US Medicare question

[Bax509]

Currently I'm on private insurance through my husband's employer - which is my primary insurance and has been great for transplant. He's planning on retiring about the time I qualify for Medicare - at which time I will likely be switching to Medicare. What has your experience been with Medicare coverage of medications, services, etc?

[Bassetmommer]

The best thing you can do is see an insurance broker. They cost nothing and will steer you in the right direction. For example, I went on a supplement, not advantage plan. And although I pay more for my premium, I pay NOTHING out of pocket for anything. She will also steer you on a supplemental prescription plan.

Here is who I use kathycoler.com/

[Bax509 in reply to Bassetmommer]

thank you - good idea. Choices seem overwhelming.

[OperationKidney]

I had my transplant about 4.5 years ago and had Medicare through all of it. They are awesome. For the first three years they pay for all of the anti-rejection meds, doc appts, etc at least for in-network services & locations. After that things tend to be a little different, but they still cover a lot of the costs. That's the case for me, anyway, but I am not sure if they do things differently for those who qualify due to age, because I am only 31. If you have a Medicare office near you, it might be beneficial to go ask them a bunch of questions!

[Porter20]

Horrible compared to private insurance. I went from paying $125.00 per prescription of Part B drugs for immune suppression drugs for 90 day supply to $600 per prescription. Nothing is covered if you cannot do generics. I had a reaction so have to take brand name. I had to move to Medicare at my 30 month condition period as Medicare as primary. There is also a big deal now where certain labs are not covered for transplant recipients. A group just went to DC to fight to get it back. Not promising my drugs almost immediately put you in the doughnut hole.

[RhenDutchess123]

Medicare has been very good for me...but you must remember they only pay 80% of approved cost...so you will need a Supplement Insurance to pick up that part..You will also need a Prescription Insurance.. and a Dental Plan.. All of these plans charge a Premium and have a deductible to be met each year....It is all very confusing..so get help navigating it

[RhenDutchess123]

It also matters what age you are ...

[orangecity41]

It is good to check with insurance broker. There is Advantage Plan and Original Medicare. I also got Advantage Plan that has a option for SNP (Special Needs Plan) if needed in future. It is possible that plans can vary by State you are in.

[Hawk12]

I qualified for Medicare due to age. It has been great. Do NOT get any “Advantage” plan!

My secondary is Blue Cross/Blue Shield Federal, which also covers my prescriptions.

Hopefully, your husband can keep his insurance as your secondary insurance and for prescription coverage when he retires .

My wife and I have several newer, expensive drugs, and most Pharmaceutical companies have discount cards that you can sign up for (no paperwork required), which will limit your copay to something like $10 to $15 as long as you have COMMERCIAL INSURANCE, NOT Medicare!