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Financial discussions/tips concerning expensive treatment
Osteoporosis & Bone Health | Last Active: Feb 14 6:46pm | Replies (64)Comment receiving replies
rjd,
I agree that we need a Medicare/insurance expert to advise us. That would be great. The Medicare rights website is very helpful.
AARP has a website that addresses all of it.
As far as receiving Evenity at an infusion center, that’s what I am currently doing. My Part B covers it at 100% and I have not had a fracture.
Also, the Advantage plans are required to cover what Traditional Medicare would cover, but not necessarily at the same amount. Where Traditional Medicare would cover at 100%, an Advantage plan might cover at 50% or 75%.
I live in a poor state. Maybe the poorest in the country. As a social worker for 45 years, I am an advocate for the financially disadvantaged. In my state, low income seniors on Medicare also qualify for Medicaid. Medicaid differs from state to state. The Medicare/Medicaid combination is the best coverage anyone could have. These beneficiaries are completely covered and need no other insurance. In my city, in the poorest areas, I see billboards advertising Advantage plans with this message:
“Hey! If you have both Medicaid and Medicare,_________ Advantage plan can make your benefits even better!”
False. These beneficiaries are giving ip 100% coverage to venture into the Great Unknown of Insurance.
Replies to "rjd, I agree that we need a Medicare/insurance expert to advise us. That would be great...."
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I was unaware that a medical benefit under Medicare Part B could possibly be covered at 100% by Medicare alone except some preventative care. Are there other examples you might know about? Here is a link to a chart issued by Medicare.gov about costs. https://www.medicare.gov/basics/costs/medicare-costs
Do you have any examples about a benefit covered 100% by Medicare that is covered at less (50-----75%) by an Advantage plan?
Agree that Medicare/Medicaid is probably the best for cost but you have to be very low-income and with few assets to qualify for Medicaid in most states.
Are you saying if you sign up for an Advantage plan (there are 'no premium' Advantage plans that function like an HMO) then you are ineligible for Medicaid?
I do not know how to respond about receiving an injection at an infusion center and covered by Part B even if you have had no previous fracture. (Unless the rule has changed since I looked at it over a year ago or medical providers have figured out a work around... ) And then also covered at 100%......Would love to know what the Medicare Rights Center says about all this.
The situation you describe would be the best case solution for all of these disparate financial issues involved in getting drug treatment for osteo. Wouldn't that be nice??