Insurance

[Laqueen]

Hello! In June of the year 2024, my husband retires from his job, so the insurance I was getting. I can no longer get, form his job. I do have social security and Medicare. The Doctors I did have for my sleep apnea therapy are leaving and really at this time I am beginning not to care.I guest I’ll just do the best I can. So if you can give me some knowledge on what to do! God knows I’ll Love it!. Thank you in advance!!!

[LSAT]

You are not giving much information . How long have you been on CPAP? Have you had any problems during that time? I personally went over 10 years without seeing a sleep doctor. Whenever I needed a prescription, my PCP providede it. My numbers remained steady for those 10 years and if a slight adjustment was needed, a turn of the dial provided it.

[chunkyfrog]

Doctors generally have colleagues they can recommend you use.
Contact the practice so you will have uninterrupted care.
Your existing Medicare will continue without your husband's insurance.
Less paperwork and fewer chances for "unintentional" screw-ups by insurance.

[Janknitz]

When your husband leaves his job, it sounds like you will be losing your Employer Group Health Plan which currently supplements your Medicare. That qualifies as a "change in circumstance" and you will be eligible to get a new Medicare supplement policy (Medi-gap) under a "special enrollment period" without underwriting.

Choose wisely, because not all doctors are covered by all supplemental insurers. You can get help finding a good supplement plan from your state SHIP (HICAP in California) which offers FREE counseling in Medicare supplement policies. Their number is on the back of the Medicare and You booklet you get every November/December. You can also find your state's program online at Medicare.gov. You want to be sure to find a supplement plan that covers doctors you are going to be comfortable working with on your sleep apnea issues.

You must sign up for parts B (outpatient) and D (Drugs), or an Advantage part C plan that covers outpatient and drugs within a certain STRICT time limits after the change in circumstance, so I suggest you start looking in April so you are ready to go in June when your husband leaves his job. You will be financially penalized if you don't sign up for Part B and D within a certain amount of time when your husband retires, and you may not be able to get a Medicare Supplement in place until the following January if you blow the special enrollment period.

Most of us here learn to monitor our own TREATMENT by using software to look at our data, and by how we feel. If there are problems that can't be easily solved, that's when a knowledgeable sleep medicine doctor can be helpful. Your primary care doctor can monitor your general health, but may not understand much about CPAP therapy.

If you are having issues now, you should find a sleep medicine doctor who takes Medicare and the supplemental insurance you are likely to sign up for so you don't have to switch again in June.

[ChicagoGranny]

The Doctors I did have for my sleep apnea therapy are leaving

Before they close shop, make sure you get a copy of your sleep study summary and your latest CPAP prescription. It's your legal right to have this.

[chunkyfrog]

. . .
You must sign up for parts B (outpatient) and D (Drugs), or an Advantage part C
. . .

There is another choice: part D , but NEITHER part B nor C.
My part B plan f supplement was totally ripping us off.
Paying the deductibles and the 20% copay is way less than the premiums were.
Too bad Medicare allowables vs "msrp" is such a damn secret!

[Janknitz]

There is another choice: part D , but NEITHER part B nor C.
My part B plan f supplement was totally ripping us off.
Paying the deductibles and the 20% copay is way less than the premiums were.
Too bad Medicare allowables vs "msrp" is such a damn secret!

This is true, sometimes it is less expensive just to pay out of pocket, and definitely worth exploring your options.

But be aware that there are co-insurance payments when you get beyond 20 days of skilled care, and some (NOT ALL) supplemental insurers cover part or all of those co-insurance costs, which start at $200 a day.

None of this is "secret" BTW, but people don't always know to look at the consequences of their health insurance decisions. It's all there at Medicare.gov, but people don't know what the rules are or what questions to ask until they or a family member are lying in that bed or getting a bill for something.

The situation that breaks my heart pretty much every day is seeing someone denied the care they need by a bean counter at a supplemental insurance company based on lies, myths, and total lack of concern for human life and dignity.

[loggerhead12]

You have to get on the ball with your Medicare. We're a few years away but already planning for it. This is one of the best overviews I've seen:

https://www.youtube.com/watch?v=RZmpOo3QKEo&t=2s

[chunkyfrog]

Every state has free consultation for senior medical insurance. (Do it)
We use them EVERY year, because those sneaky insurance dudes hope we will be lazy,
and they will then take full advantage of us.

[D.H.]

To the original poster:

Assuming you take "regular" Medicare, they will pay for a sleep doc, sleep tests, and a new CPAP every five years. Of course, it's subject to the usual deductibles and copays.

[Really]

Hello! In June of the year 2024, my husband retires from his job, so the insurance I was getting. I can no longer get, form his job. I do have social security and Medicare. The Doctors I did have for my sleep apnea therapy are leaving and really at this time I am beginning not to care.I guest I’ll just do the best I can. So if you can give me some knowledge on what to do! God knows I’ll Love it!. Thank you in advance!!!

Not sure what the question is?

[Janknitz]

Not sure what the question is?

Why are YOU whining???

[zonker]

either laqueen has figured it out or forgotten they've asked the question.

hasn't been back for a week.

[ChicagoGranny]

The Doctors I did have for my sleep apnea therapy are leaving and really at this time I am beginning not to care.I guest I’ll just do the best I

Ask your PCP if he will write the prescriptions for CPAP supplies and machines you will need. He also will need to sign a statement that you still benefit from CPAP. If you have a decent local DME, they can verify your CPAP compliance. They can also fax the forms your PCP needs to sign to her. Since my sleep doctor retired, my PCP has taken care of this for me at my annual physical exam.

One important tip: Get a copy of your diagnostic sleep study summary and initial prescription before your sleep doctor closes shop. It's your legal right to have this. Put it in a permanent file. It could become important immediately and years later.

I guest I’ll just do the best I can.

Don't try to do it alone. Let the members here help you. Some very kind, knowledgeable members would love to help you. (Ignore the stupid trolls. Really is one of them.)

[Janknitz]

either laqueen has figured it out or forgotten they've asked the question.

hasn't been back for a week.

Maybe a drive by. Or maybe she just didn't have anything else to say. I like that better than a "yes butter"