Posted on 01/18/2017 2:12:52 PM PST by originalbuckeye
Sorry for the vanity. I have been on Medicare for a few months. I am paying extra for Part B and Part D, and on top of that, my husband is still working, so we are penalized for the 'one person working' situation.
Had you had an individual policy that provided virtually the same benefits as Part A and Part B of Medicare, you would have paid considerably more than you are now paying.
Bmk
Sign up for Kaiser. Coverage is good and you won’t pay extra
Not necessarily
Look to get into an Advantage program through Humana or Kaiser. They are better deals
The doctors that we had before the transition, work at a hospital that doesn’t take Medicare Advantage. So, I guess part of the excess expense is wanting to KEEP OUR DOCTORS. Thanks, Obama.
I have Part D.......paying $25/month. And I did fill out all the paper work. None of my drugs is new, so no reimbursement for R and D. So fed up.
Case in point, Flomax. Even the generic drug is a Tier 2 drug requiring a $250 deductible and then $45 a month after under Mr. D's plan. Using AAA, the same Rx is $18.79 per month. No deductible and no accumulation of benefits which might throw him into the doughnut hole.
I will look into the AAA discount. I wonder if it is available if you are already paying for drug insurance.
Remember that the accumulation of benefits that gets into into a doughnut hole situation is the total cost of your co-pay plus whatever the insurance co. pays. These figures will show up on your claims. Pharmacies have vastly different charges to the insurance co, so even though your co-pay might be the same at different pharmacies, the total cost of the claim is what you have to watch.
The only negative we have ever experienced, if you can even call it a negative, is that last year Mr. R got a letter from his insurance company stating they were concerned we wasn't taking his medications properly. Mr R is diabetic, takes high blood pressure stuff, etc. and he had no claims for these prescriptions. So apparently they assumed he wasn't taking the drugs.
He does take one expensive drug, but by putting all the others outside of insurance, he has never entered the dreaded doughnut hole.
We have a local grocery chain that gives certain meds “free of charge.”
I was recently in a walk in and it was determined I needed Cipro. I noticed they dispensed meds there and you could get a prescription of Cipro and take it with you for $15, that would also have been my copay at my pharmacy.
The staff at the walk in clinic were quick to tell me that Publix, a regional grocery store chain, gave Cipro, and many other medications free. I went ahead and took the drug home with me for $15, it was worth the time I would have spent going into Publix and registering, etc.
In many cases, even though my generic co-pay is $15, I will be charged just $3 or $4 because the med is an older medication, and I am only charged the $15 if the cost of the med is above that.
I totally agree it’s wise to seek out info on the cost of the med if it’s bought without aid of insurance.
Hubby just turned 65 and now has Medicare and a supplement plus Prescription. Total is about $250 per month. I’ll get on my knees and thank God since he was paying almost $900 per month for insurance for just him. No way in heck would I gripe about a $20 copay.
Shaking my head
Medicare is only the primary payer if you are not covered by another insurance plan, with the only exception being covered under the VA insurance, in which case Medicare would be primary and VA secondary.
Believe me, it’s the law.
I turned 65 last year and just retired at the end of 2016, at which time I lost my employer’s group plan.
My monthly premiums, combined, for Medicare Part B, Part C (Medicare Supplement), and Part D (pharma) is just a hair over $300/month. But, my co-pays and deductibles and out-of-pockets are paid under the Medicare Supplement plan, so I have no costs or expenses other than the premiums, unless I go in for some exotic treatment that Medicare does not cover.
There are lots of ways to save on prescriptions, but it does take some work to find the deals and then work out the math to see if it makes sense. Most people I guess just do what the insurance companies tell them to do.
My philosophy is that no insurance company is ever on your side ... health, auto, home, etc. From the very get-go you and the insurance companies are in an adversarial position, each wanting a different financial outcome from the transaction or event. Call me cynical, I know.
Except for TriCare, that’s ALWAYS secondary, by law.
Not only that, but if you have an advantage plan you are stuck wtih huge busy clinics that could care less; you have to watch every single test or xr and it has to be in perfect language, or You are on teh hook; don’t get me started on nursing home care. and we paid for this ALL OUR LIVES. Howa about that Soc Sec, which I paid into ALL MY LIFE? they GAVE SOME of us a raise this year. I got ONE DOLLAR A MONTH.aND THE KIDS laugh at us for complaining about our free money. It will get worse once I am older and sick. Right now am already taking a certain daily pill twice a week only to save $, because once I pass the $3700 mark, I’ll be paying hundreds. Good thing - I’m exercising, losing weight and learning about herbs, some of which work. But I just wanna curse.They’ll be letting (making) us die when we no longer have what THEY define as “quality of life.” I just wanna curse. Fascists come for the most vulnerable first- first unborn babies. Next handicapped who cant defend themselves. Then us old people taking up space and air and food. I’m mad as hell. oh and PS— DO NOT LET THEM FORCE A FLU SHOT ON YOU IF YOU ARE OVER 65!!!! IT’S A DOUBLE DOSE OF POISON!
“Medicare is a secondary payer, meaning that if someone who has Medicare is also covered under another plan, that other plan is primary.”
that is incorrect [at least for Part B]. once you sign up for medicare that becomes your primary insurer, with any other insurance you may have becoming secondary.
My husband and I are both on Medicare. He started the year before me and because he was health, we chose a Medicate Advantage because of the price and what it all included. Before I retired, he suffered several major illnesses and we found that the MA wasn’t a good plan for him after all. We had lots of out of pocket expenses, and he reached that dreaded donut hole the first full year. When I retired, I signed up for Supplement Plan F along with a prescription plan, and thank goodness I did. My health also went down hill (sucks to be old). But I’ve got much better overall coverage than him. I don’t pay very much for my prescriptions, and nothing at all for doctors. Just try to get the best plan you can afford, because down the road you will likely need it.
During the re-enrollment period, see if you can switch to the same plan you have. My sister’s husband did the same thing yours did. When the medical care he needed was not available where he lived, the doctors sent him to St. Louis and that was out of network.
I called her before her birthday and told her to make sure to sign up for Supplement F and regular Medicare. She was told that she could change his plan during open enrollment. Unfortunately, her hubby died, so I can not say for sure that it would be possible.
Open enrollment is past for this year though.
We live way out in the sticks. Drugstore did finally get to
where they filled my prescriptions for 3 months. All of
mine are affordable; but my doctor bills are sky high ever
since Medicare kicked in. I was writing a check and paying
my own way until I turned 65. Now, since Obamacare, the bills are very high. Must be the paperwork.
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