[jinga]

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

[Hopeless]

Originally Posted by jinga

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

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.

[jinga]

Originally Posted by Hopeless

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?

[Hopeless]

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.

[Hopeless]

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

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.

[LIT LOVE]

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.

[finz]

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 !

[Mz Migraine]

Originally Posted by jinga

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

If you are on Medicare, you should have already received the "book" Medicare & You-2014.
This "book" is custom made especially for you and the state you reside in. Strongly suggest that you read it w/a fine tooth comb. WARNING: INFO OVERLOAD!!!!

The 'book' explains all the ins plans available in your state & their policies.

SIDEBAR: YOU ARE AUTOMATICALLY ENROLLED IN OBAMA CARE IF ON MEDICARE. NO NEED TO SIGN UP!


HTH

[Hopeless]

Originally Posted by Mz Migraine

If you are on Medicare, you should have already received the "book" Medicare & You-2014.
This "book" is custom made especially for you and the state you reside in. Strongly suggest that you read it w/a fine tooth comb. WARNING: INFO OVERLOAD!!!!

The 'book' explains all the ins plans available in your state & their policies.

SIDEBAR: YOU ARE AUTOMATICALLY ENROLLED IN OBAMA CARE IF ON MEDICARE. NO NEED TO SIGN UP!


HTH

I am not sure I agree with your post. I could be VERY wrong and will be the first to admit that my knowledge is limited but I do not think the "book" is customized. Maybe your state has produced one or supplemental information but the "book" is available online at Medicare.gov and therefore, the same for all states.

Secondly, I do not think Medicare is a part of the PPACA. Medicaid is definitely a part of "ObamaCare".

As I said, I could be wrong, but just wanted to express a different opinion.

I respect your opinion and hope my disagreement is not offensive.

Maybe someone will come along with another opinion.

No matter what, Mz Migraine, I still hold you in highest regards.

[Mz Migraine]

Just for the record.....

I do not think the "book" is customized. Maybe your state has produced one or supplemental information but the "book" is available online at Medicare.gov and therefore, the same for all states.

The online book & also the PDF version of Medicare & You 2014 has all the basic information you need. However, the one Medicare recipients get through the mail is personalized for each state, not person. Sorry for the misunderstanding.
The book has all the insurance companies that are allowed to sell "health" coverage in the state of your domicile. Every "health" carrier in the USofA does not afford coverage in every state. The Medicare Book is directly from the MEDICARE, not the "state."

Secondly, I do not think Medicare is a part of the PPACA.

Last summer, I received a letter from SSDI reminding me that since I am on Medicare, I do not need to sign up for "The Affordable Care" a/k/a PPACA. This is what my letter said in part more or less:
"Medicare is health insurance, so beneficiaries do not need to buy anything during the ACA enrollment period that starts on Oct. 1, when the state-run health insurance marketplaces open for business. Seniors on Medicare can change their plans and prescription drug coverage during the Medicare open enrollment period, which is Oct. 15 through Dec. 7. Medicare beneficiaries who are satisfied with their current plans don't have to do anything."
There is also info about this on the Medicare website:

===============

No offense taken. I usually post links to confirm my statements if necessary. Didn't have time when I originally posted.
I am assuming you are not on Medicare? Asking because I receive my Medicare & You book directly from Medicare every Fall. Takes me a full 6 months to read all that stuff about the health ins companies in my state.



HTH