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Old 08-10-2018, 10:28 AM #1
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Default Medicare - Are you happy with it?

I am looking for some insight from others non-elderly on SSDI with just Medicare as their insurance.

Medicare seems to have lots of holes and gaps for those under 65. It makes for us to have a harder time accessing help and essentially delays in our recovery.

Are you satisfied with your mental health coverage ?
Are you able to pay those 20% co-pays?
Are your medications covered?
Are you able to go into a day treatment (intensive outpatient programs) and afford the co-pays?
Is transportation an issue to get to appts?
Do you have a hard time finding Medicare providers? ie..therapist. pysch
Women OB-GYN related - are you denied certain procedures and or medications?
How is you oral health?
Do you have any vision/hearing issues?

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Old 08-10-2018, 02:19 PM #2
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Default Re: Medicare - Are you happy with it?

I have Medicare and spent a lot of last Summer looking I to what Medicare B would pay for. I discovered for me a Medicare advantage plan would work best for me. However, the biggest issue is meds/ pharmacy. You are only allowed up to 3500.00 then you hit "the donut hole" where you have no coverage for meds until you reach almost 5000.00, then co verage is only about 40%. With just one of my meds I would hit the hole therefore I elected to stay on my spouses plan. Medicare does not pay for transportation. Some MedicAre advantage plans cover dental.

I would go to Medicare.gov and search options in your area.
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Old 08-10-2018, 03:40 PM #3
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Default Re: Medicare - Are you happy with it?

No I'm not happy with Medicare for all the reasons you listed. In Texas there was a Medicare advantages program I was eligible for and it covered all that and more. My hearing aids were fully covered but glasses were only covered to about $150. There was a transportation company that did nothing but work for medical insurance companies so if I couldn't drive I could use them. But the MH coverage wasn't the best. They fought with hospitization and IOP's and would only cover a few days. Was hard to get Ts and PDocs cause so few were listed and most did not accept new people.

Now I live in the non metro area of Minnesota and there's no Medicare advantage plans I'm eligible for but I am eligible for the expanded Medicaid here and that pays co-pays but I've no dental, vision, hearing or transportation. The MH coverage is much worse because there's no providers. I did just start seeing a T and he is covered but I don't think much of him.
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Old 08-11-2018, 10:34 AM #4
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Default Re: Medicare - Are you happy with it?

Do the advantage plans cover the 20% co-pays? From my understanding it would not offset it. In fact in speaking with medicare they told me it would not benefit me an advantage plan.

@deejay - That is crazy about your meds. I thought the gov was to do away with the donut hole thing....

@nammu - That is great you get medicaid now. It has better coverage than the standard medicare (with or without the advantage plans) Some states are strict in things they cover. Dental vision and hearing is imperative!!! There are less providers with the medicaid you have? Thing I been noticing is there are plenty of providers with medicaid IF you have addiction. Mental health in communities have taken a back burner for addiction.
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