Medicare CPAP costs

chunkyfrog wrote:My mother was not permitted to trade up, but that was awhile back.

When I enrolled in 2012, neither the Medicare Advantage Plan that I started with, or the Medicare Supplement Plan that I switched to required any sort of physical or whatever. I do recall end-stage renal disease being mentioned, though, but I recall that being mentioned relative to the Medicare Advantage Plan (Part C), not the Medicare Supplement plan. This was referred to as "guaranteed issue":

https://www.medicare.gov/pubs/pdf/02110.pdf

I've wondered since I first heard about Medicare why a plan that's designed for older people that may not be quite as focused mentally is so complicated. 4 different parts, and it doesn't cover vision or dental. One of the parts is free (Part A), 1 part may be optional or may be required (Part B) and you pay for that, and 2 of the parts are optional (Parts C and D) but again, you pay for those (except that Part C can be free). And the differences between Medicare Supplement plans and Medicare Advantage plans (Part C) and how Medicare Advantage plans that have no monthly payment work, and on and on. Fairly complex set of decisions to be made.

No answer has occurred to me yet *smile*. Maybe it leverages all the free time that retired people are supposed to have *smile*. Actually, I find myself pretty busy...

RogerSC wrote: I've wondered since I first heard about Medicare why a plan that's designed for older people that may not be quite as focused mentally is so complicated. 4 different parts, and it doesn't cover vision or dental. One of the parts is free (Part A), 1 part may be optional or may be required (Part B) and you pay for that, and 2 of the parts are optional (Parts C and D) but again, you pay for those. And the differences between Medicare Supplement plans and Medicare Advantage plans and how Medicare Advantage plans that have no monthly payment work, and on and on. Fairly complex set of decisions to be made.

No answer has occurred to me yet *smile*. Maybe it leverages all the free time that retired people are supposed to have *smile*. Actually, I find myself pretty busy...

Yes it is a complicated process. That's why we have so many advertisements with salesmen wanting to "help", unsolicited phone calls and full mailboxes.

RogerSC wrote:

mike1953 wrote:

hobbs wrote:For what it is worth I just signed up for Medicare , B, D and F. From the research I did if you get REALLY sick, you better have F.

original poster cannot get a medigap policy because they are using a Advantage plan. But you are absolutely correct it they have major medical problems in the future they will have a lot of out of pocket expense. Also the Medicare subsidy (paying the Advantage Plan premium) is ending. Meaning those with Advantage plans will have to pay the monthly premium themselves.

Well, what luck! We're in the Medicare open enrollment period, so the OP could change from the Medicare Advantage Plan (a Part C thing) to a Medicare Supplement Plan until December 7. That coverage wouldn't start until Jan. 1, 2016, of course, but they could set that up right now, after doing some research on Medicare Supplement plans.

Not so fast, if you have been on a Advantage Plan for more than one year you may not be able to get a Medicare Supplement policy (Medigap). You are only guaranteed acceptance into a Supplement policy within the first year of a Advantage Plan. You would have to complete a medical physical form and maybe a physical before acceptance and if there is any medical problems you may be denied or additional premium if accepted.

mike1953 wrote:

RogerSC wrote:

mike1953 wrote:

hobbs wrote:For what it is worth I just signed up for Medicare , B, D and F. From the research I did if you get REALLY sick, you better have F.

original poster cannot get a medigap policy because they are using a Advantage plan. But you are absolutely correct it they have major medical problems in the future they will have a lot of out of pocket expense. Also the Medicare subsidy (paying the Advantage Plan premium) is ending. Meaning those with Advantage plans will have to pay the monthly premium themselves.

Well, what luck! We're in the Medicare open enrollment period, so the OP could change from the Medicare Advantage Plan (a Part C thing) to a Medicare Supplement Plan until December 7. That coverage wouldn't start until Jan. 1, 2016, of course, but they could set that up right now, after doing some research on Medicare Supplement plans.

Not so fast, if you have been on a Advantage Plan for more than one year you may not be able to get a Medicare Supplement policy (Medigap). You are only guaranteed acceptance into a Supplement policy within the first year of a Advantage Plan. You would have to complete a medical physical form and maybe a physical before acceptance and if there is any medical problems you may be denied or additional premium if accepted.

I knew that they could make you wait up to 6 months to switch between an Advantage plan and a Supplement if you've been on the Advantage plan for more than a year, and if you have a pre-existing condition. I wasn't aware that you would have to have a physical. Going to look into that one if I get time, since it interests me.

RogerSC wrote: I wasn't aware that you would have to have a physical.

They don't all require a physical and some have very minimal health questions.
It varies by companies...the more liberal the underwriting...usually it's paid for with premium.
I have a family member who sells Medicare supplements...and the underwriting can vary widely among the various companies offering the Medicare Supplement plans.
While the various plans like C or F or whatever, are the same with all companies...the underwriting can be widely different. The plans had to be standardized but the underwriting didn't.

I really can't speak to your Advantage plan but I would advise you to look into switching to a medigap plan F during this open enrollment period - if you are eligible ( plans don't have to take you if you didn't join when first eligible, or first year, and may charge a premium depending on your medical pre-existing conditions). I have been on Medicap plan F since the beginning, have been hospitalized x4 with almost every test known to medical science - some type of still un-diagnosed probable auto-immune disorder, ER x3, Etc. and had all my APAP & supplies totally paid for ( I did meet the 90 day compliance). I have had no out of pocket medical expenses (except for premiums)!

You can get FREE counseling about your Medicare options through your local "SHIP" program (in California it's called HICAP). Look on the back of your "Medicare and You" book for the number. They are a federally funded program with no fees.

Janknitz wrote:You can get FREE counseling about your Medicare options through your local "SHIP" program (in California it's called HICAP). Look on the back of your "Medicare and You" book for the number. They are a federally funded program with no fees.

If you would look at my signature you would see that I have a link to all SHIP State Phone Numbers, as I am a SHIP counselor for the State of Kansas. Yes a insurance company may ask for a physical depending on the answers on the medical questionnaire.