My wife is currently covered by my insurance plan. However, with the economy the way it is, if I lose my job, I want my wife to have coverage. Currently she has been on disability and has Medicare Part A.
My question is should I enroll her in Part B and Part D in case I lose my job? I don't want to be in a situation where she is not covered.
If you lost your job, you could go on COBRA for what, 9 months? Find out how much Medicare Parts B & D would cost and figure out how you'd pay for it if you lost your job. AARP is probably the easiest to figure out online. Probably not doing it this year would be safe, IF you'd get COBRA, so take a little time to do it and until you see what your situation is. My husband has both B and D and did not, this year or last, fall through the donut hole, mostly taking generics. It costs I think $38 a month for Part D. I'm not sure how much B costs.
If you go to my home page - www.thealzheimerspouse.com - look on the left side, and scroll down until you come to the Medicare logo. Click on that, and it takes you to the Medicare website that can give you the answers to most any question. There is even a section for local help.
I think you have to be an employee with a company with a minimum number of employees to qualify for Cobra. When we were in business we just had 8 full-time employees including ourselves and we were not Cobra qualified. When we sold our business we went with Cobra for a while in the interm before being elgible for Medicare.
Ordinarily Part D has to be taken out in December for the following year but if change of employment were a factor they may have enrollment in the middle of the year. Maybe Jane can help you more with this.
I believe you have a certain number of months after you lose your job to enroll in Medicare and Drugs. They will backdate it to the date the insurance stops. I would recommend applying the day you find out you have lost your job. Imohr is correct about minimum employees for COBRA. Jane is our resident expert and can tell you what you need to do.
...maybe it depends on the state, or the insurance company, but my company was teeny-tiny and even after we were down to one employee (unpaid, me), we could offer Cobra. BUT!!! if the company itself goes under, then there is NO Cobra for anyone, even ex-employees who had gone onto Cobra before the company went under.
Guy, you might save money on your policy by having your wife on Medicare Part B. Check with your company benefits people.
The Government Medicare website now has excellent tools for figuring out the costs of Medicare Part D and choosing the most cost-effective insurance plan available in your area -- tailored to your specific situation, including the exact meds your wife is taking. They also have a similar tool if you want Medigap insurance.
When we retired my husband was already 65 and had only Part A. We got him on Part B (no Part D at that time) and got him a Medicare supplement for the month following retirement.
There is no reason for you to make this decision now. Your wife will be eligible to replace the coverage you are getting through your employer when she is notified that she will no longer be covered. The fact that she is currently covered saves her ability to be moved into new, private coverage at the time when the old coverage has been taken away.
There are different Medicare supplements and different Part D plans. The prices are different in different states, but you can get prices with no problem.
There isn't any urgent need to make the decision right now, but depending on who pays what, Guy might save a bundle by moving his wife off his policy and onto Medicare Part B plus Medigap, even Plan F. We saved thousands per year by doing that.
Yup, that makes sense Sunshyne. If there is a financial reason to make the change, do it. If you are moving her policy out of being scared that all coverage will be lost, there is no reason to be scared.
This may not apply here. When my wife turned 65 she was covered under my office policy. I still had a year to go before being eligible for medicare. We called the medicare office and were told we did not have to do anything until I switched to medicare. The next year, when I made the switch, my wife was told she could not enroll in medicare because she had not applied the year before. My office policy said she was not able to stay with them because she should be on medicare. It took a lot of arguing before the various insurance companies and medicare agreed to cover her. Since then my recommendation to anyone turning 65 is to apply for medicare, but ask to have it delayed until needed. Then at least you are on their records. I'm not sure how this works with disability.
When you are dealing with large companies, government or private, you are still dealing with people. People do not always have the right answer and can cause us lots of headaches such as Marsh has.
I would suggest that you put her on Medicare B now (open season ends 12/31) and pay the $96.40 per month and continue to keep her on your insurance.
Medicare A and/or B will pay first and your insurance will pay secondary.
My husband and I both have both Medicare A & B and we kept his work insurance and use it as a Medicare supplement. It has a drug benefit so we don't need Part D. Between Medicare and BC/BS, the only out of pocket expenses we have ever had were med co-pays. The combined premiums are expensive but when one recent ER visit including ambulance, xrays, CAT scan, doctors, etc. was $1600, it's worth it. He has also had several hospitalizations and we have had no out of pocket expenses.
I think I will get Medicare Part D and Part B. I was able to go through the Medicare site to sign up for Part D, but not for Part B. Not a very intuitive site.
Doesn't enrollment for Part B start on Jan. 01-09?
Medicare Part B is a Government program -- one size fits all. If your wife receives Social Security, you can have the cost deducted from that.
Medicare Part D policies are issued by private insurance companies. They have the same general coverage (sort of) but the details and the costs can vary wildly. That's why you need that special tool, to help you compare the actual costs. You are allowed to switch policies once a year, that's why there is an "open enrollment" period. Ditto for Medigap policies. (Medigap provides additional coverage over and above what Medicare covers. Medigap policies are also issued by private insurance companies.)
Some stuff from the Medicare website re eligibility etc. (Look in the yellow menu on the left of the Medicare site to find more info.)
Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:
* You are receiving retirement benefits from Social Security or the Railroad Retirement Board. * You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them. * You or your spouse had Medicare-covered government employment.
If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
* You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig's disease, your Medicare benefits begin the first month you get disability benefits.) * You are a kidney dialysis or kidney transplant patient.
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.
If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, call the Social Security Administration or visit their web site . The toll-free telephone number is: 1-800-772-1213. The TTY-TDD number for the hearing impaired is 1-800-325-0778. You can also get information about buying Part A as well as Part B if you do not qualify for premium-free Part A. See also our FAQ on how to enroll in Medicare (below).
FAQ: How do I enroll in Medicare?
The Social Security Administration handles Medicare eligibility and enrollment. You can contact the Social Security Administration at 1-800-772-1213 to enroll in Medicare or to ask questions about whether you are eligible. You can also visit their web site at www.socialsecurity.gov.
General information about enrollment in Medicare is provided below. Our other FAQs Who is eligible for Medicare and Should I sign up for Medicare Part B? may also be helpful to you.
IF YOU ALREADY RECEIVE BENEFITS FROM SOCIAL SECURITY:
If you already get benefits from Social Security or the Railroad Retirement Board, you are automatically entitled to Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) starting the first day of the month you turn age 65. You will not need to do anything to enroll. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If your 65th birthday is February 20, 2004, your Medicare effective date would be February 1, 2004. (Note: if your birthday is on the 1st day of any month, Medicare Part A and Part B will be effective the 1st day of the prior month. For example, if your 65th birthday is February 1, 2004, your Medicare effective date would be January 1, 2004.)
IF YOU ARE NOT GETTING SOCIAL SECURITY BENEFITS:
If you are not getting Social Security benefits, you can apply for retirement benefits and Medicare online. If you would like to file for Medicare only, you can apply by calling 1-800-772-1213.
The online link is: http://www.socialsecurity.gov/applytoretire
IF YOU ARE UNDER AGE 65 AND DISABLED:
If you are under age 65 and disabled, and have been entitled to disability benefits under Social Security or the Railroad Retirement Board for 24 months, you will be automatically entitled to Medicare Part A and Part B beginning the 25th month of disability benefit entitlement. You will not need to do anything to enroll in Medicare. Your Medicare card will be mailed to you about 3 months before your Medicare entitlement date. (Note: If you are under age 65 and have Lou Gehrig's disease (ALS), you get your Medicare benefits the first month you get disability benefits from Social Security or the Railroad Retirement Board.) For more information about enrollment, call the Social Security Administration at 1-800-772-1213 or visit their web site. See also Social Security's FAQ: When should I sign up for Medicare benefits? which explains the enrollment process.
This has a link to the Social Security FAQ page: http://ssa-custhelp.ssa.gov/cgi-bin/ssa.cfg/php/enduser/std_adp.php?p_faqid=166
It is my understanding that if you are under age 65 and you are Disabled , you have to wait 2yrs from the date that your recieve your SSD benefits. I left my job to care for my wife, I was on the road 4 nights a week. I am paying out of pocket $850.00 per month for COBRA but it will last only 18 Months, I am not sure what is going to happen with the 6 th month gap. I find out this September.
Welcome to my website. You are absolutely correct about the 2 year waiting period. That is at the top of the Alz.Assoc. priority list when we go to the Washington DC Forum next month. We have lobbied hard to get that waiting period waived. The reason it is not waived is because most lawmakers are not aware of Early Onset AD. They think it is just an elderly disease, and since the elderly are already on Medicare, they don't see a problem. We are working tirelessly to get it changed.
Please be sure to log onto the home page - www.thealzheimerspouse.com - and scroll through all of the resources on the left hand side. Look at the EOAD section for those under 65, and scroll through the previous blogs. I am sure there will be many topics to which you can relate.
Check out the "Welcome New Members" section on this board - post a little about yourself if you would like. We're sorry for the reason you are here, but you have come to the right place for support and information.
Another reason for signing your wife up now for Part B--every time you delay and miss an enrollment period, the premium goes up by 10 percent. I wasn't sure my husband would need the Medicare coverage, since he is covered on my health plan for retired Federal employees. However, in light of the increases in premium if you wait, I decided to sign him up for Part B as soon as he was eligible.
I continue to work and cover my husband on my group coverage at work. I opted to turn back Part B coverage for my husband and continue him on my policy. I save the 100 per month but the biggest reason is that I was told by insurance representative for senior services in my state that since my insurance was better, there was no sense in keeping his Part B. He is under 65 so any supplement plan or drug plan would be very expensive. Since he is covered by a plan that is at least as good or better than medicare part B he will not be penalized when I leave work and he no longer has coverage. I have since verified this with Medicare and with my insurance benefits coordinator. Also, my employer sends out a notice each year that states we are covered by Creditable Coverage which is all you would need to not pay increased rates if you signed up later. You are correct that while SSD can start you still have to wait 24 months for Medicare. The problem there is that a supplement plan for someone under 65 can be expensive if you can get one. I'm sure others can add more details but this is one area I understand. I had really looked forward to my DH getting Medicare because I thought it would allow me to quit earlier but with the cost of decent health care thru the roof, I had to re-evaluate. AS it turns out , I am glad I have been able to stay working. It really helps me to have a somewhat normal life away from home.
I need someone to hold my hand. Since my husband's company is no longer going to pay in part our insurance, I need to apply for Medicare. I had declined Part B in the past since insurance was part of his retirement benefits. For us to keep our insurance as it is would be over $1200 a month for medical & prescriptions. I am assuming that going through Medicare for him would be less expensive...is this true? I am healthy, so I shouldn't have any problems getting insurance on myself. I can also stay on the insurance that we have now, paying the premiums. I called the SS office today, they are sending the necessary papers to apply, since his insurance is stopping, he would pay no penalty, I would just need to take the papers to his former employer to confirm he had lost his insurance. I hate feeling so stupid, however, I have no idea how Medicare works. I have been reading the past post. I also, will be reading the booklet sent from Medicare that I never thought I would be using. All this scares me, I have never handled insurance in the past. Damn economy anyway, I thought we would be fine until at least he turned 62 years old, when I knew his insurance benefits would end. I have until March 27th to make some sort of decision. I don't even know if that is enough time to complete this process. HELP!
Kadee-- A few basics on Medicare. Once accepted, Part A covers hospitalizations--no premium, has co-pays Part B covers Drs. office visits, out patient, durable medical equipment, etc. premium this year $96.40 deducted from his Social Security. Co-pays Part D--Prescription coverage--multiple policies in each state to pick from--some have deductibles, some have premiums, most if not all have co-pays. The Medicare site has a place that can help you pick the best one for you.
ID cards are provided, which you show as needed at time of service. Medicare is billed first, then you get billed for any copays, though some providers have a way to know what Medicare will be paying and can bill your co-pay immediately. Medication co-pays are due when you pick up meds.
Kadee--Part A of Medicare--Hospital Insurance--is free. Part B--Medical Insurance--runs just under $100 per month. I'm not sure of the Part D (prescriptions) cost, but I'm sure someone else can advise you. Social Security will send you a Medicare Handbook, and I think it's pretty user-friendly.
Another reason I opted for the double health insurance coverage for my husband was that I read a report given out by the Alz Assn that compared hospitalization costs for a dementia patient vs. someone without dementia. In other words, they compared an individual with dementia having, for example, an appendectomy vs. someone without dementia having an appendectomy. In each case, the expenses for the person with dementia were significantly higher. Also, I don't know what the costs are if someone with dementia has to be hospitalized on an emergency basis to have psychological issues addressed--i.e. getting paranoia or hallucinations under control. Of course that doesn't happen in all cases, but it isn't outside the realm of possibility. There is another thread that deals with the emergency situations and perhaps the others who have been through it can give an idea of the cost involved, and whether Medicare or another type of health insurance covered it.
Kadee Everyone has already given very good advice and you may feel comfortable moving ahead. But I remember being in your place and feeling overwhelmed with the decisions I had to make re: insurance ,finances and care. Even though I use a computer in my work I still felt some what inadequate in getting all the information I needed from a web site. I kept second guessing myself and asking myself too many questions. I wanted a real person to talk to . After some calls I learned that our local Agency on Aging has specialist who gets the training needed to help seniors navigate through the Medicare process. ( At that time my husband was only 60 ) I found it very helpful to ask my questions to a person who could provide the reassurance I needed to do the best thing for us.She was also able to send me select copies of information so that I could see and keep things in print. You may want to call both the nearest Agency on Aging, and your local Alz. Ass.( although mine was not helpful) Every state also has a state office that can direct you to representatives that can provide information. I can hear in your words that you are feeling the weight of having to make these decisions and so I urge you to reach out to try to talk these decisions over with individuals in your own area. Your needs are individual to your situation and we here can only make general suggestions.
Please know that the decision making gets easier as time goes on.
Kadee, I sympathize with you. I also found this process intimidating at first. If you hang in there and take it a step at a time it does somehow come together. There is nothing more I can add to the great advise above, just hold your hand. You can do it! M
We both have Medicare Parts A and B. We also kept his BC/BS after he retired. We pay about $350 for both of us. It has a great prescription plan with low copays on our meds and no "donut hole".
Medicare is primary and BC/BS as secondary pays whatever Medicare doesn't. The only out of pocket expense we pay is the medicine copays.
With Medicare, you really need some type of supplemental insurance to pick up the balance. 20% may not sound like much, but it really adds up when you're faced with a horrendous bill. As an example, Claude's open heart surgery in 1991 cost $50,000. 20% would have been $10,000 for us to pay.
That figure was from 18 years ago!!! It probably would cost $250,000 now.
Kadee, once Medicare is in place, it works like regular insurance. The doctor or hospital will send the bill to the appropriate agency, and then after the bill has been settled, will send you a bill for anything left over.
Some people buy a "Medigap" insurance policy, to cover the big stuff. Medicare has a good web site on Medigap policies ... eligibility requirements, the different types of plans that are available, and a tool for helping you pick the plan that's best for you.
http://www.medicare.gov/medigap/Default.asp
There are several basic types, A through something like K. So first, decide whether you want any extra coverage and, if so, which type. (My husband has Plan F.)
Once you've decided whether you want Medigap and, if you do, which type of plan, then you pick out the insurance company. The basic types of plans cover exactly the same thing, no matter which insurance company offers them. This online tool makes it very easy to pick the policy that costs the least in your area. (Note, when you're working with this web-site tool, that some companies now offer low-premium versions. While the premiums are much lower, you do have to pay more for the doctor/hospital services. So be sure you know which one you're buying.)
I found out that the best deal in my area was USAA, which is a great way to go if the premiums are good in your area.
Then Medicare also has a good, online tool for finding the very best Medicare Part D "deal" for your particular situation. Medicare Part D is for medicines ... they are not covered under Part A or Part B or Medigap. Go to:
http://www.medicare.gov/pdphome.asp
This has a bunch of useful links. To use the tool, click on "Medicare Prescription Drug Plan Finder, which used to be the 5th in the list in the center of the page -- I assume it still is.
Upper left, you'll see "Find & Compare Plans that Cover Drugs. Click on the "Find and Compare Plans" button.
Use the Personalized Plan Search.
It will ask you to enter each drug that your husband takes, the dosage (including how many times a day), etc., so have all that info ready. It will also ask where he lives, because different plans are available in different areas. When you've done that, it will generate a list of all of the plans in your area, and how much each plan will cost for a full year including the monthly premiums and out-of-pocket for the meds. If they allow you to order 3-month supplies by mail, they'll show the costs savings for that, too.
You can click on links to the different providers to learn more about them, and get all sorts of other info, too.
(It is really too neat, SO much easier than trying to figure it all out yourself.)
Thank you do much to everyone who responded to my post. I am printing off every word so I can read more carefully. I do have a question, how long will it be until this coverage will take in effect? Our insurance from retirement ends on March 31st. I also need to find myself insurance. I hate to sound stupid, however, since I have never purchased personal insurance, how do I go about obtaining?
Kadee - good luck with all of this. When you are filling out forms for Medicare, there should be a section that allows them to forward the balances of what they do not pay to the secondary insurance carrier. Make sure you get that information in if you can - life is so much easier if you don't have to handle all the forms. Ours is now sending quarterly statements so less paper!
Kadee -- My daughter just had to buy her own health insurance. She went through an agency that gave her a listing of different BC/BS products to chose from (she got a PPO that costs about $190 a month) and the agent went over them with her. You can also check out www.ehealthinsurance.com At the website you put in your basic info and it will give you a summary of plans that are available. Maybe you could also check with your car insurance, homeowner insurance or life insurance agent and see if they handle health insurance.
Kadee, I just saw your post and want to make one comment. I do not know your husbands age, remember if he is within six months of turning 65 he will only have 6 months from the time he gets Part B Medicare and turns 65 for an open enrollment for a Medi gap policy, this means no health questions asked for a supplement to Medicare. If he is not yet 65 and is disabled he also will have an open enrollment from the time he goes on part B to get a disability medicare supplement policy and then will still have the age 65 open enrollment to change if he needs to.
Another source of help to investigate services in our area is the social service dept of the hospital. Staff there are "up" on medicare, supplements, Rx plans, etc. and can work through info on the computer with individuals. I used my computer at home to review everything through the Medicare site, then reviewed it again w/staff at the hospital. Of course, I don't know whether all hospitals provide this service. Best wishes to you in your search.
My husband was approved for SSDI under the compassionate allowances for FTD last week but he still has to wait the two years before he can get Medicare.
It took us 60 days from applying to Social Security to getting approved. I was surprised that it went so smoothly. I think it might have been helped by the fact when I applied I included a copy of every medical record I had plus a copy of anything I could find on FTD from the Social Security website regarding the disease and the new compassionate allowances for it. The woman who handled his application said that it had been approved through the compassionate allowances and asked where I got all the information on FTD I had included. She was surprised when I told her it all came from their website.
Sunshyne, I did check out the website you suggested. I was thinking, however, was not sure, but SSDI is for folks who draw very little SSD, that is not the case with my husband.
I am still freaking out over this insurance deal. I just thought of something that I am sure everyone knows...and will think I am stupid, however, here's my question. After I decide which prescription & supplement medical plan, do I contact them to enroll? How does that work? A Big THANK YOU !
Kadee-you are doing an awful lot that is new to you. You are not stupid. I chose the AARP supplement and drug program with just a phone call. I found the company very responsive and easy to deal with. Like you-it was all new to me. If you select a cross over supplement you don't even file forms. I found when making doctors' appointment if I told them I had MC and AARP I got in right away because they know they will be paid. A friend who works in a doctor's office confirmed this. Slow down lady-you're doing fine.
Thanks bluedaze! I know I am not stupid, but boy I do feel that way. I feel like a little kid that just doesn't want to do something. I Want MY Mommy! I thought I was doing pretty good dealing with dementia, then something like this comes up & I just don't want to deal with it.
Kadee, you are doing all right...I also chose the AARP supplement and drug program...was easy and they were great on the phone. They sent me a form to fill out is all. All of DH's doctors and even the hospital get paid righ away. Hang in!
SSDI is social security disability insurance where the amount you receive depends on how much you have paid into social security. SSI is Supplemental Security Income which is for low income, poor people.
Kadee-if there is a Social Security office near you it might be easier to just go there and let them walk you through the process. You can call for an appointment so you don't have to wait around. Ask what paper work they will need you to bring. Sometimes in this computer age it is still easier to have a face to face meeting.
that is what i did, took DH with me and had all the paperwork. the lady saw he had issues and rushed it thru pretty fast. they sure had alot of paperwork to bring in though. even prior divorce papers! it worked well face to face. divvi
Deb, Yes my husband is on SSD, his 2 year waiting period is over. I did talk with the SS office & they sent the necessary papers to complete & return for Part B. He already has Part A with no charge. I now just need to decide which plan would be best for him. And find myself coverage. Still don't want to handle this, however, I will put my big girl panties on and do it.
Kadee; I'm glad you are feeling a little better and I hope things work out well for you. My husband is also under 65 and that adds a problem when you start looking at additional plans. Perhaps your state will be different than mine but the only insurers who offered plans for persons under 65 and on Medicare were outrageously expensive. Just please be sure as you look at options that you make it clear your husband has not reached 65. I wouldn't want you to be surprised finding out the cost was too high. Good luck with your search.
AARP was a lot more expensive than the USAA medigap or the Humana Medicare Part D, at least, where I live.
Kadee, any company will make it easy for you. You can apply right there on the Medicare website (I did that with Humana) or by phone (I did that with USAA and they were super nice and friendly.)
I know all of this is scary, but hang in there. Really, most people have been in your shoes at one point or another. They all understand this is difficult for you.
Ask lots of questions, ask them to repeat if you don't understand.
Sunshyne, My father-in-law has Humana, so I have been considering that. I didn't find anything in the booklet about USAA. I live in Indiana. There are more than one Humana though.