Re: Xolair cost for seniors

[Guest guest]

>

> 2. I'll turn 65 in a few years. Will medicare or medigap or medicare

> drug coverage pay the Xolair costs and what will the copays be?

>

Good question. I turn 65 in 12 years. My current medical plan will be

converted into a supplement and I will have Medicare, IF it is still

around at that time. I am sure my supplement will cover it, but the co

pay is what I worry about. I will be on an extremely fixed income then.

Doug

[Guest guest]

I am not an insurance expert, but I have had some experience with insurance.

When I retired my school had been paying for my medical insurance as well, but

it was just for me. My husband had insurance through the government as he was a

letter carrier when he retired. When he retired he had the option of keeping

his " government " health insurance. It covered him until Medicare kicked in

several years later and then he had the option of keeping GEHA as a supplemental

insurance. When I retired, I was eligible immediately for Medicare (my age) and

my husband added me to the supplemental policy.

There are a number of supplemental policies offered such as AARP offers one.

Don't know the specifics, just know they offer a supplemental policy. Then

there are insurance groups such as Secure Horizons, where you can get the

minimum coverage under Medicare and pay a co-pay for everything. You can also

pay a premium and get extended and added coverage to your Medicare. Humana also

has such a policy.

The best suggestion I have is for you to go to the Medicare site and see if

there are some answers there. Then I would also suggest looking on Internet for

" Senior Policies " until your Medicare kicks in. The premium on these policies

can be high.

I also think that what state you live in might make some difference in your

policy.

Oh-usually, when you change jobs and get the medical insurance coverage, there

is a three month waiting period before it kicks in for pre-existing conditions.

At least that's the way it was with the policy I worked under several years ago.

It might be helpful for you to begin investigating supplemental policies and

their prescription plans, especially. That is still where my biggest expense

is--my co-pay for all of my other meds. At least I pay nothing for my xolair!

There is probably someone else who can give you even more information.

I know that when my husband retired and then when I retired about six years

later, our biggest concern was treatment of my asthma and making sure we were

adequately covered. Each person just has to do research and comparing on their

own to find the best coverage that is available for their situation.

Best wishes and hope you find good insurance coverage.

Adah

mister_manganese <mister_manganese@...> wrote:

My wife's employer pays for our medical insurance which pays for my

Xolair shots. She will retire in a couple years and loose the

coverage. My employer doesn't offer medical insurance.

I have some questions about this upcoming situation:

1. If I find a new employer that offers medical insurance, am I likely

to have the new insurance company deny Xolair costs as a treatment for

a pre-existing condition?

2. I'll turn 65 in a few years. Will medicare or medigap or medicare

drug coverage pay the Xolair costs and what will the copays be?

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[Guest guest]

Although I am still debating if it was the xolair I was reacting to as I am

allergic to latex and was having reactions in an medical office building. I am

on Medicare the xoalir I think is under what is called a cancer drug. It is

strange but it is covered 100% .

Karin

Karin,

Since this shot is relatively new, insurance companies do not have a code for

the doctors office to use when filing claims. " Chemotherapy " is the closest

thing they have it to describe it.

When I first saw that on my benefits statement, I about fainted dead away. Mine

is NOT covered 100% but 90% of the contractual amount.

Doug

Group founder

[Guest guest]

Hey, Man, I think your best move would be to be sure you continue your wife's

insurance after she retires on a COBRA basis until your Medicare kicks in. The

key is continuous coverage - if there is a lapse, pre-existing conditions can

apply on any new insurance you get, including conversion to a supplementary from

your wife's primary. Just simply don't let a lapse occur, and they have to let

you convert to COBRA, so it shouldn't be a problem.

If your wife retires at 65 and goes to Medicare, she'll probably just convert

her primary to a supplementary. However, if you're not employed with anyone who

has a medical plan, you'd lose coverage. However, she might be able to continue

the primary coverage under COBRA for just you while she is on Medicare - but

that probably would leave her without supplementary until you hit Medicare, at

which time she might be able to convert the Cobra to a supplementary. It gets

kind of tricky and you really have to watch what you're doing or you'll screw

up, but you should be able to work something out to your advantage.

I retired a bit early at 63 and used Cobra until I hit 65 when Medicare kicked

in and I simply converted the BCBS Cobra coverage into BCBS supplementary - it

was seamless. Re the Xolair, Medicare covers part and BCBS supplementary covers

the rest - actually, I think BCBS ends up paying more than Medicare. In any

event, I haven't had to pay anything yet. The only drawback is I have to go to

the hospital for the injections, which is not really a big deal because I just

pop into Outpatient Services, they poke me and I'm gone. Getting there takes

longer than doing it.

Terry

----- Original Message -----

From: mister_manganese

Sent: Saturday, September 22, 2007 12:53 AM

Subject: [ ] Xolair cost for seniors

My wife's employer pays for our medical insurance which pays for my

Xolair shots. She will retire in a couple years and loose the

coverage. My employer doesn't offer medical insurance.

I have some questions about this upcoming situation:

1. If I find a new employer that offers medical insurance, am I likely

to have the new insurance company deny Xolair costs as a treatment for

a pre-existing condition?

2. I'll turn 65 in a few years. Will medicare or medigap or medicare

drug coverage pay the Xolair costs and what will the copays be?