I have a friend who has original Medicare, but, is in desperate need of a Supplemental Health insurance to help pay the additional 20% of health care. She was told by a representative from Humana that due to her existing health condition it maybe hard for her to qualify for supplemental insurance. She has kidney disease (dialysis every 3 days of week), heart disease (bypass heart surgery), and diabetes.
My questions are: Does anyone know if there any hope of her getting Supplemental Health insurance with the existing health condition she has? If so, do you know the names of the Health agencies?
Any assistance you can provide me will be greatly appreciated.
The SHINE Program (Serving the Health Information Needs of Everyone) provides free health insurance information, counseling and assistance to all Massachusetts residents with Medicare. A counselor will review programs that help people with limited income to pay health care costs. You can reach a SHINE Counselor at (800) 243-4636, press 3 or press 5 if calling from cell phone. TTY (877) 610-024
Thank God for this message board, it is such a blessing to be in a support group online that will provide you with answers, advice and recommendations when you need it.
I was told it's difficult to obtain supplemental insurance if the person doesn't apply for it within the first six months after turning 65.
I also agree with the others that an Advantage plan might work best for your friend. They may work different in different states. However, my own present Advantage plan has 0 copay for PCP doctor and 5 co-pay for specialist. Medication varies from 0 co-pay/ deductable to as much as over 100 depending on the tier level. 0 co-pay for routine dental exam. 0 co-pay for routine eye exam. 250 annually for glasses. 0 co-pay for routine hearing test, and even pays up to a certain amount for hearing-aides if needed.
With your friend being on dialysis I'm not sure how that will work in her best interest with an Advantage plan.
But some insurance companies will help the person sign up for additional help for state insurance if they qualify. My mother didn't even know she qualified for additional help from the state based on her income, expenses and size of her bank account savings until representative from Healthsprings helped her apply.
There are plenty of companies that will take her with existing health conditions. She also might be eligible for Medicaid as well as Medicare.
These are plans which are defined by Medicare, not the insurers. If a person wants everything covered with no deductible and no co-pay, choose a plan F supplement. Mine is through BCBS and have used it through 2 knee replacements and a couple of smaller issues without paying an additional penny. There were no health questions and no medical exams to get the coverage.
My husband and I pay about $300 per month for this coverage, another plan for drug coverage, and his Medicare part B (my Medicare part B comes from my SS check). This is less than the deductible that my sister has on her advantage plan. I figure that I would rather pay on a regular basis and not worry when I get sick. She likes to think that if she manages to get through the year without having to pay the whole deductible she saves money. It is a matter of preference.
As to pre-existing conditions, that was not an issue in the past for the medi-gap plans, but I haven't read all the information on the new rules for 2020.
I would recommend that you or your friend start with the Medicare site and get some solid information before talking to insurance companies. Remember who pays the insurance company "assistant" who you might talk to on an insurance site. I have been lied to or misled more than once by what are really just sales people.
I hope Trump hasn't totally wrecked the Act -- as he has removed the mantatory insurance coverage which made this possible.
Are you near a Kaiser Permanente?
Or, call AARP. You must've gotten many ads in the mail these past weeks.
T th AARP United Health Care but stick with original Medicare and supplement. Don't be lured into an advantage plan.
The LCSW knows the dialysis center wants to bill that 20% for payment to the dialysis company thus have a vested interest in helping patients find secondary coverage to help the dialysis company get paid additionally because the Medicare reimbursement rate for dialysis treatments is close to nothing (in 2010 it was $131 a treatment). I’ve been out of that field since then.
I think no matter who you find to cover her, the premiums, deductibles and co-pays will be high due to her pre-existing conditions but not insurmountable if mom can pay.
Humana is trash and they want everyone in an advantage plan because they are getting rich off of them.
A broker will be able to look at all companies and tell your friend what the options are. She may have to go through underwriting and then she may or may not be accepted, do the math and see what makes better sense.
If she doesn't qualify can she put a set amount aside monthly to cover her copays until the deductibles are met? I would encourage her to do that.