6 replies to this topic

[Doug]

I'm running out of time to pick my plan and I am completely lost as to what plan would be best for me.

I need the most coverage with drug coverage.
I am a 27 M c-5 quad I live in Florida any help would be greatly appreciated

so many questions
What plans are you on are they good-bad?
Can I get extra coverage from another insurance to cover what medicare does not? My book said 65 was min age to add a supplimental plan........Honest its just a huge mess and I have 15 days to sort it out...

Edited by Doug, 15 December 2008 - 07:23 PM.

[Doug]

I know this is not an interesting topic but any help would be nice.

[Hapahowlee]

My husband receives SSDI and has Medicare. He was injured in 1985 (before I came along) and it became effective about 6 months after his accident b/c the social worker got the ball rolling with paperwork.

Neither hubby nor I were aware there were different plans. Every year he just receives a thick booklet that explains his benefits. I believe it costs him a little under $100 a month that comes straight out of his SSDI payment.

Hubby works very part time and in order to get insurance coverage for me, he had to sign up also. So his work insurance became the primary and Medicare is secondary. All of his doctor bills are always covered b/c whatever his work insurance doesn't pay, Medicare will. By having insurance through his work, his meds are covered. I believe you can get supplemental insurance whenever you want. Medicare only pays 80% and if you don't get some type of prescription coverage, it may end up costing you a lot of money if you take meds. I know it's paid off for both of us to have the insurance through his work, although the prescription coverage is only $1,000 a year per person. Hubbby is fine b/c he only takes 2 meds that aren't that expensive. I also take 2 meds, but mine are expensive and I cap out by October of each year and have to pay about $250 cash for my meds until the new year.

I do have 2 prescription discount cards that brings the costs down on cash purchases. One I obtained free of charge and I paid $25.00 for a Walgreens discount card b/c the freebie card didn't cover one med I was taking. These cards are actually good for anyone in your household.

Sorry no one has gotten back to you, but maybe no one else is aware of different Medicare plans either. Good luck.

[Illinois Boy]

There are different plans out there that use your Medicare payments for better coverage.... Also prescription drug plans, which I didn't sign up for because my drugs aren't that much a month........

Happa, when you gonna send me some home grown to sample?

Jim

[airart1]

i kept my medicare, but i did di prescrips with wellcare, they pay evertyhing i need...........

[qbounce]

Your talking about HMO medigap plans that cover everything that medicare can do for you, but with substantially lower rates based on a plan that only provides you with doctors under one healthcare providers roof. You should begin with the hospital in your area that best serves SCI patients.

Then, ask that hospitals medicare coordinator which suplimental insurance they accept. If you receive SSDI benefits because your disabled (as Happa also suggegted) the state takes approx. $100.00 out of your check per month, depending on what kind of program you set yourself up with.

I just switched over to AARP Secure Horizons plan. Doctor visits are free, and referal specialists, $5.00. Many other things are included, and NOT extra, like Part D drug coverage, $5.00 a perscription for genaric, X-ray's, blood tests, basic tests. Medical supplies (catheters, BP are covered). CT-Scans , MRI's are still 20% your bill, but it beats paying 20% for EVERYTHING with just streight Medicare.

Also, it has a Dental plan for $5.00 a month extra, and will even pay for some type of gym membership. This is all through a very reputable hospital in my area that has a great Physiatrist, specializing in SCI. So, I'm sure she might even have recomondatiolns for family doctors and possibly a good Urologist too.

All this is new to me too. I'm coming from my original medical group which was a joke dealing with under my current SCI condititions.
Good luck . . . . and, it really takes only a few phone calls to find which medigap plan your SCI hospital accepts.

[Hapahowlee]

Excellent report Bouncer! I've been meaning to check into other types of coverage as maybe a secondary for me and now that I know there are different Medicare plans, I'll check into that too, but will have to be for 2010 for Medicare. We have dental coverage for about $17.00 for both of us. That's through Mr. Hapa's work insurance, which also offers memberships to clubs and eye care. Neither of which we use right now. Sometimes there is just TMI and it does get overwhelming.


Patience Jim . . . crops aren't ready yet, but damn this desert soil is good for growin'