boring anthem to medicare switch question

[frankva]

I have had anthem since my diagnosis in 1994. I have kept it even though on medicare part a due to disability just so I would have the drug coverage. Medicare part d is now available and my anthem costs per year have grown to about $10, 500. If i do the med part d thru anthem my drug costs will be 350 per month plus I'll have to pay med part b. So my total costs will be a lot less, say about 5000 per year if I switch.I know with medicare I'll have the deductible if I went in the hospital and the small part b deductible and the 20% co-payment on part b services. I am not too concerned about those charges. I probably can pick up a med supplement policy to cover catastrophic costs later. I am inclined to go ahead and switch. Am I missing anything in my analysis? I would pick the anthem part d so my drugs would come thru the same precision rx mail order, which I like. Advice appreciated.

[aztecan]

Hey Frank,

I'm not sure I understand what you are asking. Also, what is an anthem? That is a new term to me.

As far as Part D Medicare goes, it works well for some, depending on your income level. A number of insurance companies are offering things called "Advantage Plans" which cover the deductibles, co-pays and, in some cases, the donut hole that comes with Part D.

Is this of any help at all? I am not clear on what you are asking?

HUGS,

Mark

[frankva]

Thanks Mark. I guess I should have said Anthem Blue Cross Insurance. My main concern is whether there are  very many items or big expenses uncovered by medicare that I should be concerned about.I have looked at the medicare book and I am aware of the usual  exclusions, deductibles and 20% co-payment. My hiv doc says medicare covers most everything.I will look at the advantage plans again, but I don't think any cover the donut (other than generics).I can afford to cover the donut. Unfortunately, my doc says some of her hiv patients get part d and then cannot afford the donut, which is a public health policy disaster! I have also looked over the medicare supplement plans and don't see that they offer much.I would probably have to pay a lot for one of those and derive little coverage.Also I should have added to my question that my vl is undetectable and cd4 high and don't have any acute problems.

[gerry]

I think the main risk with Medicare is if one ends up in the hospital; there is no cap on out of pocket expenses.  Out patient services that would are generally not covered include physical therapy, mental health (other than prescribing drugs), dental, vision.  I'm sure there are others.  It sounds like you already did the math and have a back-up plan for hospitalization.  One thing to remember about the donut hole for people with huge prescription costs is it is very much front-loaded for the year.  This means that the bulk of your out of pocket expenses for prescriptions will likely hit you within the first quarter of the year.

[dgls44]

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