👩🏾‍⚕️ Medicare & You 2019 💊 - Page 4

shoekitty · ‎03-10-2010

I am looking for a PPO, which do you have? I hate the medicare advantage HMO i have. I do not pay much for premium, but they are so slow to pay, I keep getting bills. Two Dr dropped my plan as well. I hate having to always wait for referrals . They wont even make an appt til you get the approval, which costs me weeks sometimes.

ShowMe · ‎09-06-2010

@shoekitty wrote:
@ShowMe

I am looking for a PPO, which do you have? I hate the medicare advantage HMO i have. I do not pay much for premium, but they are so slow to pay, I keep getting bills. Two Dr dropped my plan as well. I hate having to always wait for referrals . They wont even make an appt til you get the approval, which costs me weeks sometimes.

@shoekitty.......The policy I have is with United Health Care through AARP. Have had it ever since I have been on Medicare. That was when I was 65, and am now getting near 79. It is a policy that even covers me if I were traveling out of the country and would get sick or be hospitalized. It is my understanding that a person I recommended this to told me they don't offer this policy for traveling out of the country any more. It was the highest they offered at the time I took mine out. They recommended the one just below my policy. She was not 65 at the time, nor on SS. So therefore, it was quite a high premium. I have no idea what the cost for someone retired and on SS would be today, but it covers just about everything mine covers. I too think it depends on what state you live in....and if your primary doctor takes Medicare patients. Can't hurt to check it out.

Having to wait for a referral can really be a pain in the butt. Have sat in the waiting room at my eye doctor's office when people check in that have gotten a referral from their doctor. Then they get to the doctor's office and the doctor's office hasn't received the referral from the doctor. The girl at the front check in desk has to call the doctor's office and have them fax over the referral before they can be seen. Very frustrating for the patient. So, they have to sit there and wait before they can see the eye doctor.

I also have my prescription coverage through United Health, but it is pretty costly. Not sure what I'm going to do yet about that for next year.

Good luck. If you can, please let me know what you find out.

ShowMe · ‎09-06-2010

Can really tell that it is getting close to be the time of the year for folks to get their health coverage. One HMO commercial after the other. They are all saying the same thing.....no cost to you. But what they aren't saying is that you have no idea what your deductible will be for the coming year, that you need a referral to see another doctor other than your primary, co-pay, etc .....could go on with this.

Just a suggestion here.....listen, read, and watch. It's your health that is important here.

gidgetgh · ‎03-09-2010

My husband received his 2019 book yesterday. Without even opening it, I took out last year’s from the drawer and put this year’s in the drawer.

Maybe because he has a really inclusive supplemental policy is why I never have to refer to the book.

Why is it, when I have a 50/50 guess at something, I'm always 100% wrong?

NickNack · ‎03-10-2010

@ShowMe wrote:
Can really tell that it is getting close to be the time of the year for folks to get their health coverage. One HMO commercial after the other. They are all saying the same thing.....no cost to you. But what they aren't saying is that you have no idea what your deductible will be for the coming year, that you need a referral to see another doctor other than your primary, co-pay, etc .....could go on with this.

Just a suggestion here.....listen, read, and watch. It's your health that is important here.

@ShowMe Are you talking about commercials for HMO plans or for Advantage plans? I've never seen a commercial that was specifically for an HMO plan. I have an Advantage plan that is a PPO. I have never wanted to see a specialist that didn't take my plan, and I don't need a referral. My plan is $0 a month and has been for three years. It will be for 2019, too. My co-pay for a specialist is $35.

I didn't want an Advantage plan, but when I went on disability I couldn't afford the $800 a month that I would have had to pay for a supplemental plan. I couldn't understand why it was $800 when my friends were just paying $100+. I called, and it was explained to me that it was because I was on disability. I have checked each year to see if it's still that high. Perhaps it will go down when I'm 65, but by then I probably won't qualify for a supplemental plan. I may not qualify now.

All in all I've been very happy with my Advantage plan.

The Bluebird Carries The Sky On His Back"
-Henry David Thoreau

ShowMe · ‎09-06-2010

@NickNack wrote:
@ShowMe wrote:
Can really tell that it is getting close to be the time of the year for folks to get their health coverage. One HMO commercial after the other. They are all saying the same thing.....no cost to you. But what they aren't saying is that you have no idea what your deductible will be for the coming year, that you need a referral to see another doctor other than your primary, co-pay, etc .....could go on with this.

Just a suggestion here.....listen, read, and watch. It's your health that is important here.

@ShowMe Are you talking about commercials for HMO plans or for Advantage plans? I've never seen a commercial that was specifically for an HMO plan. I have an Advantage plan that is a PPO. I have never wanted to see a specialist that didn't take my plan, and I don't need a referral. My plan is $0 a month and has been for three years. It will be for 2019, too. My co-pay for a specialist is $35.

I didn't want an Advantage plan, but when I went on disability I couldn't afford the $800 a month that I would have had to pay for a supplemental plan. I couldn't understand why it was $800 when my friends were just paying $100+. I called, and it was explained to me that it was because I was on disability. I have checked each year to see if it's still that high. Perhaps it will go down when I'm 65, but by then I probably won't qualify for a supplemental plan. I may not qualify now.

All in all I've been very happy with my Advantage plan.

@NickNack.....Yes, I was talking about HMO plans. One is Humana..... Your being on disability is probably a different story. Have to admit, I don't know much about the disability coverage. Is it Medicaid?

You said you do have a co-pay for a specialist. With the coverage I have, there is never a co-pay.

Of course if you are not 65 and on SS, you are probably going to have to stick with what you have now. And, I don't know if when you turn 65 you can get off of disability. That is something you need to talk to some one knowledgeable on that. Maybe the person you talked with that $100+ were on retired and on SS.

NickNack · ‎03-10-2010

@ShowMe wrote:
@NickNack wrote:
@ShowMe wrote:
Can really tell that it is getting close to be the time of the year for folks to get their health coverage. One HMO commercial after the other. They are all saying the same thing.....no cost to you. But what they aren't saying is that you have no idea what your deductible will be for the coming year, that you need a referral to see another doctor other than your primary, co-pay, etc .....could go on with this.

Just a suggestion here.....listen, read, and watch. It's your health that is important here.

@ShowMe Are you talking about commercials for HMO plans or for Advantage plans? I've never seen a commercial that was specifically for an HMO plan. I have an Advantage plan that is a PPO. I have never wanted to see a specialist that didn't take my plan, and I don't need a referral. My plan is $0 a month and has been for three years. It will be for 2019, too. My co-pay for a specialist is $35.

I didn't want an Advantage plan, but when I went on disability I couldn't afford the $800 a month that I would have had to pay for a supplemental plan. I couldn't understand why it was $800 when my friends were just paying $100+. I called, and it was explained to me that it was because I was on disability. I have checked each year to see if it's still that high. Perhaps it will go down when I'm 65, but by then I probably won't qualify for a supplemental plan. I may not qualify now.

All in all I've been very happy with my Advantage plan.
@NickNack.....Yes, I was talking about HMO plans. One is Humanna..... Your being on disability is probably a different story. Have to admit, I don't know much about the disability coverage. Is it Medicaid?

You said you do have a co-pay for a specialist. With the coverage I have, there is never a co-pay.

Of course if you are not 65 and on SS, you are probably going to have to stick with what you have now. And, I don't know if when you turn 65 you can get off of disability. That is something you need to talk to some one knowledgeable on that. Maybe the person you talked with that $100+ were on retired and on SS.

@ShowMe My Advantage plan is Medicare, not Medicaid. It's just a regular Advantage plan that anyone else could choose that's on Medicare. Disability just means that I am not Social Security now (I'm 62) and Medicare. Yes, the person that paid $100+ (this was two years ago and I don't remember exactly) has a Supplemental Plan and Part D. Their Part D was an additional cost, of course. They are retired. I was hoping to get the same type of plan but couldn't afford the $800 it would cost me due to being on Disability.

I do think that when I turn 65 it isn't considered Disability anymore. I just know that it's hard to get approved for a Supplemental plan once you've had an Advantage plan.

The Bluebird Carries The Sky On His Back"
-Henry David Thoreau

ShowMe · ‎09-06-2010

@NickNack......I wish you nothing but the best. As I told you, I don't know anything about disability. Good luck.

By the way, when I retired and went on SS and got my supplemental, I was pretty healthy. Did have high blood pressure and glaucoma, but other than that lived a pretty normal life. But my, how that has changed.....

shoekitty · ‎03-10-2010

@ShowMe

Thanks for the info. I have a call into my medicare agent as we speak to get the cost.they will get back to me by Monday, so I will let you know!

Mom2Dogs · ‎03-09-2010

@meem120

@meem120 wrote:
Im changing my drug plan too. Ive only been retired 4 years and it has gone up from $36 a month to $83.00. too much

I am not 'of age' yet my dh is......I am wondering if the amount you are charged for a drug plan depends on the meds you are taking. My girl friend just enrolled in Silver Scripts, her plan is less expensive than DH's plan, we are both in the same county and state...I didn't think therer would be a difference in price. Do you know?