Mom Needs Help

I am having trouble finding a good Medicare supplement policy (low prescriptions and upfront costs) for my mother. A couple of her prescriptions are $100 per month! She's almost 70 and still has to work. What a shame. Us kids could group together to pay on a policy, better than her losing everything and suffering so!
Linda A.

Start With AARP

A good site to look for insurance is the AARP site. My mother has medi-gap insurance that I found by looking in their site. It's not the one that AARP offers. She just signed up with Kaiser senior advantage and they cover up to a $1000 in prescriptions a year. It doesn't cover everything but it is quite good. You might be able to find one in your area. They do charge a monthly charge of $19 per month. Some companies offer similar policies for no monthly premium(United Healthcare). You just have to read the fine print.
AM

Quotesmith for Comparisons

I have just gone onto Medicare and spent several weeks researching the costs of the supplemental insurances. I would suggest you go to www.quotesmith.com and put in your data and they will do a comparison of several companies. Quotesmith is a free service for you.

Also call your state insurance office (every state has one) and they will send you a booklet giving a comparison of lots of companies. Not all insurance companies are licensed to do business in every state. I found a company that had the very lowest premium only to find that they weren't licensed in my state, so had to go to one that was.
Rosalie

Prefers HMO

Instead of medigap insurance, I chose an HMO plan that takes my Medicare check directly from the gov't and works as an HMO plan for me. It offers much better coverage and the paperwork seems to be much smoother than straight Medicare.

The only down side is that in the last 3 years, plans have changed such that I have felt I needed to change to a new one each year. One company went out of business, and the other raised prices dramatically. This meant I had to re-compare in November and switch, but the process of switching is very simple One form to the new company-they handle discontinuing with the previous plan. In my area, there were 7 or 8 plans to choose from, ranging in price from $0.00 to $100.00 (average was 30.00 a month.)

The plans vary in what they cover- i.e. not all have prescription coverage. I decided based on monthly cost, coverage, and which plans would let me see the dr. I have used for years. There is no refusal for preexisting conditions except for 2 things: cannot have end stage renal disease or have had a kidney transplant w/in 36 mos.
Kev

SSI Solution

If your Mother is low income, she may be able to sign up for SSI benefits. This will pay for prescriptions, eyeglasses, etc. Social Security won't tell you about this. You will have to contact their office and ask.
Cee

HMO Warning

Be careful when signing up for medigap insurance, when my Grandmother signed up for an HMO type policy we did not realize she was agreeing to have her Medicare benefits assigned to this HMO. The HMO provided her care (in which she was very limited in all choices) and in return for this they collected her Medicare benefits and her monthly premiums). So if you don't like the policy down the road for one reason or another, it can be very difficult to change at this point.
Michele

Advice from an Elderly Advocate

I work for an Area Agency on Aging. Our agency has an insurance specialist who helps people to find and compare Medigap policies. The person seeking information should check with their local Area Agency on Aging to see if it has a similar service, or if their state government has a department of insurance that may be able to direct them to information.

There is a wide price range for Medigap insurance, but the government requires that all Medigap policies offer the same features from one company to the next. Medigap policies are categorized alphabetically. We typically recommend the "Plan F," which pays the Medicare deductibles and pays the 20% co-pay for outpatient care.

Medigap policies that have a prescription benefit are much more expensive than the Plan F level. There's not a lot of financial help for prescription unless the person is eligible for Medicaid, however, most pharmaceutical companies have a Patient Assistance Program or Indigent Drug Program for people who are over the guidelines for Medicaid but still have trouble paying for meds. The patient can ask their doctor for help in obtaining free medicine from the pharmaceutical company.
BAS

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