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Old 02-27-2009, 03:22 PM
 
Location: Rural New Mexico
557 posts, read 2,606,079 times
Reputation: 346

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Quote:
Originally Posted by j_me53081 View Post
Don’t get an Advantage plan. You can get a Medigap plan and it will pay your Part B and fills the gaps of original Medicare. These are sold at private insurance companies. Look out they will try to sell you and Advantage plan! You can find a Part D plan on Medicare.com . There will be a doughnut hole from $2,510 to $4,500 that you will pay all medications yourself. This also happens in most Advantage plans also. Call Social Security and ask for extra help. This is for prescriptions only. It is income related also. If you are low income you can get Medicaid through the state and that will pick up the expenses that Medicare does not pay for.
If you are eligible for Medicare and Medicaid doesn’t ever get an advantage plan they do not coordinate well and all you need is Medicare and Medicaid, thus being dual eligible.
I agree. A Medicare Advantage Plan is just that!--A PLAN TO THE ADVANTAGE OF MEDICARE!! If you can afford it, go with a Medicare Supplement; the higher the letter plan, the better. Medicare Advantage plans are varied--some provide Part D prescrip. drug coverage only; some medical only,some both. I have Humana Gold Choice--poor choice if you need tier 4 drugs!! See previous thread. They are denying me a med I've been on for 8 years and can't have quality of life without. BEWARE!
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Old 02-27-2009, 04:53 PM
 
Location: Knoxville, TN
2,171 posts, read 7,642,189 times
Reputation: 1537
Quote:
Originally Posted by SunInHair View Post
I agree. A Medicare Advantage Plan is just that!--A PLAN TO THE ADVANTAGE OF MEDICARE!! If you can afford it, go with a Medicare Supplement; the higher the letter plan, the better. Medicare Advantage plans are varied--some provide Part D prescrip. drug coverage only; some medical only,some both. I have Humana Gold Choice--poor choice if you need tier 4 drugs!! See previous thread. They are denying me a med I've been on for 8 years and can't have quality of life without. BEWARE!
Why did you choose that plan if they don't cover the drugs you need? Formularies vary greatly. I check them every year when I can opt out and into new plans and make sure they are included.
There's a lot of factors to be weighed in deciding on a health plan. Sometimes the cost of getting added or cheaper benefits is actually more than the benefit itself.
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Old 02-27-2009, 06:33 PM
 
48,505 posts, read 96,616,707 times
Reputation: 18304
Basically that is what the future is in the proposed government system;managed care.Symtoms will be feed into a computer and the allowed test and treatment will come out. Even drug choice will be managed.Genariac drugs work for some but they are aftreall about ten years from the latest drugs by definition.Drug coverage will always be a problem for the latest drugs as they recover the cost for all drug research;testing and a profit.
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Old 02-27-2009, 10:29 PM
 
Location: Mississippi
114 posts, read 418,730 times
Reputation: 82
Here is the link for prescription drug plans. Click on Formulary finder. Enter your state then enter your drugs.
Medicare.gov - (http://formularyfinder.medicare.gov/formularyfinder/selectstate.asp - broken link)
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Old 02-28-2009, 02:38 PM
 
Location: Rural New Mexico
557 posts, read 2,606,079 times
Reputation: 346
Quote:
Originally Posted by knoxgarden View Post
Why did you choose that plan if they don't cover the drugs you need? Formularies vary greatly. I check them every year when I can opt out and into new plans and make sure they are included.
There's a lot of factors to be weighed in deciding on a health plan. Sometimes the cost of getting added or cheaper benefits is actually more than the benefit itself.
But I DID choose the plan (Humana) because they would cover the drugs I needed! In fact, Humana covered this drug for a whole year and then suddenly decided to deny coverage. They are blaming it on changes in Medicare.
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Old 02-28-2009, 02:41 PM
 
Location: Rural New Mexico
557 posts, read 2,606,079 times
Reputation: 346
Quote:
Originally Posted by texdav View Post
Basically that is what the future is in the proposed government system;managed care.Symtoms will be feed into a computer and the allowed test and treatment will come out. Even drug choice will be managed.Genariac drugs work for some but they are aftreall about ten years from the latest drugs by definition.Drug coverage will always be a problem for the latest drugs as they recover the cost for all drug research;testing and a profit.
Unfortunately this is not a problem for only the latest drugs as there are some drugs, often "tier 4" type drugs, some of which have been around for years, have no generic version.
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Old 02-28-2009, 02:50 PM
 
Location: WA
167 posts, read 516,878 times
Reputation: 88
I have Sterling - a Medicare Advantage Plan. It's great. Only a $25 monthly premium. I had an $80,000 surgery and they paid all but $100 for each day in the hospital. And that caps at $500. In total it cost me approx. $400. I have WellCare for my drug coverage, and that's great also. Feel free to ask me more questons. serena
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Old 02-28-2009, 03:14 PM
 
48,505 posts, read 96,616,707 times
Reputation: 18304
But if you look the plans are setup by the governmentt and the number of drugs in the top 100 they list are what the governamnt requires covered.In fact many private insurance plan do not pay for the same tier 4 drugs. But generic are still at least seven and often ten year old drugs which is my point.The mian disadvanatge of advanatge plans is basically choice which is how they cover more than standard medicare.For some it makes sense and other it doesn't.Same as for those who have coverage thru empooyer for a medicare supplement they pay for or is provided it makes no sense and you are not required or penalized for not taking the medicare prescription drug plan.The only reason for a drug over ten years not being able to be made in generic version I know of is if the governamnt gives a extension to recover fair profit for development; at least if made in this country.
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Old 02-28-2009, 05:21 PM
 
Location: Knoxville, TN
2,171 posts, read 7,642,189 times
Reputation: 1537
Quote:
Originally Posted by SunInHair View Post
But I DID choose the plan (Humana) because they would cover the drugs I needed! In fact, Humana covered this drug for a whole year and then suddenly decided to deny coverage. They are blaming it on changes in Medicare.
I haven't heard good things about Humana. A lot of doctors and pharmacies around here won't take it.
If you need help with the cost, see if the drug company offers any. Many do.
And tell your doctor. There may be a generic equivalent or he may be able to provide you with samples.
I've found that the most effective way of keeping my medical expenses affordable is simply telling my doctor: "I can't afford it. What can you do to help me that I can afford?" It's amazing what you can get when you ask for help. But if you don't ask, no one knows you need it.
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Old 03-07-2009, 04:54 PM
 
Location: SC
9,101 posts, read 16,413,103 times
Reputation: 3620
Quote:
Originally Posted by mcorrales View Post
I will be eligible for Medicare beginning November first. Early retirement due to permanent disability. I will be getting Part A, Part B and need to get something to cover the difference between what they pay and what the remainder is. Also, I have prescription coverage now through my employer (until October 31st) and still pay out of pocket almost $200 a month for my meds. What can I get that will give me almost 100% coverage? Need recommendations please.
Go to Medicare.gov and go to their Medicare Part D (prescription drug plan) section. Be prepared to spend 20 minutes or more in front of the computer and simply answer the questions about your Rx needs which are designed to help the computer pick the most cost effective plans for your particular needs. You will need to know the names of your prescriptions and dosages. You'll be given a list of plans and companies with contact info and rates from the least expensive to the most expensive. Just choose one of the least expensive ones as they will cover your needs at the best price. (You can always change plans as your needs change).
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