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Author Topic: "WELCOME TO MEDICARE" NOW WHAT???  (Read 2193 times)

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Offline rioz

  • Member
  • Posts: 54
"WELCOME TO MEDICARE" NOW WHAT???
« on: December 28, 2009, 11:52:02 AM »
Hello All,

I just received my CMS Welcome letter and don't know what to do. I've tried to research options but am TOTALLY overwhelmed. I am currently covered under my wife's policy but with the economic crisis I wanted to relieve some of her stress in regards to HAVING to keep her job for my benefit. Of course, staying employed (and covered),  is not her decision. We own a home which I am desperately trying to hang onto. We are open to changing our marital status for whatever benefit that may present but I need a good source or better yet advisor for this complex situation. Any ideas or advise is (in advance)greatly appreciated.

Best wishes to all,

Richard
Living with HIV since 1985
Living with AIDS since 2007

Truvada, Lexiva, Norvir, Levothyroxine, Testim, Sertraline, Crestor

Offline pozniceguy

  • Member
  • Posts: 1,169
  • Niceguy Dallas
Re: "WELCOME TO MEDICARE" NOW WHAT???
« Reply #1 on: December 28, 2009, 07:58:27 PM »
welcome to the "old guys" plan... Medicare has many advatages, depending on what your curerent policy cost /covers.  Medicare with a supplement usually gets you far more flexibility and coverages than almost any private insurance.    you neeed a local counselor who can sit down with you and your current plan and compare the medicare coverage wi/without a supplement...

good luck  I have been with medicare for nearly 10 yrs....no real issues,   a few quibbles about social/poltical decisions...

Nick
remember the good times...honor the past but don't live there
Le stelle la notte sono grandie luminose, nel cuore profondo del Texas

Offline Boo Radley

  • Member
  • Posts: 1,252
  • Not a "real man" and damn proud, mithter... FAB
    • Animal Rescue New Orleans
Re: "WELCOME TO MEDICARE" NOW WHAT???
« Reply #2 on: December 28, 2009, 10:06:02 PM »
Welcome to the club house, Richard. 

I'm single with no children so clearly our situations are different but I hope similar enough for you to get some ideas about your options. 

I've been on Medicare A & B since 2004 & still get confused as hell every year that 25 pound Medicare "letter" arrives.  This year I put it under the bed and one (at the least) of my cats peed on it -- I trust their judgment so tossed it in the trash.  I wouldn't advise the same actions for you, or at least not yet.   The most confusing section is the one listing the various private health care providers available to you -- reading it always makes me think there has been a radical change which isn't advantageous to me but that hasn't been the case so far.  I think some twisted bureaucratic mofos just get kicks from confusing me personally.

Like Nick said see if you can find someone locally who can help you decipher all the mysterious and confusing info-mation with your circumstances in mind.  Depending on the state you live in and even the city your options won't be the same as mine or Nick's.

I've never gone through Medicare per se because I opted to become a member of an SSA approved Medicare health care provider or, IOW, an HMO.  I can't really recall how I chose Tenet Choices 65 but the deal is they get my $96.50 Part B monthly premium and I get a plastic card with my name on it.  Since I'm on SSD the Part B premium is deducted from the SSA direct deposit so I never even know it's missing.  I hope I'm correct in assuming you will be enrolling in Part B since I can't figure out what Part A is for by itself...   

Here is a link to the Peoples Health (formerly Tenet blah blah blah -- they seem to like changing the name every other year) site which might give you a better idea of what I'm explaining so poorly:

http://www.peopleshealth.com/PeoplesHealth/default.aspx

"About Choices 65 (HMO)

With Choices 65 (HMO), you’re able to get more coverage than with Medicare alone and for no monthly premium beyond what you pay now for Medicare Part B. In addition to medical healthcare services, Choices 65 (HMO) also offers Medicare Part D prescription drug coverage, preventive dental services and routine vision services for no additional monthly premium."

So, IF you have the same basic options your work is to determine which HMO/POS/PPO/whatever works best for you.  The Part D prescription coverage is definitely a godsend since my monthly $1300 bottle of Trizivir costs me $25.  The primary care doctor visit co-pay is $5 and my psych visits are going up from $10 to $15 in 2010. 

I apologize for writing so little with so many words but hope something in all the dross helps.

Good luck!
String up every aristocrat!
Out with the priests and let them live on their fat!





Everything I do, say, think, excrete, secrete, exude, ooze, or write © 2007 Sweet Old Boo, Inc.

Offline rioz

  • Member
  • Posts: 54
Re: "WELCOME TO MEDICARE" NOW WHAT???
« Reply #3 on: December 29, 2009, 08:45:42 AM »
Poz and Boo, I  thank you both for your responses.

Richard
Living with HIV since 1985
Living with AIDS since 2007

Truvada, Lexiva, Norvir, Levothyroxine, Testim, Sertraline, Crestor

Offline veritas

  • Member
  • Posts: 1,408
Re: "WELCOME TO MEDICARE" NOW WHAT???
« Reply #4 on: December 29, 2009, 09:57:06 AM »

rioz,

This sight might help you  in your decision for medicare part D:

https://cvs.planprescriber.com/mapd/client/156894/web/index.jsp?groupid=156894

It also gives you phone numbers for help. These decisions are not easy, however the help is out there.

Good Luck

v

Offline Boo Radley

  • Member
  • Posts: 1,252
  • Not a "real man" and damn proud, mithter... FAB
    • Animal Rescue New Orleans
Re: "WELCOME TO MEDICARE" NOW WHAT???
« Reply #5 on: December 30, 2009, 01:03:28 PM »
Poz and Boo, I  thank you both for your responses.

Richard

You're welcome.  I fear my response wasn't very useful but am unsure of your specifics -- are you on SSD/SSI?  Stupid question since I think one only qualifies for Medicare after retirement or becoming disabled (AND of course formally acknowledged by SSA as such).

Because you have a legal spouse and (I assume) the cute baby in your pic (the one on the left...  ;-> ) is yours I haven't a clue how those aspects change your options.  Your mention of changing marital status blows me away since I thought those arduous and inhumane Catch-22s were part of the past.   What happens to the children of single parents who become disabled?   What options are there for couples in your position?   Does your wife's employment affect your disability income? 

All those questions simply reinforce the need for finding a counselor in your area who knows or can find the answers.  You probably know a lot already but that Welcome to Medicare packet is like stereo instructions.  The first time I got it I was overwhelmed but luckily the packet from Tenet came within a week and it was all so much simpler and re-assuring.  Copays, coverage information, the formulary, lists of physicians available by geographic area & area of practice, etc. were much easier to deal with.

And the above further illustrates your need to determine what plans are in your city/state, if any.   I believe these Medicare plans are available in every state but don't know.   I hope it's a relatively easy process once your options are clearer. 
 
I think the link veritas provided is for CVS pharmacy Part D Prescription plans only.  The Choices 65 plan covers all medical care -- doctors, covered procedures, other services, as well as prescriptions.  If that type of plan is available and the provider has a decent reputation that may be preferable -- even though Rx crap is subcontracted under Choices 65 if I have a problem Choices 65 has to address it -- in 5 years I've had no problems.

Good luck. 
String up every aristocrat!
Out with the priests and let them live on their fat!





Everything I do, say, think, excrete, secrete, exude, ooze, or write © 2007 Sweet Old Boo, Inc.

Offline rioz

  • Member
  • Posts: 54
Re: "WELCOME TO MEDICARE" NOW WHAT???
« Reply #6 on: December 30, 2009, 01:26:18 PM »
Hey Boo,

Your response was helpful. I am on SSDI (disability). One qualifies for Medicare after two years on SSDI. To that point I should note for any individuals on SSDI that even if they feel they can go back to work and get off disability, once you qualify for Medicare you can never be removed regardless of work and or income.

Yes, I do have a legal spouse and that's my granddaughter! I am flattered by the cheeky compliment. Thank you. Arduous and inhumane Catch 22's appear to be alive and well from my experiences. We had to enter into a legal separation agreement so that I could receive a New York State run exemption program which reduces real estate taxes for people with limited income on disability. The local tax assessor, upon reviewing my tax return, asked "How could you afford to live in your house?" to which I responded through clenched teeth, "NONE OF YOUR BUSINESS!" Wife's income doe not affect SSDI benefits.

Fortunately I live close enough to NYC to access resources there.

Take care,

Richard
Living with HIV since 1985
Living with AIDS since 2007

Truvada, Lexiva, Norvir, Levothyroxine, Testim, Sertraline, Crestor

 


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