Insurance

Discussion in 'Health & Wellness' started by Cody Fousnaugh, Feb 20, 2020.

  1. Cody Fousnaugh

    Cody Fousnaugh Supreme Member
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    Do you have all the insurance that you need? Pension medical (if getting a Pension), medical (Medicare), vision, dental, VA (Veteran/Dependent) and Rx Plans.

    Right now we could both use vision and dental. When my wife was working, we both had from her company, plus my VA, both on Medicare/Supplement and Rx Plan. However, when she quit the company, to move back to Colorado, we didn't keep the vision and dental due to the cost of both.

    Due to us being Diabetic II, we get a free eye exam once a year from Medicare, but Medicare will not pay anything for new lenses or glasses. I will get an exam, but won't need glasses again due to my laser cataract surgery I had in 2018.

    Our teeth aren't really bad, but having dental insurance would be nice.

    BTW, I do not qualify for dental thru the VA.
     
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  2. Bill Boggs

    Bill Boggs Supreme Member
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    No, I've never had enough insurance. We set priorities based on our incomes and sometimes there nothing left over for insurance
    that we don't think will be worth a darn if and when we needed it, so we go on operating by the seat of our pants until we luck out
    or tragedy strikes or we buy what seems most needed. I hope you have fared better Mr Fousnaugh.
     
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  3. Cody Fousnaugh

    Cody Fousnaugh Supreme Member
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    Well, we pay $550 each, per month, for Medicare, Supplement and Rx Plan, plus the yearly deductible for Medicare and the Supplement. I get all of meds from the VA, of which we have to pay a co-pay for the meds and anytime I see my VA doctor. So, that is over $1000 total (both of us) per month in premiums. Seems like on a yearly basis, in January, both Medicare and the Supplement go up in monthly premium and deductible.
     
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  4. Cody Fousnaugh

    Cody Fousnaugh Supreme Member
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    We are very seriously thinking about the dental plan/Rx plan that we seen online. It's $17 each. We would still have to pay something, like 50% of the cost of different dental procedures, but 50% is much, much better than 100% without any dental insurance.
     
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  5. Beth Gallagher

    Beth Gallagher Supreme Member
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    Our insurance is confusing at this point; we begin Medicare with an employer supplement next month so hopefully we have it figured out. I was pissed to learn that because of an IRA NUA rollover last year, our Medicare premiums will be $290 a month each instead of $145. I assume that will revert back next year since they re-evaluate income annually. We do have Rx, vision and dental included with the supplement, and neither of us is a veteran.

    The supplement has a $3000 annual out-of-pocket limit, so in case of devastating illness the most we'll pay is $3000 plus the Medicare deductible. All of the supplements, advantage plans, etc. are so confusing.
     
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  6. Ken Anderson

    Ken Anderson Senior Staff
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    I just changed my Advantage plan to one that includes dental and eyeglasses. It doesn't come close to paying full-price for dental but with the sliding scale at our dental clinic, it makes it more affordable, and it does pay most of the cost of one eye exam a year and it covers more than I usually pay for eyeglasses. I have zero copays for most things, I pay nothing for prescriptions, and I am allowed more than $100 for off-the-shelf medications. Where my biggest expense comes in, I think, is in lab testing. Both the hospital and doctor's office sends out for lab testing and my plan doesn't cover much of the costs. I've been questioning the lab tests as to the necessity and refusing some of them.
     
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    Last edited: Feb 20, 2020
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  7. Yvonne Smith

    Yvonne Smith Senior Staff
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    We have the Humana Advantage plan, and it includes vision and dental benefits, as well as transportation to doctor appointments if needed, Silver Sneakers membership , and even over the counter meds free each month.
    Bobby also has the VA doctors, but we mostly use the ones that are accepted by our Medicare plan.
     
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  8. Al Amoling

    Al Amoling Veteran Member
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    My Medicare advantage plan has copays of $35 for specialist $10 outpatient diagnostic tests. Generic drugs free. My one brand drug is $105 for 3 months. Wife's plan(not advantage plan) covers all her meds and doctors/hospital cost for $300/month.
     
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  9. Cody Fousnaugh

    Cody Fousnaugh Supreme Member
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    We just bought a year plan (discount card) from Aetna that has: dental, dental Rx, vision and hearing. It isn't insurance, so we have no deductible to pay per year. The plan, for a year, cost us $179 for both of us. One thing for sure, having discounts on things sure beats the heck out of paying full price.

    I still have to get a Medicare PCP, which will most likely be the PCP my wife uses. He will be my back-up if I can't get into see my VA doctor for something. I have found that trying to get an appointment with a VA doctor can darn near be impossible. That is, in-between the normal twice a year appointment that is already scheduled.

    I wanted to stop my Medicare, Supplement and Rx Plan and just go with my VA, but my wife didn't like that idea at all. Actually, the last surgery I had done thru the VA was in 1988. I wanted to save us money, but my wife told me this, "in the long run, we wouldn't be saving money by you only having the VA. Medicare is a guarantee "pay out" whereas the VA has to qualify a Veteran for almost everything before paying for anything.
     
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  10. Von Jones

    Von Jones Supreme Member
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    I'll be eligible for Medicare in a couple of years and planning ahead.
     
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  11. Ken Anderson

    Ken Anderson Senior Staff
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    They make it sound like it's the most important decision you could ever make but, in actuality, whatever you choose, it's only for a year, and you can switch to something else if you want to, or if your needs change. I've changed plans every year. This time, I stuck with the same company but switched to a different plan because the cost, to me, was pretty much the same, only it offered more of what I'd use. If you find out that you're paying out of pocket for something on a regular basis, you can look for a plan that covers that more completely.
     
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  12. Hedi Mitchell

    Hedi Mitchell Supreme Member
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    Geez .$135 a month advantage plan for us...why do you pay so Cody...sounds like a rip off.
     
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  13. Von Jones

    Von Jones Supreme Member
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    So from what I've read the supplement replaces Part B (office visits, etc.) or you can elect to pay for it and have the supplemental insurance?
     
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  14. Ken Anderson

    Ken Anderson Senior Staff
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    I think the main choice is deciding between a Medicare Supplement or a Medicare Advantage plan. Because my wife sees a lot of specialists and takes a boatload of medications, a supplement worked best for her, while I have the advantage plan.
     
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  15. Beth Gallagher

    Beth Gallagher Supreme Member
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    The supplement does not replace Part B, Von. Medicare A & B cover 80% of health care costs (doctor and hospital), so the medicare recipient is responsible for the remaining 20%. Most people carry a supplemental policy or buy an "advantage plan" to help cover those expenses. Here's some info on Advantage Plans... https://www.medicare.gov/sign-up-ch...ge-plans/how-do-medicare-advantage-plans-work
     
    #15
    Last edited: Feb 20, 2020
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