[Lillianlee]

My husband has high blood pressure ,diabetes, neuropathy, sleep apnea, and is over weight. He will be retiring in January 2012
And we do not know how to select the right medical (Medicare)insurance coverage that will give him the medical care
He needs. He is on 12 different type of medication, of which 4 can not be changed over to generic. We also have
To take medication into account.

Any suggestions or information on where we can get information that will help us make a sound decision would be
Appreciated.

[Fr_Chuck]

Unless of course you are considering one of the Advantage plans, Medicare is medicare, and you sign up though the government for it.

If you are talking about a policy to pay the co pay amounts of medicare again most are the very much the same, they are normally only a few choices in plans, each of the vendors will sell one of the 4 or 5 plan types available in your state.

Almost none of them cover all the different drugs well. So honestly don't expect to find one that pays well on all of the drugs used.

On this, go to the drug store and talk to the druggist there. Ask him to look at the drugs used and which drug plans would pay the best. ** some places will help you, others won't but it is a place to start.

Next ask the several companies that offer coverage for drugs ( normally drugs is a separate benefit) ask them for a list of their drug schedule and it will tell you what they will or won't pay for a long list of drugs.

On average, ** and I will give a disclaimer I am a licensed insurance agent*** but I do not current sell, I keep my license for other purposes. I have found that over all, for most people the AARP plan though United Healthcare is about the best plan around for cost and coverage, Does that mean it will pay for everything, no, does it always have the most coverage for some specific drugs no, but over all it is very good.

[Lillianlee]

Thank you Chuck.
I have contacted AARP and I do agree with you as far as the Part D coverage for prescriptions drugs.

If you do not mind me asking, we are still struggling with the decision on whether to sign up for
HMO coverage or PPO coverage. Being that he has so many health issues we want to make sure that he
Has the best coverage. Both his doctors that he wants to keep seeing do take the plans covered through
HMO. What would be the pro and cons of HMO verses PPO if he is seeing his same doctors.

[Fr_Chuck]

I am a little rusty in the medicare markets, But also look at the Hospitals he may want to use, any special heart doctors or surgical groups ? Normally you are going to have increased coverage with the HMO but they may limit or question referrals . Also issues have come up at times at surgery if not all the people there are covered under HMO, the hospital and main doctor may be, but the person who puts you under are always outside contractors, The specific drugs used in the hospital are not always covered
But then under the PPO plan often they are out of plan also. That is just a risk we always take.

Plus of course each year they have a open enrollment so during basically Oct or Nov you can change to another plan or another company if you did not like the old one.

I would take the HMO personally if my doctors and hospitals were covered under it and I could afford the slightly higher fees. **

Which of the AARP plans were you looking at. Also what state, I may find some comparison charts for that plan and state.
Note, if I am off here shortly, it is almost midnight, I will be back on tomorrow evening

[Lillianlee]

Thank you so much for your response.
When I am talking to the different brokers, I am comfortable to a certain degree that I understand what
they are telling me. In some cases, they start talking over my head and try to pressure me into singing
up with their plan. I decline, of course, as I am still checking into to the various plans.
AARP is sending me some information booklets to review.

The information you have provided me is most helpful and appreciated. Once I have looked through the
information I will have more questions for you and am hopeful that you will continue to direct me in
what to look for. I would not have thought to inquire about the hospital that he usually goes to.

We reside in Orange County California.

Once again, thank you very much for your valued input.

Regards.

[Fr_Chuck]

Check out your state department of Insurance, I did not get a chance to go there, but often many have a Medicare area where they will show all the plans, ( which ones are the same as others) and the costs.