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Lolly · 06-23-2006, 09:38 AM

“…One more question: on another post you mentioned "Medicare supplemental" do you mean the new government program or a private outside insurance?
I am currently living in France but may be moving back to the USA. I am on Herceptin here and have been approved for disability with social security. As part of that they gave me Medicare hospitalization. I am trying to find out if I will be covered for Herceptin and exactly what I'll have to do to be covered. You can understand my concern. Hence my question about "medicare supplemental." Thanks.
Sarah”…

Sarah, it’s gotten kind of complicated, but here’s what I understand of the system; however, you should definitely check things out for yourself by going to Social Security and Medicare’s on-line sites. Links below.

Medicare coverage is a multi-layered program, and the first layer is what you have, Medicare Hospitalization or Part A and which is automatic once you’re on Social Security; there’s no premium for Part A, but it ONLY covers hospitalization, and there are co-pays for that.

Then there’s Part B, which is optional and which I believe costs under $100 a month. The premium is automatically deducted from your monthly disability payment once you’ve signed up. It covers your doctor’s visits and tests, and some prescription meds, but only the one’s administered in your doctor’s office like infused chemo’s(Herceptin included, as far as I know).

Part D is the new prescription plan, and here’s where the medicare supplemental comes in: You can buy into a Medicare Supplemental Insurance Plan, and there are many available, and these plans will pick up a lot of the costs Medicare doesn’t cover. You just have to look at the various ones that offer coverage in the state(s) you’ll be locating to, choose your best option, and sign up. Each supplemental plan usually has additional drug coverage which will cover most prescription meds not covered under Part B. Most of the supplemental plans are quite reasonable. My dad’s total cost for Part B and his supplementals is under $200 a month. Additionally he has a $10 co-pay each time he sees his PCP and a co-pay for his prescriptions, which as I mentioned will vary from one plan to the next; this brings his monthly medical expenses up to around $300 right now.
It helps if you can get some advice from an insurance person; I went to several seminars given by some of the companies offering supplemental programs in our area to help my dad figure out which one would be best for him. You can also call customer service for each plan you’re considering and ask for an information packet to be sent to you.

This is just the basic outline of how the programs work, but you’ll have to do some research to decide what’s going to work best for you. Here are the links to Medicare and Social Security, in case you don’t’ have them:

http://www.medicare.gov/Coverage/Home.asp

http://www.socialsecurity.gov/mediinfo.htm

Hope this helps somewhat J

<3 Lolly

06-23-2006, 09:38 AM	#9
Lolly Senior Member Join Date: Aug 2001 Location: Oregon Posts: 1,756	clear as mud “…One more question: on another post you mentioned "Medicare supplemental" do you mean the new government program or a private outside insurance? I am currently living in France but may be moving back to the USA. I am on Herceptin here and have been approved for disability with social security. As part of that they gave me Medicare hospitalization. I am trying to find out if I will be covered for Herceptin and exactly what I'll have to do to be covered. You can understand my concern. Hence my question about "medicare supplemental." Thanks. Sarah”… Sarah, it’s gotten kind of complicated, but here’s what I understand of the system; however, you should definitely check things out for yourself by going to Social Security and Medicare’s on-line sites. Links below. Medicare coverage is a multi-layered program, and the first layer is what you have, Medicare Hospitalization or Part A and which is automatic once you’re on Social Security; there’s no premium for Part A, but it ONLY covers hospitalization, and there are co-pays for that. Then there’s Part B, which is optional and which I believe costs under $100 a month. The premium is automatically deducted from your monthly disability payment once you’ve signed up. It covers your doctor’s visits and tests, and some prescription meds, but only the one’s administered in your doctor’s office like infused chemo’s(Herceptin included, as far as I know). Part D is the new prescription plan, and here’s where the medicare supplemental comes in: You can buy into a Medicare Supplemental Insurance Plan, and there are many available, and these plans will pick up a lot of the costs Medicare doesn’t cover. You just have to look at the various ones that offer coverage in the state(s) you’ll be locating to, choose your best option, and sign up. Each supplemental plan usually has additional drug coverage which will cover most prescription meds not covered under Part B. Most of the supplemental plans are quite reasonable. My dad’s total cost for Part B and his supplementals is under $200 a month. Additionally he has a $10 co-pay each time he sees his PCP and a co-pay for his prescriptions, which as I mentioned will vary from one plan to the next; this brings his monthly medical expenses up to around $300 right now. It helps if you can get some advice from an insurance person; I went to several seminars given by some of the companies offering supplemental programs in our area to help my dad figure out which one would be best for him. You can also call customer service for each plan you’re considering and ask for an information packet to be sent to you. This is just the basic outline of how the programs work, but you’ll have to do some research to decide what’s going to work best for you. Here are the links to Medicare and Social Security, in case you don’t’ have them: http://www.medicare.gov/Coverage/Home.asp http://www.socialsecurity.gov/mediinfo.htm Hope this helps somewhat J <3 Lolly Last edited by Lolly; 06-23-2006 at 09:51 AM..