I am on SSDI, and using an Medicare Advantage Plan that is not going so well for me. Does anyone know of some that have good benefits for people with high medical costs (AS, Crohn's, etc.) and RX coverage? Thanks.
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To Amy: It is not insurance fraud to not present a bill to your insce company. Consider it the same as having a small dent accident with your car that isn't worth even repairing or a scratch that can be fixed with a touchup paint pen. However, it doesn't make that much sense unless your minimum copay on drugs is higher than the Walmart price.
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Once you get SSDI how much do you have to pay out to medicare and ins. I have know idea how it works. Cause right now I have medicaid and it pay for everything because I'm working part time and can't afford to pay for ins. That started 2 yrs ago when I had cancer.
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Unfortunately Dwayne, I'm going to be completely honest with you. The only plans out there for pre-existing conditions in adults (before the health care law goes into effect in 2014) are extremely high deductible, high cost.
What Medicare Plan do you have? I'm an HR person.
What Medicare Plan do you have? I'm an HR person.
I have Bravo Health at the moment. I also have SLMB hoping to get QMB if the limits go up this year for medicaid. Have you heard anything about that? I am on LIS for the RX coverage, so that helps out with the meds, but still hard when on fixed income. Any help will be appreciated. Thanks. by Dwayne Allison 1 year ago
In what state do you live?
Medicaid and Medicare together are nice - I used to have that. I'm in the process myself of going back onto Medicare from employer's benefits.
Okay, I know I shouldn't tell you this because, well, it's insurance fraud but you know, it's us against them. Do you have any meds that are on the Walmart/lists for cheap meds? What I do is fill those at that pharmacy and then fill the others through the MA plan. It keeps your out of pocket from reaching the donut quicker.
If you do that, you should hit the donut hole not as quickly. Now, all brand name drugs, in the donut hole, cost 1/2 price but are credited for 100% cost. Generics are 97%. For example, if a drug costs $400/month in the donut hole, you would pay $200 but be credited with paying out the $400.
I usually have to take out loans to pay for meds for the donut hole (I usually hit it in February) but once you get out of it, the catastrophic costs are better.
One more thing - sorry! Even if you could get a different, private health plan, because you are eligible for Medicare, that plan would be a secondary payer. You would have to file everything through your MA plan first and then go to the secondary. It's $$$$ and not fun!
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