What are the financial challenges after transplant with medicare?

Posted by willie0027 @willie0027, Nov 8, 2019

What financial challenges are there after a transplant and medicare

Interested in more discussions like this? Go to the Transplants Support Group.

@willie0027 yes i am just like you but i can't get Medicare untill 2 years disability which is in May. But i have been talking to a lot of people including The social workers at Mayo Phoenix where i got my transplant. Right now i have Blue Cross Blue shield federal plan and this last March when i turned 60 i got Tricare Prime as a secondary. So i did have to retire when i got the transplant and was able to keep my BCBS from my prior work but paying my regular co-payment each month which i was very Happy covered the transplant and 1 year of follow up for only about 10,000 out of pocket which for a bill close to a million whs pretty good. My issue now is i would like to switch to medicare asap since then for me i also get Tricare for life which according to a few people i have talked to will be perfect and ill save the 600.00 a month for Blue Cross. I will still hafe to pay the normal copay for part b but that will be a lot less. I think its about 130 a month at the moment. Btw also after the first year my copay for BCBS went to out of network for the drs at mayo and this year so far has cost me over 20000 that's for just 1 long 5 week hospital stay ant 2 short ones less than a week each. So im told by Mayo that Medicare will be better than blue cross for most things and having tricare will cover almost all the copays. I hope that helps. One other thing in my conversation with Mayo they did say that there are some i guess there called supplement plans that are better than others so they told me when yhe time comes lets sit down and discuss what would be best for you. That was before they knew about Tricare for life. Right now i have tricare prime which helps a little but not very much having Blue Cross as primary. But when i get the for life plan works very well with Medicare. I should mention tho that Tricare is a military Veteran and dependents plan only. So if your not retired military or you spouse than i would talk to the Mayo Social workers and find out what they recommend. Good luck and i will be available to answer any questions i can.

REPLY

I have a Medicare advantage plan. My out of pocket hospital costs are $100. I also had misc other costs which were $716 for the transplant. I also had $10,000 coverage for lodging, gas and parking for one year. When I go back for my 2 yr check in April, I will have to pay for lodging,etc myself. I was surprised and grateful for the good coverage. I pay $107 a month for my ins.

REPLY
@cmael

I have a Medicare advantage plan. My out of pocket hospital costs are $100. I also had misc other costs which were $716 for the transplant. I also had $10,000 coverage for lodging, gas and parking for one year. When I go back for my 2 yr check in April, I will have to pay for lodging,etc myself. I was surprised and grateful for the good coverage. I pay $107 a month for my ins.

Jump to this post

@cmael. That’s a great price, we pay about $209 a month for my supplemental. With Medicare advantage do you still have a supplemental too? My coverage is expensive but the coverage has been phenomenal.
JK

REPLY
@rosemarya

You’re not alone in inquiring about financial coverage for a transplant. Here is information from United Network for Organ Sharing (UNOS) - How can I cover transplant costs?
"Some transplant candidates and recipients have difficulty affording the cost of a transplant or related expenses such as travel, lodging and post-transplant medications. There are a number of local, regional and national organizations that provide some assistance through grants or services. In individual cases, local community organizations or faith groups may be able to help, and friends and families may solicit funds through public events or appeals. Every transplant program has a social worker or financial coordinator who can work with you and advise you on insurance and funding options."

To read more about basic costs (medical and nonmedical), insurance basics, financial assistance and resources you can click on this lin
https://transplantliving.org/financing-a-transplant/

@willie0027, Have you met with your transplant team, yet? You will have a counselor, or social worker, or finincial advisor (depending on how your transplant center has it set up) and they can help you with your individual situation.

Jump to this post

Willie-If it’s smooth sailing after the transplant you have to come up with lodging for 4-5 weeks in close proximity to your transplant center. This of course would include meals and transportation and all other incidentals. After you get home there’s are only 3 basic expenses. Meds - labs once a month - and yearly visits to your transplant center. I just recently went to labs every 3 months after my 3rd anniversary. And as every one has echoed expenses vary greatly depending on insurance coverage. So here is hoping everything goes smoothly for you.

REPLY

My daughter started a Go-Fund me page to help us with lodging for my wife and other family during my hospital stay, as well as helping with bills due to lost time from work. The other expense that is a challenge or me is the drug co-pays, which are quite high. JK mentioned earlier in this discussion that there are no co-pays for anti-rejection meds, but this is not the case for me. I am on Medicare and have not heard of this. I have searched for the best Part D coverage I can find, but all have high co-pays for many of the drugs I need. One important aspect for those on Medicare is to chose the best supplemental plan you can. The co-pays for hospital stays could bankrupt any one. I have a Plan F policy that covers all co-pays. I will most likely never be able to retire in order to pay for the insurance costs.

REPLY

@mostlybill Do you have Medicare B? My immunosuppressants are covered under Medicare B, not D.
Plan F is what I have also. When I chose that my husband thought I was going overboard but I told him I just had a feeling we would be glad, and of course we were. Plan F is being discontinued, but people who have it will be grandfathered in I have heard. I just wish I had some type of out-of-country coverage. I am not sure if any of the supplementals pay for out-of-country.
JK

REPLY
@contentandwell

@mostlybill Do you have Medicare B? My immunosuppressants are covered under Medicare B, not D.
Plan F is what I have also. When I chose that my husband thought I was going overboard but I told him I just had a feeling we would be glad, and of course we were. Plan F is being discontinued, but people who have it will be grandfathered in I have heard. I just wish I had some type of out-of-country coverage. I am not sure if any of the supplementals pay for out-of-country.
JK

Jump to this post

Contendwell, Thanks for that info, I will need to look into that. There is a pharmacist on the transplant team I will contact. The co-pay for my Cyclosporine alone is over $100 per month.

REPLY
@contentandwell

@mostlybill Do you have Medicare B? My immunosuppressants are covered under Medicare B, not D.
Plan F is what I have also. When I chose that my husband thought I was going overboard but I told him I just had a feeling we would be glad, and of course we were. Plan F is being discontinued, but people who have it will be grandfathered in I have heard. I just wish I had some type of out-of-country coverage. I am not sure if any of the supplementals pay for out-of-country.
JK

Jump to this post

#contentandwell I did the same thing as I turned to Medicare. I have been very happy with my Plan F. I pay about $165/month for it, which is a godsend based on all the recent testing! My husband turns to Medicare next year, and I am walking him through his optimal choices for coverage due to his transplant.
Ginger

REPLY
@contentandwell

@mostlybill Do you have Medicare B? My immunosuppressants are covered under Medicare B, not D.
Plan F is what I have also. When I chose that my husband thought I was going overboard but I told him I just had a feeling we would be glad, and of course we were. Plan F is being discontinued, but people who have it will be grandfathered in I have heard. I just wish I had some type of out-of-country coverage. I am not sure if any of the supplementals pay for out-of-country.
JK

Jump to this post

Yes. I asked the specialty pharmacist at my transplant hospital about this and my cyclosporine is covered by Part B with no copay. It was my local Walgreen's drug store that charged me the copay on cyclosporine when I needed to fulfill a dosage change quickly. Thanks for this info, it was a great help.

REPLY
@mostlybill

Yes. I asked the specialty pharmacist at my transplant hospital about this and my cyclosporine is covered by Part B with no copay. It was my local Walgreen's drug store that charged me the copay on cyclosporine when I needed to fulfill a dosage change quickly. Thanks for this info, it was a great help.

Jump to this post

@mostlybill, I don't want to take this discussion off course, but I have learned to always ask any medicine related question to my specialty pharmacist, even if the medication does not go thru the specialty pharmacy. R

REPLY
Please sign in or register to post a reply.