Medicare insurance & supplemental plans

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I did something similar today George, but eyeballed it, and came to a similar conclusion.

What's not clear to me is what happens if one is prescribed a medication which wasn't known when signing up for a plan.
 
Differs by the type of medicine.

Boy, does it!  This year we changed drug plans (you can change every fall).  We were with United Health Care (through AARP) for both health and drugs.  For 2012 they decided to drop from their formulary the only pharmaceutical that I take on a regular basis, as well as two other occasional-use ones.  It made me angry enough that I spent a couple of days on the Medicare site and found another plan that had both that drug and the others I take occasionally - and it cost less!  Checking the company formulary is essential to know whether drugs you regularly use are covered.  You can't plan for drugs you don't know you'll take in the future, but you can make an educated guess by inputting every drug you've taken over the last few years and see how the plans cover them.

Coverage for both health and drugs varies by state and by county, so yes they go by zip codes.  When you're looking for the plans on the Medicare site, your zip code is the link to what each plan provides and for how much and with how many strings attached.  I looked at whether you have to get permission every time you get a common drug - that would be a major hassle and a complete waste of my time and theirs.  But, whoever said government was efficient!

ArdraF
 
Wendy said:
Be thankful that you don't need prescriptions NOW.
Only doctors can write prescriptions. I don't go to doctors unless I break a leg or have a heart attack so the odds of me getting a prescription are very low.
 
zzyzx said:
Only doctors can write prescriptions. I don't go to doctors unless I break a leg or have a heart attack so the odds of me getting a prescription are very low.

I'm clueless about what a doctor would prescribe for a broken leg. But your folks died at, or before, ages when many issues start to show, so you can have hereditary issues in the future that will require medication and you will be over $100. 10 years ago I hardly ever took a pill, maybe an aspirin every so often. Now I take 10 a day. Would have bet against that happening 10 years ago.
 
BernieD said:
I'm clueless about what a doctor would prescribe for a broken leg.
They are called pain pills.

But your folks died at, or before, ages when many issues start to show, so you can have hereditary issues in the future that will require medication and you will be over $100.
Drinking, smoking and drug taking problems are not hereditary.

There is no doubt in my mind I will end up taking medications in the future. I have never claimed that I will never have any medical complications. But when those problems pop up the last thing I will do is go to a doctor. I will try every alternate medicine available to me, such as herbs and vitamins and more exercise.
 
For anyone taking prescription drugs for which there is currently no generic (aka expensive), this site provides some insight on when generics are expected to become available. I can't speak for its validity or accuracy, but it does show one of my $$$ drugs going generic in 2013 and another in 2015.

If I choose to NOT take prescription coverage and continue to buy meds in MX or CDN, would I be able to add prescription coverage later (after they've gone generic)? I could, of course, buy the generics in MX or CDN when they become available. But, if they'll fall under the $4 copay offered by various pharmacies, I probably would buy them locally.
 
Gotta jump in.
Having a lifelong aversion to "Insurance", since I can count at least to 10, I wonder how many are just going with the "B" Medicare and avoiding insurance companies completely. I'm 69 and have yet to sign up for anything except A since I'm technically employed and on my employers insurance. That will change this year and I'll be in this mess too.

I realize that this question implies that you must be able to absorb high CoPays, but I suspect that many of us just need catastrophic coverage, and could readily handle a few thousand per year if required.

Thoughts?

Ernie

 
I had chosen not to take the drug plan when eligible and was getting my Lipitor through Canada.  I finally decided I should bite the bullet and sign up for drug coverage before I might need more medications.  Well because I had not taken coverage at 65 I am now penalized approximately $12 per month in addition to the regular premium.

Sheila
 
Thanks Sheila. I'd read something about penalties, but didn't quite understand how it worked.
 
Biggest problem I have found is that with my insulin, even going to Canada, it's still about $500 per quarter after I hit the donut hole. Bummer. Just no generics. So far my doctor and druggeit has been able to work some near miracles. Obamacare is suppose to do away with the donut hole --- In 2020 and if the courts don't strike it down. Yea for small things


Jerry


 
There is nothing simple about Medicare.  It's as bad as the tax code :(
 
If you don't take coverage when eligibile your premiums go up 10% per year and that will be for the rest of your life when you do sign up.

I signed up last year and we found that Tom's insurance had been carried from his last project for 6 months to his next so I dropped medicare.  If you can present whats called a "letter of credible coverage" from your or spouses employer showing you have no break in coverage you are supposed to be exempt from the 10% annual increase, I will find out.

I found what I had for perscriptions was not near what his company had for way less.  Right now we are paying $190 for both of us with $3k deductible.  I dread going back on medicare because he is earning realy well while working and I had to pay extra as the premiums are income tested.  The first year after retirement they will be really high, soon as we can show a tax return with greatly reduced income they will be reduced back down. It's the most complicated mess I've ever seen.  As we age I'm sure I will become confused about all of it.  I imagine there are elderly doing without coverage because they can't figure it out.
 
Ned said:
There is nothing simple about Medicare.  It's as bad as the tax code :(

Worse. I understand the tax code but have no idea what's going on with Medicare and Donut Holes and HMOs and prescriptions and everything else. Which explains why we just keep paying our monthly premiums and hoping that everything is covered....which, so far, it has been.

Wendy
home in Cortez
 
Thanks Carolyn.

[quote author=PatrioticStabilist]If you don't take coverage when eligibile your premiums go up 10% per year and that will be for the rest of your life when you do sign up.[/quote]

I assume that means 10% of the part D premium, and it wouldn't continue to increase every year?
 
One of my neighbors pays $0.75 copay for prescriptions, but he has memory loss and can't explain it to me.

Another (elderly) neighbor takes 15 different meds a day and has had several surgeries in the last couple of years. She's paid $0 out of pocket, or a small copay for some meds.

I'm moving to Mexico!
 
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