How much do you pay out of pocket on Medicare?

[mariannas]

Currently, I have private insurance through my spouse.  However, he's thinking about taking a new job and there is a distinct possibility that I will have to start looking towards Medicare for my coverage as we aren't sure if Cobra will be available to us. 

I understand that part A is for hospital coverage, B is for outpatient services, and D is for prescriptions.

Soooo...my question is this...how much of your health care is actually covered by Medicare?  I am not yet on SS Disability, but I am going to apply soon (if the super sweet part time job I'm angling for doesn't happen).  I got a letter in the mail saying I would be eligible for $770 per month, but that's not a lot. 

I guess I'm just wondering how everyone makes ends meet...it looks fairly impossible from my current standpoint.

[Wallyz]

I would encourage you to stay with your private coverage if at all possible.

[willieandwinnie]

Will his new job be offering insurance? If not try cobra, it will be expensive though. Medicare covers 80%. You should apply for Social Security as soon as possible. Are you working now? I can tell you that all of this is daunting. Ask all the questions you can think of and then some. 

[mariannas]

Oh yes...obviously I will stay on private insurance if I can, but Cobra is not always available (it depends on the plan evidently) so there is a possibility I won't be able to use it (also...it only lasts 18 months).  I've had Cobra before and it was $500 per month, but it was a sweet (as in 100% coverage no questions asked) plan. 

No...not on SSDI yet...I have the online portion filled out and now I have to go in person to the SS office.

Right...I understand that 80% of the costs are covered through Medicare, but I was wondering what (on average) those costs end up being.  I fully understand that every patient is different, but I'm just looking for some sort of figure. 

Daunting is right...I'm so accustomed to private insurance and everything is just so easy.  I'm wading through the Medicare booklet though...slowly, but surely.

[silverhead]

I believe Cobra is automatically extended to 3 years if you are ESRD, at least it was that way when we first started on this roller coaster ride......

[boxman55]

SSI will deduct approx 96.00 for medicare automatically before you get your check. Then you want to get insurance that covers the remaining 20% I go thru AARP United Health Care it costs 179.00 per month for me. Then you need a part D for prescriptions. There was 57 choices for me in the state of WI. I picked Humana it costs me 14.40 per month plus prescriptions. not knowing your prescription requirements you have to look at that. you can go online and plug in your scripts and your costs will show up. pay attention to what they call the "doughnut hole" It means if you reach 2500.00 approx. in outlay for the year the cost of your pills go up till you hit 4500.00 approx then your costs come down again. Also it is cheaper to get a 90 day supply. I went this way because Cobra was going to run 500.00 approx. The big thing to remember is do not let your insurance (any type) lapse. you will never get anything as an ESRD except Medicare at 80% ...Boxman

[G-Ma]

Try all you can to stay on private ins.  That's the only way you will get picked up by another insurance going forward.

[jbeany]

If you end up with only Medicare, you will need gap coverage for the 20%.  Depending on the clinic, dialysis fees per month, even 20% of them, are enough to break you in a hurry. You can get a gap insurance for about $100 per month.

[mariannas]

If you end up with only Medicare, you will need gap coverage for the 20%.  Depending on the clinic, dialysis fees per month, even 20% of them, are enough to break you in a hurry. You can get a gap insurance for about $100 per month.

What's a gap insurance?  This is the first I've heard of this.

[thegrammalady]

when i visit my parents in oregon i have to pay the 20% medicare doesn't cover. i am billed approximately $35 for each treatment.

[boxman55]

marriannas. Please read my thread above. Gap insurance is what they call insurance providers that cover the 20% Like the one I purchased from Humana...Boxman

[jbeany]

My gap insurance is thru Blue Cross.   It's called MyBlue Medigap Insurance.  The social worker at my unit gave me the paperwork I needed to get it.

[mariannas]

marriannas. Please read my thread above. Gap insurance is what they call insurance providers that cover the 20% Like the one I purchased from Humana...Boxman

I'm sorry...I thought the insurance you purchased from Humana was Part D.  Sorry for misunderstanding.

[Run8]

You can also check with your clinic, they have many programs that can help with medicare and insurance payments. My s.s. worker at davita got my medicare payments paid for.

[boxman55]

marriannas. Please read my thread above. Gap insurance is what they call insurance providers that cover the 20% Like the one I purchased from Humana...Boxman

I'm sorry...I thought the insurance you purchased from Humana was Part D.  Sorry for misunderstanding.

Your right. I am the one who is sorry. I meant to say AARP United Health Care is my Medigap. My mistake...Boxman

[florida.flyer]

I was told at my Davita clinic that the kidney foundation will pay my cobra payments when that time comes.

[lruffner]

I have a question too!!

 I am on disability and will be eligible for Medicare in November. I am currently covered under my husband's BCBS, but I was wondering if I should pick up the medicare B  as well? Blue Cross is a 90/10 plan ans will pay accordingly, but I just don't know what to do really. If you turn it down in the beginning, can you pick it up later? I am still 1-2 years from dialysis and probably <1 year for transplant listing. I just hate to have the extra monthly expense when I don't really need it yet.

Thanks

[boxman55]

Iruffner, if you can afford the automatic deduction that Medicare A&B takes before you get your disability check (96.00) then get it and use it as your secondary insurance to BCBS...Boxman

[jbeany]

My social worker told me that if I wanted a transplant, Part B was a must.  It also costs more if you don't start it when you are first eligible.

[lruffner]

Thanks for the info Boxman.

My social worker told me that if I wanted a transplant, Part B was a must. It also costs more if you don't start it when you are first eligible.

jbeany-
I don't understand the transplant part, because there are a lot of people who are not on disability/ SS who get transplants. Does your transplant hospital not transplant anyone who doesn't have Medicare? I know that the hospital where I am being worked up, just requires that you have some form of insurance, unless it is a child. I have a meeting with the transplant coordinator next month, so I will ask her these questions. Thanks a bunch.