Speaking from experience, I have found the Medicare HMO plans are the best way to go. They offer a prescription drug plan as well as Medical, Hospitalization, Vision Care and Dental. My husband was disabled at 37 years old, so I have been dealing with this for almost 16 years.
Most of the plans have several levels of coverage some ranging from 0 to a small payment for the plan each month. Social Security offers a level of help depending on the financial standing to assist with prescription Copays.
There are many approved companies in the book sent out by Medicare. They key to choosing a plan depends on the coverage you need. My husband is on the Summitt Coventry plan with a 0 pay each month. His primary care is 0 copay, specialist is $20, the prescription plan is in tiers as to whether they are generic or brand and where the medications fall. Most of the common medications are $5.00. The most he pays is $35.00. An ER visit is $50 and they cover ambulance and in hospital stay.
Our choice was based on the plan that offered my husband's physcian on the plan.
You will find you will need to look at each plan offered within your area and decide which will work for you. This link explains what I have spoken about: http://www.medicare.gov/navigation/medicare-basics/coverage-choices.aspx
This link will help walk you through how to make a choice: http://www.medicare.gov/navigation/medicare-basics/coverage-choices.aspx
The biggest problem you may encounter will be deciding which company you want to go with as there are many to choose from, like Untited, Humana, Coventry, Vista, Wellcare, ect. This link can help you find plans for your area: https://www.medicare.gov/find-a-plan/questions/home.aspx
I hope this helps to make things clearer for you. Joan
If possible, I would really like to hear more from someone who is familiar with the changes now taking place due to the changes currently being made in medicare. I need a PPO. I have to see too many specialists to deal with an HMO. I have been on Anthem for a few years, but now they are also backing off their coverage, and want me to change companies. Also is anyone familiar with the concierge programs? I am probably going to need at home help fairly soon also unless I have spinal surgery in the lumbar area and it works. Right now I'm recovering from cervical spine surgery, I know an HMO is probably more logical, but the stress of having to deal with all their rules makes things even more difficult, especially in concert with all the pain issues. I know I'm asking a lot....is there perhaps an insurance expert out there?
I will opt out and see if one of the moderators can find someone familiar with the insurance issues. I am going based on my husband who is Post Stroke and the issues he has to deal with. We are in Fl. He is a Diabetic as well as the stroke, has herniated discs and Sjogrens/Fibromyalgia. The only way I could afford the medical care he has was to go with the HMO vs a PPO.
I hope you can get the information as I reviewed all the changes, and found that this is the best coverage for us. Joan