supplemental plans with SSDI\medicare
 

Hi.

I am trying to get imput from others who are on ssdi\medicare and what supplemental plans they were able to find to cover scripts and fill in where medicare doesnt

Caution
 

You can choose either a supplemental plan or an advantage (Part C) plan. One word of caution,....... I had a similar question and did some research. A supplemental plan, while it gives you much better coverage, it can be costly. Also, in the small print, it states that if you are "below Medicare age of 65" and have Medicare due to disability, the cost of a supplemental policy is higher and the rate STAYS higher and continues at the disability rate even AFTER you turn 65.

Each individual has different situations and different needs. You need to take your situation into consideration. Just be careful you understand the fine print. I had wanted a supplemental plan even with the cost until I discovered that it would continue to be assessed at that rate beyond reaching full retirement age at which time disability reverts to retirement. I went with an advantage plan because that best suited my situation.

Also, plans differ from region to region. Don't forget that you can have original Medicare (Parts A & B) and add Part D for prescriptions, as another option.

There is no easy answer to your question. I suggest that you research the various options for your region, the coverage, and the costs.

Good luck to you. I am one month into my advantage plan and so far so good. Very happy with it. Time will tell.

thanks hopeless. do adv plans pick up after medicare? and do they pay visits to specialist?

Hi jinga,

I hate to use the word "replace" but that is the best way to describe an advantage plan.

You present your Advantage card, not your Medicare card when you see a doc, fill scripts, have diagnostic tests, etc. They are usually like an HMO. You can shop around for them as they vary with the amount of co-pays. Some have a $5 or $15 co-pay to see a primary care doctor, and a slightly higher amount for a specialist. Many include drug coverage which is either a percentage or a tiered co-pay.

You can go to Medicare website, and search ALL advantage plans offered in your area. You put in your zip code and get a list of ALL the plans for your locality and you can compare them.

Advantage plans have a contract with Medicare and must cover all the things offered by Medicare but they also have added benefits. These plans must be approved by Medicare each year. There are time limits as to when you can enroll after first becoming eligible for Medicare so be careful that you act promptly. Otherwise, you will have to stay with original Medicare until the next open enrollment.

My area had many different plans from which to choose so I printed out some comparisons and spent some time reviewing them. Depending on your area, some are FREE as long as SSA is taking the Medicare premium for Part B out of your check. Others have an additional charge but it is low.

I could have chosen a FREE HMO type advantage plan but it had a more limited network and some of my docs were not on it. Because I wanted to keep my docs, (all 8 of them), I chose an advantage (PPO type) plan that costs me $44 per month. It also had better drug coverage.

If you like and want to keep your docs, be sure they are in the network for any advantage plan you pick.

A benefit of original Medicare is not having a network.

It is a big decision but one that you can change each calendar year.

Supplemental plans pick up after Medicare leaves off.

Advantage plans are kind of like an all-in-one plan (Parts A, B, and D) that replaces traditional Medicare.

Hope that makes some sense.

Remember you have to pay for Part B, Part D and the Supplement if you go that route. It can be expensive but it provides excellent coverage.

Depending on your monthly benefits, some states will cover a portion of your costs or offer you Medicaid.

Thanks for that info Hope and LL !

I'm still covered through my husband's work family plan, but I'll have to make the switch at some point.

"Also, in the small print, it states that if you are "below Medicare age of 65" and have Medicare due to disability, the cost of a supplemental policy is higher and the rate STAYS higher and continues at the disability rate even AFTER you turn 65." I never even THOUGHT about an issue like this. Thanks for the heads up regarding that issue !

Even though all of my medical care that is related to my disability is covered by WC, I still have to pay the higher rates. :(

If you have a particular treatment regiment in mind--say you want inpatient Ketamine twice a year, than research which insurance companies approve that procedure regularly. For anyone needing top quality medical care the higher level plans (f-h are excellent generally) they're actually a good value. Expect yearly rate hikes though...

Dear Lit Love,

Excellent point. I had generalized about different situations needing different coverage and no set answer to the original question posed.

I am very glad that you pointed out some specifics on coverage for treatments.

Thanks