Popular Post Longjohn ★ Posted January 13, 2022 Popular Post Share #1 Posted January 13, 2022 The Medicare disadvantage plan that I was on ever since I retired was costing me too much in out of pocket. It had a yearly $7000 out of pocket. It included a drug plan that wasn’t awful. My Brilinta had like a $40 co-pay. I just picked up my Brilinta under the new plan. $435 co-pay. I think this is the last I will have to take of it. On the bright side I just had an oncology appointment today with no co-pay. 5 2 Link to comment Share on other sites More sharing options...
Airehead Posted January 13, 2022 Share #2 Posted January 13, 2022 Oncologist loves you I bet. Link to comment Share on other sites More sharing options...
donkpow Posted January 13, 2022 Share #3 Posted January 13, 2022 I looked at that stuff, there are all kinds of plans. I currently have an HMO type plan. When things turn south, I'll need a plan that suits my needs better. They have a free program here in Ohio to help people wade through all the plans and get the one that suits. Unfortunately the window to opt in only happens annually or something like that. Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 13, 2022 Author Share #4 Posted January 13, 2022 Just now, Airehead said: Oncologist loves you I bet. I had a good time with her at my appointment today. When what they do works it makes everybody happy. They were not real happy when they had to stop chemo and call an ambulance for me back in August. I wasn’t real happy either, I had to pay for the ambulance ride (same road, about a mile and a half) and the emergency room. That was on my disadvantage plan. 1 Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 13, 2022 Author Share #5 Posted January 13, 2022 5 minutes ago, donkpow said: I looked at that stuff, there are all kinds of plans. I currently have an HMO type plan. When things turn south, I'll need a plan that suits my needs better. They have a free program here in Ohio to help people wade through all the plans and get the one that suits. Unfortunately the window to opt in only happens annually or something like that. Don’t wait until you need it, they won’t accept you with pre-existing conditions. The only company that will is AARP United Healthcare and because of pre-existing conditions I have to pay twice the monthly rate. 1 Link to comment Share on other sites More sharing options...
Zealot Posted January 13, 2022 Share #6 Posted January 13, 2022 Ouch! Link to comment Share on other sites More sharing options...
Further Posted January 13, 2022 Share #7 Posted January 13, 2022 Picking out insurance is part of the reason I kept working 1 Link to comment Share on other sites More sharing options...
Razors Edge ★ Posted January 13, 2022 Share #8 Posted January 13, 2022 11 hours ago, Further said: Picking out insurance is part of the reason I kept working And keeps me from seriously considering early retirement. What a mess. Link to comment Share on other sites More sharing options...
Popular Post Further Posted January 13, 2022 Popular Post Share #9 Posted January 13, 2022 3 minutes ago, Razors Edge said: And keeps me from seriously considering early retirement. What a mess. I always said I would work until I died, but I thought I’d be dead by now 1 4 Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 14, 2022 Author Share #10 Posted January 14, 2022 On 1/13/2022 at 8:10 AM, Further said: I always said I would work until I died, but I thought I’d be dead by now Me too. whelp my new insurance is saving me money on medical care, doctor bills, hospitals, emergency rooms, etc. but my new drug plan isn’t very good. I scheduled surgery on my other eye today and they called in prescriptions for eye drops. $90. Co-pay. 2 Link to comment Share on other sites More sharing options...
shootingstar Posted January 14, 2022 Share #11 Posted January 14, 2022 On 1/13/2022 at 6:04 AM, Razors Edge said: And keeps me from seriously considering early retirement. What a mess. While it can be a consideration especially for some Canadian employees who have chronic medical conditions, for me it's other reasons that's stalling my decision when retire. Link to comment Share on other sites More sharing options...
Ralphie ★ Posted January 15, 2022 Share #12 Posted January 15, 2022 12 hours ago, Longjohn said: Me too. whelp my new insurance is saving me money on medical care, doctor bills, hospitals, emergency rooms, etc. but my new drug plan isn’t very good. I scheduled surgery on my other eye today and they called in prescriptions for eye drops. $90. Co-pay. What the large print giveth, the small print taketh away! 1 Link to comment Share on other sites More sharing options...
smudge ★ Posted January 15, 2022 Share #13 Posted January 15, 2022 On 1/12/2022 at 8:14 PM, Longjohn said: The Medicare disadvantage plan that I was on ever since I retired was costing me too much in out of pocket. It had a yearly $7000 out of pocket. It included a drug plan that wasn’t awful. My Brilinta had like a $40 co-pay. I just picked up my Brilinta under the new plan. $435 co-pay. I think this is the last I will have to take of it. On the bright side I just had an oncology appointment today with no co-pay. I can't believe no one gave you the $5 card for the Brilinta. I would have told the pharmacy to keep it at that price, especially if you're on your last month of it. Link to comment Share on other sites More sharing options...
FX_James_7.9 Posted January 15, 2022 Share #14 Posted January 15, 2022 why would anyone sign up for medicare advantage? Link to comment Share on other sites More sharing options...
Ralphie ★ Posted January 15, 2022 Share #15 Posted January 15, 2022 47 minutes ago, FX_James_7.9 said: why would anyone sign up for medicare advantage? I wouldn't know it is a scam if longjohn hadn’t warned us all. 1 Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 15, 2022 Author Share #16 Posted January 15, 2022 2 hours ago, FX_James_7.9 said: why would anyone sign up for medicare advantage? Eville insurance brokers that assure you that this is the best plan for you. They must get one heck of a kickback from the insurance companies. Link to comment Share on other sites More sharing options...
shootingstar Posted January 15, 2022 Share #17 Posted January 15, 2022 I will be dead by then: hopefully my mid 20's nephew if he lives and works forever in the U.S., health care insurance will improve by then. Somehow, doesn't seem hopeful, since your system so entangled with too many for-profit parties at different levels. And if majority patients offered truly a better system, they still won't believe it. Link to comment Share on other sites More sharing options...
Tizeye Posted January 15, 2022 Share #18 Posted January 15, 2022 Never ever Advantage Plan. If you ever want to do something unAmerican, like travel, you are suddenly out of network. We know seniors don’t like the travel when they retire…right? Insurance say may be covered. But at what costs out of network. Staying with regular Medicare and Plan F. Drugs…was with AARP Walgreens @ $32/mo. Was happy when saw reducing to $27, but the devil is in the details. Two of my relatively common generics were moving to Tier 2 and gaining a copay. Additionally, free was mail order only, pick up at pharmacy was now $5/Rx. Estimated annual cost for current med was $485 in addition to the monthly. Switched to Silverscripts (CVS) $6/mo and estimated annual cost with the same $5 copay/Rx is $42. @Longjohn check cost with GoodRX.com. When had higher tier Rx to treat acute illness, such as an inhaler for congestion, GoodRx was cheaper. 1 Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 15, 2022 Author Share #19 Posted January 15, 2022 Good RX was $415 22 minutes ago, Tizeye said: Medicare and Plan F. Drugs…was with AARP Walgreens @ That’s the plan I just signed up for it started January 1st. So far I’ve filled five prescriptions and they all had a large co-pay. Good RX has a price of $415 a month for BRILINTA. My $435 was for 90 day prescription. My old plan that was part of my disadvantage plan my eye drops were covered but they raped me on hospital visits, doctor visits, cat scans, MRIs, etc. The Brilinta website has a discount card you can get if you qualify that drops your co-pay down to $45 a month. I shouldn’t need to take it after what I have runs out because my heart attack was the end of February and you only have to take it for a year. Link to comment Share on other sites More sharing options...
Airehead Posted January 15, 2022 Share #20 Posted January 15, 2022 Is there a cap on drug costs and then they are free? Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 15, 2022 Author Share #21 Posted January 15, 2022 8 minutes ago, Airehead said: Is there a cap on drug costs and then they are free? I don’t know. They sent me a crapton of paperwork that I couldn’t read because of the fine print and my recent eye surgery. 1 Link to comment Share on other sites More sharing options...
Tizeye Posted January 15, 2022 Share #22 Posted January 15, 2022 You will love Plan F, it is the Rx plans that are the problem. Entire cost of my recent surgery as well as pre and post appointments, radiology exams, plus all other outpatient care and tests during the year...$0. I can live with the monthly charge. In fact, I've gotten some rogue bill demanding payment that I knew was an accounting error. It was just a matter of convincing the billing clerk of that as I point out her error. RX requires special oversight. One thing I have in my back pocket is the VA. I've known several people that, while they had care outside the VA, they have had a VA doc rewrite their expensive cancer or transplant medications and filled at the VA. 1 Link to comment Share on other sites More sharing options...
MickinMD ★ Posted January 15, 2022 Share #23 Posted January 15, 2022 My cousin in NJ does a lot of checking when choosing a Medicare Advantage Plan and checks it against what Medicare Covers as well as the Veteran's Administration - her husband has heart and bouts-of-senility problems and they're handled at a veteran's hospital. There are tradeoffs of one-plan vs another and she takes the best bet. Personally, I have retirement health insurance through my employer, who pays 3/4 of a near-Cadillac Medicare Supplemental Plan and I pay $170/month with Health, Prescription, Dental, and Vision coverage. There are a lot of small copays ($15, $30, etc.) but the whole idea is to prevent huge expenses for health and prescriptions. Of course, I never gave it a second thought when I became a teacher in my 30's, but now I figuratively pat my younger self on the back for taking a pay-cut to go into teaching but getting "delayed pay" in a good pension and benefits. 2 Link to comment Share on other sites More sharing options...
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