Looking for medicare advantage program in southern oregon with great drug co erage for zytiga

My wife and I are considering a move to southern Oregon and one of our considerations is Medicare advantage programs or Medicare part D programs that provide coverage for advanced therapies Such as Zytiga. Medicare plans with part D coverage vary greatly which can substancially increase out of pocket costs. For example, i just. Hecked Wlagreens Medicare advantage program and my total out of pocket expense just for Zytiga would be over $48,000 Per year. This makes the cost prohibitive and would negate any benefit we would receive by our move. Instead it would add to our out of pocket expense that is unsustainalbe. So Inthought I wouldnreach out to the board to see if there is someone here wh has experience with medicare part D ormedicare advantage. Thanks for any helpyou can provide.

Check on www.ehealthinsurance.com. They are excellent in showing what is available and can help determine coverage by plans. The Medicare website also shows this, but doesn’t have qualified peoples to talk to regarding plans and coverage.

I use Silverscript for my D plan. I will check the online calculator to see what the drug would cost. I suggest you do the same. What plan are you on now? If you are on an Advantage plan you will have difficulty going back to tradiational Medicare and a supplement and D. If you are on Advantage, then you wouldn’t normally have a D plan.

Some clarification. If you are using traditional Medicare A and B then you will also have a private insurance company Medicare Supplement plan to pick up the 20% that Medicare doesn't cover, and a Part D private insurance drug plan for rx drugs. But you would not have an Advantage Plan.

If you want an Advantage Plan, you will leave the Medicare coverage and get all reimbursements from the private insurance company that you choose for the plan. Medicare will pay most of the premium and you will have an amount also in most plans that is less than the supplement plan. With an Advantage plan you do not also purchase Pat D for drug coverage as drugs are included in the Advantage plan.

Generally an Advantage plan will have a lower premium than a supplement plan, but will have much larger co-pays and deductibles. Plus, the Advantage Plan will have limited networks, where the supplement plan is limited only to providers that accept Medicare.

The potential problem of moving to an Advantage plan comes when you want to move back to traditional Medicare and a supplement. The supplement can be underwritten and due to your cancer will no doubt deny coverage. So be very careful about switching plans.

If you move to another state, you will have a Guaranteed Issue Right with Medicare. That means that you can move from a Medicare Advantage Plan to a Medicare Supplement Plan and a free standing PartnD plan without any medical underwriting related to your current health status. In essence, you get a new complete enrollment period to pick the best plan for yourself without any risk of rejection due to pre-existing conditions. I strongly encourage you to explore all of your Medicare options given your current health status if you do in fact move.

As it sounds like the medication component is critical for you, you may find that a stand alone D plan works best for you rather than the embedded prescription plans that come with an advantage plan if your new area. Every area of the country is different as to options and cost. Just because an Advantage plan has been good for you where you currently live, does not mean that type of plan will still be the best option somewhere else. Again, because of the move, you could go with a supplement and free standing D without medical underwriting if that works best in your new geography.

Medicare.gov is a very user friendly website. If you go to the Part D section of that website and put in your perspective zip code, you can create a drug profile for yourself and then you can see the cost breakouts for your drugs for all advanrage plans in that marketplace as well as stand alone drug plans. It will thus provide a comprehensive drug plan shopping experience for every drug plan option available in that area That may help you decide if you want to go with an advantage plan in the new area or if you want a stand alone part D plan, at which point you would also need and be able to buy without prejudice a supplement plan.

Good luck if you move and with your continuing treatment.

Portland zip 97201. Go to Medicare.gov. many options.