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Related: Culture Forums, Support ForumsAs an old man, can I start grousing about the price of things?
Humana is dragging its feet approving my wife for medicare part B. And I think I know why - they are avoiding having to cover one of her prescriptions, a eye drop that costs $385.00 for 2.5 ml.
I'm not thrilled.
marble falls
(57,252 posts)doc03
(35,378 posts)Medicare Advantage?
bhikkhu
(10,724 posts)So as far as I can see it really is kind of a scam on the elderly. You can get your coverage directly from the government's medicare coverage. Or you can use an intermediary like Humana. People often do that if they had their coverage with an insurer prior to medicare eligibility. And can wind up with problem's like the OP's, along with higher costs.
I'm not an expert, having only started looking into it, but I was just talking to an older neighbor who has been dealing with the same sort of thing. Very complicated and confusing, especially if you begin the process by talking with your existing for-profit insurer. My eligibility isn't for another couple of years.
yellowdogintexas
(22,270 posts)Part B is "original" Medicare. It has worked beautifully since 1965 with high customer and provider satisfaction.
Everyone in the country should at least have the option to choose it. (I have said this since 1975 when I began working there)
Advantage plans will nit pick you to death with micromanagement and stall your claims. Part B will not.
Advantage plans have networks and if you leave the coverage area you pay much more Part B does not
Advantage plans are designed to create a profit for the carrier. Part B is not
Part B has the fastest turnaround time, lowest cost per claim, least difficulty with approvals and lowest error ratio . Your coverage is exactly the same no matter where you use it.
If you choose Part B and decide to add a supplement later, the insurance company can subject you to underwriting which means they have the right to reject you based on your medical history. If you do it when you begin Medicare, they can't
In my opinion, the best option is Part B with a supplement. There are several supplemental plans (E, F G etc); Each of these plans is supposed to be identical in coverage from state to state. These do have to be purchased from private insurance, and there is some profit involved but nothing like regular insurance or Part C.
www.medicare.gov is full of information
XanaDUer2
(10,751 posts)My practice is having issues with Medicare Advantage. To each their own, but I'll go traditional. My bf had $$$$$$ nuerosurgery and paid about 3k for it.
ProfessorGAC
(65,199 posts)"A" is hospitalization coverage. "B" is medical.
As eye drops seem like pharma, maybe the OP means Part D, which is Rx drug coverage.
I'm confused by the complaint.
XanaDUer2
(10,751 posts)Thats it for sure. Is it traditional Medicare? ETA I have Medicare part D for RXes
yellowdogintexas
(22,270 posts)Or it could be the Plan D prescription coverage?
THe Plan D prescription coverage is very tricky to navigate because they are not all the same. Some plans have a drug in its formulary one year, then change it to another tier the next year, or totally remove it the next. I have had to change mine a couple of times. It is a total scam, which is why the Administration has been fighting to allow Medicare D to negotiate drug prices in the same manner as other government insurance plans. These plans should all be the same.
OldBaldy1701E
(5,161 posts)As an American, you can start grousing about them. They have us by the balls and we won't stop them from continuing to squeeze.