What happens when I go on medicare in a couple of months?

[cherylann]

So far, I have had insurance that paid 100% for my machines and my co-pays for supplies have been minimal. Can those of you on Medicare give me and idea of what to expect?

Thanks.

[Logies101]

I have Medicare and a secondary also, once I pay my $147 deductible for the year the rest is taken care of. My husband has a different secondary than me, pays a bit more per month and they take care of the deductible.

[k_ogre]

they pay 80% I pay 20%

[RogerSC]

I'm on Medicare with Medicare Supplement plan F. I just pay for Medicare, no other deductible or copays for anything, cpap (machines and supplies), other doctors visits, etc. In fact, Medicare and the Supplement plan that I have pays for more stuff than I need. I was on a different Supplement plan year before last, and I had the $147 deductible plus copays, so switched plans to F last year. Anyone who thinks that Medicare is free to its users is sadly mistaken, but it is pretty cheap, maybe $250/month for both Part B and the Medicare Supplement that I have. That doesn't include dental or vision coverage, that's also additional. But no problems, so far, for the last couple of years, it's been fine.

So it's much like being on any other health insurance...be careful to look at Medicare Supplement versus Medicare Advantage plans. I spent a couple of months on a Medicare Advantage plan (Part C), and the Medicare Advantage plan really wasn't worth what I was paying for it, so I dumped it in favor of a Medicare Supplement (Medigap) plan.

As far as drug plans (Part D), I have a Humana/Walmart plan that's about $16/month, but I won't go into a Walmart so I use the mail order option. I pay no copays using mail order either, make sure all my drugs are generic so far. I went into a CVS (yuck) one time on this plan and it cost me a $30 copay as a non-preferred pharmacy for a generic drug, so I've stuck with mail order since then.

Not sure why health coverage for us elderly people is so complicated, all the different pieces. And it changes every year, so you need to look around again each year at all the pieces (except Part B) and figure out where the best deals are *smile*. And which ones are accepted by your favorite doctors and clinics. Could be a lot easier...

Probably more than you need to know, but having spent a bunch of time getting my full medical coverage spun around Medicare, it's worth pointing out some pitfalls *smile*. And be careful and understand the timing of everything. If you don't you'll pay a penalty for the rest of your life for messing the timing of getting started, ridiculous.

Pretty cool, eh?

[Sonnyboy]

Do you live in a zip code that is part of the Medicare Capped Bidding program?

I think you might.

If so, here is a publication by Medicare:

https://www.medicare.gov/Pubs/pdf/11461.pdf

[chunkyfrog]

I purchased a plan F part B supplement.
My only expense is my premium. Which are not cheap.
With my surgery, my only expense will be for bras not dispensed through Medicare.
((AFAIK)). Had I gotten a Medicare Advantage plan, I would have had little to no choice in providers
or machines, and who knows how I would be FUBAR with my cancer?

[cherylann]

Oh, Lordy. Just when I thought I was beginning to understand Medicare someone throws out a new phrase - Medicare Capped Billing. What the heck is that? I live in Tulsa, OK.

Thanks, everyone for all the info.

Roger, definitely not more than I wanted to hear. I think Medicare is a major rip-off. We have paid our entire working lives for insurance that we don't get to use for 40 or so years and then we have to keep paying for it. I spent 45 minutes on the phone with someone from BCBS last week and my head was spinning when I was done - I finally just had to hang up I was getting so confused. It shouldn't be this complicated. Too many decisions to make.

[chunkyfrog]

Your state offers free consultation for those wandering through the Medicare morass.
Contact the Oklahoma Department of Insurance. --As soon as possible.
http://www.ok.gov/oid/Consumers/Informa ... /SHIP.html

[bwexler]

For this years coverage I found a knowledgeable insurance broker, one who handles many companies and plans.
I chose a Medicare Advantage Plan, the agent pointed me to the one he thought best fit my needs.
I scrutinized it for a couple weeks and determined he was right. Compared to the Advantage plan I had last year, after the changes they made for 2015, I will save about $2,500 this year if nothing major happens, if it does I will save more.
I highly recommend you seek out a similar broker, tell him what your goals are and let him guide you to the best choice, then just check out the top two or three choices he recommends.

[mike1953]

So far, I have had insurance that paid 100% for my machines and my co-pays for supplies have been minimal. Can those of you on Medicare give me and idea of what to expect?

Thanks.

For Oklahoma Medicare information and help
The Senior Health Insurance Counseling Program (SHIP) is a non-profit organization helping to inform the public about Medicare and other senior health insurance issues. This division provides accurate and objective counseling, assistance, and advocacy relating to Medicare, Medicaid, Medicare supplements, Medicare Advantage, long-term care, and other related health coverage plans for Medicare beneficiaries, their representatives, or persons soon to be eligible for Medicare. Call our Senior Help Line at 1-800-763-2828 for assistance.

[chunkyfrog]

Your state offers free consultation for those wandering through the Medicare morass.
Contact the Oklahoma Department of Insurance. --As soon as possible.
http://www.ok.gov/oid/Consumers/Informa ... /SHIP.html

--and yes, you can call them.
This is especially good for first-timers.
This is the best time, as they are swamped in the renewal period each year.

[purple]

When I started, there was a delay of six months between when I received my first Social Security check and Medicare Coverage began. Since the first Social Security payment is paid after the month of when coverage begins. That would be like seven months. If your only income is Social Security, then there are now some DME's who will forgive the Co-Pay, although they are not legally allowed to forgive the Yearly Deductible, so you need to be careful where you let that get used up. Some Medical Providers will also forgive the Co-Pay, like those associated with Medical Schools, or Charity groups. Some Doctors will not accept new Medicare Patients, but will continue on with patients they previously had. I would guess that is about to change as Congress has increased the amount Medicare will pay doctors, so doctors will be more willing to accept new patients, and possibly to forgive the Co-Pay.

If your income is low enough, then you can also apply for your States Medicaid Program. There is Traditional Medicare and the other version, Medicare Advantage, from private companies. Then of course Medicare Supplement, which picks up your CoPays, Deductibles or maybe ---things like that.

First, you need to find all the doctors you need now, so they might be available to you when your Medicare- which of them you get- so that doctor will hopefully keep you as a patient after Medicare begins. Also to as much as possible, to prepare you for the long delay from your first Social Security Check, and when Medicare starts.

More likely someone will chime in here and tell me I am wrong about that delay. I hope that Congress has changed it. It is a dumb idea for Congress to save money by delaying medical care. As of now, I believe that the best medical care is pro active. When you get a new problem or symptom, go to the doctor. I have gone through months of pain while trying to save money. I ended up going to the doctor for the health problem anyway.

Traditional Medicare pays new masks, hoses every three months. New head straps every six months. A machine, (with a Co-Pay) whenever yours is broken. I have met other Sleep Apnea suffers whose machine broke in the middle of the night, and by nine AM the DME was begging to bring a brand new machine over to their house. When the person said they had a school they were doing all day, the DME rep wanted to bring the Machine over to their school, already set, brand new, to deliver to them. On the other hand, used to be they replaced machines every five years, that is up in the air. I think they are also generous about stolen machines. However, the 13 month Co-Pay begins, and the first two payments are larger than the others.

Best wishes.