Another health insurance question

Medicare B covers Provenge I think.
My Blue Cross has Zytiga etc. from a Specialty mail tier 4 program. I think it is cumbersome but doable.

As JNF alluded, rather than Medicare Advantage, those of us with expensive drugs, albeit many doctor administered, may be off with a Medicare Supplement Plan.

A Plan F or a Plan N while they are somewhat higher premium, pretty much fix your costs as all deductibles and co-paus are reimbursed, You still need a Medicare D Drug Plan which also should be high end.

There is an animal called donut hole that may or may not be eliminated as a result of "Affordable" Care Act. Once you get to a certain level of non-doctor administered expensive drugs, your out of pocket skyrockets until it maxes out. That is affectionately known as the donut hole.

I only became Medicare eligible this past August and so far both my drugs Lupron and Xgeva are doctor administered, so no direct experience with the donut hole yet.

LupronJim

My Blue Cross has a formulary. So does the VA. You have to check the formulary to see what it covers.

I don't think I have a choice. I am part of the State of Michigan Teachers Retirement System. Right now, as I said, I get my insurance through my employer. It has been excellent so far, except for the ridiculous battle over Cadodex (they quickly gave in when Dr. Scholz contacted them).

When I re-retire, I go to the State Plan. That keeps changing, so I'll have to see what they have. I know they piggyback on Medicare

Mel

I am a federal retiree with Medicare and Blue Cross. My Blue Cross plan is secondary to Medicare. It has no doughnut hole.

Mel,
You may want to dig a little deeper with your HR department or outsourced Benefits Administrator for your plans. If you are eligible for BC/BS or any of the major carriers retirement plans, they generally cover the excess charges of everything that is covered by Medicare (your copays). My friends who have state or company retirement coverage in addition to Medicare have plans that cover all or almost all of their copays and deductibles from Medicare as well as very generous pharmacy coverage. They have not bought Part D because their retirement plan is much more generous for RX's. Generally, injectable medications like Provenge are covered under Part B not the pharmacy plan. A few who are state and city retirees are concerned, however, that their excellent retirement plans could change as the entities struggle with long range underfunding of their plans.
Pat