MBC and Going on Medicare soon, any advice.

I am on a Medicare Advantage Plan, a PPO with BC/BS. It costs $79/month and has an annual cap on out of pocket expenses that is $3k. Since it is a PPO I can go to different health systems in my area. I don't know if the same plan is available in all states.

Others seem to do original Medicare plus a supplement, including BC/BS Medex and also a drug plan.

Advantage plans include dental, vision and drugs so it is all in one plan.

Hi Windy

Medicare with the supplement has worked out well for me. I can see doctors and not have a problem with copays. I see enough doctors to make it worth the expense. I think its plan “F”. I also have a PDP plan. Thats okay too.

I have a dental “discounted rate” plan through dental plans.com. My dentist participates. I have substantial cuts in dental bills even though its still a small fortune.

I’m Leary to put all eggs in one basket. I’m on a slew of medications, see a lot of doctors between evaluations and maintenance and surveillance. Its a lot so getting things covered the way I have is worth it too me.

Good Luck.

I was nervous when I had to go to medicare. After being on it for a few years, I changed to medicare plus a supplemental plan “F” which when I entered the plan, they cover all medicare approved copays.

I have had expensive mris etc and they covered it.

I can go to any medicare participating providers so long as they are accepting new patients.

Medicare does not pay a lot to providers. I think that is a reason they give you 15 minutes, to 30 min, to 45 min. Depending on what type of visit you are having.

I have to arrange for rides and it takes me hours to get to and from the office for only 15 minutes. But if they can get the job done in that time, God bless.

Not meaning to complain. Its just the way it goes. When I have more then one problem at a time, it’s a complicated patient history that nobody should ignore. One thing affects another thing and so on. This organ malfunctioning could cause different problems. I saw 15 doctors in January. I’m excused and taking a break from the d & c. So gave myself 2 weeks of a clear schedule. Thank God because i need it with this myopathy.

It is challenging navigating medicare. I tried to convince my mom to stay on Plan F. Supplemental. She has a history of cancer. She moved to a less expensive plan, she is to pay copays. I am nervous for her.

Hi, @sam2020 I just turned 67 and have already learned more from you than I knew. I thought you could only enroll by the end of the year. My husband is still working so we saw no reason to add additional (he's 66) Medicare Supplemental Insurance since the monthly fees and confusion as to what and what not is covered. @windyshores may I ask what state you're in I'm in FL and was quoted no less than $150.00 monthly. I know I need more monitoring/tests but we cannot afford it right now. Thank you!

I do not have MBC so I am not aware of all that you need to consider.
I chose traditional Medicare and Supplement from AARP/United. Been 7 years … I have never been turned down or charged more than a VERY SMALL beginning of year deductible ( $250 ish). All my doctors accept traditional Medicare and it’s national, not regional, so if you travel within the US you are always covered. I’ve had three surgeries, a hospitalization and countless medical appointments, PT, and chiropractic adjustments completely covered by my plan. One does need a drug add on at the outset also. My current understanding is that any infused drugs ( administered in a health facility) are completely covered. Oral meds can be a different story.

My spouse choose a Medicare Advantage plan … he did not like it as it actually is run by private insurance companies and not all Medicare doctors take Medicare Advantage … so be aware and ask your doctors if they do. Some of his did not. When my spouse converted to traditional Medicare, the supplement charged a premium ( forevermore) for “pre-existing” conditions … so do your homework.

I am very comfortable with Traditional Medicare.

I have had MBC for 4+ years and all of my Doctors are at Mayo. I am on a traditional Medicare plan that covers basic costs, and Supplement F with Blue Cross Blue Shield Florida that covers deductibles and the 15% not covered in the basic plan. This past year I also had surgeries to put titanium rods in my femur bones and only had to pay a small fee for my Covid tests. Mayo doesn’t pay costs for Medicare Advantage plans. I got on my plans when I was 65 and am grateful to be able to concentrate on health issues and treatments. Complicated but worth the time to work out the decision at the start.

See:
https://www.charlotteobserver.com/opinion/article267774792.html

@sam2020 When to sign up for Medicare and what plan you choose is a somewhat complicated process. There is a discussion I started on Medicare and Mayo Clinic where the members discuss Medicare.

--Does Mayo Clinic Take Medicare?

Additionally, if you type Medicare in the Search box on Mayo Clinic Connect you'll see many different discussions members have had about all things Medicare.

I selected Traditional Medicare where I pay for Part B, Supplement G with TransAmerica (Medigap) and Part D for prescribed medications. I decided to go this route in order to have the most flexibility to get medical care at any place in the US that takes Medicare. I've had these policies for 3 years and while I have to track what is paid for by Medicare and what is not paid I have found very little out-of-pocket expenses. Frankly it's the Part D policy that is rather maddening. Some prescriptions have no co-pay, others have a small co-pay, and others are not covered at all. So far I have not encountered prescribed medications that are unaffordable for me.

Make CERTAIN that she signs on with REGULAR Medicare and NOT Medicare Advantage. I have had regular Medicare for 18 years with a great AARP supplement and have paid nothing for Proton radiation for prostate cancer and a mastectomy and proton radiation--both at Mayo Clinic in MN. Buy the most comprehensive supplement package you can find. Mine pays any deductible. I can consult with any physician in the US. It gives me peace of mind. That is what money is for. Good luck.

@bcwarrior I am in MA. I am super happy with my Medicare Advantage plan. Please note it is a PPO, not an HMO, through BC/BS of MA.

I went to no less than 4 financial counselors (after my breast cancer diagnosis, not before) and all recommended this plan for me. Half of those on Medicare are on Advantage Plans. (Regular Medicare still covers some things.) Clearly that proportion is not posting on here though 🙂

I like the annual cap on out of pocket expenses. I have been on it for 7 years now and haven't had any problems with coverage, including three different hospital systems.

@jackiestack what does this mean? "Mayo doesn’t pay costs for Medicare Advantage plans." Are you saying that Mayo does not accept insurance through Medicare Advantage Plans? I really wonder if you are referring to an HMO plan. I would love an explanation.