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Posted 9/18/2015 6:18 PM (GMT 0)
Hi everyone!

It's been a while since I have posted. Life is getting in the way of most things now it seems. Hope everyone is doing well. My question today is about insurance. My husband Jeff, who has NASH and is currently listed, has been offered Medicare. I am learning now that you can't keep your policy on the Healthcare Marketplace (he has a great policy there, that we would really like to keep) and Medicare at the same time. Is there anyway around this? I ask because we were told you need to have two insurances at time of transplant. So, I always thought Medicare and Blue Cross. I read it is against the law to keep a plan on the marketplace once you have Medicare.

Any ideas?

Thanks as always for any help!

Lena
Posted 9/18/2015 8:23 PM (GMT 0)
Hi Lena,

My understanding is that your husband can keep his Healthcare Marketplace policy after enrolling in Medicare....but and it may be a big one...he will lose any and all tax credits/savings associated with the now..."non" Affordable Care Act. My guess is that the cost will become prohibitive for many folks in this situation, but if Jeff has to have both policies to remain active on the list...maybe it's doable...at least in the interim...until he gets his transplant.

I'd definitely get on the horn with a Medicare rep. They've been very helpful and informative the few times I've called. The biggest hassle is having to wait on hold, but there's an option for you to request a call-back and it actually works....shocking I know...lol.

Fortunately for me, I have Medicare (66 and retired) and I'm still insured via my wife's employer with United Healthcare, but in a few years I'll have to revisit the minefield of health insurance.

Best of luck to you and Jeff.
Posted 9/18/2015 10:03 PM (GMT 0)
Hi Lena,

From the Healthcare.gov site:

Q. "Can I choose Marketplace coverage instead of Medicare?"


A. "Generally, no. It’s against the law for someone who knows you have Medicare to sell you a Marketplace plan."



The rules for Medicare that apply to Jeff are found in the below link.



/www.healthcare.gov/medicare/medicare-and-the-marketplace/

It sure is nice to hear from you! Where is Jeff listed? I recall you wanted to list in CA at one point.

Themister was on the first pre-existing Obamacare program (PCIP). We paid about $450 per month for him. When he became eligible for Medicare, he no longer could keep PCIP, and his drug costs are now over $5,000 per year with co-pays and donut hole. He has a Medicare Advantage plan with a "OPTUM transplant network".

I suggest you call his transplant center and ask the finance person in pre-transplant which product they accept. Keep in touch. We miss you! Big Hugs
Posted 9/19/2015 2:18 AM (GMT 0)
Hmmm...govt websites that are inconsistent and confusing...I'm shocked...shocked I tell you.

It's clear that it's against the law to sell a marketplace plan to someone with medicare, but what I'm reading is that you can keep your marketplace plan when enrolling in medicare. The webpage clearly states that...

"If you like, you can keep your Marketplace plan too."

It may be that you can only keep your marketplace plan for the remainder of the year, etc...
problem is...it's not clear.

Here's the link and an excerpt from the Healthcare.gov website:

https://www.healthcare.gov/medicare/changing-from-marketplace-to-medicare/

"If you have a Marketplace plan, you can keep it until your Medicare coverage starts. Then, you can cancel the Marketplace plan without penalty.

If you like, you can keep your Marketplace plan too. But if you’ve been getting premium tax credits or other savings on a plan you bought through the Marketplace, these savings will end once your Medicare Part A coverage starts. So you’d have to pay full price for the Marketplace plan."

themiz...how was the mister notified about his PCIP policy? Did he receive a cancellation notice?

I wonder if anything has changed.
I'd still advise calling Medicare and get some clarification.
Posted 9/21/2015 3:37 PM (GMT 0)
Hi themiz and woofer5!

Thanks so much for your help! This is certainly a learning experience, especially when you are no where near the age of Medicare. I am reading and reading lol.

themiz, Jeff was listed at USC (University of Southern California Keck Hospital. I am hoping to get him dual listed somewhere back east, maybe Atlanta or Florida, but waiting for hi MELD to get a little higher before I start that journey.

I have missed you all too! How is the mister doing? I Will try to check in more often.

Thanks again!

Lena
Posted 9/25/2015 8:53 PM (GMT 0)
Do they consider a Medicare suppliment policy as a second policy? Would that give him comparable coverage? Is the cost better with the suppliment?
Posted 9/25/2015 9:01 PM (GMT 0)
Hi Rubi,

Not sure if they consider that a second insurance, but I have learned that he needs to stay with straight Medicare and not go on a sponsored Medicare plan that includes everything. Pay for Part B, Buy Part D and get a Medi-gap/Supplement plan. That way his immunosuppressant drugs would be 100% covered instead of just 80%.

The hard part for us know, is figuring out which Supplement plan to pick. It can get expensive and I don't know which would be the best, so we are going to have to make an appointment to get some help. It's very overwhelming.

Thanks!

Lena
Posted 9/25/2015 9:20 PM (GMT 0)
Here's a link to a chart that will help you narrow down WHAT you need. You will have to check with an insurance agent to get prices. If your regular insurance agent does not have the plan that fits you, you will have to look at other companies. Good luck.

https://www.medicare.gov/supplement-other-insurance/compare-medigap/compare-medigap.html
Posted 9/25/2015 9:22 PM (GMT 0)
Thank you Rubi! I will check it out right now :)
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