Humana offers Medicare gap/supplement AND Medicare Advantage plans. They play on both sides.
I've got regular A & B Medicare plus a BCBS 'F' supplement that picks up what Medicare doesn't cover and Humana 'D' for prescriptions......mama has regular Medicare A & B and Omaha 'G' for her supplement and Humana 'D' for prescriptions.
Don't like paying the premiums on everything but I'm pretty sure that I'd dislike paying the full cost of doctor and prescription bills, if we didn't have insurance, even less......I reckon there just ain't no pleasing folks like me.
Don't like paying the premiums on everything but I'm pretty sure that I'd dislike paying the full cost of doctor and prescription bills, if we didn't have insurance, even less......I reckon there just ain't no pleasing folks like me.
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One other thing as a benefit for anyone preparing to sign up for Medicare. While Part A (hospital) is automatic, Parts B (physician) and Part D (prescription) require one to sign up.
When I first signed up, I was still working, so I figured that I didn't need Part B. However, if one doesn't sign up for Part B, when one goes to sign up later, one gets penalized every month for any months missed. Since I would have to "jump through hoops" to get a waiver for Part B, I decided to go ahead and sign up. Sadly, they didn't tell me that the same penalty plan would apply to prescription coverage. I had 14 months without prescription coverage, so we get to pay 14 months worth of penalties every month.
So, that said, if you are signing up for Medicare, sign up for both at the get-go.
When I first signed up, I was still working, so I figured that I didn't need Part B. However, if one doesn't sign up for Part B, when one goes to sign up later, one gets penalized every month for any months missed. Since I would have to "jump through hoops" to get a waiver for Part B, I decided to go ahead and sign up. Sadly, they didn't tell me that the same penalty plan would apply to prescription coverage. I had 14 months without prescription coverage, so we get to pay 14 months worth of penalties every month.
So, that said, if you are signing up for Medicare, sign up for both at the get-go.
I'm signing up for medicare for the first time and I've been studying up; there's a boat load of vids on youtube about the different plans.
Most say stay away from Medicare Advantage and go with a supplement or Medigap plan (they're the same thing).
With Advantage you have to go to one of the network doctors, and the ins co. decides what is covered.
With a supplement you go to any doc you want, you and the doc decide what you need and if it's covered by medicare then it gets paid.
Advantage looks good on paper, but there are a lot of horror stories out there about people getting really sick and not being covered.
Most say stay away from Medicare Advantage and go with a supplement or Medigap plan (they're the same thing).
With Advantage you have to go to one of the network doctors, and the ins co. decides what is covered.
With a supplement you go to any doc you want, you and the doc decide what you need and if it's covered by medicare then it gets paid.
Advantage looks good on paper, but there are a lot of horror stories out there about people getting really sick and not being covered.
All I can do is give my experience. I got really sick, was put on a ventilator to keep me alive and enough drugs to keep me out for almost a month and I was covered. Spent about another month recovering from that and while docs tried to figure out what caused it with even the CDC getting involved. They never did find the cause with everything from vaping to some weird bug being mentioned. They all had their pet theories but never could agree. Lots of docs and specialist (and cute nurses) all was covered. Medicare passed some new rules this last year telling them what they had to cover so make sure your info is up to date.
The OU group and Mercy group are both in network and that covers all my docs including specialist.
The OU group and Mercy group are both in network and that covers all my docs including specialist.
Maybe something's changed for the better, I'm glad it's working for you. Sucks to have to worry about money when you're sick.
Oh and I am not telling anyone to switch, but if you are on Humana and use the Humana pharmacy, check out the things I mentioned in the OP. Might as well get some of your money back.
If one has two medical policies as I did years ago, they received approval on one but failed to obtain approval on the other policy. End result was I owed tens of thousands of dollars because the nurse that was supposed to obtain approval didn't tell me that the one policy (Blue Cross) wasn't going to pay. This was at OU Medical Center and I took issue with the bill-naturally, and wrote the Medical Director. He apologized and the bill was reduced to a manageable $6,000.00.
The moral of the story is to be sure your insurance covers the bill as it's supposed to do.
The moral of the story is to be sure your insurance covers the bill as it's supposed to do.
You are basically gambling with your health with Medicare Advantage. You pay into a system all your life only to subcontract it out to a carrier that may or may not cover you. Here's the deal, if and when you get sick, you'll likely hit the out of pocket max anyways. Which you could have spent on premiums for a supplemental and had better coverage.
Also consider this, by far and large all Medicare Supplement Plans are the same (suffice a few that actually put networks on them) from any given carrier. The only difference is price. So a part F with Humana is the same as Part F with Cigna. The coverage is mandated by the government, so they can't back door you so to speak.
DO enroll in part D, even if you have no drug formulary or a small one. Make sure you check the website every year if you are on a lot of meds and it will keep costs down. Part D carriers are always changing. PM me if you have any questions, I can walk you through the website if need be.
IF you have coverage through your employer or your spouse's employer then you qualify for a SEP and you won't be penalized.
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