Chronic Pain members - Welcome, please introduce yourself

Here, here Jim. I can relate. Preparing for Medicare and choosing my supplemental insurance for the first of the year. New territory.
Rachel

@rwinney

We found a good financial advisor who takes care of finding the best secondary. He's been a big help. Our secondary medical insurance is with IAC (Individual Assurance Corp.), and prescription is with Humana. I like the 90 day mail order pharmacy at Humana. Of course a couple of meds are controlled substances so they can't do more than 30 days on them. But they mail out prescriptions a week ahead of the refill date so we don't run out of anything.

Jim

Going on 3rd year of Medicare with a Plan G supplement. Its around $100 a month and after an annual deductible of $149 it covers everything (that medicare covers). I never pay a cent over the initial deductible. EnvisionRX is my Part D - its around $15 a month. I think all Part D's are pretty much the same. If you know you are going to have a lot of medical you need either F or G, F covers everything but premium difference is much more than the $149 deductible with G. Of course premiums vary based on gender and the state you live in. Good luck.

@moemoe

I can understand your reluctance after your past experiences.

I urge you to seek a second opinion. Have you sought a second opinion from a multi-disciplinary health care facility like a university medical center or a Mayo Clinic?

Thanks Jim. Any and all info helps!
Rachel

Thank you for this information, it definitely is something a lot of us need to hear in order to help us select a better quality of life

Thank you very much for the information. My biggest concern, given my diagnoses and what that may bring for the future, is the ability to go out of network for Doctors. Also, coverage for my more expensive meds that have not been covered traditionally like Lyrica CR, Cambia and Emgality.

If your concern is network, get a Medicare Supplement, NOT an Advantage Plan. For Advantage, the feds give your Medicare premium to a private company like United Healthcare, and it operates like an HMO with a network and a huge interest in keeping the cost of your care below the "capitated" amount they are paid by CMS.
As far as the prescription costs, when you are looking at a Part D provider, check their formulary to see if it is covered and what your costs will be. Its a bizarre system, you can't count on a steady monthly cost because you go through different phases. You might pay a $250 copay in January because it includes your deductible and $50 in February then suddenly in June it goes back up and then goes way down again in Sept depending on what phase you are in and your overall (not individual drug) out of pocket costs are. Honestly, I haven't cracked that nut, and I use GoodRX for my pain meds because they arbitrarily cut them on me earlier in the year.

PS - if you have a supplement, you can go to any doctor that accepts Medicare. That was my point on supplement vs. advantage. Advantage includes other stuff like dental, vision, drug, and Silver Sneakers (yeah, we will use that) but you are limited to their network.

Hmm...that is bizarre. I'm not crazy about fluctuating monthly costs. I will continue on with my research. Thank you for the advice. Very helpful.
Rachel