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Before this year, I had drug coverage through my supplemental insurance. I still have the coverage, but it has been moved to Medicare Part D, SilverScript.

Now, I also pay for part D out of my SS check..I pay double because of my income.

I got a letter from Silverscript telling me that I had about $1600 left in my Part D allowance and thereafter I am in the donut hole. I got this letter beginning of June. Since just one of my drugs costs over $900, I will be reaching the donut hole next subscription filled.

My question is...is everyone on Medicare now forced to have Medicare Part D? Or is this something my supplemental insurance decided to do?

Birgit
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When you say "supplemental insurance," are you referring to something provided by your current or former employer, or are you referring to a Medigap or Medicare Advantage Plan? If you have supplemental via your employer or retirement plan, then I think they pushed the coverage over to Medicare Part D. They also probably have you in a Medigap Plan, not your former insurance, even though they might pay it. It's all confusing to me. I've always had a private individual policy that I paid for, due to being self-employed. When I went on Medicare, I saved a bundle. I got Medigap policy, plus a drug plan. I too will reach the hole before the end of the year, but hopefully it won't be until very close to the end. I'm on all generic meds, but I have to take a lot of different meds due to a complicated and somewhat very bad heart problem. Anyway, good luck.
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Yes, my supplemental insurance is provided by former employer. I pay 78+ monthly out of my pension check. I used to have a very good drug plan, covered most anything and I paid deductible on 90 day prescriptions. Now, I pay the same, but I am enrolled in medicare part D.

Yes, I guess it would be a Medigap...pays after my deductible, 80% of what Medicare does not pay.

I wonder if I would be better off dropping the Medigap and enrolling in one of those all in one Medicare programs?

Sorry to read about your heart problems and wish you well. Take care,

Birgit
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Sounds like you need to do some research. Find out specifics of coverage you have now. Look at what you could get in Medicare supplement and Part D on your own. Look at Medicare Advantage plans too. Often, especially with Part D, the medications you're on will dictate what policy works best for you. Insurance company websites may even offer a calculator where you can enter what you are taking and see what they will pay.

It takes some effort the first year but after that it's just a matter of reviewing premium increases and any coverage changes. Usually if you are happy with what you have you can let it renew.

Nice that you had employer provided coverage but that's something that is slowly going away, and many retirees never had it to start with.
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I have been hearing lately that the Medicare Advantage plans are going to changed due to Obamacare. I would check carefully before jumping into one of those right now.

Far too many ifs and buts for my liking.

Both DH and I have original Medicare and a Supplement by United of Omaha (not thru AARP). We both also have the Walmart/Humana Part D plan. Since DH receives all of Rx medications at no cost thru the VA he hasn't used any of the $300 deductible. I receive mine by mail order at far less in some cases than the WMT $4/$10 cost. I do however have a $300 deductible. I usually just order all my drugs in January, pay the $300 and I'm good for the rest of the year. Many of my drugs then become "free" with no cost to me.
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Bobcatkitty wrote I have been hearing lately that the Medicare Advantage plans are going to changed due to Obamacare. I would check carefully before jumping into one of those right now.

Currently all insurance companies selling Advantage Plans get a capitation equal to 39.4% of the Medicare Premium. The changes you mention are pretty simple - that 39.4% is going to disappear or at least not increase. The reason Advantage plans have been able to offer people things beyond traditional medicare for zero or at most small premiums is the capitation.

Capitation was created during the Bush administration - the thinking was the Private Sector could do it cheaper. Now that 10s of millions have moved to the Advantage plans, maybe it is time to take away the subsidy and watch how fast the Advantage plans fail.

I find it easy to understand people having an interest is any service whose cost is roughly 40% lower than the traditional version of such services.

Gordon
Atlanta
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<<Capitation was created during the Bush administration - the thinking was the Private Sector could do it cheaper. Now that 10s of millions have moved to the Advantage plans, maybe it is time to take away the subsidy and watch how fast the Advantage plans fail.

>>


Poor people just default or are exempt from paying co-pays and deductibles. Defaults reduce the income to health carem providers, which means that others must pay.

Medicare Advantage plans usually insure that those co payments and deductibles are actually paid.

People are WILLINGLY choosing to pay extra money to support the health care system, and the government has offered a subsidy to encourage that.

In other circumstances, Democrats and liberals would be championing that kind of program. But since it was a Bush and a Republican program, their aim is to destroy it.

Another example of Democratic partisanship.


Seattle Pioneer
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All I know is that once I leave my company sponsored Medigap supplemental insurance, I can never get back in. So I have remained.

But I do think I should do some homework to see if there could possibly be anything better out there.

I don't know what Captitation is...never heard of it. But you say now it is going away next year.


Birgit
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All I know is that once I leave my company sponsored Medigap supplemental insurance, I can never get back in. So I have remained.

But I do think I should do some homework to see if there could possibly be anything better out there.

I don't know what Captitation is...never heard of it. But you say now it is going away next year.


If you have significant health issues, you probably should stay away from Medicare Advantage, because in most parts of the country there are significant restrictions on hospitals and docs on their approved list. It sounds to me like you've probably got a decent deal overall with your company plan. They pay for your Medigap, and that's not peanuts. Anyway, good luck in your hunt for better coverage.
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True, I am not restricted to any docs or hospitals. That's a big plus. And yes, I do have some health issues.

Birgit
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My question is...is everyone on Medicare now forced to have Medicare Part D? Or is this something my supplemental insurance decided to do?

Birgit


I have an HMO (Health Net). As such drugs are covered under their plan. So far no complaints.

Count No'Count
... I do fret that a major health incident may result in less than the best care. My SIL is recovering from an burst aneurism in her brain. Seems to be doing as well as can be expected. But they put her in Cedars Sinai, one of the best in the world. Would Health Net send me there?
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Medicare Advantage has low monthly premiums but high deductibles and copays. I think a major incident can get very expensive.

Also in my area the best rated hospitals and doctors are out of network. Hence, either you cannot use them or the bills get very large.

I think Medicare Supplemental is better insurance even though it costs more. You pay more but it protects your assets.
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I think Medicare Supplemental is better insurance even though it costs more. You pay more but it protects your assets.

Maybe I am lucky to have it then. I do have choice of any doc or hospital. If your hospital stay is longer than Medicare will pay, they take over the bills.
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Maybe I am lucky to have it then. I do have choice of any doc or hospital. If your hospital stay is longer than Medicare will pay, they take over the bills.

Would you share more information?

CNC
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Would you share more information?

I have supplemental "Medigap?" insurance through my late husband's company. I would guess that each company has their own plan. My initial question was that I wondered about being my plan being thrown into Medicare part D this year.

Birgit
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