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Medicare Question

Lenny

Well-known member
SUPER Site Supporter
Who is on Medicare and what prescription plan do you have?

I've been with Blue Cross / Blue Shield for a long time but calling them on the phone is like talking to a government agency....a thousand miles of bullshit. I was on the phone with them for FORTH FIVE MINUTES for a FIVE MINUTE question!
 
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Ceee

Well-known member
Site Supporter
I had to go look to make sure. My Medicare part D plan is with Clear Spring. I think you have to find a part D plan that is available in your area, covers whatever prescriptions that you're taking, and is available at the pharmacy that you want to use. I think I pay about $14 per month. It takes some looking around.
 

Lenny

Well-known member
SUPER Site Supporter
I had to go look to make sure. My Medicare part D plan is with Clear Spring. I think you have to find a part D plan that is available in your area, covers whatever prescriptions that you're taking, and is available at the pharmacy that you want to use. I think I pay about $14 per month. It takes some looking around.
Thanks but I need a plan that will pay for more expensive drugs.
 

waybomb

Well-known member
GOLD Site Supporter
Have you looked at AARP/United plans? You can list your 'sripts and it will let you know what you'd have to pay.
 

Lenny

Well-known member
SUPER Site Supporter
Have you looked at AARP/United plans? You can list your 'sripts and it will let you know what you'd have to pay.
I clicked on your link and this is the message I got: "This XML file does not appear to have any style information associated with it."

Thanks
 

Junkman

Extra Super Moderator
You can go to the Medicare website, and fill out the information about your drugs, and they will recommend a plan for your locality and tell you the cost options. The more expensive plans pay for more expensive drugs, but even then, you have to watch them closely, because they can change on you midstream. I have Wellcare, and last year it was $13 a month. United Health Care was more like $48 a month, I just got my annual summary of costs, and I think that my out-of-pocket costs were about $1200 for the year, but that included some vaccinations that Medicare doesn't pay for. One way or the other, it is going to come out of your pocket.
 

echo

Active member
Watch United.
In the near past they have a hard time paying their bills. (Per newspapers)
 

Junkman

Extra Super Moderator
United Healthcare, the largest insurer in the US, recently announced a new policy it said would help hold down health care costs: It would review claims for emergency department care, opening up the possibility that the company might deny coverage if a patient’s medical needs were not actually an emergency.

After outcry from doctors and patients, the insurer said it would delay implementation until the Covid-19 pandemic has passed — but it still plans to institute the policy eventually.

United Healthcare framed the maneuver as a way to contain costs, as the New York Times reported. But there are problems with that idea, according to the half dozen health policy experts I spoke to. It’s not clear emergency room misuse is actually a rampant problem. And even if some patients do unnecessarily visit the ER, United’s new policy risks discouraging people from seeking necessary care without any guarantee that it will actually bring down costs.

“Too blunt and the wrong problem” is how Tom Tsai, a health policy researcher at Harvard University and a surgeon at Brigham and Women’s Hospital, succinctly put it to me.

“We shouldn’t reduce emergency department visits because we expect to save money,” Laura Burke, a physician at Beth Israel Deaconess Medical Center in Boston who has studied emergency room use, told me. “Because there is no evidence that’ll actually happen.”

The problem is not that patients overuse or misuse the emergency room, said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation. Emergency department visits have actually been stable for years and, after a drop during the Covid-19 pandemic, have not yet recovered to previous levels.

If anything, the problem is the prices that hospitals charge for ER services, experts said. Those have been rising in recent years. United may be trying to send a warning on prices to providers with its new policy — “a shot across the bow,” as Hempstead put it — but in doing so, patients are being put at risk of facing huge medical bills they may struggle to pay.

“It’s not fair to patients,” she said. “It puts the patients in the middle.”

 

Lenny

Well-known member
SUPER Site Supporter
You can go to the Medicare website, and fill out the information about your drugs, and they will recommend a plan for your locality and tell you the cost options. The more expensive plans pay for more expensive drugs, but even then, you have to watch them closely, because they can change on you midstream. I have Wellcare, and last year it was $13 a month. United Health Care was more like $48 a month, I just got my annual summary of costs, and I think that my out-of-pocket costs were about $1200 for the year, but that included some vaccinations that Medicare doesn't pay for. One way or the other, it is going to come out of your pocket.
Thanks. "One way or the other, it is going to come out of your pocket." is one of my concerns. Some plans have two or my tiers and that is one thing I want to look into.
 
the cost of Advantage Plans and Part D plans - along with medigap plans - vary by area.
this site presents the options based on your zip code:
or for the general menu

every year/six months my medigap and part D was increasing - I was paying more in insurance than it would cost 'no insurance straight out of pocket' - so I was looking at Advantage Plans.
the AARP/United plan ranked dead last for my zip code, so 'be careful out there'
 
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