Jump to content


Do you want up to date information about Scleroderma? Check out our Medical pages at www.sclero.org for all your Scleroderma questions!


Photo

Insurance


  • Please log in to reply
5 replies to this topic

#1 Clementine

Clementine

    Gold Member

  • Members
  • PipPipPipPipPipPip
  • 684 posts

Posted 01 August 2007 - 10:42 AM

Hello,
I have a question. I am currently on my husband's health insurance plan. I will also have Medicare in September. I know that Medicare will be the secondary insurance and will cover whatever my other insurance doesn't cover, but do you know how prescriptions are handled? I have RX coverage with my private insurance company. Do I need to get an RX plan with Medicare too and they can help cover drugs? I think it's called Plan D an dit probably costs more than the difference I pay for meds.
Thanks,
Jennifer

#2 peanut

peanut

    Gold Member

  • Members
  • PipPipPipPipPipPip
  • 738 posts

Posted 01 August 2007 - 11:29 AM

Hey jen,
just got back from SS office. I asked about Medicare. She told me that typically they like to use Medicare as the first insurance and private health ins. as the second - so the govt will pay first... I dunno about plan D though. Hum... Try calling your local SS office?

peanut

You can deprive the body but the soul needs chocolate
my HMO makes me wear a helmet...

#3 Clementine

Clementine

    Gold Member

  • Topic Starter
  • Members
  • PipPipPipPipPipPip
  • 684 posts

Posted 01 August 2007 - 11:53 AM

So weird! I would have thought the opposite! The lady I spoke to on the phone today actually told me the opposite of what you were told. I'll definitely be on the phone.
Thanks Nut. Did you get any valuable news today?
Jennifer

#4 peanut

peanut

    Gold Member

  • Members
  • PipPipPipPipPipPip
  • 738 posts

Posted 01 August 2007 - 02:41 PM

SSD has all my info. Now I wait for the usual 5 months. They said even if I'm approved early the earliest I qualify for is Jan 2008. Work Disability covers me for 18 months so I'm totally okay. I just wanted to get the process started in case I do get rejected.

Here's my thinkin': I checked all my numbers against the SSD qualifications and it seems I can qualify 2 ways: 1 - one of my conditions meets their definition of disabled (which one of mine alone doesn't) 2 - the accumulation of all my conditions proves disability.

ooo gotta pack for my trip.
i so look forward to cooler weather.

nut

You can deprive the body but the soul needs chocolate
my HMO makes me wear a helmet...

#5 LisaBulman

LisaBulman

    Platinum Member

  • Members
  • PipPipPipPipPipPipPipPipPipPip
  • 1,135 posts
  • Location:Massachusetts

Posted 01 August 2007 - 02:48 PM

Hi Jennifer,
I have private insurance through my husband and Medicare part A only. Part A is hospital coverage only. If I was admitted to the hospital the claim should go to Medicare first. they would cover all expenses except for the inpatient deductible. The deducitble amount would then be sent to my other insurance and they would cover the balance unless I had some sort of deductible with that.

As for the part D, do not get it. I was auto enrolled in it because as soon as you are eligible for Medicare they give your info out to companies who offer it and you will automatically get enrolled. To avoid this you must contact Medicare and inform them that you have rx coverage privately. If you are enrolled in Part D it can really mess up your other insurance, (you may be disenrolled), and you certainly don't want that to happen.

Hope this helps! If you have any ?'s I'll be happy to help. I used to work for a major health ins company in the Medicare supplemental dept.
Hugs,
Lisa
Lisa Bulman
(Retired) ISN/SCTC List Coordinator
(Retired) ISN Sclero Forums Assistant Manager
(Retired) ISN Assistant News Guide
(Retired) ISN Fundraiser
International Scleroderma Network (ISN)

#6 Clementine

Clementine

    Gold Member

  • Topic Starter
  • Members
  • PipPipPipPipPipPip
  • 684 posts

Posted 02 August 2007 - 03:15 AM

Lisa,
Thank you for the information! I was not aware of the automatic enrollment for Part D.
I need to make sure I only get Medicare Part A because it is no charge. Paying the premium for Part B won't help me. My husband's insurance is really good.

I'm sure I'll have more questions. Thanks for your expertise!
Jennifer