Medicare only, no supplement

Posted by hello1234 @hello1234, Nov 1, 2023

Hi all,
I want your opinion. I am under 65 years old (one year to go!). I received Medicare after my kidney transplant. The price quotes for Medicare Disability Supplemental insurance are crazy high, until I reach 65 years old. I am thinking of just using my Medicare Insurance and paying any out of pocket charges for the next year. Does anyone use Medicare only with no supplement? What is your experience regarding the out of pocket charges?
Many thanks!

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@valbob

We recently received a letter from Mayo Clinic advising us they do not accept Medicare Advantage plans, only regular Medicare. We are blessed to have regular Medicare A & B and our secondary is Tricare for Life, the coverage my husband and I get as a benefit from being retired Coast Guard. These two plans covered his transplant and pre and post coverage 100%, Medicare 80% Tricare 20%. No deductible, no co-pay. We get our meds from Express Script, as part of the Tricare program and that does have a deductible and co-pay, that continues to increase each year. In the last 12 months his cost for meds has been $1,981.84.
Ask your provider's billing staff what plans they accept and which they think is better. When looking for coverage for my parents I found that very helpful. They know not just which plans say you are covered for certain things but actually pay for them. I was told some plans say they have certain things but the pre-approval process makes it almost impossible to get them. Good Luck.

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Hi @valbob 😊
Thank you so much for your detailed response and excellent advice!
Your post is very helpful.
I hope everything is going wonderfully with your hubby's transplant!

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@myfablife

Hi all please be careful of the mc advantage plans unless you are low income, one stay in the hospital especially TP patients it can wipe you out, if you are fortunate enough have $$ in your bank then it will work for you. The meds are expensive if you do not have a part D plan I have lower co pays b/c I have been able to get help with rx coupons. Their r more options for kidney TP versus LTP patients “ why I am not sure”
Advantage plans are for folks that are healthy , not taking specialty meds. I to went to a MC class for the aging and they were very informative. MC Advantage Plans have high deductibles, co pays most test have to be pre certified b/f they can be done. I have MC/supplement which is expensive but so far they have covered my medical needs rx’s my deductibles are very low. It’s a tough choice but if you have any assets own a home you can get into a financial mess with owing the 20% it adds up I was on private insurance when I had my LTP I am still paying monthly payments and it’s been 3years . Mind you this was my choice. Good luck most of all stay healthy.

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Hi @myfablife 😊
It is great to hear from you! Thank you for joining into this discussion and thank you for your warning me to be careful about the 20%.
One of the most expensive items on my monthly budget is INSURANCE.
My homeowners/ hurricane insurance is crazy high, my car insurance is high and now my under 65 year old health insurance is very high.
I can't wait to turn 65 years old and buy a normal 65 and older Medigap policy.
I have another year of crazy premiums (if I decide to purchase a supplement.)
Thanks again @myfablife for joining into this discussion. I appreciate it.
I hope all is going great with the transplant!

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Hi, I hope u r doing well, yes I am 63 so I have a little ways to go b/f my premium will decrease haha who would think I cannot wait to turn 65😊 I am so frustrated with the system and how it works. Yes u r so correct everything is going up how they expect people to SURVIVE. I just try to stay positive 🙏🏻🙏🏻 that the good lord watches over all of us to keep us safe and healthy and most of all out the hospital. I am still on monthly labs, still taking a lot of immunosuppressants due to the rejection, I was recently dx. w/ckd stage 3b 🙏🏻 that will stay stable..
Happy Thanksgiving we have so much to be grateful for🍁💚❤️

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@myfablife

Hi, I hope u r doing well, yes I am 63 so I have a little ways to go b/f my premium will decrease haha who would think I cannot wait to turn 65😊 I am so frustrated with the system and how it works. Yes u r so correct everything is going up how they expect people to SURVIVE. I just try to stay positive 🙏🏻🙏🏻 that the good lord watches over all of us to keep us safe and healthy and most of all out the hospital. I am still on monthly labs, still taking a lot of immunosuppressants due to the rejection, I was recently dx. w/ckd stage 3b 🙏🏻 that will stay stable..
Happy Thanksgiving we have so much to be grateful for🍁💚❤️

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Hi @myfablife 😊
It is great to hear your update.
I am also 63 years old. When you purchased your Medicare Supplement policy, was there an underwriting process with a lot of health questions? (With Medicare disability supplement insurance is there a guaranteed issue period of time like when we turn 65 years old when there is no underwriting for health issues?)
Regarding your 3b ckd, I know people that have remained stable ar that stage, so hopefully that will be you too!
Which immune suppression meds are you on now? I take Mycophenolate and Envarsus XR.
Are you trying to keep a low protein diet for your kidney?

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Hi hello1234, no underwriting policy at all, or medical qx. what I was told I am paying a little more b/c I am immunosuppressed and of course had a LTP but when I turn 65 it will be better now if you have had a kidney it’s different b/c they acknowledge it a little better. why!! but it is what it is.
You made my day about the kidney encouragement, yes low protein , I drink enough to keep me hydrated or I blow up. I am really taking care of myself no hbp, heart disease but I am pre diabetic watching that closely.
I am on 3/2 prograf a day 2000 celcept a day. These meds save our lives but do a number on our bodies. Don’t get me wrong I am still grateful💚 I hope this helps out.

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@myfablife

Hi hello1234, no underwriting policy at all, or medical qx. what I was told I am paying a little more b/c I am immunosuppressed and of course had a LTP but when I turn 65 it will be better now if you have had a kidney it’s different b/c they acknowledge it a little better. why!! but it is what it is.
You made my day about the kidney encouragement, yes low protein , I drink enough to keep me hydrated or I blow up. I am really taking care of myself no hbp, heart disease but I am pre diabetic watching that closely.
I am on 3/2 prograf a day 2000 celcept a day. These meds save our lives but do a number on our bodies. Don’t get me wrong I am still grateful💚 I hope this helps out.

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Hi @myfablife 😊
It sounds like you are doing everything humanly possible to keep your kidney function stable. That is great!
Your monthly labs will keep an eye on your kidney function for you, and I am very hopeful that your kidney numbers will continue to hold and maintain at this level.
Change of subject....Do you take any medication like Pepcid or Protonix to protect your stomach? (I think I may try Pepcid to see if that keeps the acid feeling away).

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No I have not taken those but I take tums when needed. TP team ok with it so far. Yes I am still glad I am on monthly labs.

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@hello12345
Hey their "old" friend -- but apparently not old enough. I am coming up on 68 and so have been enjoying the benefits of Medicare A and B with a supplement for three years. Prior to qualifying for Medicare, I was lucky enough to be on COBRA from my previous employer, so I have no direct advice for you on costs. As a Mayo patient, I am consistently reminded that they do not take Medicare C or affectionately known to me as Medicare DISAdvantage. And while the supplement to Medicare is expensive it is cheap when compared to my annual heart transplant checkup cost at Mayo in addition to the other gifts of aging.

Hope you are well and...
Best always,
s!

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Hi, so I'm 62 and my Cobra ran out from my employer 7 months after my transplant (heart double lung), I saw the cost to get a supplemental in the premium was outrageous and then it doesn't cover prescription. I ended up after a lot of research using the AARP Medicare advantage plan their PPO plan. I can tell you that Mayo Clinic is in network and they are accepting that insurance and it was significantly cheaper when you add up all the max out of pocket and everything versus a supplemental. I know I'm going to revisit this when I turn 65 and probably switch to a supplemental then but right now I have a plan that covers Medicare a and b, prescriptions, dental, optical and the premium is 40 bucks a month now there are copays but I have not found them unreasonable at this point and I have biopsies and a lot of care that is done at Mayo. Be careful when people tell you that a Mayo does not accept an advantage plan it depends on the plan and it's kind of the other way around it's whether or not the advantage plan includes Mayo Clinic in their Network. Hope this helps best of luck.

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@scottij

@hello12345
Hey their "old" friend -- but apparently not old enough. I am coming up on 68 and so have been enjoying the benefits of Medicare A and B with a supplement for three years. Prior to qualifying for Medicare, I was lucky enough to be on COBRA from my previous employer, so I have no direct advice for you on costs. As a Mayo patient, I am consistently reminded that they do not take Medicare C or affectionately known to me as Medicare DISAdvantage. And while the supplement to Medicare is expensive it is cheap when compared to my annual heart transplant checkup cost at Mayo in addition to the other gifts of aging.

Hope you are well and...
Best always,
s!

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Hi @scottij 😊
It's so great to hear from you!! Thank you so much for joining in...
After my transplant, I also had COBRA for almost 2 years.
When my COBRA ended, I purchased a Blue Cross individual policy to replace the COBRA. I probably should have purchased a supplement at that time.
The price of the individual policy in 2024 is crazy high.
Also, the individual health policies have super high deductibles so it really didn't cover the 20%.
I looked at my health charges this year and mathematically I would be better off with Medicare only (unless I needed some major surgery, which I did not).
If I just paid the out of pocket directly like I ended up doing this year, and kept my high premiums, it would have been worth over $10,000 in my pocket.
I am being told that the Medicare supplement requires underwriting now since I didn't do it immediately after my transplant.
I am not sure if there is any guaranteed issue period for Medicare Supplement disability like there is at age 65.
Do you happen to know if there is a guaranteed issue period for a Medicare Supplement policy after a transplant?

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