Two more days and I’ll be switching to Medicare from my safe and secure insurance policy that has brought me thus far. It’s a bit daunting learning all the Medicare language. And because I’m not 65 yet, my options are more limited. Apparently, once I turn 65 I will have more options and insurance will be cheaper. Apparently.
In case you are trying to dance ððŧ through this maze as well, maybe this will help you out. Here’s what I have learned so far as it pertains to me.
Medicare has three main parts. Part A covers in-patient, with a $1,550 deductible. Part B covers doctors, tests, and specialists with a monthly premium based on your income, a $233 deductible, then Medicare pays 80% of all costs. Part D covers drugs. (There is a Part C, but that’s basically a combination of A and B in what’s called an Advantage Plan. I’ve been told to steer clear of those, and my doctor isn’t sure they would be covered, so I ruled out Advantage.)
In order to avoid paying the $1,550 deductible for Part A, and the 20% coinsurance for Part B, you have to have a supplemental insurance plan. I wish the letters aligned with the stars, as it can get confusing. Basically, to cover Part A deductibles, you have to get Plan B or higher. To cover the Part B coinsurance, you have to get Plan A (or higher). In Texas, you can only get Plan A if you are under 65. There was some disagreement about this, but I’ve double and triple and quadruple checked. The Medicare.gov website even says State Farm provides Plan G, but in reality they don’t. My local State Farm said they don’t provide any supplements, but it’s probably because she didn’t want to quote $20,000 per year for Plan A. Yikes! ðģðģ No thanks.
I will have to pay Part A $1,550 deductible if ever I go into the hospital. We are praying that doesn’t happen. This last surgery was hopefully the last one for me. I don’t know if I could handle another, to be honest. This is part of the reason we opted to do it now rather than later. If ever I’m in an accident and have to go to the hospital, I may be reaching out to my friends in a GoFundMe account. ðĪŠð
All insurance companies provide the exact same supplements. Plan A is Plan A regardless of who provides it. And the doctors take it no matter whose plan it is. Insurance companies can charge whatever they want, however. That may range anywhere from $300 to $1700 per month. So basically, whoever provides the insurance for the lowest premium wins. It is up to the consumer to do the research.
I set out calling multiple insurance companies, then I discovered the Medicare.gov website also lists insurance companies and how much they charge. TransAmerica had the least expensive premium at $336.18, so I sent off the application today, and they confirmed they received it. They are a solid company, with a good reputation, and met my insurance friend’s approval test as well.
Something else I learned. Once I pick an insurance company, I’m pretty much stuck with that company. So I am praying I chose wisely. The reason is because I am currently in what is considered a “one time only guaranteed issue.” I don’t have to pass any medical tests or underwriting questions since I’m new to Medicare. If ever I decided to switch, I would have to go through underwriting. Guess what, I won’t be switching!
Plan D will be through Cigna. After multiple calls to brokers and Medicare, they were the best option at $23.10 per month. You can input your medications into the Medicare.gov website and their formula shows you how much it will cost by different insurance companies. Again, Plan D is the same for all companies, but their cost isn’t necessarily the same. Cigna won. There is a hefty deductible for most companies (which I won’t meet by the end of the year), but it will save me some money over paying for my medications out of pocket.
I kinda chuckled when I chose Cigna, because that’s who currently provides my insurance. They have been really good to me, although they tried to send me out of the MD Anderson network to get my chemo. They won’t have any say in that because infusions fall under Part B, not Part D, since it’s given in the infusion center. I will likely be moving to a mail-order pharmacy for drugs as it is cheaper. Honestly, this seems like it would be easier anyway.
I’m still crossing my fingers and toes as we wait to see if all this pans out the way they say it should. We might have to pay over $500 premiums per month plus deductibles, but at least we won’t be paying $2,500 per month for Cobra any more, in addition to coinsurance. (We still have to pay for Cobra for Tim until the end of the year, but thankfully my part is removed.) I’ll keep you posted as I discover more about this whole Medicare dance that I am now a part of.
à la prochaine…until next time.