I just received a letter today, as did many thousands I'm afraid, stating that the company my husband retired from is cancelling health care coverage starting 2009.Will it be possible for me to obtain a medigap insurance policy for him with his diagnosis of AZ? Do I take a cheaper policy since we won't be treating anything big, like heart disease or cancer. It's been 6 years since diagnosis, he is in a memory care unit (not a facility that accepts Medicaid) and as far as I can tell, he is in stage 6. The cost of this disease is killing me. I have to provide insurance for him now and for myself in 4 years. I think I need to see a lawyer about whether divorce is feasible so I can keep assets for my old age. This would be a divorce in name only, nothing would change as far as my visiting him etc. However, do I automatically lose my power of attorney and health care representative? This wouldn't bother me if I were convinced that his children were responsible enough to see that he got good care and that his wishes were carried out. At this time they can't even take care of their own families. I just feel that the secure retirement we saw 10 years ago is disappearing under more bills and less income to the point I worry about caring for myself. Does any one have any suggestions for me? I guess what I really want is both my power and my money. I'll probably end up with neither.
Medicare - This is one question I can answer. All of the medigap companies are REQUIRED to accept your husband no matter what his preconditions are as long as he had insurance from someone during the month that you buy the new insurance to start the beginning of the next month.
When we retired, my husband was already on Medicare and he had enough preconditions to scare the living daylights out of me including a pacemaker that was less than a year old. I was informed by the Blue Cross company I called that, of course she would set him up immediately. All she needed was the numbers from the current insurance card and a check to cover the first quarter's payment. We did everything over the phone and I sent her the check. His new cards appeared in the mail within a week with a start date of the first of the following month.
Now as for that divorce. We've been discussing that in another thread. Please read some of the recent threads so you can find the discussion. This is something I know nothing about, but basically from what I've been reading DON'T DO IT. But do find a good, certified elder care attorney. That facility is lying to you for one thing. And what you believe about saving your assets is also probably not true.
Wheatleygirl1 I can offer this suggestion. Yes, you will be allowed a Medigap policy if your husband has Medicare it has to be done in a certain time period of loosing your retiree coverage. Second, I would suggest looking into a facility that does accept Medicaid. If your husband is in stage 6 of this disease he most certainly would qualify medically. As the disease progresses will the memory care clinic you now have him in be able to handle the care? and if they do will it drain you financially, most likely it will. I would try to find a care facility that does accept Medicaid while you can still private pay, that way he will be accepted into a good facility, you will be set to apply for Medicaid when the time comes that you feel you need to. The sooner you apply the better off you will be financially. I hope this helps you.
The company I retired from did the same thing a about a year and a half ago. If you are referring to GM, I understand that your husband’s pension will be increased by $300.00 per month. In my case, a “Health Retirement Account” was established for me for about the same amount, and I can easily afford a Medicare supplement plan. I actually save money with Medicare and a supplement when I compare my current cost to my previous company supplied coverage. Medicare has a great interactive web site (www.medicare.gov) that allows you to input information and choose several plans to compare. Go to the home page and click on Medicare Health Plans – 2008 Plan Data and follow the prompts. This will be updated to 2009 data in the fall, prior to when you have to make a decision. Good Luck! DickS
Wheatleygirl1, the time period allowed to get the Medigap policy is 63 days. There are several different types of plans (A through what, K?) For the most part, a given type of plan offered by different insurance companies are alike in what they cover, they only differ in how much they cost. (A few companies offer versions that have very low premiums but also a very high deductible. These are clearly labeled at the Medicare website DickS mentions ... but you can assume if the cost is way low, it's a high-deductible version.) I've been looking for a policy for my husband. The best one I found was through USAA. This is a very good organization, and they do accept non-military for Medigap.
Jane, correct me if I'm wrong, but I think you will also need Medicare Part D, to cover his medicines. Again, the policies are pretty much alike, but they differ in the drugs that are on their formularies, which affects how quickly your husband will move into the "gap". The medicare website that DickS mentions now has an excellent tool for comparing Medicare Part D -- use the "personalized" form. You enter all your husband's drugs, dosage per day, etc, and it does all the calculations for you. Humana turned out to be best for us, and we could get that through USAA, too,(that's the coverage they offer for meds.)
Just one more thing. If you get a traditional medigap plan you can choose to get Part D from ANY provider. It doesn't have to be the same provider as the medigap plan. If you choose to get an Advantage plan, try for a PPO, not an HMO type plan. It is more expensive but you don't need permission slips to see a specialist. The Plan D is built in on an Advantage plan.
From what is on this thread, you have all the basics that you need to make a decision. Getting educated from here is easy. You are going to be fine.
Just a note here. I signed up originally through my employer for a PPO. I thought, for such a negligible amount of money in the difference, I too liked not having to get a referral. Then I started taking to people at work who had been hospitalized on the PPO & they switched to the HMO, because they ended up with all sorts of bills from the hospital with the PPO. With the HMO they had none. This was through Anthem. So you have to consider & know what the pros & cons are. I switched to an HMO after hearing the horror stories. Also found out they wouldn't cover some ER visits because the person hadn't been transported in an ambulance. One guy argued with Anthem, he said he had been trying to save THEM money to no avail, so he has never had someone drive him to the ER since.
I have an Advantage PPO. My husband has the original medigap plan, also a PPO. I literally NEVER see a bill or an explanation of how money was spent (except for some weird reason from my last Emergency visit and I think that was because I needed to send the Hospital a $50 co-pay). I see copies of EVERYTHING that the medigap pays for my husband both from Medicare and from his insurance company.
Go figure.
So far every doctor either of us has seen has been an in-plan doctor because it looks like all the major medical groups in this area take both the Blue Shield company (mine) and the Blue Cross company (my husband). The one exception may be my new therapist. They do take the Blue Shield company, but not the plan I'm currently on. They are in the process of asking my Blue Shield company how come they aren't on that plan too. It will be very nice for me if they succeed, but even if they don't I will have some coverage anyway since they already do business with Blue Shield.
As for Emergency, both of us have been covered for EVERY visit with both insurance companies even though I've only used the paramedics once. And that was not just with the Medicare coverages. I had a big deductible individual policy with Blue Shield before I was 65. I had a bad year and had more than enough medical bills to cover the deductible, so when I went to Emergency with a bad back it was covered.
And if you want to hear HMO horror stories I can give them to you. One year of fighting my way to a gynecological oncologist (I had two of the three cancers and an ovarian tumor). My husband wasn't allowed to go to a cardiologist after his pacemaker surgery so he was never set up for telephone pacemaker checks until 6 months after we moved to Pennsylvania. I didn't even know he was supposed to have telephone pacemaker checks. No knee surgery for me in California even though all I needed was minor surgery. Instead I used a walker for months followed by a cane for years and was on major pain meds.
Personally I will never go on another HMO until I'm penniless.
It could be the individual insurance plan or it could be the medical group you belonged to. I still don't know which of the two it was.
I, also, wasn't allowed to go to Emergency unless the paramedics brought me. So I literally arrived the first time the paramedics brought me unconscious. I'd managed to stay conscious long enough to unlock the door and choose a hospital, then out like a light until after I'd been in the hospital for an unknown amount of time. The second time I couldn't stand up, so I couldn't go to the doctor's visit that had been scheduled because I was in pain. Took three paramedics to get me out of the chair and on the gurney. In both cases I should have gone to Emergency days earlier.
No, VA. Your comment made me think, who in the future will be watching over ME? I watched over my husband throughout the cancer, like a hawk. But with the caretakers who are homebound, with no support system, who will be watching over them?
good question. i am asking that myself. i have mainly my son/mom/sisinlaw call to check on us but they are 3hrs away. i have no clue, none of his kids are on 'call' or even call to ask about him on a good day so i am on my own here. except for a backup aide i can call if needed. divvi