Health 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.

*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.


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

***
10/8 -
Thank you for your input. We met with someone from Humana this afternoon. The local Humana policy does not allow for Part F since I'm under 65.

We are considering part C, since I already have A&B and need Prescription coverage, too. They said it would be $42/mo. She is checking on two drugs I didn't see on their list, then we need to list all of our financial health costs for me now with our BC/BS increase and what it would be if we switch me to Humana.

One thing I'm wondering: I take Creon and it wasn't in the drug book, but they had Pancreaze. That's something different, isn't it?

 

[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.

*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.


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

***
10/8 -
Thank you for your input. We met with someone from Humana this afternoon. The local Humana policy does not allow for Part F since I'm under 65.

We are considering part C, since I already have A&B and need Prescription coverage, too. They said it would be $42/mo. She is checking on two drugs I didn't see on their list, then we need to list all of our financial health costs for me now with our BC/BS increase and what it would be if we switch me to Humana.

One thing I'm wondering: I take Creon and it wasn't in the drug book, but they had Pancreaze. That's something different, isn't it?

 

[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.
<br />
<br />My husband doesn't want to change jobs if he doesn't have to and isn't sure he could find anything better anyhow.
<br />
<br />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.
<br />
<br />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.
<br />
<br />*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.
<br />
<br />
<br />Any advice, I would appreciate it. I'm going to post this in two forums to make sure it's seen.
<br />
<br />***
<br />10/8 -
<br />Thank you for your input. We met with someone from Humana this afternoon. The local Humana policy does not allow for Part F since I'm under 65.
<br />
<br />We are considering part C, since I already have A&B and need Prescription coverage, too. They said it would be $42/mo. She is checking on two drugs I didn't see on their list, then we need to list all of our financial health costs for me now with our BC/BS increase and what it would be if we switch me to Humana.
<br />
<br />One thing I'm wondering: I take Creon and it wasn't in the drug book, but they had Pancreaze. That's something different, isn't it?

 

[tleigh]

Debbi,
I have experience w/ Humana as a true secondary through my husband's work and not as a private ins. One of the things I ran into specifically w/ prescriptions is that they have a 4th tier of "specialty" drugs. I had several meds that fell into this category. So, they would require me to pay 20% up to a certain amount before they would step up and cover it. It may be a question that you can ask specifically.

 

[tleigh]

Debbi,
I have experience w/ Humana as a true secondary through my husband's work and not as a private ins. One of the things I ran into specifically w/ prescriptions is that they have a 4th tier of "specialty" drugs. I had several meds that fell into this category. So, they would require me to pay 20% up to a certain amount before they would step up and cover it. It may be a question that you can ask specifically.

 

[tleigh]

Debbi,
<br />I have experience w/ Humana as a true secondary through my husband's work and not as a private ins. One of the things I ran into specifically w/ prescriptions is that they have a 4th tier of "specialty" drugs. I had several meds that fell into this category. So, they would require me to pay 20% up to a certain amount before they would step up and cover it. It may be a question that you can ask specifically.

 

[JustDucky]

Debbi, a few years ago, I had Humana Complete as my part D insurance. I am now using Medco as I found that they kept going up on their prices and the coverage changed. When I first had Humana, they covered both brands and generics through that infamous doughnut hole. Now, they cover generics only through the hole (with Humana complete, from what I understand, there are 3 levels of coverage...Humana basic which covers the basic meds with a deductible up until the doughnut hole and then nothing until you pay over 4 grand out of pocket and then catastrophic coverage kicks in. Then there is the middle layer of coverage, same as basic but no deductible, then there is the complete which covers the deductible and covers generics through the gap) What makes this a pain is that some of our meds have no generic equivalents such as insulin or the enzymes so it can get expensive even with generic coverage through the gap, but at least it is something.
As stated, I ultimately changed to Medco complete where they cover generics (I don't think any plan covers both generics and brand through the gap, but I hear that starting this coming year, brands will be covered 50% when in that phase) and have a decent mail order service. I get many of my IV's that way (otherwise they aren't covered), I just have the doc write for generic forms of my IV's, call and make sure they are covered and then have the order processed. IV fluid has to be ordered seperately, but they are covered and you then have to reconstitute them yourself, but I find that is no biggie if I can avoid a hospital. As far as price goes, I pay 6 bucks for 90 day supply for most of my generics when ordered through the mail order, which is cool and also pertains to my IV's. Colistin is covered by my part D insurance, so this is awesome.

If you have any questions, give a holler, I will try to help....
Jenn

 

[JustDucky]

Debbi, a few years ago, I had Humana Complete as my part D insurance. I am now using Medco as I found that they kept going up on their prices and the coverage changed. When I first had Humana, they covered both brands and generics through that infamous doughnut hole. Now, they cover generics only through the hole (with Humana complete, from what I understand, there are 3 levels of coverage...Humana basic which covers the basic meds with a deductible up until the doughnut hole and then nothing until you pay over 4 grand out of pocket and then catastrophic coverage kicks in. Then there is the middle layer of coverage, same as basic but no deductible, then there is the complete which covers the deductible and covers generics through the gap) What makes this a pain is that some of our meds have no generic equivalents such as insulin or the enzymes so it can get expensive even with generic coverage through the gap, but at least it is something.
As stated, I ultimately changed to Medco complete where they cover generics (I don't think any plan covers both generics and brand through the gap, but I hear that starting this coming year, brands will be covered 50% when in that phase) and have a decent mail order service. I get many of my IV's that way (otherwise they aren't covered), I just have the doc write for generic forms of my IV's, call and make sure they are covered and then have the order processed. IV fluid has to be ordered seperately, but they are covered and you then have to reconstitute them yourself, but I find that is no biggie if I can avoid a hospital. As far as price goes, I pay 6 bucks for 90 day supply for most of my generics when ordered through the mail order, which is cool and also pertains to my IV's. Colistin is covered by my part D insurance, so this is awesome.

If you have any questions, give a holler, I will try to help....
Jenn

 

[JustDucky]

Debbi, a few years ago, I had Humana Complete as my part D insurance. I am now using Medco as I found that they kept going up on their prices and the coverage changed. When I first had Humana, they covered both brands and generics through that infamous doughnut hole. Now, they cover generics only through the hole (with Humana complete, from what I understand, there are 3 levels of coverage...Humana basic which covers the basic meds with a deductible up until the doughnut hole and then nothing until you pay over 4 grand out of pocket and then catastrophic coverage kicks in. Then there is the middle layer of coverage, same as basic but no deductible, then there is the complete which covers the deductible and covers generics through the gap) What makes this a pain is that some of our meds have no generic equivalents such as insulin or the enzymes so it can get expensive even with generic coverage through the gap, but at least it is something.
<br />As stated, I ultimately changed to Medco complete where they cover generics (I don't think any plan covers both generics and brand through the gap, but I hear that starting this coming year, brands will be covered 50% when in that phase) and have a decent mail order service. I get many of my IV's that way (otherwise they aren't covered), I just have the doc write for generic forms of my IV's, call and make sure they are covered and then have the order processed. IV fluid has to be ordered seperately, but they are covered and you then have to reconstitute them yourself, but I find that is no biggie if I can avoid a hospital. As far as price goes, I pay 6 bucks for 90 day supply for most of my generics when ordered through the mail order, which is cool and also pertains to my IV's. Colistin is covered by my part D insurance, so this is awesome.
<br />
<br />If you have any questions, give a holler, I will try to help....
<br />Jenn

 

[Aspiemom]

Bump

 

[Aspiemom]

Bump

 

[Aspiemom]

Bump