Help with Medicare choices

[Dgarrett]

Anyone on here on Medicare Advantage Program Parts A,B and D. Currently covered under my husband’s plan which covers my Ibrance and Xgeva and other meds, but he is looking to retire in February 2020. Trying to find affordable plans any advise is welcomed. I’m currently on disability for my MBC. Thanks and have a blessed day!

[nstonerocks]

I called social security and they advised me which plan was best. You can make an appointment with them to speak to someone is person near where u live.

[Dgarrett in reply to nstonerocks]

Thanks. I’ve talked with them before they have been very helpful.

[library2019]

I am on Aetna Medicare complete coverage is great

[Red71]

My husband an I made an appointment with a Medicare specialist who gets paid to help people decide on the plans they want. (We didn’t pay her).We decided to keep my husband’s Federal Blue Cross/Blue Shield as our Medicare supplement since he was eligible to do that. It was a bit more expensive than some of the plans she had but it covered medication so we didn’t have to buy a third policy. Best decision we’ve made. I have paid nothing for my scans, treatments, bloodwork, and medication. No copays, no nothing. She said it would be a little more expensive but it would be a Cadillac plan. She was right. At the time I was not diagnosed with MBC. And my husband just had a right knee replacement. I am so glad we made that decision to keep the more expensive coverage!

[diamags]

I have parts A & B and then a drug plan. My supplemental is through USAA. I can see any doctor accepting Medicare, anywhere in the country. No co-pays. I love it. I hope that helps. The agents push the more "HMO" plan, but that does not allow you to see whoever you want. And if you're traveling, it is highly inconvenient.

[Francesca10]

I am dreading this change coming in January for me. Right now on cobra and they cover everything. Ends December. I am Medicare eligible now but waiting till I turn 66 which will be full retirement age. Can not afford to not work in NY as single woman. Have started doing research into plans covering ibrance. Refuse to do hmo. Agh

[kearnan in reply to Francesca10]

Check it out and call Medicare. I start next month after not paying a penny for anything while on marketplace medicaid which ended March 31st of this year. I was not eligible for Medicare until August of this year. Who knew? NY has a special medicaid ONLY for stage iv breast cancer, ovarian and pancreatic cancer? So I am currently on that but that will automatically end at the end of this month bc they know I am now eligible for medicare after two years with SSDI. Check with Medicare because I have been doing so much research and if you do not join Medicare when eligible (Plan B is $135.50) a month, then you get hit with a penalty and will pay more than the $135.50 when you enroll.

[blms]

You will be fine if you are on disability as far as your cancer meds go. I have AARP supplement and highest of all plans

[Buffwright]

I wish I were so lucky. For premiums and co-pays with max out of pocket of 3000, I paid about 3800 while working. On Retiree insurance my premiums went from $60 to $850. On Medicare since June with parts A, B, D and F, I have 5800 out of pocket plus premiums of about $600/mo , plus after a couple of months it will take to pay the $5800 (this month Ibrance costs me $2500), i’ll pay $600 (5%) per month for Ibrance. I’ll check into assistance, but my SSD and long term disability insurance income is probably too high to get any. (I’m not yet drawing on my pension). I like the idea of a system that makes insurance or Medicare more accessible to all, but let’s all make sure that our reps know that given high cost meds, Medicare for all isn’t a panacea!

[kearnan in reply to Buffwright]

There are other options but you have to be willing to put the money into a trust and let them pay your bills. They pay mortgage, property taxes, etc. I am a stage iv. I had been on ny gov. marketplace medicaid bc I was in between jobs when diagnosed. I did not have to pay a penny for anything. I called them when awarded SSDI, assuming I would be kicked off immediately for too much money. They said no...we keep you until open enrollment. So at the end of March 2019, my medicaid ended with them and I was not eligible for Medicare until August. I didn't know but in NY there is a special medicaid for stage iv breast cancer, pancreatic and ovarian cancer so the hospital got me on that which I have until end of month. I stupidly thought Medicare would be just liked Medicaid and now,of course, I know that is not true. Plan B ($135.50) and Plan D (Silver Script Choice) $37.90 will be docked from my August SSDI. The man from Plan D told me I would have to pay like over $4,000 in August for my meds, then in September over $3,000 and then after that $700 a month (on top of the deductions). They realize people cannot live on that. The cancer center has a volunteer attorney and two social workers which have been a blessing. I am now in the process (with the help of the attorney who told me she primarily does this for all the patients there) of enrolling in a pooled spend down trust so that I can have dual coverage. I have already signed the paper work and then CDR sends it to Medicaid for my spend down. In other words, in NY you can only get $869 a month (they consider SSDI income) and I am getting $2,400 a month so I put the excess of that money ($1,550) in the trust with the Center for Disability Rights (CDR) and for a $240 initial start up fee and then they only charge $20 a month for four withdrawals. It is my money but they will be mailing out my rent, paying my utilities and credit card. They pay for anything except cigs, alcohol and firearms I put my rent as a reoccurring event so they will do that automatically and the other bills has a short disbursement form (say my credit card for food and clothes) and I scan it to them and they will pay it. You can even go on vacation. They just cant send you the money directly otherwise you are over the limit and will lose medicaid;. And once I get approved, Medicaid will pay three months' back payment of what will be my unpaid meds as I do not have that kind of money. Once I get approved, Medicare will be my primary insurer and Medicaid will be my secondary. Medicaid will even start paying my Plan B and Plan D deductions (and eventually reimburse me for what was taken out). And I will have all the same benefits for Medicaid as I did in the past. You should look into it. I am single and the type of trust I am joining you cannot have more than $15,000 in savings. So the paperwork is sent in and I just have to go to medicaid to apply so that they will deny me to tell me I make too much money and this way when CDR sends the trust documents over to Medicaid pooled spend down trust I am "active" in the system. There are all different types. You can own a home, a car...you should look into it. Since I only have SSDI and will be in treatment for life, This will give me the most options and Medicaid will pay for my deductions.

[Bailey3266]

Here is a link I used and I have CIGNA & am on disability—it is not income related and covers my entire copay. From what I understand it needs to be renewed every 12 months. It was very scary applying as my copay is $3-6K/per month with $10K max. The doctor needed to call CIGNA and then I spoke to CIGNA and actually cried when they told me I was covered 100% of copay by Pfzier! Here is the link. BTW CIGNA copay is zero as is BCBS for any “preventative meds: like letroziole, Lipitor, Ativan and Ambien. I pay for Caltrain Biotin & Glucosamine Chondrointin (which helps my arthritis that is aggravated by Letrozole (I wish I’d known about that one 21 months ago—it’s like a miracle, so far on that 2xs day & it’s allowing me to walk more!

Good luck; here’s the link:

PfZIER CO-PAY “0” Card:

ibrance.com/sites/default/f...

[kearnan in reply to Bailey3266]

Pfizer and the other pharmaceuticals have that option for women on private insurance. They give it for free or for like a $10-copy. But note that if you are on Medicare and/or Medicaid, by law, the pharmaceuticals companies will NOT give you any discount at all. It's full price. There are cancer organizations for women with private insurance that have high-copays and many of them will pay for up to a year the cost of your med. You have to be approved but if so the cancer organization can pay for your meds for a full year depending on their funds. There are several organizations that will do this but most of them you need to be working and/or on private insurance with high co-pay. If your center has a resource room (social workers, nurse navigators), speak with them. They will know what organizations to reach out to.

[Bailey3266]

Ps SSDI automatically gives you Medicare part A n maybe part B; but then they charged quite a bit $300+ I think taken out of disability check; I did this for 2 years and cancelled it as it was 1/4 of my monthly check (I think it’s due to my husband’s high income that they charged me so much! I am now 55 and shud look into Medicare again; I’m not sure once you opt out of you can pick it back up again & mustvakso look into AARP!

Thx for any help!

[Dgarrett]

Thank you all for your informative comments!