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I wish they covered the Shingrix shot, my part D charges $300.00. I found out too late that Obamacare would have covered the shot at 100%. I was waiting for Medicare.
He ordered a bone density test. I haven't scheduled it yet. Glad I didn't, in case I'd have to pay for it. I need to research that.
Medicare will cover one DEXA bone density scan as preventative for women 65 and over. You can go ahead and get it if you're 65, female, and have not had one before. It will be covered.
At least mine was covered when my doc ordered it as part of my Welcome to Medicare visit. I have no medical history or current issues, so it was purely preventative and not related to any ongoing conditions or medical history.
[Just looked it up — your doc needs to code the DEXA scan as justified by "asymptomatic menopausal state". Medicare will accept it then. It should not be coded as just a "bone density screening" without the asymptomatic menopausal state code or it will be rejected by Medicare.]
Last edited by Jessie Mitchell; 12-28-2019 at 07:38 AM..
This has been an invaluable, eye-opening thread. I, too, thought that once you hit 65, that Medicare + supplement would pick up everything. Evidently that only is the case if you are sick or have chronic conditions. My mother in her 90's has Medicare + United Healthcare 'F' plan supplement and they have picked up all the considerable costs for her conditions. I was thinking to wait until 65 to do certain things, but after reading this thread I've learned that my yearly blood panel might not even be covered. If you're trying to keep someone healthy, it seems counter-intuitive to allow them only one blood panel every five years.
Curious if anyone has vetted whether it's better to get a follow-up 10-year colonoscopy while under-65 on ACA/Blue Shield or to wait until Medicare? From this thread, I'm thinking it might be better to do it several months prior to turning 65. Ditto with the Shingrix vaccine (thank you for the info, organic_donna).
When I worked, employees close to retiring intentionally scheduled medical care and/or potential surgeries to take place BEFORE losing employer healthcare and going on Medicare. We had a somewhat significant deductible, so I'm not so sure this was really all that cost-effective for them.
I had simple cataract surgery with the standard lense replacement (nothing exotic) under employer plan a year before retirement because I could not see well any longer and do remember paying, because of deductible, close to $1k for use of hospital, anethesia, etc. for each eye. I don't think that same surgery under Medicare would have cost me anywhere near that - provided I had a supplement. Entire thing would have been paid.
Interesting and good to know. Thank you. I will be paying closer attention to this topic. I had thought the only hurdle was finding doctors that accept Medicare, as I've heard anecdotally of people losing their doctor when they turned 65.
Interesting and good to know. Thank you. I will be paying closer attention to this topic. I had thought the only hurdle was finding doctors that accept Medicare, as I've heard anecdotally of people losing their doctor when they turned 65.
This is a regional issue, not a problem in my state. I have heard of issues in California, certain parts of TX, and some parts of NJ/NY. You also shouldn't have that problem in Arizona with the number of retirees out there. However, Mayo is no longer accepting new Medicare patients in FL or AZ and has a long waiting list for its very expensive Concierge program - which up until recently was a way to circumvent Mayo's restriction on Medicare patients. The Rochester Mayo, however, has not restricted its Medicare patient load. Again, upper Midwest, very different dynamic up here, MN a liberal state, and Mayo original flagship up there. Very bad form for Mayo in MN to refuse new Medicare patients. At that facility, in fact, it is a now participating provider to both in and out-of-state residents, the latter of which previously were charged the excess fee.
This has been an invaluable, eye-opening thread. I, too, thought that once you hit 65, that Medicare + supplement would pick up everything. Evidently that only is the case if you are sick or have chronic conditions. My mother in her 90's has Medicare + United Healthcare 'F' plan supplement and they have picked up all the considerable costs for her conditions. I was thinking to wait until 65 to do certain things, but after reading this thread I've learned that my yearly blood panel might not even be covered. If you're trying to keep someone healthy, it seems counter-intuitive to allow them only one blood panel every five years.
Curious if anyone has vetted whether it's better to get a follow-up 10-year colonoscopy while under-65 on ACA/Blue Shield or to wait until Medicare? From this thread, I'm thinking it might be better to do it several months prior to turning 65. Ditto with the Shingrix vaccine (thank you for the info, organic_donna).
Just make sure you follow ACA guidelines on getting the Shingrix vaccine. I was told you cannot get it at a pharmacy. It has to be given at your doctors office as part of a exam, I think they said Wellness. I found out the last month of my ACA, but none of my doctors had the vaccine available. I think ACA is a lot better than Medicare for prevention care.
And part D is terrible too. ACA charged me $20.00 for Restasis, and Medicare’s cost was so expensive I dropped the medication.
I think ACA is a lot better than Medicare for prevention care.
I'm so glad to be reading this thread. This is a 180 reversal from how I had viewed healthcare. Everyone I know says "I can't wait to be on Medicare". Thank you all for your insights. I will plan accordingly.
I have been on ACA for 6 years and have been very happy with the insurance. It was through BCBS, and with my subsidy it was much less expensive than Medicare. They covered all my prescriptions too.
I couldn’t wait to get on Medicare either, but so far it doesn’t look too promising.
Medicare isn't better than a good employer plan - or even a good employer-retiree plan - but it is better than an unsubsidized ACA plan. Those are unaffordable - huge premiums and deductibles. Many unemployed early retirees - not old enough for Medicare - are paying huge premiums because for one reason or another they don't qualify for subsidies. Husband/wife - $1,500/mo., single older adult $1k. These are ridiculous figures, imo.
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