Medicare Enrollment

[tigergem]

My brain hurts from trying to sort through all the medicare enrollment stuff that has to be done by the 31st.

I was with a Humana PPO advantage plan that provided decent coverage for 2009, but for 2010 they nearly doubled the premium, increased the copays, cut out a bunch of services... so I need something cheaper anyway to help my Chapter 13 budget.

Who the heck dreamed up this system??? I mean the coverage is ok, but this stupid competitive plan mumbo jumbo is enough to drive a person batty.
I think that Medicare plans should be UNIFORM. I mean omg... the choices... the differences...

Oh and medicare.gov is no picnic to navigate either.

I guess (I think, I'm not sure... leaning toward...) I am going to go back to regular Medicare and just try to find a Part D provider.

[tigergem]

Well. That is done. Why it was such a headache? Trying to choose a 2010 Prescription Drug Plan, you can sort the 50 or so plans by premium cost... and the monthly premium costs are listed there. But then pick one and you click on "enroll now" and the cost jumps from (one example) $18.60 per month and a $63.00 annual deductible to $24.80 and a $54.00 annual deductible. Click on a couple of others just for grins - - same thing! When you get to the enrollment page, the cost is higher than is presented in the comparison list. So I called Medicare and they said, well you just have to call them and ask what is the actual cost. CALL ALL 50 PLANS SO I CAN MAKE A COMPARISON??? Why can't they have the information programmed into medicare.gov like they are supposed to??? Oh. Even better. I went to that (first example) web site and instead of a $54.00 deductible they stated $150 deductible! Tried to call them and sat on hold long enough to choose a different plan and hung up. The plan I finally chose costs a little bit more per month and has no deductible and the information on their web site actually matched the "enroll now" page - - even though a little more expensive than listed on the comparison page.

This whole annual Medicare ordeal is really almost too much. Last year medicare.gov was at least helpful and accurate. Not this year. Maybe they forgot to pay the database programmers?

[aces67]

You should try being on the other side of that

I used to work for a family doctor doing the medical billing. OMG! Some of our elderly clients would switch from Medicare to a PPO and then forget to even tell us. When you call Medicare they will say the coverage is effective even if they aren't the ones you're supposed to be billing.

It's quite a headache for everyone! They should make the whole thing a lot simpler than what it is.

[tigergem]

Ha. I had a Humana PPO last year and made a doctor appointment. I thought I asked all the right questions... Do you accept medicare assignment? lol... got there (3 hours away) and there was a HUGE SIGN like a BANNER.... We do not accept YOUR PPO!!! I about died. Well. As it turns out the doctor gave me a "free" exam anyway for the misunderstanding... oh and then went ahead and billed them anyway.

Now. For 2010 I thought I had it all straightened out. Enrolled in a part D plan and another plan with NO premium that does not have drug coverage. Think everything is hunky dory and then called medicare just to be sure. Oh no. Your zero cost PPO plan will CANCEL OUT your drug plan. So now I am back to the beginning at the last minute here trying to figure it all out again. But I refuse to stay with Humana.

[AngelinaCatHub]

Suggestion

Here is what I did. I took part B of course, I have BCBS for part D and certain "gap filler" coverage. $96 for part B, $140 for BCBS.

Do you have a spouse that is younger than age 65? If so, you may have her open an individual Health Savings Account. It must be done through a bank or CU properly. Your spouse can put aside $2900 plus $900 "catch up" if over 55. This is taxed free and you can use it as well. It carries over every year as well. The monies can be used for other than medical however, it then is taxed and penalized at 10% more.

It is advisable only to use for medical. You don't have to use it, if you wish to pay the deductible yourself, but in the event of a big bill, it will be there.

Google about it and see if this will do for you. 'Hub

[aces67]

Ha. I had a Humana PPO last year and made a doctor appointment. I thought I asked all the right questions... Do you accept medicare assignment? lol... got there (3 hours away) and there was a HUGE SIGN like a BANNER.... We do not accept YOUR PPO!!! I about died. Well. As it turns out the doctor gave me a "free" exam anyway for the misunderstanding... oh and then went ahead and billed them anyway.

Now. For 2010 I thought I had it all straightened out. Enrolled in a part D plan and another plan with NO premium that does not have drug coverage. Think everything is hunky dory and then called medicare just to be sure. Oh no. Your zero cost PPO plan will CANCEL OUT your drug plan. So now I am back to the beginning at the last minute here trying to figure it all out again. But I refuse to stay with Humana.

Yeah it's just so confusing now! There are way too many options and when you get people that have dementia or alzheimer's it's even harder to decipher what they have b/c they really have no idea It's makes the billing quite a chore.

[tigergem]

nonono I am not (no way) paying $140 for supplemental coverage. I like to eat and so do my dogs. I went with a $30/month PPO with Part D attached. If I didn't have to have that Part D I would just go with original medicare. It's like a whatever kind of thing. You're dammed if you do have a supplemental plan and you are dammed if you don't.

[junker]

i live in a rural county in northern california, which doesnt even offer all of the plans like humana and others, all i can get up here is a pffs, or private fee for service plan from bluecross and secure horizon. looking it over. it actually seems like WORSE coverage than original medicare. higher deductables. both for hosp and doctors. so i have no choice but to stay with medicare..and stay healthy.

[OHBOY]

The way I see it, the whole Medicare program is a big farce !

My point and example is as follows: While I was under 65 and working, my employer based health insurance paid for my medical and prescription drug benefits with a very reasonable co pay ( with both, employer & employee paying for the premiums of the policy).

Now that I am retired, I was forced to enroll into Medicare, which than became my primary insurance, and the former employer based policy ( to which both former employer & I continue to pay for) has become the 'secondary' insurer.....meaning that the secondary private insurer is for all practical purpose SKATING !!!!!!!! and..... as the private insurer has been ordered only to CONSIDER making VERY MINIMAL percentages of reimbursements of what Medicare allows for a procedure ....the TAXPAYER IS PAYING THE BILL FOR MY MEDICAL NEEDS, the very same bill that SHOULD be paid for by my private insurer....

Of course, as part of this wonderful 'package' premiums, co pays and deductables have ballooned....

Now anyone of our representatives that voted for such an arrangement in the first place is CORRUPT TO THE CORE....and...I always visualize the sorry SOBs sunning themselves on a remote beach in the tropics.......

Please keep in mind too, that IF I was enjoying my retirement overseas, the very same private 'secondary' insurer would automatically become the 'primary' insurer ......., hmmm.....

Anybody that trusts government to take care of our health needs is a fool !

[SweetGeorgia]

Yeah, but I'd take Medicare in a heartbeat. Even if I had to pay for it (say $1000 a month, which I've paid for COBRA in the past).

I have insurance through my husband's employer, but after a big medical "event" I'm reluctant to get follow-up medical care lest I make my husband stand out as an expensive employee. Yes, even with excellent insurance I am avoiding medical care and probably making the entire system more expensive, in the long run, for all of you. Sorry about that.

[tigergem]

The way I see it, the whole Medicare program is a big farce !

I dunno... I had surgery recently and what would have been a $55,000 bill without it, my co pay (total out of pocket) was $150.00.

But for the smaller stuff, doctor visits and medication, the coverage seems not so good.

And the mechanism in place for making it all work doesn't work so well either.

I picked another PPO advantage plan for 2010, and here it is almost the middle of the month, and not only have they not sent me prescription drug cards yet or any way to pay my premium, but when I called them yesterday, I wasn't even in their system yet. I said I was afraid of getting canceled for non payment of premium by the time they figured out I was even enrolled! But also... they will BILL me for this month of service that they are not even bothering to provide!

[momisery]

We use to have a great plan too, it was an HMO, I paid about 50 bucks a month and out of pocket was just co pays. Now all we can find is a PPO. It costs 250.00 for hubby and me per month, but has a deducatable of 550/1100 and a total out of pocket of 11000.00. This does not include medications. That is extra, and it really is horrible. Times have changed, and we moved. Some areas do not have HMO"s... maybe no one does now.. I am not sure. I am looking forward to medicare, on one income, being mine it is hard to pay for the monthly premiums, let alone the 180.00 we pay for his medications. We can not afford to go in unless we have too. I guess that will drive the costs up more too because my blood pressure is too high. But I simply can not afford everything, and his meds HAVE to be taken. Mine, I can wait, I am not too high, just over the acceptable ..

[tigergem]

I like PPOs better than HMOs because I like to have the freedom to choose my doctors. The one I picked for 2010, is $33.00 month that I have to pay on top of the $96.40 that medicare deducts from social security anyway. Medications are $9/ copay for generics and $39 copay for most regular brand name drugs. There are exceptions that are higher. I forget what my doctor visit copays are but I guess I am about to find out because I have a doctor appointment next week lol.

[OHBOY]

Quote: "..Medications are $9/ copay for generics.."

A 'slew' of generics at Walmart is $4... but maybe yours covers for 3 instead of 1 month (?)

[tigergem]

Yeah that is 90 day supply.