We have until Monday, Nov. 9, to decide on our insurance. Doing the math, to me it's a no-brainer--switch my husband (retired and 65) to medicare for 2016 rather than keep him on my health insurance, because I pay a high monthly premium and my deductibles and co-pays have gone up considerably. I'm pretty sure we'd spend about $3,000 less in medical costs in 2016 if we switch him to medicare and supplements--the best supplements. ($12,000 my insurance and projected medical costs vs. $9,000 medicare with projected medical costs.)
Here's my concern, though. Awhile back I heard medicare will only pay for Remicade if you're on a biologic. Dave's doctor told him this week there's a good chance he has PsA!!! If that's so, and our rheumy wants to try a biologic on him, I guess I'd like to see him have more choices.
Does anybody have some advice for me to make an educated decision??
Depends on you supplement. It covers remicaid because its a part B service. The biologics are coveted under part D. You can buy a supplement that covers the donut hole and has a stop loss
Good plan. I'd look at a Type C coverage that's more customizable (used to be called advantage) Talk to them at Wal-mart too....... United has a few really good plans
Yes, Sybil! Idk if I mentioned a few months ago, our rheumy told him it would be very unlikely his joint problems were PsA because he's never had a married couple who both have it. Duh, that doesn't mean it can't happen!!! Especially since Dave's dad and brother have psoriasis, and Dave is a "picker" and I've been wondering if those spots he continually scratches and picks are psoriasis! Now his primary doctor noticed his fingernails are lifting, too, so she's going to msg the rheumy about it possibly being signs of PsA. Isn't that just dandy?
Anyway, I've been online and on the phone most of the day getting as much info as I can about medicare advantage and the health insurance through my employer. I'm almost going nuts trying to make the best decision--and getting more and more confused! This is so stressful I'm actually hurting all over-stress is definitely a trigger here! Grrrrrrrrrrrrr!!! I'm mad I was planning on spending the whole day cleaning the house and the dumb insurance stuff has ruined that plan! I could use some drugs right now! Ugh ugh ugh.....
Took the plunge today and removed my husband and 24-year old daughter from my health insurance! Yay, the premium went down by $400 per month and I'm pretty sure his Medicare Part B and C won't cost that much. At least, I know his copays and deductibles won't be as much on Medicare as they were under my insurance. I'll let you know at the end of 2016 if it was all worth it! So happy this decision is behind me.
Congratulations on the decision! Was quiet surprised by the double shocker in your post: 1) Dave’s possible PSA diagnosis. 2) You actually saying you could “use drugs right now”. Last thing I would expect you to say! Ha-ha can’t fool me know you meant that in a humorous tense but…anyway now you can relax and take a deep breath knowing better days are ahead! Yah!!
Can't believe that Dave might be on his way to a PsA diagnosis as well. There was someone else here who had a spouse with the diagnosis, let me see if I can remember who it was.
Actually, janeatiu, I'm not scared of the different biologics anymore! From the surprising success I've had with Enbrel, and all the positive outcomes I hear from others on Humira, Otezla, etc., I'm encouraged about them and not a bit fearful. Would I prefer Enbrel keeps working so I don't need to try other biologics? Of course! But that might not be possible. I do have to say that the DMARDS and prescription pain pills frighten me. Not quite as much as a mouse, but I think they have many more real SEs and can be harmful to the liver and kidneys. My PsA symptoms were yucky at their worst, but it seems like a failed liver would be a bigger pain, but in the you-know-what!
janeatiu said:
I remember how much you didn't want to take Enbrel...so I imagine the likelihood of you ever taking anything else is approximately ZERO!
Grandma J said:
Haha thanks, Rachael! I guess I was joking about the drugs! I'm so afraid of them I could probably never get up the guts to take any!!!!