Hi Toni,
I just love your column. I am retired and turning 65, this June and have no idea what I should do?? Currently I am on a COBRA policy from my old employer.
I am a type 2 diabetic, have high cholesterol, hypertension, but my main concern is that I was diagnosed with early stage of breast cancer in January 2012. I have received all of my care from MD Anderson in the Medical Center and also the new facility in Sugar Land. I had a partial mastectomy and am currently taking Chemotherapy with my radiation treatments to start this summer.
I am unsure what I should do, enroll in Original Medicare with a Medicare supplement and get Part D or go with a Medicare Advantage plan. If you could help me sort this out I would greatly appreciate your help.
Thanking you in advance, Marianne, a loyal weekly reader
Dear Marianne:
I know you are concerned about having health problems such as being a diabetic with some high blood pressure issues, but I am sure the cancer is what you are most concerned about. Correct??
Because you are turning 65 in June, 2013…I have some great news for you. There is a special enrollment called Medigap open enrollment. Medigap is also called a Medicare Supplement.
This is the best time for you to purchase a Medicare Supplement and the open enrollment period last for a 6 month period beginning the first day of the month in which you are 65 or maybe you are older and have just enrolled in Part B. During this open enrollment period you may enroll in a Medicare Supplement and not have to answer any health questions.
After the 6 month window, you will have to submit to a complete underwriting for a Medicare Supplement. You may not qualify for a certain policy or it may cost more, if there are any health issues.
With you having cancer and using the MD Anderson System, I would recommend that you opt for “Original Medicare” and a Medicare Supplement with a Medicare Part D Prescription Drug plan to pick up what Medicare does not pay for.
This week, a healthcare professional advised me to make my readers aware that many of the newest healthcare and cancer procedures are not readily approved by Medicare Advantage plans as these procedures are generally approved with “Original or Traditional Medicare”. He has to fight everyday to get his patients the care they desperately need when they are with a Medicare Advantage plan. I always advise my clients to speak with their doctor or specialist before making any changes to their Medicare. I advise you, Marianne, to do the same.
Generally, Medicare Advantage plans are good options when someone is relatively healthy. Such as a person who is taking mainly maintenance prescription drugs, going to the doctor a few times a year for checkups and not needing serious medical attention for health conditions such as cancer, diabetes, heart problems, Alzheimer, MS, serious kidney problems requiring kidney dialysis and the list could go on and on…
You also asked about enrolling in a Part D plan. I would advise you to enroll in a Medicare Part D prescription drug plan because each month you wait there is a 1% penalty, even thought Part D is voluntary.
**** Toni’s Confused about Medicare workshops answer questions such as what is difference between “Original or Traditional” Medicare, a Medicare supplement or Medicare Part C (an Advantage Plan)”. These questions will be answered at the Confused about Medicare Workshop to be held at Oyster Creek Manor at 3505 FM 1092, Missouri City, TX 77459 on April 11th at 6:00 PM. The presentation is free of charge and open to the public. RSVP by calling 832/800-4674 as seating is limited.
Toni King, author of the Medicare Survival Guide which is on sale at www.tonisays.com. Toni is an advocate/consultant for those “Confused about Medicare”. Email questions to toni@tonisays.com or call 832/519-TONI (8664).
