Anyone else trying to choose SS Suplemental Insurance?

[madmax]

Counting on my DU folks for some clarity about SS Supplemental Insurance. Been told that Medicare doesn't pay medical costs - I'm suppose to choose a plan or SS will chose one for me. Right now 93.00 comes out of my SSD for Medical and 36.00 for Rx's.

Checked out www.medicare.gov and there are so many plans available. Have read here on DU to stay away from North Carolina BC & BS but, checking out their 'star' ratings NC BC/BS ranks pretty high. I believe DU'ers more than any star ratings ;)

My husband's group plan through Aetna is my primary with Medicare as secondary. This year (as of Jan 1 2011) his company changes plans, the new plan sucks so I'd like to get decent insurance through Medicare just in case...

I'm on SS Disability and will be 62 in August - will then be switched over from SSD to SS along with a big cut in benefit. I was diagnosed with cancer 2.5 years ago BUT! The good news it that, that diagnosis may have been a false positive based on a half assed needle biopsy. I have 2 new doctors now that have serious doubts and want me to go to M.D. Anderson for a second opinion - guess they want to cover their asses since they didn't make the original diagnosis. According to what the original dr. told me - I should, by now, be on my deathbed. He said, Stage IV and 3 years. All my scans, blood work etc. have been clean - even after the needle biopsy of a small tumor near my pelvic bone they could not find any cancer anywhere. I could/can plow the North 40 without a mule. Don't get me wrong - I'm not complaining one bit. Pardon the cliché but, it was a blessing - I appreciate my life so much more now than I ever did. The only thing I'm pissed about is the emotional toll it took on me. Now, I'm able to think a little bit better and the 'bitch is back' (almost).

Just to add a little more excitement - I developed Cochlear deafness so trying to do anything by phone is out of the question. Hell, even in person it's hard if there is noise in the background. Anyone offer some suggestions about the plans, either first hand or what you've read, heard, etc.

Still have about a week to get this into SS.

Sorry I went off on all the other stuff but, with prior conditions and all that jazz it gets crazy but, life is good.

[old mark]

1. K&R...my wife has in with her disability...she bases her choice on what meds

are covered. She has several different medical problems, including HepC -she will be starting a new med to reduce her viral load, which has increased dramatically over the last 3 years. She did take a full course plus 1/2 a course extra of interferon several years ago - cost over $1500/month, which was covered by our insurance at the time, but we both have different private insurance...she has medicare as a backup, too.
It is ridiculously complex thanks to the GOP - but determing what you need most and try to find coverage that will guarantee that.

Good luck.


mark

[madmax]

5. Thanks Mark

I feel so bad for Mrs. Mark. Sounds like so much to deal with physically and emotionally. The money it hard, too but dealing with all the drugs and related craziness is such a burden. Give her a hug for me and you get one too, it's not easy being a spouse :hug:

[emilyg]

2. After much research and

talki ng to other people I dropped my BC medicare coverage and went with AARP Medicare Advantage. My decision ws made on getting the most for my money.

[madmax]

6. I looked at that one too...

I think I need to join AARP to get that but, it's not expensive.

[emilyg]

28. Call them and check it out.

[Blue_In_AK]

8. That's what my mother-in-law had

and between that and Medicare they covered 100% of her final illness, major heart surgery and a month of unsuccessful recuperation.

[emilyg]

27. Good to hear that.

[CountAllVotes]

3. why the big cut in SS benefits when you turn 62?

Have you been on SSDI for a long time?

As for the medical question, I guess you need to check out supplemental plans and pick the one you can best afford.

It is a shame you cannot stay on your husband's plan. :(

[madmax]

9. Yes

Was a combination of diseases that decided to kick in all at once.

Sensori-nureal hearing loss, which became progressive (I worked for Delta Airlines) and Rhuematoid Arthritis started at 40 ish which has gone off the charts! Nothing is helping at this point the feet are the worst, plus now it's osteoporosis. Have had 4 fractures in my pevlis and had them 'glued'. They found them after doing scans. And here's the thing - tumors in women with osteopososis and R/A are often misdiagnosed as malignant when in fact they're benign.

The insurance co. and Medicare paid mega bucks that they could have saved IF the Dr. would have listened to me and agreed to a 'do over' biopsy. I told him if the needle can't do it bring out the long knives, man! I'm not squeemish and I don't care about scars. I'm over my bikini days. :mad:

[nannah]

4. from what you have said

it sounds like you were open for ss disability due to cancer and may no longer fit the criteria for disability but as a 62 year old, you are able to collect straight social security. When you qualify for social security disability your monthly amount is set as if you worked till full retirement age. When you collect straight social security at age 62 your amount is discounted because you are not full retirement age.

However although your improved health may have altered your disability determination it is worth asking for a reconsideration of your situation based on your hearing limits. At age 62 your prior work history and education levels play a role in the determination of disability. The loss of hearing, if not correctable, could very well make you eligible for Social Security Disabilty again. Another aspect of hearing loss can be loss of balance which is a big issue in ability to work. Also, how are your hands???

Tell me a bit more about your general state of health.... hands, feet, knees, neck . at 62 there is usually a bit of wear and tear.


edited to eliminate unnecessary information

[madmax]

10. I thought that once you turned 62 you automatically

have to go on SS and be removed from SSD. That's how they save money.

I'd rather work but, there are overlapping conditions. However, the biggest obstacle at first was the hearing loss. I wasn't born deaf and have 5% di stored hearing in one ear. I had a cochlear implant 2 months before this other dr. said I had cancer. I lost my motivation to work with it. Now I've tried playing with it but, because I have some residual hearing in one ear it's like listening to two different radio stations in each ear. It's complicated to explain but, if one had normal hearing for a long time and then looses most - do not go for this implant. It works miracles for ppl born deaf. It's major bull if you are familiar with sound. You do not hear the sound the way you remember it - you have to 're-program' your brain to associate this new sound to what that sound was like before. Sheesh, it's hard to write the explanation.

My feet are really bad, I fall all the time. Luckily I haven't broken a hip - yet. The hands and wrists on/off depends on the weather. In another post the osteoporosis has caused a lot of insufficiency fractures. One at a time and 2 in the sacrum.

I don't think there is much of a choice about forced early retirement at this point.

[nannah]

17. i don't believe that you do automatically have to change

to SSA. People draw ssdi until they become full retirement age. I think your disability was based on your cancer rather than your other issues. I think you have a case for continued ssdi depending on your education and work hx. i am not a lawyer but a social worker in the field of disability. I think you might ask some more questions.

[madmax]

12. nannah........

doh, ok I just talked to the other half. He said, I'll still be on SSD because of all the health conditons but, they will cut the dollar amount. What I'm getting now is based on what I was making at the time I became disabled and that's going to get cut. ok, better than nothing seeing as how I can't get a job now doing anything.

[Justitia]

7. My son (also on disability) chose State Farm for his Medicare supplemental - it was fine.

Got it through a local State Farm agent, very easy.

[madmax]

11. I didn't know that you can go to an ins. co.

and do this. I have State Farm for my home owner and car insurance. I like my agent and she's close by - bet I could stop there this week and get it done.

This way she can answer my questions. This online stuff is ok but, there's nothing like talking to a real live body!

[Justitia]

16. Yup, definitely talk with the agent you already have. Best wishes. -eom

[madmax]

13. Just wanted to add

People don't think hearing loss or deafness is a big deal because they can't 'see' it.

It's a BFD. Every waking moment I spend so much energy trying to hear. One's heart beats without any thought (well if you don't have a heart conditon), seeing is passive, breathing, etc. Our senses if not inhibited by disease or other just happen - without any exertion on your part.

You hear things other people say - you grow each day with new imput that you don't even realize is happening. When you can't hear it's a freaking JOB! I'm exhausted by the end of the day. I'm so grateful for CC TV it's a way to learn news without any stress, the internet is a GOD SEND. How the hell did I live without it! Now that Obama signed - whatever it is he signed that youtube and videos on the net be CC too, I'm in deaf persons heaven.

Also, the frustration hearing people show and express when they have to repeat something. Or they look at me like I'm mentallly challenged and don't understand what they're saying. The stress level goes UP and I believe it has also contributed to high BP. It's a vicious cycle.

Off the top of head so it's not an exact quote. When Helen Keller was asked if she could have just one sense, hearing or sight she said, hearing. Parapharsed, sight cuts you off from things, hearing cuts you off from people. That's it in a nutshell. I've become quite the recluse over the years and this is hard for someone who is an extreme extrovert. But, hell I'M ALIVE!! :bounce: :bounce:

[riverbendviewgal]

23. I can empathize with you

I too have loss of hearing. I had spinal meningitis when I was 10 months old
When young I experienced being bullied because of my hard of hearing. I thought I was just deaf on my right ear. BUT Canadian doctors insisted I get a hearing test and I found out I was half deaf on my left ear. A hearing aid has made such a difference.

I agree with you about people being impatient with you for not hearing...I do feel isolated and most of my life I felt like I was on the outside looking in. BUT the good part of my being deaf is I read a lot when I was younger and now too. This brought me the world through my reading and also different points of view. It made me the progressive I am today, otherwise I most likely would have turned out to be like my Republican loving family who believe it is wonderful to be ignorant of the rest of the world.

I was given an hour to live when I had the meningitis and I am also thankful to be alive...My mission is not done....

I'm American born but came to Canada in 1969...I love our health care system..

My husband and younger son both had cancer late in the 90's. They had the best of everything and we had no costs..I am not a bankrupt widow I am now retired, early and I don't worry about my medical insurance. I do have private insurance for eye care, dental, hearing aid, prescription but that is just $1600 a year. When I am 65 my prescription drugs will be just $2 bucks a prescription.

Canadians just shake their heads at the Americans who don't want our health care system....We are happy up here.

[madmax]

31. Amazing experience.

You do understand :hug: was your husband hard of hearing, also? Mine is not but, has the patience of Job. I commuted to NYC to work, the train ride was 1.5 hrs. each way and I didn't want to talk to any seat mates because between the noise of the train and my hearing loss it was frustrating and a drain. I would either read the paper, books or magazines, did for 14 years. I don't have the time now to read and I miss it.

When I was feistier back in the day, when someone would be rude to me regarding my hearing loss I would say something like, 'you must really get off tripping a blind person'. Or something equally tacky. :rofl:

It would help if the US wasn't such a greedy country and would look to see the best working social programs of other countries and adapt them to our needs. Even if it means that we have to pay 'something' to keep the corporate pigs happy for a time.

My new Rheumatologist is from Hungary. She trained both there and in the US. I can really vent about how our country's health care, she thinks it's criminal that people have to suffer for basic health care and immoral, too.

[loudsue]

14. Kickin' for more input. I'm interested in what other DUers have to say, too.

I'm facing those decisions in another year.

:grouphug: I love this place.

[madmax]

15. me too

can't kick my own post. Since HCR and no single payer or Medicare for all I can use all the input I can get.

:kick:

[CTyankee]

18. I just signed up for AARP. Went with the least expensive but have the most

coverage. You can get a cheaper monthly premium but less is covered for drs visits and hospital copays.Medicare only covers 80%. I haven't heard any complaints from people we know who have it. I chose it also because AARP is nonprofit and I didn't want to put myself in the hands of a Humana-type organization...

Hubby and I had a great plan, negotiated by his union, but when he was laid off the deal was it would only continue until his 70th birthday. Now that day has arrived and we are on the AARP, as of Dec. 1.

My experience, tho, was that it took a while. You'd be better off signing up by phone at this point. Perhaps you can get your spouse to call for you and tell them what the problem is with your hearing loss. I'm sure they've dealt with this before.

[madmax]

21. Smart move to look into this now

Each year they send you a packet to sign up and you have the month of December but, with holidays and such it can get crazy. Now with HCR and whatever that means, one needs a degree to understand it all.

[Ruby the Liberal]

19. I highly recommend talking with your insurance agent

Every state has to offer plans A-L and they are standardized nationally.

Depending on what conditions/needs you have, some will be more appropriate than others.

Its complicated, but anyone with an insurance license in their state of residence is trained to navigate the system (including continuing ed and possible testing). If not your agent, have her recommend someone in her office who works with this on a daily basis.

[madmax]

20. I think that's the way to go for me.

It's a small office very small town flavor. I'm also favoring AARP if she's familiar with that one I'd like more info because I have heard (pardon the pun ;) that AARP is very good. If she can't do that than something comparable would do.

I was lucky that between my husband's Aetna and Medicare we didn't have co-pays and everything was covered. The torture was free.

[silverlib]

22. My husband is on Mutual of Omaha...

not on the medicare.gov site, but his sister has it in Kentucky and loves it. I called them directly in Texas and they had a Texas insurance rep call me. It's the cheapest. The main thing to remember is that all supplemental plans are the same by law - only the price is different. Now this does not include the Medicare D coverage for drugs. They are all different. I'm speaking of the C, D, E, F, etc. My husband has the F - now copays for anything (prescriptions not included). He has Well Care drug coverage, and I'm not impressed.

[Ruby the Liberal]

26. It isn't just the company, it is the coverage

Hence the A-L plans. Most companies offer most if not all plans.

I just had Mom's switched this year after a diagnosis of type-2 diabetes, which wasn't covered appropriately from her old plan.

You need to also plan to review this with your agent annually or upon changing conditions. It doesn't cost any more to go through an agent. They get paid by companies discounting plans run through them.

My best for a happy and healthy 2011. :)

[TheCowsCameHome]

24. At 65 I went with UHC, and I believe

the AARP's plan is the same UHC program.

I think I found the UHC plan had a lower premimum than AARP's, and so far (one year now) they've paid 100% of every claim I've submitted.

[jbnow]

25. Wish it was simpler to help

Been told that Medicare doesn't pay medical costs

Medicare covers 80% of medical costs. Supplemental insurance can help with the rest.
It doesn't cover prescription costs and if we aren't enrolled in one of the Part D plans we can be penalized by charging extra for the plan when we do get it.

I'm on SS Disability and will be 62 in August - will then be switched over from SSD to SS along with a big cut in benefit.

Are you getting some Long Term Disability through your employer that you are losing when you reach (early) retirement age? Because we don't take a cut when we move from Social security disability to Social security retirement. Switching at 63 completely puzzles me

I can't help qith your choice though because I am in another state. What insurance you can get varies by state... and also by age. When you are under 65 your choices are usually more limited. Federal law doesn't require insurers to sell Medigap insurance to those under 65 but some state laws do. North Carolina is one of them, insurance companies have to offer at least 1 kind of Medigap to those under 65. My state is the same.

But I know in my state AARP insurance is not available to those under 65...

There is also a choice between Medicare Advantage and Medicare supplemental insurance. That A through L that has been mentioned is the supplemental insurance and being under 65 yoou probably have limited choices, but they can still be good.
While many companies sell them and prices may vary the plan is the same no matter who sells it. Plan A or Plan C or whatever has the same benefits whatever company you get it from
With these you have to have a separate prescription plan.
In my state plan A and C are the ones available for those under 65. Plan C pays all of the deductibles and copays which may be a relief if you get many tests, specialists, time in hospital etc.

Then there are the many medicare advantage plans. They usually include prescription coverage, an all in one thing. The money is taken from your check. They often include extras like dental or vision. There are many levels of coverage.
The ones I have looked over here all had copays from 20 to 50 to see your doctor and more for a specialist. Things like physical therapy were 30+ per visit. Tests like MRIs were about 50.
Hospitalization was 76 to 250 per day for the first 6 days or something.
Of course the higher copays went with lower cost policies.

It is late in the year for you to do a lot of comparison but the best thing to do is probably to sit down and estimate what you might need next year in terms of visits or specialists or hospital and what you'd pay under the various policies and add in the policy cost and try to find best deal.

Hope I didn't just make it more confusing.

[madmax]

29. I'm confused but, that's not new

Since State Farm handles all our insurance needs I think I'll see what she can help me with.

I elected to take an early retirement amount 8 years ago from my pension with Delta Airlines which I knew would be cut in 1/2 when I turned 62. Or I could have waited until 62 and gotten more. I chose to take it early.

I think what concerns my husband is this change of his employer contract with Aetna. He's in an HMO now and they're changing to a PPO. We have to use Dr.'s in network, and Aetna will pay 80% then we pay up to 3500.00 per year max out of pocket. We're looking for supplemental SS Ins. which would cover the co-pays. The way it worked out for us this year was good. Awe, hell - this insurance racket is such a PITA. I don't mind paying for insurance - like one pays HO and Car Ins. but, health care insurance can drive you broke and if you don't have insurance, well just kiss it goodbye.

I have a Rx Plan with Coventry Health and Life Insurance plus Aetna Rx so my Rx's are 8.00 for generic - up the wazoo for name brand. I take all generic except for Celebrex which I no longer use because it doesn't work and Lexapro for insanity ;) That's 30.00 but, my husband says it's worth it :P

on edit: the only good thing about this change is that I'll no longer need referrals. Big deal, right.

[madmax]

30. You're right, I should have looked into

this sooner but, I think I got side tracked with I'm dying - I'm not - Well maybe - Who knows.

We also didn't know that his company was going to change their plan - maybe HCR pushed them to do this.

For the coming year - I see normal visits with the RA Dr. and GP. Seeing the Oncologist in February after I have one last CT scan. Then she wants me to go to M.D. Anderson after that scan, if comes up clean again, to r/o cancer so my Rhuematologist who also doesn't think I had cancer either, can treat me for what I DO have. The RA is crippling me now. With the diagnosis of Stage IV cancer they just stopped treating it except for large doses of Dexamethasone which is like cortisone on steroids and pain killers.

All the pain I was having was due to fractured bones - no one told me I had fractures - I had to read it in the reports. Then hunt down how to treat them - glue! I've also been given IV Reclast for the osteoporosis. That cost 4K!! And some places charge up to 17K - how the hell do make up these fees? I Googled Cost of Reclast and it's all over the place, they seem to just pick a number.

It's snowing here and the RA would be unbearable today but, I have Dexamethasone and was told to use when I could tell that the RA was going to progress to a flare up. I'm in limbo until February. The Dex is not good for bones, it's probably one of the reasons for these fractures along with osteoporosis.

[BrklynLiberal]

32. I signed u w/ith a BC MediBlue plus plan...so far so good...but based on some of

these posts, I had better check out the AARP for next year. I believe it is too late now to change this year.

It is almost impossible to get really good information about all this.