Supplemental Policies for Medicare

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straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13455
   Posted 12/12/2009 11:44 AM (GMT -7)   
Hey Everyone,
 
I have a question, for you folks on SSD like me what are using or plan on buying as a supplemental policy to your Medicare coverage?
 
I am going to be buying one for myself and one for my husband who will be 65 next month. Our secondary coverage thru his employer ends when he turns 65, including our script card. They will help pay for his supplemental policy a little according to this letter from his employer. Nothing is paid towards my policy. I called AARP who offers different types of plans thru United Healthcare and it is recognized by Medicare and approved.  Supposedly, the employer has something worked out with this company as well, I hope it is a discount. From what I am told because he is 65 he can pick from 12 different plans and I am stuck with one plan, and one plan only. This really burns me, I feel discriminated against, because (1) I am disabled and (2) I am not 65).  The plan for him is great, it pays all of Medicare's deductibles and the other 20% Medicare does not pay. The one for me does not pay the deductibles and the hospital co-pays which is $1,100. I believe this may be per admission. I have to double check this.
 
Just so you guys know Medicare increased their deductibles this year, drs visits is $155 and the hospital is now $1,100. That little increase in our pay this year does even cover the increase in the deductibles, once again we lose. What a joke.
 
After speaking with this lady at AARP, I was not aware that Texas is the only state that Medicare allows a person to buy an independant supplemental policy. The policy has to be Medicare approved. I was shocked when she told me this. I asked her what in the world do folks do that live in the other states? She said most go thru high risk pools or some have Cobra for a time. That is just not right.
 
So my question to those of you that do not live in Tx what are you doing for a supplemental plan? This is just scarey business if you ask me. We are already in the poor house and there is no way I can get by without a supplemtal policy to pick up some of the medical expenses. If I was healthy I would not need any of this, if I was healthy I would be working and one happy person too. GGGGGRRRR just something else for us to have jack with. My mood is in the toilet for the day. I started my day with the dry heaves and trash can in my hand.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 12/12/2009 1:54 PM (GMT -7)   
Susie,
I don't have an answer for you as I'm not on the Medicare train - yet. But what I've got is probably even worse as I've got NO rx coverage. Course I know that once you can get Medicare or Medicaid you can't get a lot of the pharmaceutical plans I'm eligible for now. My head spins with all of this.

I'm in the process of seeing if my endoscopy is going to be covered, and seeing if the HALO procedure would be. So far it seems the EGD will be covered only if I have it in the hospital and not the outpatient surgery center (I'd have to pay 30% at the outpatient center). And from what I've been able to find out so far they'll only pay for the HALO if I have a diagnosis of esophageal cancer. Nice, eh? (for those of you who may not know, the HALO is like Radiofrequency for precancerous esophageal cancer cells, like I have).

Susie, it's all getting very, very scary. Even the changes - whatever they end up being - that come from Congress this year aren't going into effect for a few years.

You know one of the questions I hate most - what are you going to do? Like you said, we don't have a clue either!

Hugs,

PaLady

SunnyDottie
Regular Member


Date Joined May 2008
Total Posts : 27
   Posted 12/12/2009 3:28 PM (GMT -7)   
Hi, I live in FL and I know the policies vary from state to state but I turn 65 this Feb. I had an "Advantage" Plan with Blue Cross and Blue Shield but they went up too high on everything. I shopped around and have gone with AARP. I am also on SSD but my policy replaces Medicare and is called "MedicareComplete Choice Plan 2 and is a Regional Plan but all of FL is in my network. Best of luck. This stuff is nuttty!

Hugs, Lorrilee

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 12/12/2009 3:35 PM (GMT -7)   
The Medicare Part D plan with all the prescription drug stuff is enough to make anyone stand on their head! When I was working in health care and the Medicare plans changed a few years ago, even WE couldn't figure it out - and that includes all the people where I used to work who did the coding and such. I used to have clietns come in with their adult children with manuals for all of us to try to figure out what was covered. Sounds like Florida's plan may make some sense, but then there are a lot of seniors there on Medicare and they vote! ( probably shouldn't say "they" anymore - I think I'm a "we"! LOL)

PaLady

edt
Veteran Member


Date Joined Dec 2008
Total Posts : 773
   Posted 12/13/2009 7:37 AM (GMT -7)   
I have tried to get a supplemental insurance plan several times and the premiums are outrageous, plus they put a disclaimer on the neck and back.  So even if I could afford the premium I've felt whats the point, at this time thats the only reason I go to the Dr.
I've considered changing my Medicare to one of the HMO's but I like the freedom of choice, although, I'm finding alot of Dr.s are no longer taking Medicare due to the continued reductions in payments to M.D.'s.
I also haven't signed for Medicare D at this point my meds are still affordable....at age 65 according to what I was told by Medicare I will have a chance to sign for Medicare D without paying the fine (or whatever they call it)  for not signing now.
My true feeling is if Dr's and Ins Companies would go back to the way it was years and years ago....let insurances cover Hospital stays and charges, emergency procedures and xrays and stay out of regular office visits......Dr.s go back to $22 office visits which people could afford to pay and Dr's WERE making nice livings.....and Insurance premiums were affordable as well.....oh...hold on...somebody pinch me I think I just landed in OZ.  Sorry couldn't resist!!
XXOO
Patti

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 12/13/2009 4:25 PM (GMT -7)   
Patti,
I don't remember $22 office visits, unless it was when I was a child! I don't think doctors could make a living with that, BUT I think they could with some similar strategy - maybe a higher cost for an initial office visit for a condition, and then follow-ups are less, and they would have no insurance paperwork to do. I have seen on the news occasionally that a rare practice is going that route. None around here that I know of. Unfortunately, the 2 main hospitals in this region have sort of taken over most of the doctor's practices, so the doctor's aren't independent anymore.

Off topic from Susie's initial post, though.

It's scary to me to see that those of you on Medicare for your disability are having such a hard time. It seems I'd better get used to having substandard care, and struggling to get that. And if they don't increase the rate Medicare reimburses to doctors, our choices will be severely limited. We'll all be stuck going to the outpatient clinics inside the hospitals, and getting rotating residents. Fun, fun.

PaLady

edt
Veteran Member


Date Joined Dec 2008
Total Posts : 773
   Posted 12/13/2009 4:34 PM (GMT -7)   

PALady,

Off topic again....$22 visit was 1980 to be exact....seems when Insurances started providing coverage for Office Care everything went up including Malpractice insurance which caused OV to go up and so on and so on.  

Sorry Straydog for going off the topicnono

XXOO
Patti


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13455
   Posted 12/13/2009 7:21 PM (GMT -7)   
Hey no apologies needed Patti, I am with on this one totally. I loved the old indemnity insurace, the 80/20 then major medical at $10,000. Everyone made money including the insurance companies, everyone was happy what the he!! happened?
 
If you take a lot of medication 9 times out 10 Medicare part D is not the way to go. It is limited meds on their plan and if you sign up for it you cannot get any free meds from the drug companies or a discount rate. As it is none of my meds are on it so I am not bothering with it. No sense in throwing good money after bad.
 
Here in Tx Medicare does offer an HMO but good luck finding drs willing to take you and it is  all controlled and limited. I would rather be able to pick a little than be locked in on an HMO, been there done that on the private world, no thanks.
 
Because we have current policies in effect in addition to Medicare we are not hit with the pre-existing clauses so we are ok there and the new company has to insure us.  Tuesday is my day picked to call and see what all needed to get us set up for coverage.
 
I am going to contact the Humira people and see what they will do about my Humira. I hope they can help me.Same with all the other high dollar meds.I do have my 3 blood pressure meds taken care of thru my PCP and he also gave me 2 months of breathing meds similiar to Advair.
 
Its going to get really interesting after Jan 19 thats for sure. Palady I hope someone gave you incorrect info about the Halo procedure that is just rotten. Oh well, don't let me get started.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.

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