Medicare On The Road

[mjobes]

We have taken long trips over the years, but are now going full-time.  Sold home in CA and plan to use SD as our domicile for a couple of years at least.  We are Medicare recipients who use an HMO.  We have looked into Medicare Supplements, but Wow, they are expensive.  Would rather keep our HMO plan.  How do you-all handle this when full-timing?  We are OK for the next 6 months with our current CA health provider, but then must choose a new group/health plan.  Are we stuck with choosing one in SD, even though we won't actually "live" in SD? 

Thanks for any and all input.  Happy Trails.

[elkhartjim]

I would suggest calling your current insurance company asking them what they recommend then shop for the best policy. Is HMO the kind of policy you have a primary physician that has to refer you to specialists.

[hermanmullins]

Mjobes,

Welcome to the Forum. 

Some where I either saw or heard that in South Dakota that there is only one company that will write coverage there. 

Herman 

[BillAdams]

SD is (was?) a bad place to try to get health insurance as a full-timer.  We left SD due to the fact that the coverage available was only available in SD.  That might have changed but it was a disaster when the change took place.

[manholt]

Try Horizon or Blue Cross/Blue Shield/

[manholt]

My DGF said AARP.

[tbutler]

Medicare Advantage Plans are HMO's run by private companies and are state based.  That may leave you out of the network in other states.  They work well for those that seldom travel.  Some may compensate out of network treatment but may require you to visit a certain cooperating physician.

Basic Medicare, Part A, covers hospitalization, Part B covers doctor's visits and treatments, Part D covers prescription drugs.  You can purchase supplements to help cover the gaps in Medicare.  Supplement plans will pay many of the deductibles.   Medicare and You is an annual publication that explains all of this. 

There is a company, GoMedigap.  They will help you find the best price for a supplement plan for basic medicare.  There is some great information on that website and you can call to talk to a representative if you prefer.  Go Medigap isn't licensed in all states but they are good to go in South Dakota.  We started using their service when we went on Medicare and they periodically review our supplement.  So our choice was the standard Medicare plan with a supplement.  It is working for us, wherever we are located in the US. 

I have never been turned down by a doctor because I was on Medicare.  I'm certain that there are some who do but in our travels I've always been able to find the treatment I need.  I had knee surgery as I was starting on Medicare and asked my doctor if he had any problems with medicare.  He laughed and said, "Have you seen my waiting room?  I wouldn't have any patients if I didn't take Medicare."

 

[obedb]

We use United Health Care (AARP)  as a supplement to Medicare. We have used the package several times for serious stuff. Breast cancer for her and a D&C. Prostate Cancer for me and treatment for either Lyme Disease or Polymyalgia Rheumatica. Two doctors. Symptoms and blood work are similar. Probably the worst that I have felt in my life ( and I have busted a lot of stuff up trucking). When you go through the run ups for treatments like that, there are procedures that run the bill up. Betty had two surgical removals of tissue and then the cancer group at GBMC decided that in spite of her age radiation was the way to go. 36 treatments for her and 44 for me (prostate cancer).

Never paid a dime through it all for either of us. No co-pays/ nothing. Betty gets prescriptions for HBP and cholesterol through the mail for no charge. When we travel, she has to go with Walmart  and even that is chump change.

I guess at $450 or so per month it might be considered pricey, but we are able to afford it. Never an argument from anyone on the insurance end. Don't think we could find a reason to change.

[manholt]

Byron.  You are correct.  1% per month, for the Total amount of that bill, is chump change!

[wildebill308]

On 6/1/2017 at 3:21 PM, mjobes said:

We have taken long trips over the years, but are now going full-time.  Sold home in CA and plan to use SD as our domicile for a couple of years at least.  We are Medicare recipients who use an HMO.  We have looked into Medicare Supplements, but Wow, they are expensive.  Would rather keep our HMO plan.  How do you-all handle this when full-timing?  We are OK for the next 6 months with our current CA health provider, but then must choose a new group/health plan.  Are we stuck with choosing one in SD, even though we won't actually "live" in SD? 

Thanks for any and all input.  Happy Trails.

While I will never go full time again. I think if you were domiciled, say in Texas. when you travel you just call your primary care physician and get a referral. I have done it in the past and /or used a dock in the box when on the road. I may not be "full time" but I am gone as much as 4 months at a time. Never had a problem geting prescriptions or seeing a doctor. I have Unitedhealthcare through AARP. 

Bill 

 

[obedb]

When you are on Medicare you do not need a referral.

[tbutler]

I just picked up the latest GoMedigap Newsletter and it had an article on Traveling with Medicare.  This article is short and a very easy read.  It gives information on coverage with Medicare, the original, and supplements and how they cover you as you travel in the US and its territories, in Canada and internationally, anywhere in the world.  It also describes how Medicare Advantage plans cover travel in the US and in Canada and internationally. 

I would highly recommend this quick read for anyone who travels and has a Original Medicare or Medicare Advantage Plan.

Regarding costs for any plan, they do vary.  Medicare Part A covers hospitalization.  If you qualify with enough working and paying into Social Security and Medicare credit, that coverage is at no additional cost.  Medicare Part B, covering doctors visits and routine health care is about $120 per month for each of us.  Some people who were covered before we were are paying slightly less, grandfathered in. 

We have Plan G Medicare Supplement with a private insurer, the costs for that will vary depending on a number of variables including the company you choose, your medical condition when you sign up and your age when you sign up.  You can choose from a number of supplement plans with varying coverage, deductible amounts, etc.  If you choose Plan G it will be identical for every company offering Plan G.  Plan G is defined by Medicare and every company offering it has to have the same exact coverage.  The same is true of each of the Medicare Supplements.  Our Plan G supplement costs each of us about $100 per month.  Mine is slightly higher because I'm an XY (male), not an XX (female).  Compare those costs with what we were paying before going on Medicare.  We were in a group plan through our employer but had to pay the full cost of that policy on our own.  It was costing each of us more than $500 per month.  We love Original Medicare!  

I just had a severe ear infection.  I went to an Urgent Care Center, cost $0.00.  Had an examination and prescriptions.  I went back several days later, not getting better fast enough, got a referral (not needed but helped me find a local specialist, doctor(s) they recommend).  Went to one of the four offices listed as Ear Nose Throat (ENT) specialist, got tested, examined, more medication, a follow-up treatment, cost $0.00 for the doctor, $4.00 per prescription (5 now in all) through our Medicare Part D Prescription Provider.  All done within two weeks, never turned down, never a question regarding coverage.  Show the card(s) and it is all done.  I'll say again, I've never yet been to a doctor or hospital that doesn't accept Original Medicare.  I'm certain there must be some somewhere but there isn't even any hesitation at any doctor, urgent care center or hospital I've been to.  We are more than 500 miles from our current home, have been on the road for six weeks, don't have a doctor in this area.  No problem.

[manholt]

Tom.  Great info!

[tbutler]

Thanks.  I had to work hard to keep all the terminology correct.  Part this and plan that, got to stay with the program or it gets even more confusing.  Original Medicare has Part A, B and D.  Then there are supplement plans (C, D, F, G, M and N) provided by private insurers but defined by Medicare so they are identical no matter which company is offering them.  That is, plan C is the same from every company that offers it, only the cost will vary depending on the company offering the coverage.  The same is true for each of the other plans.  The supplement plans are designed to cover gaps and high deductibles in Original Medicare.  The various plans (C, D, F, G, M and N) offer differing degrees of coverage and thus those with better coverage and or lower deductibles, cost more.

Finally, there is the option to go with a Medicare Advantage Plan which substitutes for Original Medicare.  Medicare Advantage Plans can vary in the kind of coverage they offer and deductibles.  These plans are more familiar to people who currently have an HMO.  They are simpler to understand in that you are dealing with a single company with a single policy.  Your Original Medicare covers part of the cost of these plans and then you may pay more to get better coverage or lower deductibles.  As the article points out, many of these plans have in network and out of network provisions and can be limited when traveling out of your home state. 

Making a choice involves taking time to consider and compare all your options.  It is time consuming and can be daunting with all the choices that you have.  For us, the ability to travel freely and get medical attention when needed anywhere in the US was an overriding consideration.  For those who spend less time on the road, this may not be the case.  Having choices means that you can choose what works best for you.  It also means that you have to take time to consider all the options to be sure you actually do have what works best for you.

[wildebill308]

On 6/4/2017 at 7:22 PM, obedb said:

When you are on Medicare you do not need a referral.

I have a Medicare Advantage Plan that requires a referral if out of my network except for emergency care. Never a problem.

Bill 

[rolex]

I use Medicare, not an HMO, and have found that for most medical situations, even when at home, a walk in clinic has sufficed. When traveling, in the rare situation where we need a specialist, then a referral for the clinic or an ER visit is in order. One thing we did when we full timed '99-'07 (pre medicare) was to establish a primary doctor by one of our children so that we did our annual physical when we visited (annually!) That also gave us someone to call when a problem arouse and we were in a more remote location. 

[hermanmullins]

Rolex,

We have also found that the Emergency ERs are quite helpful when on the road. Just be sure and ask if the take Medicare before treatment. It can get quite costly if they don't. 

Plus they are much quicker than a hospital ER.

Herman