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Old 05-03-2009, 11:39 PM #1
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Question Gap insurance and dental

I recently had to pick up part B as Cobra will not accept me if I have an alternative coverage available. DH employer closed last month. They have the 65% this month, but will no longer be a business after the end of this month and we will have to pay the 100% of Cobra for DH. I will now have the part b taken out X2 as one for this month and one for next.

I found a good Part D plan I am satisfied with.

But, I want a gap coverage. AARP has 12 types from their carrier? Health america maybe?
But; the most popular is F(I think) $147 a month and I can not change it until I am 65. That one pays 100%. There is a $90 plan that I would have to pay the deductables and copays.
One is the F, the other L.

I am a chronic pain patient that needs aggressive follow up with Trigger points, epidural, MRI at least every few years. I need test for other things too.

Does anyone else have gap insurance? What plan?

Also, what about Dental care? Do you have a plan from Delta or anything like that?

I still have to find out about DH, AARP has a plan for the medication they can add him to.....Not sure about health.
He will either have to find a joba againg with benifits or find a part time job for paying our health care now.

I like the AARP PArt D. My copays will be $7 generic a month, if I but @3 months mail order, it is $0!
I only have $644 a month and work part time.
Di
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Old 05-04-2009, 08:09 PM #2
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One of AARP's part D plans covers generics during the gap. That is the one I have. Most of the other part D plans do not cover anything in the gap. With the cost of the MS meds, it doesn't take you long to go in and come out of the gap and then the highest you pay is 5 percent of the cost of the meds.

I think you will be pleased if this plan is available where you are.

A word of caution: before you sign up for any health plan, call all your doctors and make sure they accept the health plan you are looking at.
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DiMarie (05-06-2009)
Old 05-05-2009, 07:08 PM #3
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I have AARP's Plan F, and I appreciate it! I like not having any co-pays or deductibles. I don't care for the high premium, but by the end of the year I will have had two surgeries and will have more than made up for my premiums. I was never told I could not change it and I would check into this if I were you.

I have Community CCRx Part D coverage. Last year I had no co-pays for most of my drugs, but this year I do, and a higher premium, too. I have one medication that costs $500+ a month, so I am soon facing that dreaded donut hole, and I am not sure where the money will come from. No one covers the donut hole anymore, but my first part D carrier did, and that was nice.

I have no dental, and desperately need it. But even the discount plans have waiting periods and exclusions for work required that predates signing the contract. So what am I paying for? I dread my next trip to the dentist. It will break me.

The only thing I would avoid like the plague is anything resembling an Advantage plan. Sure the premium may be lower, but so are your coverage and provider choices.
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Old 05-05-2009, 10:13 PM #4
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Confused

Quote:
Originally Posted by lefthanded View Post
I have AARP's Plan F, and I appreciate it! I like not having any co-pays or deductibles. I don't care for the high premium, but by the end of the year I will have had two surgeries and will have more than made up for my premiums. I was never told I could not change it and I would check into this if I were you.

I have Community CCRx Part D coverage. Last year I had no co-pays for most of my drugs, but this year I do, and a higher premium, too. I have one medication that costs $500+ a month, so I am soon facing that dreaded donut hole, and I am not sure where the money will come from. No one covers the donut hole anymore, but my first part D carrier did, and that was nice.

I have no dental, and desperately need it. But even the discount plans have waiting periods and exclusions for work required that predates signing the contract. So what am I paying for? I dread my next trip to the dentist. It will break me.

The only thing I would avoid like the plague is anything resembling an Advantage plan. Sure the premium may be lower, but so are your coverage and provider choices.
Oh gosh, that was the sell they gave me on Humana last night, the Advantage Plan. It was $38 with medication, hospitalization, doctor visits.
If I could get some steady part times hours to cover it would be great. DH has not been working or even planning as of today to find something to at least cover our medical. With all my medical issues I need something that will cover my doctors.

I had dental up until April and as long as I do not break a tooth I am OK, but still see where I need that too. The plans are supposed to give discounts?
I am at the point of taking half doses of medications to try and stretch them. Not a good idea.
Dang, I was so hoping not to have to pay for plan F, and get away with the Advantage plan. I was really hoping that was a viable option.

The guy made it seem like the plan was offset by the government and same exact coverage. I am seeing the Humana representative on Monday.
I was shocked that the Part B is over $90 a month now OMG, the gap coverage, the part D, that is half my check?

Like you say too, nothing for dental and paying for that, I can't believe how much it hurts to lose his job, not only the income but paying the benefits on our own, and not everything available.

Thanks for information.....I feel like I am trying to get up a steep mountain,
Di
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Old 05-06-2009, 03:14 AM #5
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Di, I avoided Medicare Advantage plans because they limited who I could see, and I have some pretty specific medical needs and really don't care to get shuffled around between docs. Another reason was that I did not feel as free to make my own decisions and choices. And the managed care aspect did not interest me . . . too "HMO" for me. And on top of it all, Medicare Advantage plans have a much higher overhead costs than do traditonal Medicare. And in spite of this, as many as 20% of those who dis-enroll from a Medicare Advantage program do so because they can not get the care they need when they need it. "There is some evidence that disabled beneficiaries 'are more likely to experience multiple problems in managed care.'[15] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans."

Check out the Medicare Part C section in Wiki: http://en.wikipedia.org/wiki/Medicare_(United_States)

I could not afford to try to save money taking out a MA plan. I pay my Medicare premium ($96+) and my supplement ($150+) and my Part D ($50) every month, on top of medical costs not covered by Medicare ($400-500/mo) . . . so I know about the bite it takes out of a meager SS income. I am lucky in that I took out a supplemental long term disability policy when I was hired at my job . . . but it expires at 65, at which time my income will be cut in half. I spend as little time as possible thinking about life at that point, as there is nothing I can do about it!
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Old 05-06-2009, 10:55 PM #6
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Gosh I feel so trapped....I only have $600 or so in benefits, so now the $96 comes out.
To have the Plan F and Part D on top of that we never will make the mortgage.

I did call and I can try to see just to doc's; The PCP and the Neuro to manage my care for the rest of this enrollement. They both take the AETNA Advantage HMO premium and plus, $42 a month.

I can get the meds OK, except the Lexapro. I am concerned too I may be able to swing the trigger point injections, but the epidural for the lumbar and the D&C may be out.....They tried Provera to release some of the lining, but nothing happened...ERGH. The post meno lingering issues.Maybe a plunger

Even if dh place of work reopens, I am sure we would not have the medical or pay he had before after 42 years. We were so hoping he could work until 66. He will be 61 next week.

Golly, I hate fretting over this too....I worry about the kids after we are gone, economy is so bad. At least the home will be paid for, if we don;t lose it. Our oldest is 34, on his own, a ds 26 at home(medicaid for a year seizure disorder) and the youngest 13 anxiety/panic and moderate agoraphobic.... no SSI, our earnings are too high.

Yes, Dental too, I want something preventative but also if I lose a filling.
DH and DD are temp on Cobra, I am will have to figure out something for dh as the cobra will not be affordable next month losing the 65% contribution.

I keep saying I can't lose sleep over this, and then praying we do not need to use the medical anymore then a visit for something minor.

The information and experiances are so helpful
di
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