timill

I just had a phone appointment with someone, funded by the state of Massachusetts, to help decide between basic Medicare plus a Medigap plan, or a Medicare Advantage plan. I have gotten some useful information, but am going to double-check everything, because in at least one case what she told me contradicts what the official Medicare.gov site says. It's a relatively minor point--the existence of a roommate discount for some Medigap plans--but I asked about which plans it applied to, and she said it doesn't exist.

The new and interesting information is that apparently, because I am under 65 and disabled, I'm eligible for a Medicaid plan, without an income limit. It's called CommonHealth, and seems to be part of the state's "Commonwealth Care." If I understand correctly, after Medicare paid 80% of a bill, it would cover the rest, but only at providers that take MassHealth.

If I got basic Medicare (parts A and B), a part D drug plan, and a Medigap plan, I could see any provider that takes Medicare, without worrying about what's in-network. However, a Medigap plan would cost significantly more than this CommonHealth thing.

Or, I could sign up for another Medicare Advantage plan. The advantage there is there are some that would cost no more than the Medicare Part B premium. The disadvantage is being limited to in-network providers unless I'm willing to pay significantly more for that service.

I thought the question was, is it worth $250-$300/month (Medigap + prescription coverage) more to not have to worry about being in-network and prior authorization. It sounds like this CommonHealth plan would cost significantly less per month, but if the provider doesn't take MassHealth, I'd be paying 20%. Which gets back to the larger problem that there's no way to find out what number that will be 20% until after the visit.

If I understood correctly, all these options have copays for some things, and CommonHealth may require prior authorization for some things.

After putting it off for a while, I read through the manuscript of a non-quite-autobiographical book about my mother's life, and sent the editor some comments. This was difficult because it's largely about her experiences as a child survivor of the Holocaust. It's based on a series of interviews with my mother, which the editor was doing and compiling when my mother died unexpectedly. So that went back this afternoon.

The delivery pharmacy somehow got the wrong dosage of one of my prescriptions. This is annoying partly because I noticed the problem, told them, and we both contacted my doctor. (The prescription is 1/day, and they filled it as half a pill every day.) I thought we'd agreed that they would hold off until one of us heard back from her, and I took delivery yesterday because I thought they were bringing the other thing I'd ordered. So now I have to contact Carmen again, and figure out what to do here.

After several days of looking at Medicare open enrollment stuff, I sent an email this afternoon to the state-funded office that provides free advice on the subject, asking for an appointment. The questions are, roughly, do I want Medicare Advantage next year, or do I want basic Medicare, a separate (Part D) drug plan, and a Medigap policy. My existing Medicare Advantage plan isn't being offered next year, so I have options, but also have to decide something.

We have, however, heard back from the handyman/moving guy, and arranged for him to take the air conditioners out of our windows, and also bring more things from the storage unit. He took just long enough to get back to us that Adrian was trying to find someone else to do the job, but I'm glad we don't have to.