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Avatar universal

medicare supplement?

Does anyone here have a medicare supplement plan that will approve treatment? I just found out I am losing my medicaid because of income limit. I still have medicare but I feel I should get a supplement plan becasue of the hep c. Is anybody familiar with these things? I am disabled and 60 years old but need to treat, I do have a supplement prescription plan with Humana and Wal Mart. I know they cover Solvaldi with Dr's authorization. Maybe that is all I need? I do not know.
10 Responses
446474 tn?1446347682
Medicare Part D covers drugs. Not the supplement plan. The supplement covers the 20% the Medicare doesn't pay (Hospital, doctors, labs, etc) that is now paid for by Medicaid.

You need both a Medicare supplement (if you don't want to pay the 20% for hospital and doctor's costs). Plus a Part D drug plan.

What Part D plan is available to you is based on where you live. You should research what Part D plans are available and then get a copy of their latest formulary. Sovaldi + whatever other drugs to treat hep C are listed there

To learn how to get Medicare drug coverage go to the Medicare web site. You will also need a Medicare Supplement.plan also known as a Medigap plan. If you are disabled and have high medical costs I would highly recommend a supplement with Plan F option.

Medicare Supplement Plan F is the most comprehensive plan out of the 10 available Medigap policies. The expansive coverage makes this a popular plan, though it is also the most expensive. Plan F leaves a beneficiary with no out-of-pocket expenses because it covers all remaining hospital and doctor costs after Original Medicare (Part A and/or Part B) has paid its portion.

You should learn more about Medicare and all of its parts. Choosing the wrong plans can be very costly especially if you have many medical expenses! I would suggest you consult with someone who knows Medicare before choosing your plan. Here is California we have a free advocacy group HICAP that helps seniors and the disabled.
HICAP, the Health Insurance Counseling and Advocacy Program, was established by the California Department of Aging in 1984. The program is designed to provide Medicare beneficiaries and persons 60 years of age and older with assistance in dealing with Medicare, HMOs, long-term care insurance, and other health insurance issues.
Maybe their is something similar in your state?

With Medicare after choosing your plans somethings you can change once a year (enrollment period) others you can't change or may have to pay a fine.

I knew I was going to have many cancer treatments and a liver transplant. If I had to pay 20% of these costs or for my pre and post transplant drugs I would have been bankrupt years ago.

Good luck.
Hector
Avatar universal
Hector, I do not know what this forum would do without you! You are awesome. And you know what? I ran on to a pic of you the day after your transplant in the hospital. I then looked up on your history fighting this terrible disease. Wow, I had no idea. You are one good example of a fighter for life.
Ok, I am in Indiana. I guess what I have is not a supplement, It is a PDP plan with Humana and WalMart. It will cover prescriptions only. You are exactly right, I am reading now about the medigap plans. I do not have alot of medical costs ecept the Hep C stuff now. I am disabled due to degenerative disc, arthritis, and fibromyalgia. I have found a number to call next week that I hope will help me decide about the plans because I do not know alot about medicare. I just got my disability a few years back. My Gosh, it is so confusing, all the different plans and steps. Thks so much for your help and now I know where to start out at!
446474 tn?1446347682
Yes you are on the right track. Medicare is very complex there is no doubt about that. But understanding it is to our advantage and it all starts to make sense with a little research. For those of us who are disabled it is very important to understand it so we can choose proper coverage for ourselves so we can receive the best medical care available at the lowest cost to us. We have enough to deal with and don't need to have insurance issues blocking our way to get the care we need.

Another excellent website to understand Medicare and disability is http://www.allsup.com. The site explains in very clear, layman language everything anyone needs to know about disability and Medicare. They helped me get my SSDI approved and helped me to choose my Medicare plans including my Supplement plan and my Part D drug plan. I can tell you that they have saved me many thousands of dollars in premium costs every year and got me the maximum coverage for my very expensive medical issues. They helped me to find the best Part D plan to cover all of my pre and post transplant drugs. I sent them a list of all of the drugs I needed coverage for and they found me the top 3 plans available to me with price comparisons of how much I would pay to each drug per year. Saving me 10s of thousands of dollars per year. Some post transplant meds retail for $2,000-$3,000 per months. Maximum coverage is essential as not taking these is not an option.

Just to mention...I know many folks on Medicare and our California Medicaid program who are treating with both Sovaldi and Ribavirin as well as Sovaldi and Olysio.So be clear, there should be no issue of you not treating because of any insurance related issues. Please be absolutely clear about that.

Here is a link to a physician's group magazine that tells some of my story with hep C,cirrhosis,liver cancer and liver transplant. A San Francisco politician tells her story of her experience being infected with hep B and I tell my experience with hep C and its consequences. Hopefully folks sitting in their doctor's offices may read the article and be encouraged to get tested and if need be treated for their hepatitis.
"The ABCs of Hepatitis"
http://www.hillphysicians.com/yourhealth/HillHealthMagazine/Pages/Hill-Health-Mag-Article3.aspx

If you have an particular questions let me know.

Take care.
Hector
Avatar universal
Great job, Howie.  Glad you were able to share your story. I'm sure it will help others.

Nan
Avatar universal
Wow that was very interesting, I read all through your story and the magazine link.  My goodness, we talk to people on here and we never really know what all they have experienced with the hep c. I am so glad they are doing all the research now with Hep, how far they have come and where it is going. We should really get this stuff treated as soon as we can before it has a chance to take us places we never could have imagined! And thank you for the information you have given us all, it is a big help to us.
11452490 tn?1418747669
Thanks for the info.
I have been worried if I'll be approved for Harvoni.
Have Medicare, supplement G and Humana D plan. Waiting for approval from pharmacy. Beginning stage of Cirrhosis. 1a,  50 million VL other than that normal on other tests & low platelets, Feel ok. Low income SS.
I will see if I can access your story on Hill Physicians.

                        Ride the Wave
683231 tn?1467323017
old article updated link

http://www.hillphysicians.com/yourhealth/HillHealthMagazine/Documents/HillHealth_Summer14.pdf
2059648 tn?1439766665
I also have Hills.  As soon as I opened the magazine I knew this had to be
HectorSF.  The world can be so big and so small at the same time.
Avatar universal
I have Humana but had over 35 years employed and it paid for 2 treatments.
17995206 tn?1462168488
Hi Buddy !!
If you really have any query about Medicare insurance then please visit our website link:- http://goo.gl/9fgaw6
We probably solve your problem.
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