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Medicare Health Insurance


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#1 Sweet

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Posted 11 November 2008 - 03:31 PM

Hi,
As most of you know I became disabled in the eyes of SS this year. It was retroactive back to a year and a half though and I received a big lump sum check. I've heard a person is eligible for Medicare Insurance after 2 years of being disabled.

I received a "Welcome to Medicare" packet the other day. I just finished reading it and boy is it confusing. They enclosed a card saying I am entitled to Part A (hospital coverage) and Part B (Medical coverage) effective 2/1/09. It appears I have a ton of decisions to make before then!!

I was hoping someone else here has this and could make some sense of it.

I get Part A, I can opt out of Part B if I want, but of course I don't want to, I want the health insurance. However it sounds like it's fairly minimal and they are suggesting I might want to opt for Part C (extra coverage) and Part D (Rx coverage). But no where does it really tell me what all "Plain Part B" covers. It also doesn't give me plans to pick from if I want to add Part C or D. Evidently if I choose just plain ole Part B, the premium is about $99. a month, so I'm thinking if I add Part C and D, then my premium will be more than the private insurance I have now and I'm wondering what good is Medicare!

I've been in the medical profession for 26 years and can tell you all about a million other health care insurance options, but Medicare is one I never dealt with.

Any ideas? I'm going to go to the Medicare Website in hopes of gaining more knowledge, but if it's anything like the info they already send me I'm not hopeful.
Warm and gentle hugs,

Pamela
ISN Support Specialist
International Scleroderma Network (ISN)

#2 Wohali

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Posted 11 November 2008 - 05:02 PM

From what I understand Part A is for hospital care only, Part B covers doctors visits and regular labwork. No idea what Part C is but Part D is prescription coverage. There are different insurance companies that offer it at different prices I think. My mom is of retirement age and recently started receiving the Medicare info then Blue Cross sent her an info packet a week or so after Soc Sec sent her the letter about medicare coverage starting. So you may get offers in the mail from other insurance companies and of course there are plenty of commercials on tv about calling for booklets on various plans.

#3 Peggy

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Posted 12 November 2008 - 02:12 PM

Part A is for hospitalization and Part B is for the doctor visits. If you take Part B they will take $98.00 out of your social security check for your part of that premium. There really isn't a Part C as they created Part D for the "drug" coverage to keep it simpler for seniors to remember................part D........D for Drugs.............. that's why they skipped the letter "c".

Now the decision is if you want a supplement to cover the 20% that medicare doesn't cover for part A and part B. Medicare only pays 80% of anything and you are responsible for the other 20%. Most people take out a plan to pick that up so they are covered for 100%. Those plans are pretty cheap now and in Minnesota some of them are even free.

The Part D prescription coverage is the new one where ever November 15th to December 31st of every year you can switch to a different plan if you don't like the plan you pick. In order to make a decision on which plan is the best one for this is to enter what drugs you are taking to see which plan will cover them and which plan will be cheapest. Most agents that sell this have a computer program that has all the plans available in your area that will make that comparison so you can make an educated decision. These plans change every year too so that's why they allow you to switch to a different one every year if you wish.

The thing about Part D is there is a "donut hole" where when your drugs (the total cost - yours and the insurance) reaches $2600 you are back to paying 100% until you hit $3600. There are some plans that cover this donut hole so you have coverage but they are some states, like Minnesota, that don't have any that cover this so you have $1,000 out of pocket before your coverage starts again.

I hope this helps. I sold this as an insurance agent until I too became disabled due to sclero. I, like you, in February, 2010, will be making this decision. It's a big one but I know compared to what we pay for our insurance for me now it's alot cheaper. I also need to find out before I do it too if my sclero clinic/hospital is covered by medicare so I'm not hit with huge non-covered costs that are now covered by the insurance I presently have.

Good Luck

Warm hugs,

Peggy

#4 Sweet

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Posted 12 November 2008 - 07:12 PM

Peggy, thank you, your post was very helpful!!
Warm and gentle hugs,

Pamela
ISN Support Specialist
International Scleroderma Network (ISN)