A quandary...Medicare

Insurance is for the unexpected as well as expected expenses. For example, what if you were in an auto accident?

I’ve been paying for home insurance and car insurance for more than 30 years and have never made a claim on either. But if my house had burned down, or if I had been in a bad accident, I would have been grateful for the insurance.

All insurance is a gamble, and only you can decide what is most important for you.

I am a little confused by your rational. If you are going on medicare and medicare is your primary insurance, you really need Part A and Part B. People who don’t take Part B normally do so because they still have an employer based plan that overlaps with Part B benefits. It sounds like you can skip or take very low cost other additional plans such as Part D and you may be eligible for a Part B discount with low income status.

I have Parts A,B,D and only see my endo twice a year, take very low cost Part D and buy my insulin in Canada to bring back to US.

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I am not sure that is really true when you talk about Medicare Part B as we age into the Medicare group it is a certainty that that we will from time to time need outpatient services and these keep getting more and more expensive.

Medicare Part B covers the outpatient services. I despise insurance and have never taken collision on even my new cars, have no life insurance and just a lot of liability insurance but otherwise am pretty much self insured. Part B is one of the very few coverages that I would not skip.

Yes, and the part B charges also keep getting more and more expensive.

I learned from experience that trying to save money may be foolish in the long run. When I had to pay for my own insurance, I had a $10,000-deductible policy. I figured I could slowly pay back up to $10,000, but if I got a brain tumor or had a stroke and ran up hundreds of thousands of dollars in expenses, I couldn’t.

So I had to pay for my own lab tests, and I found I was rejecting tests for that reason. The last time before my diabetes Rx, I said I didn’t want the standard tests. They had always been normal. But if I’d had those lab tests, I might have learned I was prediabetic, and I could have controlled things before they got worse. At Dx my BGs were in 300s and 400s. Unlike type 1, which comes on fast, type 2 comes on slowly, so I’d probably had those high numbers for months and they probably helped to destroy my beta cells.

Now I realize my health is more important than money.

I’d recommend that you get the Part B, despite the cost.

If you don’t sign up now, then decide to sign up later, your premium will be higher.

Medicare Part B Penalty

If you sign up late for Medicare Part B, you will have to pay a late penalty premium every month for the rest of your life, along with your Part B premium. Your monthly Part B premium will go up 10% for each full 12-month period that you could have had Medicare Part B but did not take it. You will pay this higher premium as long as you have Medicare Part B.

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Additionally, not having Part B precludes from having any of the other Medicare options you may or may not need or want in the future except for Part A

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On Medicare, I think you’ll still get free insulin from NovoCare and LilliCare programs. You’ll just need to meet the spending requirement for out of pocket for the programs. So On Jan 1 one goes to WalMart or other pharmacy with scripts planned out to total over $1100 out of pocket, have them print out the proof of your actual spending that you’ll return to the pharma programs, and then you’ll meet that program criteria. It is not so that being on medicare denies you getting it free. Once getting it free the pharma’s require you to notify your medicare company to NOT cover that free med any more during that year. SO what – it doesn’t matter. No big deal about that. One of the qualifying conditions will be that you just need to meet the min out of pocket. That’s the work around for being on Medicare to get the patient assistance on the insulins. Call them on phone to see.

Either way you use so little insulin that the cost is not a major concern. . . What are we talking about? There are many other possible issues and risks. I am a little confused about your situation.

A good general rule is: Very foolish in most instances for somebody to not get Part B if possible, or to not go with the advantage plan - I wouldn’t skip something here for coverage myself. But, I cannot advice you personally. Every situation is different.

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Hello!
I don’t spend 1100 on my insulin a year.
Currently I get my insulin free due to my financial situation.
Even if I do pay for my insulin (should I lose the privilege of free it would add up to 600.00 per year.
I am MDI.
So I don’t understand how to do this with the way you mentioned.
Thanks.

Yes.Iunderstand.

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Yes. Aware of this.

Thank you.

Thank you for your response.

Thank you for your thoughts.

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I am not sure whom you are replying to with this quote but if there is anymore I can help you with, just let me know. It sounds like PartA+PartB+very cheap ($14/month) Part D might be best for you. I am on medicare and MDI but do not qualify for any low income programs.

Make an Excel sheet with all your options and costs and then keep a copy of the Excel sheet as there are annual changes in either your status or the various Medicare programs. By keeping the spreadsheet, you will save a lot of time in future years not having to research and read everything about each option in subsequent years. The first year is the tough one to pull it all together.

Not getting Part B is an error in judgement, IMO. You NEVER know what is going to happen. I had surgery that was billed for a quarter million dollars last year. medicare coverage reduced MY liability for that hospital stay/surgery to ZERO. This coming week I have an unexpected, possibly life-changing surgery scheduled. I’d be freaked out with good cause if I didn’t have Part B.

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@Dave44 I’m sorry to hear that! I hope everything goes well!

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Thanks. I won’t know until I’m in recovery, what the prognosis will be.

I’ve had a variety of surgeries and only one resulted in an awful result, despite assurances from the surgeon (cocky) that my hearing had been preserved. I was so wrapped up in a huge dressing that I wasn’t quite sure if I could still hear or not, but I did end up totally deaf in the ear that was operated on. Even after that, he claimed that after swelling went down I might hear again within the next few months. Basically he gave me false hope which I still feel was a cruel thing to do.

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I agree with others that Nature Orbs would be making a big mistake by not getting Part B. By the time we’re eligible for Medicare, our bodies are aging…and no matter how well we’re aging, things happen.

I recently had to have both knees replaced. It cost me ZERO! I would not be able to walk by now if I didn’t have the insurance.

To Dave44- I wish you the best of luck on your surgery. Please post and let us know how you’re doing.

Ruth

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Will do. I’m hoping that my worst fear won’t come true on this.

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@Dave44 Hugs, best wishes, thoughts, and prayers your way.

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