That makes sense. My mistake. Thanks.
Marvin
Forums
Re: Keeping private insurance after Medicare eligible
Marvin-
I'm not positive, but Velcade should be covered under Part B of Medicare if it is given in a doctor's office. I advise you to call Medicare and ask all of these questions, and the insurance company that you think that you will deal with, either through private insurance or through a combination of Medicare and supplemental insurance.
Nancy in Phila
I'm not positive, but Velcade should be covered under Part B of Medicare if it is given in a doctor's office. I advise you to call Medicare and ask all of these questions, and the insurance company that you think that you will deal with, either through private insurance or through a combination of Medicare and supplemental insurance.
Nancy in Phila
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NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
Re: Keeping private insurance after Medicare eligible
See:
http://www.Velcade.com/Paying-for-treatment/Insurance-frequently-asked-questions
But, you should really think beyond just Velcade. The unfortunate truth is that many with multiple myeloma will become relapsed/refractory and will need to use other drugs down the line, not just the current drug one might happen to be on. So, I would be investigating the insurance provider's policies for other drugs such as Revlimid, Kyprolis, Pomalyst, etc.
http://www.Velcade.com/Paying-for-treatment/Insurance-frequently-asked-questions
But, you should really think beyond just Velcade. The unfortunate truth is that many with multiple myeloma will become relapsed/refractory and will need to use other drugs down the line, not just the current drug one might happen to be on. So, I would be investigating the insurance provider's policies for other drugs such as Revlimid, Kyprolis, Pomalyst, etc.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Keeping private insurance after Medicare eligible
I will be talking to Medicare shortly. I have a little time before the make-up-your-mind deadline. I'm just trying to get perspectives from people who have dealt with them.
I appreciate the the input from ya'll. It does help!
Marvin
I appreciate the the input from ya'll. It does help!
Marvin
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Marvin
Re: Keeping private insurance after Medicare eligible
I had a private family policy thru BCBS of Florida. I could stay on after 65 if I so desired and I did. The reason was all medicare prescription drug benefits have a minimum copay of 5% after reaching your out of pocket max. My plan after the deductible pays 100% so in the case I need Revlimid, thalidomide, etc, I would not have to deal with $500/month copay.
I was told, however, that If I switch to Medicare later on there would be a 10% penalty added to the part B coverage per year not in Medicare.
I was told, however, that If I switch to Medicare later on there would be a 10% penalty added to the part B coverage per year not in Medicare.
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rshapo7
Re: Keeping private insurance after Medicare eligible
I am 50 and have been on social security disability along with long-term disability from work 2 years in August. I am eligible for Medicare in July 2015. This has required me to start investigating all options (actually my wife as I get too confused).
I am blessed to have good long-term disability insurance, but with a cut of over 50% from income and high cost of COBRA, I previously looked forward to getting Medicare. For me COBRA ran out the end of 2014 so I bought an individual plan from Blue Cross Texas. After multiple calls to Blue Cross getting conflicting answers, I did get confirmation that I could retain my policy upon becoming Medicare eligible. Apparently since I did not purchase through the market place and don't receive any tax subsidies it allowed, but in reading the policy it clearly states that it will not pay for anything that would be covered by Medicare parts A, B or C.
For me the dilemma is that now to have same coverage, I will need to pay Blue Cross the $850 or so monthly plus cost of Medicare. I spoke to insurance coordinator at UAMS in Little Rock, and she recommends this over Medicare alone because of Medicare's lifetime limit of one stem cell transplant.
I have been in remission for over 3 years, but was on maintenance chemo including Revlimid for 3 years. I previously had tandem stem cell transplants, and they stored enough cells for another 2-3 transplants.
The budget is tight, and I don't know if it is worth paying the additional $700 per month in case of relapse? My current policy would charge me $150 for Revlimid or similar drugs, but I ceased taking those as of 5/25/14 and now just get monthly IVIG treatments due to a compromised immune system.
Does anyone know how likely it is to treat a relapse with another stem cell transplant? Also how likely is Revlimid to highly discount the drug if you are on Medicare?
Sorry for lengthy post.
Regards, Ron Baranski
Initial diagnosis: 7/27/2010
I am blessed to have good long-term disability insurance, but with a cut of over 50% from income and high cost of COBRA, I previously looked forward to getting Medicare. For me COBRA ran out the end of 2014 so I bought an individual plan from Blue Cross Texas. After multiple calls to Blue Cross getting conflicting answers, I did get confirmation that I could retain my policy upon becoming Medicare eligible. Apparently since I did not purchase through the market place and don't receive any tax subsidies it allowed, but in reading the policy it clearly states that it will not pay for anything that would be covered by Medicare parts A, B or C.
For me the dilemma is that now to have same coverage, I will need to pay Blue Cross the $850 or so monthly plus cost of Medicare. I spoke to insurance coordinator at UAMS in Little Rock, and she recommends this over Medicare alone because of Medicare's lifetime limit of one stem cell transplant.
I have been in remission for over 3 years, but was on maintenance chemo including Revlimid for 3 years. I previously had tandem stem cell transplants, and they stored enough cells for another 2-3 transplants.
The budget is tight, and I don't know if it is worth paying the additional $700 per month in case of relapse? My current policy would charge me $150 for Revlimid or similar drugs, but I ceased taking those as of 5/25/14 and now just get monthly IVIG treatments due to a compromised immune system.
Does anyone know how likely it is to treat a relapse with another stem cell transplant? Also how likely is Revlimid to highly discount the drug if you are on Medicare?
Sorry for lengthy post.
Regards, Ron Baranski
Initial diagnosis: 7/27/2010
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baranski
Re: Keeping private insurance after Medicare eligible
Insurance coverage other than Medicare A, B, and D never made any sense to me, personally. Your situation may be different but I will explain my position. I am not an affluent person, and I get by on Railroad Retirement benefits alone. I am not considering an SCT at this time.
Insurance companies try to scare the hell out people by telling them that Medicare only pays 80% and the individual is left with the liability for the other 20%. What these snake oil salesmen try to keep from you is the fact that Medicare pays 80% of the "Medicare approved amount" and you are responsible for the remaining 20%. Not 80% and 20% of the regular charge!!!
I will offer 2 examples I am taking from the Medicare summary notices I get in the mail.
Last December I had a couple of x-rays done at Barnes Hospital in St Louis. Provider charged $69.00, Medicare approved amount was $17.38. They paid $13.63, leaving me to pay $3.47.
Back in March, I had a Zometa treatment at the same facility. Provider charged $1,703.00. Medicare approved amount was $232.51 of which they paid $182.29 leaving me to pay $46.50.
As you can see, $3.47 and $46.50 are a lot less than 20% of $69.00 and $1,703.00.
Along with a couple of generous grants from ACS and Patient Access Network, to help with the costs of Revlimid and Velcade, I am able to cover my medical costs out of my card playing money.
Your individual situation may vary but it pays to seek out the accurate figures and do the math before you get railroaded into paying for a bunch of coverage you don't need as badly as they want you to think you do. Why do you think the Insurance ads on TV try to talk you into signing up for extra coverage before your Medicare benefits start? It is because once on Medicare you will have access to the true figures and not be influenced by the scary numbers they throw at you to serve their purposes.
Hospitals have a hidden agenda too. They don't care how much you spend on insurance just as long as they can be sure they will get paid. They will help you secure grants if you qualify and these will take the edge off your co-pay for chemotherapy medications.
Nobody in this world woke up this morning with the thought on their mind of what they could do to help you or me unless they were a charity organization or loved one. Insurance companies don't qualify for those titles.
Forgive my caustic attitude but when one is already on the highway to hell, some of this high-pressure financial b/s is a little hard to take.
Charlie (grouchy german)
Insurance companies try to scare the hell out people by telling them that Medicare only pays 80% and the individual is left with the liability for the other 20%. What these snake oil salesmen try to keep from you is the fact that Medicare pays 80% of the "Medicare approved amount" and you are responsible for the remaining 20%. Not 80% and 20% of the regular charge!!!
I will offer 2 examples I am taking from the Medicare summary notices I get in the mail.
Last December I had a couple of x-rays done at Barnes Hospital in St Louis. Provider charged $69.00, Medicare approved amount was $17.38. They paid $13.63, leaving me to pay $3.47.
Back in March, I had a Zometa treatment at the same facility. Provider charged $1,703.00. Medicare approved amount was $232.51 of which they paid $182.29 leaving me to pay $46.50.
As you can see, $3.47 and $46.50 are a lot less than 20% of $69.00 and $1,703.00.
Along with a couple of generous grants from ACS and Patient Access Network, to help with the costs of Revlimid and Velcade, I am able to cover my medical costs out of my card playing money.
Your individual situation may vary but it pays to seek out the accurate figures and do the math before you get railroaded into paying for a bunch of coverage you don't need as badly as they want you to think you do. Why do you think the Insurance ads on TV try to talk you into signing up for extra coverage before your Medicare benefits start? It is because once on Medicare you will have access to the true figures and not be influenced by the scary numbers they throw at you to serve their purposes.
Hospitals have a hidden agenda too. They don't care how much you spend on insurance just as long as they can be sure they will get paid. They will help you secure grants if you qualify and these will take the edge off your co-pay for chemotherapy medications.
Nobody in this world woke up this morning with the thought on their mind of what they could do to help you or me unless they were a charity organization or loved one. Insurance companies don't qualify for those titles.
Forgive my caustic attitude but when one is already on the highway to hell, some of this high-pressure financial b/s is a little hard to take.
Charlie (grouchy german)
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Grizlump - Name: Charlie
- Who do you know with myeloma?: me
- When were you/they diagnosed?: June 2014
- Age at diagnosis: 67
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