Find Senior Care (City or Zip)
Join Now Log In
M
MichaelM Asked September 2015

Where can I get truly independent advice on medical insurance?

I live with Parksinons and now 3 years retired on a disability allowance and small pension. I am resident in Brooklyn NYC. I am single and own no property. I am still able to care for myself but my copayments (my insurance is with BlueCross) come to almost 1/3rd of my available income. I recently started on medicare which has further reduced by living income. A local Eldercare lawyer is proposing a $6k fee to help my eligibility for Medicade. Isn't this excessive? How do I explore my options in an informed way?

EXPERT Carol Bradley Bursack, CDSGF Sep 2015
I agree with both responses. If you qualify for Medicare, you should be able to get a much better deal by going with your Medicare A which costs nothing, Medicare B which costs a bit over $100, and a supplemental policy (Medigap) which is offered by many companies and can be obtained through open enrollment (for 2016 the time is November 1, 2015–January 31, 2016). Blue Cross offers a Medigap policy but there are many good ones. Plan F (through any carrier) is great because, while it's more expensive than some other plans, there are no co-pays. However there are other choices if you prefer a cheaper policy along with co-pays.

Go to www.medicare.gov to look over plans.

Then, you'd need Medicare D, which is for prescriptions. This is the poorest part of Medicare, though these last years the government has been trying to close the "donuthole." This is the point when you hit a certain amount and must pay the bulk of the cost before you hit the catastrophic amount. Still, the donuthole won't be closed for years, so it's a problem.

If you want to claim Medicaid status through an attorney, that attorney should only charge you a percentage AFTER you win. . Otherwise all you owe is cost such as photo copies of medical records, etc. And $6000 sounds excessive

From the sound of your financial situation, you may already qualify for Medicaid. I'd do as MaggieMarshall suggests and start making calls. The new www.aging.gov site will lead you to your state resources.

Good luck! Please update us on your situation.
Carol

MaggieMarshall Sep 2015
I think you need to talk with someone with broader information than just Medicaid to see what services and subsidies you might be entitled to. Here is a link to NYs Office for the Aging. There are links for various topics. There's a prominent grey link titled, Where Do I Get Help? Click that and start exploring. Then get yourself a pad of paper and pen and start making calls and appointments.

http://www.aging.ny.gov

ADVERTISEMENT


GardenArtist Sep 2015
Re-examine the BCBS plan you have; you could probably get a cheaper one such as a BCBS Medigap Plan that would pick up the 20% that your Medicare won't cover. We pay $122.86 monthly for our BCBS (of Michigan) Medigap Plan C. The only out of pocket costs we have are nominal ones for a few meds and various special creams or orthopedic braces (such as mine for gardening injuries). Otherwise, BCBS picks up the costs.

Medicare deductions are standard unless someone is in a higher income bracket so that should only amount to a $104.90 monthly deduction.

$6,000 for Medicaid qualification is obscene. I would forget about that attorney.

Maggie's right in referring you to the local Aging office. Pam Stegman lives in NY and has a lot of insight into what's available, so if she comes along, she can probably offer some good suggestions.

Your city may also have a senior center; sometimes they have a lot of good resources that can help you locate more information. I know that there are people who charge to locate good medical policies, but with Medicare, what you need to look for are specific supplements or others that compliment basic Medicare.

BethAnderson Sep 2015
You can get good advice from NYSOFA.. New York State Office Of Aging. (800)342-9871
They have a trained staff that can guide you through aging issues within NYS.

MichaelM Sep 2015
Thank you for all your advices. I did go for a consultation with a lawyer who advised me that I should use POOLED TRUSTS as a means of managing my spending and enabling me to aply for Medicaid. This all for a fee of $4,000.00. However, from this website and from advice of friends, I am going to discuss with my doctor the maximum support I can get from my Medicare and possibly from Medigap. If I can drop my Blue Cross insurance then my monthly budget would be sustainable. I know in the long term, as my PD progresses, I may need institutional care and then Medicaid will be my only option. I am also looking for a Geriatric Care Manager who, I understand, can asist with Medicaid applications, Pooled Trust aplications, and a range of other options. I will keep you informed.
I appreciate the practical help this web forum provides.

JoAnn29 Sep 2015
If you opt for Medigap you will need part Medicare part D. Medigap does not supply perscription plans like Medicare Advantage. If you are low income, you may qualify for a state perscription plan which will be your part D. ( In NJ its called PADD)

Llamalover47 Sep 2015
MichaelM: Enlist the help of a reliable insurance agent. When it came time to file for myself first for Medicare and then my husband, he came to our house. Didn't cost anything.

Llamalover47 Sep 2015
I'm not implying that you're signing up for Medicare, btw.

megan2014 Sep 2015
Medicaid? Is that what you are looking for? If so, go to your agency on aging and they will direct you to the right person to help you with the medicaid application.

JoAnn29 Sep 2015
I agree with above. If u can't find an Office of aging, call Medicaid and they will give u the closest office. I wouldn't get a lawyer involved until ur turned down for Medicaid. I would check with Medicaid if a lawyer can charge this amount. With SSD they are only allowed a percentage of retoactive money, no more than $6000.

See All Answers

ADVERTISEMENT

Ask a Question

Subscribe to
Our Newsletter