need help finding insurance for MDS

[iksonak]

Hello all. This is a wonderful site for sharing. I hope you can help us. I have hubby and myself covered by my company insurance now. October I will retire, and must go on Medicare; hubby, too. I have been searching desperately for information on supplementary insurance plans and Part D plans to see which will cover MDS the best. I know we are in store for big time bills. Does anyone have any information, pro or con, to guide us in our search? We'll be living in Michigan. No treatment has begun at this time, just BMB and CBCs to monitor bone marrow.
Bless you all....and thanks in advance for any info......

[Neil Cuadra]

Originally Posted by iksonak

Hello all. This is a wonderful site for sharing. I hope you can help us. I have hubby and myself covered by my company insurance now. October I will retire, and must go on Medicare; hubby, too. I have been searching desperately for information on supplementary insurance plans and Part D plans to see which will cover MDS the best. I know we are in store for big time bills. Does anyone have any information, pro or con, to guide us in our search? We'll be living in Michigan. No treatment has begun at this time, just BMB and CBCs to monitor bone marrow.
Bless you all....and thanks in advance for any info......

Welcome, iksonak.

It's smart of you to be researching this ahead of time, before your retirement. Have you tried to narrow down the choices by learning which prescription drug plans in Michigan cover the drugs your husband is taking?

One way you could get more information about how supplementary and Part D insurance plans apply to MDS would be to listen to an expert speak on the subject. The Aplastic Anemia and MDS International Foundation is holding its annual Patient & Family Conference next month in Indianapolis, and one of the scheduled sessions on July 11 will be "MDS and Your Health Insurance." If you can attend, now's the time to sign up because conference registration is free for only 3 more days. The hotel room isn't free but there's a group rate.

I attended a similar session at last year's conference. The speakers were good, the presentation was informative, and patients and spouses in the audience had a chance to ask questions.

[iksonak]

I am trying to learn as much as possible. Would be too late after signing up to some program and learn he is not covered. Medicare J seems really good. I would like to understand the drug 'tier' system better. Dr did mention Vidaza in our future, but I can see it is so expensive (as are others).
thanks to you....

[Neil Cuadra]

The available plans differ by state, so I guess you are studying the plans in Michigan even if you are currently in Illinois. The U.S. Department of Health and Human Services Medicare Prescription Drug Plan Finder even asks for your county.

Most prescription plans have a few (typically 3, 4, or 5) tiers, or price levels. Tier 1 might cover generic drugs and have the lowest co-pay. Tier 2 might be for "preferred" brand name drugs with a slightly higher co-pay, Tier 3 for non-preferred brand name drugs, and so on. The highest tier is often one for "specialty drugs", meaning the most expensive.

You might also want to read the forum thread named What is the doughnut hole I have been reading about?

[Margie]

Dear Iksonak,
I have had a good expenience with medicare part B and a supplement from AARP whose carrier is United Health Insurance Co. I think it might be sort of expensive, but it pays on anything Medicare "covers", and will pay the 20% that Medicare does not pay. It also pays the yearly deductible and for the expense on the first three, I think it is, blood transfusions each year that Medicare does not pay for. I also have a RX policy, but that is another issue.
Everything varies from state to state. Good luck.

69YOA MDS 6 yrs. RCMD. <blasts. transfusion dependent 2 yrs, 3 mos.