Medicare Questions For Implant

[Cigar56]

Hi guys,

I'm finally eligible for Medicare in just a matter of weeks. Wife and I have a meeting with a Medicare Supplement specialist soon. What "supplement" should I/we be looking at to make sure a penile implant would be covered? My very limited understanding of it all is that not all the Medicare plans may pay because an implant is considered an elective surgery, along with a vasectomy.

So, for all of you who are successfully using Medicare to pay for your implant, what Medicare plan did you select?

Thanks!

[Gt1956]

Part A is basically mandatory. I took part B also. It covers admitted medical. Part D is for drugs mainly. I might be a bit different than many Medicare guys. I carried my employed health insurance into my retirement. At 65 it basically turned into a supplemental policy. Their mail order drug plan works good for me. So I skipped part D & as having a B supplemental, I have few co-pays.
My wifes brother only has Medicare. He keeps having shingles & can't afford the vaccination co-pay. My cost for it is zero. He has to deal with shingles every year or two.
Be careful on part B. It does not become effective until the first day of the month after you turn 65. No partial months coverage. I lucked into not having a $1200 co-pay on an endoscope cause the procedure was done on the 2nd of the following month.
The Medicare mambership card is printed on plain flimsy paper. When you get it. Make some photocopies & laminate all of them. They'll wear out fast.
I'm sure that I skipped something. But there is a quick overview on what I choose.
Btw, I'm sure that without a supplemental policy, an implant will likely cost you about a 20% co-pay of the "allowed" charges plus any meds that you get.

[Gt1956]

Cigar56, I just read your signature line. Make sure you use an implant surgeon with a really great billing staff. Your approval & co-pay amounts might be easier/cheaper if you play the cancer diagnosis up. Make sure that it gets placed into your doctors notes early & often.
Good luck.

[SteveSW]

Cigar56,
Medicare will cover the implant, with their usual co-pays etc. Your supplemental plan will pick up the rest, minus a small co-pay in some cases. If it is something Medicare covers, any Medicare approved plan is required to cover it. I paid nothing, some guys in the same situation have had co-pays of $250 to $500, depending on deductibles etc. My advice is also get the drug plan, it will save your butt. It was easy for me, no push back or issues of any kind. Good luck.
Steve

[Masonjames]

I have a Ohoma supplement. That along with medicare paid 100% of the cost. Your surgeons office can tell you what to expect from the insurance you have. I knew before hand that I'd have no out of pocket cost.

[cbinspok]

Cigar, I use United HC aarp, along with medicare and works great, but I made it clear at Drs office that the due diligence for the ins needed to be done before, and they jumped the hoops correctly, Im about a grand out of pocket with Medicare picking up about 93 k. For my 2 surgeries. Start ved now and do your homework, good luck

[Cigar56]

Thanks guys for the great information. All the responses were very helpful. Ownard.

[Gt1956]

Any ideas what the part D costs. I skipped it because of having a regular policy that covers drugs. Plus most of my meds are generic & I'm getting good results with them. My health insurance refills by mail. Most drugs are $7 for 3 months. Many of them can be bougth at Walmart for $4 a month or $10 for 3 months. Walmart even sells their own insulin. Just not in a fancy dispenser with a dial. A bottle costs around $25 & will last me a bit over a month. Only down side is you need to draw the dose into a syringe.
I read about seniors getting killed by drug prices but I'm not seeing it in my case. My only expensive one is Janumet @ $80 for 3 months mail order. Goodrx shows them at around $500 a month. If I was facing that high of a cost I'd see if my doctor could find something cheaper.
Btw, my one daughter was uninsured & suffered from depression. I search for her meds online in Canada. Seemed to me that the reputable places were clustered around Vancouver. Yes a prescription was required but hey. I was getting real name brand drugs at very low prices.