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-   -   Medicare.....What Would You Do? (https://www.neurotalk.org/multiple-sclerosis/121624-medicare.html)

SandyC 05-08-2010 07:23 PM

My mom took the safest route. She has both have A & B and raises you a supplement. With her health problems we could not take a chance. She pays nothing, absolutely nothing out of pocket except for her scripts which she also has a plan for. :wink: The total taken out of her SS is about $130 for the supplement and script coverage and whatever Medicare is charging now, hers went up too. So, maybe total about $240?

If you can afford the 20% without a supplement, that's great, but my mom couldn't afford to take the chance she'd get put in the hospital for a lengthy stay. And guess what? She did and needed 30 days of rehab. Her cost? $0. Her total hospital stay plus rehab? Well over $50G's. Her cost if she didn't have the supplement? 20%= $10G's. Jim has A & B but no supplement because he has the Va for his long stay care.

So, to answer your question, I say take the B, and look into a supplement as well. Don't take a chance and end up bankrupt if you have to be placed in the hospital for anything. Just as soon as you think you are healthy something could pop up you never expected and it doesn't have to be MS, you know? And don't forget your script coverage! Go with one that has gap coverage.

And call SS because they have income help for those who cannot afford their premiums. Some state programs do too. Good luck. I learned more than I ever wanted to know about all this thanks to mom and Jim. :p It wont help me though since SS informed me I am not Medicare eligible anymore now that I don't get a paycheck. I'll be pimping the streets for medical coverage.:rolleyes:

Lady 05-09-2010 01:00 AM

I have Parts A & B, but you can't get a supplement until you are age 65 years old. So I pay for COBRA to get all medical, dental, vision, and Rx's. I have had it for years. You never know. I have had 9 to 11 mostly major surgeries, lost count. I collect them like auto-immune diseases.:rolleyes:

The cost of my MRI's and specilists tests alone, pay for the monthly payment to my ins co. Biopsies, etc., and the blood work (Lab bills) in the thousands, for odd tests.

When a specialist bills my ins he gets very little, as we all know, nowadays. So after he bills my ins, he bills Medicare for the difference. I only pay a co-payment for drugs. The ER would be $100.00 co-pay unless I am admitted. But, Medicare would pay for the co-payment back to me either way.

lefthanded 05-09-2010 01:38 AM

Quote:

Originally Posted by Lady (Post 652888)
I have Parts A & B, but you can't get a supplement until you are age 65 years old. So I pay for COBRA to get all medical, dental, vision, and Rx's. I have had it for years. You never know. I have had 9 to 11 mostly major surgeries, lost count. I collect them like auto-immune diseases.:rolleyes:

The cost of my MRI's and specilists tests alone, pay for the monthly payment to my ins co. Biopsies, etc., and the blood work (Lab bills) in the thousands, for odd tests.

When a specialist bills my ins he gets very little, as we all know, nowadays. So after he bills my ins, he bills Medicare for the difference. I only pay a co-payment for drugs. The ER would be $100.00 co-pay unless I am admitted. But, Medicare would pay for the co-payment back to me either way.

but you can't get a supplement until you are age 65 years old -- not true. However, if you are or can be covered under your spouses policy, the rules are a little different. I have had a supplement since I was about 53 or 54. Again, check with the Medicare website: http://www.medicare.gov/ Click on the eligibility tool.

One is eligible for COBRA when your employer coverage is terminated, but it has limited coverage life. COBRA allows you to keep the exact coverage you had as an employee, but you pay the full premium. Medicare + supplements can cost less than this, but may lack the dental and eye coverage.

SandyC 05-09-2010 09:19 AM

Jim was able to get a supplement too, I forgot to add that he is Tricare for Life eligible thanks to his military career. He is 43. BUT, he had to take part B to get the supplement.

It's all a confusing cycle isn't it?

Lady 05-09-2010 10:30 PM

LH, very confusing. I think I read the whole Medicare site and still feel confused.

I am under my own work history, my own Social Security Disability, not my husbands. I have worked all my life (it seems, lol) so his Social Security does not effect mine. I believe.:confused:

Debbie D 05-10-2010 09:30 AM

Is it made confusing so we'll give up, do you think?
Sounds like math problems that make my head spin:Crazy 2:

tkrik 05-10-2010 11:49 AM

I am on a Medicare Advantage plan. For me, it was the best option with the least amount of out of pocket expenses.

In addition, because my income is so low, I am on an LIS plan for my prescriptions through some Medicare program. It is for low income, limited income sources. I pay $1.10 for prescriptions and $3.10 for C. Actually, I met the deductible a while ago and don't pay anything for the prescriptions now.

Also, I am on a state program that helps pay my premiums - while it lasts. The program may be cut.


Again, Kelly, as others have stated as well, it is better to have something than nothing at all. Things come up that we are completely unprepared for MS related or not. I would hate for something like that to happen where you don't have the proper coverage and no way to take care of yourself.

As you know, I spent a few months fighting with state programs for DD18. Ultimately, I got stuck with the bill from an ER visit. That bill was over $4,000 plus another $3,000 from another ER visit. Because she didn't have insurance, the hospital cut the bill down to 1/2 and I am still making small ($10 monthly) payments on it.

SallyC 05-10-2010 12:24 PM

Ya know, Kell, what these smart people say makes sense. In retrospect, you may be able to see, saving money, by not opting fot part B, but you cannot predict what may happen, down the pike. :eek:

Maybe you should consider getting Part B....and deffinately, look into the premium saving possibilities, Trish points out.:cool:

lefthanded 05-10-2010 12:52 PM

Quote:

Originally Posted by Lady (Post 653108)
LH, very confusing. I think I read the whole Medicare site and still feel confused.

I am under my own work history, my own Social Security Disability, not my husbands. I have worked all my life (it seems, lol) so his Social Security does not effect mine. I believe.:confused:

Lady, I know it is confusing, but it doesn't have to be as confusing if you use one of the many "calculators" that some of the Medicare sites offer. I think the confusion here, however, is that you can only carry COBRA if you were working at the time of your disablity. Here is some information about COBRA: http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.HTML And some information on how COBRA and Medicare work together: http://onque.com/tips/cobraandmedicare.html

Kitty 05-10-2010 06:51 PM

Quote:

Originally Posted by SallyC (Post 653264)
Ya know, Kell, what these smart people say makes sense. In retrospect, you may be able to see, saving money, by not opting fot part B, but you cannot predict what may happen, down the pike. :eek:

Maybe you should consider getting Part B....and deffinately, look into the premium saving possibilities, Trish points out.:cool:

Yep......all my smart friends here have convinced me that it's not worth the risk. I'll sign up for Part B and look into a supplement plan. The only prescriptions I have right now are generic and I spend about $575 a year on those. But, things can happen (just like MS did) and I don't want to be caught unprepared. Thanks for all the advice! :)


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