I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Medicare/Insurance => Topic started by: Vt Big Rig on December 01, 2015, 07:12:18 AM
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I am 63 years old. I am on my wife's insurance with her company. On dialysis since April.
My center tells me to go on medicare in January because I would not have to pay for the out of pockets expenses we pay now. (Up to $5,000).
But my wife wants to retire in September so I will lose her as my secondary insurance. I will not be 65 yet and therefore cannot find on line any supplemental plans.
I expect there are others out there with this issue. How do I get a plan to cover what medicare does not in this situation?
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You need a medicare supplement for under age 65. They are made available by state mandate in about 30 states but they typically charge a higher premium because if you have medicare and are under 65 they know you are disabled or seriously ill. Your best bet is to check with your states SHIP. Hopefully you live in a state where they offer medigap for under 65. Also note that once you enroll in medicare, you have a 6 month window to sign up for a medigap policy without undergoing underwriting. That is if it is even offered in your state. https://www.medicare.gov/Contacts/#resources/ships I am under 65 and have medigap F in Tennessee. The premium for just the medigap F started out at about 325 a month 2 years ago. It is now about 380 a month but it covers basically everything not covered by original medicare. It has saved me a bunch.
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We learned the hard way, that if you should end up getting a transplant, and are not on Medicare at the time, they will not pay for the anti-rejection medications. That was our situation years ago, hubby was on my work insurance, co-pays were cheap, everything was covered, so why get Medicare. Then, 10 years later, l wanted to retire, found l couldn't , Medicare would cover him for Dr bills, etc, but no anti-rejection meds. He couldn't get on any supplements because of the ESRD . So l had to keep working for the insurance, finally got to retire 2 years later when he went back on dialysis.
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When we researched and talked to a lot of people the consensus was that the best plan for pre 65 medicare people was the AARP US Healthcare plan F.
Its a little pricy but well worth the cost. That is what we went with and its been great so far. Price goes down when you turn 65 they tell me.
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That's the one I have Hootie. April of 2016 its going up to about 380 in my area. The 20% of monthly home dialysis along with the Neph fees are almost 700 bucks. Not to mention other medical expenses that we may incur as well as deductibles and what not makes it very worthwhile.
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We learned the hard way, that if you should end up getting a transplant, and are not on Medicare at the time, they will not pay for the anti-rejection medications.
Ditto if you go out of the country to buy a kidney from a place like BEK in Shanghai.