Insurance Question

[Aspiemom]

We have BC/BS insurance through my husband and it's a lousy plan. The deductible is $10K/ind. and $15K/fam. and our WEEKLY premium just jumped up to $230/wk, an increase of $100/wk.

My husband doesn't want to change jobs if he doesn't have to and isn't sure he could find anything better anyhow.

I'm on Medicare A&B, but my prescriptions are the problem. We've been looking into alternate private ins. plans for the whole family or something just for me to pick up the prescriptions.

Humana is coming to talk next week. Are any of you on Medicare and use Humana? What do I need to be cautious of? Do you have recommendations? I was thinking that I'd been told once that I should get the Advantage Plan or Gold Plus, but I'm not sure why that was.

Any advice, I would appreciate it. I'm going to post this in two forums to make sure it's seen.

*By the way, I don't qualify for any of the drug assistance programs. My husband "makes too much!" That's a laugh. I wish they'd look at what we pay and not just the income figure.

 

[NateJS345]

Depending on what state you live in, there may be an insurance program that is state funded. I know that in Ohio, the program is run from BCMH (Bureau of Children with Medical Handicaps). Indiana has a similar program. It is a health insurance that pays copays and basically what the insurance doesn't cover. The programs in Indiana and Ohio, the legislature made exceptions for adults with CF. Hopefully your cf center would know something about it. It was a pain to apply, but well worth it.

 

[RytheStunner]

Wow, that's an abysmal plan.

I only pay $150/month in premiums, and my deductible is only $500.

 

[triples15]

Wow, those are outrageously high! I'm sorry!! Our deductible is $3,300 and I thought that was bad, I guess you helped me put that into perspective!

I have Medicare parts A and B as well but don't know much about the Part D plans. I know there are a couple people on here who have part D plans that cover their prescriptions quite well. Jenn (justducky) comes to mind and I'm sure she'll have some good advice for you. I would think getting a part D plan would be a cheaper and better alternative than trying to go the private insurance route. When I was first getting on Medicare and trying to decide whether to take Part D I looked at plans and many had a fairly low monthly premium (ie. less than fifty bucks). There is a tool on Medicare.gov that helps you compare D plans and shows what meds they cover. That may be helpful for you.

Another thing I wanted to mention......when I was enrolling in Medicare my CF Social Worker said it has been her experience that the Advantage Plans don't tend to pay well on CF meds. She said her patients with "straight Medicare" tend to have better luck. So I'd maybe be wary of that. Maybe the social worker at your clinic would have some insight? I'm sorry I can't be of more help but just wanted to mention what I had heard.

Good luck to you!! Ugh, I wish insurance wasn't so complicated and expensive!

Autumn