Client Has Rheumatoid Arthritis

[WCMason]

The real difference here is if the injection is done in the Dr.'s office on not. If it's an office visit, then she'll be golden. If she does it herself at home, she may see hefty copays for that drug.

Not always.

I have a med supp client who wanted one of those zero premium MAPD like all her friends. I moved her as all her docs were in network. She started getting Botox injections in the doc's office for some kind of neurological issue in her neck. Copay for the specialist visit? $20. Cost for the Botox injected by the specialist at those visits? 20%. Every other month. Don't remember exactly what the 20% came to but it was enough to make her not want the MA anymore.

Fortunately since April is not a month she's getting the treatment, she wants me to come out in April to help her exercise her trial right to get her med supp back for May 1, saving me from being tagged with a rapid disenrollment.

One thing I've learned with MA plans is to make sure they know that there are many things they will be subject to paying 20% for and in a bad health year the zero premium plan may cost them more than a med supp. Still write 1/3 MA.

 

[Todd King]

I was speaking from more of the Med Supp/Part D side than from the MAPD side.