My Turn to Start Figuring Out Medicare

[pineywoods]

I set up this morning. Before I get plan will check with Doctor office. Started searching drug plans and have two meds going to be a problem. i all ready knew about TRIJARDY XR which going to ask doc to change but I surprised to find that tamsulosin used for enlarged prostate is not covered on these plans I have looked at so far.

I pretty much think I'm going to have to get a stand alone drug plan and after paying for that. I figure that even with that plan meds are going to cost me two grand before I meet out of pocket on it but that's still cheaper then paying for one of my prescriptions.

 

[Elf@shore]

I pretty much think I'm going to have to get a stand alone drug plan and after paying for that. I figure that even with that plan meds are going to cost me two grand before I meet out of pocket on it but that's still cheaper then paying for one of my prescriptions.

HI!
If you are going to get a G Plan?
You have to get a Script plan separately ,which you can customize.
This is where you need an advisor.
Make a Script list for you and yur wife separately.
Yur advisor should be able to find a plan to fill yur list. If not, should find a separate plan for what is missing scripts.
My wife has that issue, our Advisor is going to work on it.
Depending on yur State ,there are some state drug plans to help.

 

[fxsales1959]

I am about a week away before I can start applying for the Medicare stuff. I have heard nothing but bad about advantage stuff. I do have an appointment with Nicole from Morgan Medicare in a few weeks but would like to explore my options ahead of time. Any suggestions? I don't mind paying a bit extra to keep my out of pocket down. I will start in June. I am thinking Part A, B, D and G but I really I dont really know anything at this point.

I signed up for Govt. part A and B. I have a god rep down here that signed me up for a Blue cross supplement . (no cost) and covered my scripts. Unfortunately my heart center hospital got a divorce from Blue cross (Florida blue). My girl got me changed to a Humana supplement also no cost, covering all meds and visits to a local Conviva health center. Also includes a debit card for OTC meds and the like. So, right now the Govt takes $200/month out of my account and that's it.
Have been in for Blood tests(monthly since I on Warafrin). and regular visits. ( no copay)
Haven't been to heart center yet to see how that goes, but both Linda and I have the same Humana plan. Much better than the $900/month I was putting out for government health insurance.

 

[Bruce C]

I just signed up after the first of the year for Medicare and part G through State Farm. The part G cost is just over $200 a month and a drug plan through Wellmark is $9.60 a month. Any Part G plan will have a $264 I think give or take a few dollars deductible and they will all pay exactly the same which is whatever Medicare don't pickup. My prescriptions will cost me roughly $640. the first month $11. a month after that until August and nothing after that for the rest of the year which I think is pretty good since one of my prescriptions is over $1200. a month.

 

[BGKYSmoker]

Been there done that. Started in 2001 and its still a PITA.

 

[jcam222]

I set up this morning. Before I get plan will check with Doctor office. Started searching drug plans and have two meds going to be a problem. i all ready knew about TRIJARDY XR which going to ask doc to change but I surprised to find that tamsulosin used for enlarged prostate is not covered on these plans I have looked at so far.

5 of my 6 meds ( including Tamsulosin) were $0 for 90 day mail order supply on my Medicare Advantage plan. The last one was stupid expensive at $300+ for 90 days. I get that one mail order from Mark Cubans Cost Plus pharmacy for $36!!

 

[sandyut]

Hey Brian, sorry im late.

My wife is on an Advantage plan and it seem pretty luxurious compared to my ACA ins. Lots of extras, surgeries are cheap, meds are mostly free. I cant wait to get on one.

As others state, I would use an insurance consultant because there are decisions and cant be reversed once made. They are explain the different options. My wife did all that and went with the advantage plan with no regrets at all. I only dream of the coverage she gets!

Keep us posted

 

[sandyut]

The last one was stupid expensive at $300+ for 90 days. I get that one mail order from Mark Cubans Cost Plus pharmacy for $36!!

Cost Plus Drugs is fantastic for meds not covered. Mine was $200/a month locally. $65 for 90 days with Mark Cuban.

 

[Fueling Around]

...
My girl got me changed to a Humana supplement also no cost, covering all meds and visits to a local Conviva health center. Also includes a debit card for OTC meds and the like. So, right now the Govt takes $200/month out of my account and that's it.
Have been in for Blood tests(monthly since I on Warafrin). and regular visits. ( no copay)
Haven't been to heart center yet to see how that goes, but both Linda and I have the same Humana plan. Much better than the $900/month I was putting out for government health insurance.

Thanks John
I'm really leaning to Humana Advantage. Our BCBS MediGap is getting very expensive.
Been talking to good friends that also snowbird and are on Humana Advantage. They go back to New York state for the summer. Coverage is great for both Florida and New York.

 

[BGKYSmoker]

We opted to ditch all those advantage plans. When my wife retired from the fed gov she was able to keep her fed bc/bs. when she was doing chemo she was only paying $50 for it.

 

[dward51]

I pretty much think I'm going to have to get a stand alone drug plan and after paying for that. I figure that even with that plan meds are going to cost me two grand before I meet out of pocket on it but that's still cheaper then paying for one of my prescriptions.

If your choice of a plan does not include a drug plan, and you have to select a stand alone part D drug plan, make sure it meets the Medicare requirements 100%.

My very elderly in-laws "thought" they had it all covered and for 18 months they did not have what medicare considers credible coverage for their drugs. Not that they needed any drugs during that time so they had no clue. Now they are paying a penalty for the rest of their lives based on not having a part D that met the requirements for those 18 months.

I'm managing all their financial affairs now (both are diagnosed as in dementia) and found out about this recently when their retirement company notified me. Apparently they had been sending him letters, which he was throwing away and my time to appeal or otherwise fix it had long expired.

You would think they could make insurance simple - but nope, get the government involved and it's guaranteed to be a shit soup special every time.

Our Advantage plan through my retirement company has great drug coverage. The most expensive drug I have is my Pradaxa at $20 a month (like $700 on the open market). A lot of our meds are free and there is no "doughnut hole" in our plan. If you have a advantage plan option that is NOT from the open market, I would say look at that option. A lot of the ones tied to a company your worked for have very good extras worth considering if that's available. But compare the details as details matter!

 

[Chasdev]

Over my wife's strong paranoid objections, I joined Humana advantage.
After she watched for a year, she also signed up.
First thing is we saved $3000 a year in secondry insurance we needed with medicare as we pay NOTHING per month.
She was worried they would not cover expensive drugs like her COPD inhaler stuff, wrong, the co-pay now is $145 for three months and before Humana it was $500 every three months.
They also pay for my top level doses of Mounjaro.
All our docs take it, so we could not be more pleased to have signed up.
She was worried that if one us got cancer they would deny coverage.
Wrong, she just finished getting chemo and proton radiation treatments and Humana had no issues.
Having said all that, we do live in a large modern city, not a tiny town with limited access to hospitals and that is probably why Humana works for us.