Topic: Personal experience with Medicare

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Posted on: Mar 31, 2011 01:44PM - edited Mar 31, 2011 01:45PM by nurse-ann

Posted on: Mar 31, 2011 01:44PM - edited Mar 31, 2011 01:45PM by nurse-ann

nurse-ann wrote:

I am being forced (a year early) onto Medicare because I am disabled.  I'm having a hard time thinking about giving up BC/BS to go with Medicare/United.  Can anyone out there tell me how easy they are to work with?  How slow or fast do they approve tests, chemos etc.

Dx 11/18/2006, ILC, 5cm, Stage IV, Grade 2, 15/16 nodes, mets, ER+/PR+, HER2-
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Mar 31, 2011 10:27PM dsgirl wrote:

Hi nurse-ann.

I have been on Medicare for 5 years, have had no problems with medicare payments to my providers. I do have a medicare supplement insurance as well, and feel that is important to have as it pays the medicare decuctible and the 20% medicare does not pay. The most important advise I can give is always ask the doctor/clinic etc, before making an appointment if they ACCEPT medicare and your supplement insurance. I have not had any out of pocket expense for surgery, radiation, etc. (did not have chemo).

The prescription plans offered for medicare patients can be expensive, due to the fact that it costs alot in monthly premiums to have a plan that covers all drugs, or if you pick a low monthly premium drug plan, the drugs you take, if not generic, are costly. Takes a bit of reseach at the medicare website to find a plan that fits your meds, but I advise you to check that out, it's easy to use and you can plug in your meds and plans available in your area will pop up, showing you the cost of each plan.

I had bc/bs before retiring and getting on medicare, and I always had a Blue Cross co-pay, so I prefer the medicare/medicare supplement plans I have.

Wishing you luck with whatever you chose

dsgirl

Dx 6/23/2009, IDC, 1cm, Stage IA, Grade 3, 0/4 nodes, ER+/PR-, HER2- Surgery 7/29/2009 Lumpectomy: Right; Lymph node removal: Right Radiation Therapy 9/14/2009 Whole breast: Breast, Lymph nodes
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Apr 1, 2011 05:36PM nurse-ann wrote:

dsgirl:

Thanks for the info.  I'm on Medicare May 1 and I believe that I have to have everything recertified - oxygen, chemo, etc.  I'm wondering how timely they are with approvals. 

Dx 11/18/2006, ILC, 5cm, Stage IV, Grade 2, 15/16 nodes, mets, ER+/PR+, HER2-
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Apr 1, 2011 06:02PM dsgirl wrote:

Nurse-ann.

I have never experienced any wait with medicare and my supplement ins., of course I was on medicare from the get go of b/c diagnosis, just be sure your team is in the know about the switch May 1, as it is all up to them to get the approvals for treatment, at least that is how it has been for me.  I have had a few other procedures since joining medicare besides breast cancer. Hysterectomy, zenker diverticulum surgery, 2 cataract surgeries, LE therapy, and all was done as scheduled and in a timely fashion, I live in a small town, so I "travel" for all major procedures, even my primary doctor is 76 miles away, and that's the closest one.

I hope someone that has been in active treatment during switch of insurance carrrier can answer to your question.

Best of luck

dsgirl

Dx 6/23/2009, IDC, 1cm, Stage IA, Grade 3, 0/4 nodes, ER+/PR-, HER2- Surgery 7/29/2009 Lumpectomy: Right; Lymph node removal: Right Radiation Therapy 9/14/2009 Whole breast: Breast, Lymph nodes
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Apr 1, 2011 11:17PM nurse-ann wrote:

Thanks again for the info - I'm most worried about chemo - its expensive and I don't want to miss any sessions right now - its a critical time for me.

Dx 11/18/2006, ILC, 5cm, Stage IV, Grade 2, 15/16 nodes, mets, ER+/PR+, HER2-
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Apr 10, 2011 02:28PM certified wrote:

I've been on Medicare since 2001  due to disability.  Medicare and my supplemental policy have paid for all my chemo.   I checked with the business office at my cancer center. 

 If you know what chemo you'll be on go to http://wwwneedymeds.org and look up the chemo drugs.  Many times you can get them free from the pharmacuetical manufactuers.  needymeds.org is an information site that connects you to the drug manufacturers patient assistance programs.  Your doctor will have to fill out part of the forms.

certified Dx 11/12/2010, IDC, 3cm, Stage IIIA, Grade 3, ER-/PR-, HER2-

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