to Medicare. I’ve been told that the immune suppressant meds will be covered by Medicare Part B at 80% minus the part B deductible. The remaining 20% is supposed to be covered by a Medigap or supplemental policy. If I don’t have a Medigap policy I’ll be responsible for the remaining 20% cost. As I’ve looked at these options it looks as though supplemental Plan G will be my best option at least in the state where I live.

My transplant center referred me to an insurance specialist. He is the person who provided the e information above.

Anyway, I’ll need to enroll in Plan G supplemental insurance at the same time I enroll in Medicare Part B.

Part D prescription medication coverage applies to all other prescription medications (minus required vitamins).

I’ll be interested to see what others have to share.

Jayhawker

[Okralove in reply to Jayhawker]

Thank you for sharing.

[Bassetmommer]

Jayhawker is absolutely correct. If you can find an insurance broker, use them. They get paid by the insurance company and not you, so they are free. I am on plan F, which is the old G program. I pay nothing for anything renal or my infusions. NO copays, nada. However, it is an older plan and I do not think they offer it. I do pay a premium for it which is more than most plans. But for example, my immunosuppressant drugs I am on and have been are totally covered. One infusion is over$12K.

Seriously find a broker, they are well worth the effort to get the best deal.

[Jayhawker in reply to Bassetmommer]

Yes, these insurance people are paid by the insurance companyy it ws not us. Good point!

Jayhawker

[Okralove in reply to Jayhawker]

Thank you

[Okralove in reply to Bassetmommer]

Thank you

[Yankcg70]

I would highly recommend you look into a mail order pharmacy too. Sometimes they have better or co pays or will waive the difference on these types just for your business.

[Okralove in reply to Yankcg70]

Thank you. Great advice.