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Hope I can get some advice here...
I have a lady turning 65 who has RA. She's been on the same medication for 10 years and suddenly it isn't working anymore. Sounds like she might be put on Embril, which is know is expensive, to say the least...
I met with the couple, and the husband has BCBS. He's decided that she should get BCBS as well, damn the cost, because he knows the name and feels more comfortable with them. I tried hard to get through his thick skull that any of the supplemental companies would work and I could get them much better rates somewhere else AND that she will never be able to change to another med supp after her OEP is done, but he's adamant. Fine, his money.....
Here's the deal though, they spoke with her doctor yesterday and her doctor was spinning all this BS about how expensive it was going to be and how she may have to have infusements at the hospital instead of self injecting and they were going to have to pay this money and told them that her dad, who is T65, and just diagnosed with cancer last month, got this plan where he's paying like $800 a month and getting it all covered. Naturally, they call me up and ask me how expensive this was going to be for them and whether they should follow their doctor's advice...
Now, I'm fairly new at this, but won't Plan F cover all that? Even if she does have to go to the hospital or doctor's office for injections or infusions or whatnot? I don't want to assure them it's all covered and then find out they will have out of pocket expenses I don't know about!
Also, they are trying to figure out what PDP would work for them. Now, I don't sell it, and they had some guy print out the papers from Medicare.gov with each of the three drugs she *may* be on, so they'd know how much it cost. That's the best I know would know what to do. Obviously, their big fear is picking a PDP and paying too much, and picking the BCBS Plan F, and still incurring lots of OOP expenses.
And no, I don't have the name of whatever insurance their doctor is putting her dad on (or has put her dad on) but it sounds to me like the doctor has no idea about med supps and how they work. Am I wrong?
Again, I know I sound pretty ignorant, but I've been doing this for a grand total of 2 months! So bear with me!!!
I have a lady turning 65 who has RA. She's been on the same medication for 10 years and suddenly it isn't working anymore. Sounds like she might be put on Embril, which is know is expensive, to say the least...
I met with the couple, and the husband has BCBS. He's decided that she should get BCBS as well, damn the cost, because he knows the name and feels more comfortable with them. I tried hard to get through his thick skull that any of the supplemental companies would work and I could get them much better rates somewhere else AND that she will never be able to change to another med supp after her OEP is done, but he's adamant. Fine, his money.....
Here's the deal though, they spoke with her doctor yesterday and her doctor was spinning all this BS about how expensive it was going to be and how she may have to have infusements at the hospital instead of self injecting and they were going to have to pay this money and told them that her dad, who is T65, and just diagnosed with cancer last month, got this plan where he's paying like $800 a month and getting it all covered. Naturally, they call me up and ask me how expensive this was going to be for them and whether they should follow their doctor's advice...
Now, I'm fairly new at this, but won't Plan F cover all that? Even if she does have to go to the hospital or doctor's office for injections or infusions or whatnot? I don't want to assure them it's all covered and then find out they will have out of pocket expenses I don't know about!
Also, they are trying to figure out what PDP would work for them. Now, I don't sell it, and they had some guy print out the papers from Medicare.gov with each of the three drugs she *may* be on, so they'd know how much it cost. That's the best I know would know what to do. Obviously, their big fear is picking a PDP and paying too much, and picking the BCBS Plan F, and still incurring lots of OOP expenses.
And no, I don't have the name of whatever insurance their doctor is putting her dad on (or has put her dad on) but it sounds to me like the doctor has no idea about med supps and how they work. Am I wrong?
Again, I know I sound pretty ignorant, but I've been doing this for a grand total of 2 months! So bear with me!!!