Anyone familiar with choosing Medicare plans? Help!

[Crystal0608]

My gma got a letter that she has to choose a new medicare plan as her current part b & d company isn't offering it next year. Right now her part B has $15/25 co-pay and $50 ER. It covers 80% and no annual deductible. Her monthly premium is $96 which comes out of her SS check. She has had this plan since 2005.

Her part D (rx coverage) averages around $10 per rx. Looking at a paper she gave me her total medication cost as of mid September was @ $2250 and she is $600 from the coverage gap, to which she'll have to pay 100%. Her monthly premium is @ $60, which is paid by bank draft.

So her currently monthly for insurance+drugs is $156. She was diagnosed with cancer earlier this year and has been on 2x or 1x chemo since June & continuing til ?. Her weekly hospital chemo bill is @ $2,300 after ins, weekly dr visits ($25) , lab work $$, a few visits to ER & stays on the cancer floor, and she is on about 15 rx right now (@$150 mo) so her OOP is high right now.

I've looked on the medicare website but it confuses me. I want a plan that covers at least 80/20 with no deductible that covers prexisting & hospital/ cancer center/ specialists with decent co-pays. I'd like the drug plan to be no gap and cover a lot of meds. They can be together or separate and even more than what she's paying now if better. Any suggestions? TIA!

 

[aprilgail2]

I have my mom under empire blue choice senior. The normal "medicare" part comes out of her SS check and then we pay 200 quarterly. She has co-payments of 25.00 which is good. I am not sure what it covers for perscriptions as we have a seperate plan that picks up much of what the insurance doesn't.

 

[fanningIII]

I have been through this with my parents. The medicare website is certainly confusing and my parents got some help through the office of the aging. My dad actually went back to straight medicare and picked up a gap policy. He went through chemo and radiation and lung surgery last year and didn't pay out of pocket for anything. He has medicare and AARP. As for this meds, we went to cvs.com and looked at their calculator online and picked the best part D plan for him. Hope this helps/

 

[Crystal0608]

I have my mom under empire blue choice senior. The normal "medicare" part comes out of her SS check and then we pay 200 quarterly. She has co-payments of 25.00 which is good. I am not sure what it covers for perscriptions as we have a seperate plan that picks up much of what the insurance doesn't.

Thanks aprilgail!

I have been through this with my parents. The medicare website is certainly confusing and my parents got some help through the office of the aging. My dad actually went back to straight medicare and picked up a gap policy. He went through chemo and radiation and lung surgery last year and didn't pay out of pocket for anything. He has medicare and AARP. As for this meds, we went to cvs.com and looked at their calculator online and picked the best part D plan for him. Hope this helps/

I called AARP and got a quote on the part F gap policy which is what you just described . It covers 100% of everything which is awesome! With that & the RX Preferred plan, its only $21 more per month and covers much more .

 

[geffric]

I sent you a pm.. I am a SHIP ( Senior Health Insurance) counselor.. and can help..

 

[fanningIII]

Glad I could help. I work in healthcare and understand the many issues with coverage. Good Luck!