#they send you basically a D&D player's handbook sized 'pamphlet' explaining it all

[lunod]

Why did they discontinue your drug plan? Are you still on Medicare?

Turning this into a Medicare Explanation Thing since a lot of people don't know, feel free to save this if you/someone you know is waiting on SSI/SSDI case or thinking about it. Medicare comes in 5 separate parts because why not make disabled people jump through a bunch of complex unnecessary stuff.

Part A is hospital, covering specifically hospital bills not regular outpatient appointments. Part B is medical insurance which is your primary Dr and everything outpatient. When you get on disability they will give you Part A and/or Part B. If you have both they call it Original Medicare. Original Medicare also only covers 80% of the cost of everything, you have to pay 20% out of pocket and they don't have a limit meaning there's not a point where you stop paying the 20%. Oh and Original Medicare doesn't cover vision, dental, or hearing.

Part D is prescription drug coverage. They usually do not immediately put you on this because it costs extra, but also if you fail to sign up for it and then sign up several months after getting Medicare you will be penalized with an extra cost for the rest of the time that you have Medicare (yay!). Part D is not directly through the govt, it's private insurances like United Healthcare that are contracted with the govt. If you only have Original Medicare, none of your meds are covered and you have to pay full price.

Part C is also called Medicare Advantage, it is optional where you get Part A, B, and D all bundled together but you do this through private insurers like UHC and BCBS. Some of them do not charge a premium but some of them do, which is important because you would be paying for Original Medicare and then also potentially paying another premium for Part C. There is also the downside that Medicare is accepted by a LOT of places, but if you do Medicare Advantage you have to go through drs that that insurer covers. That may/may not be an issue depending on where you live. Upside is it may cost less (because they often have limits on how much you pay before they cover 100%) or cover more things than Medicare.

Last one is Medigap which is a separate plan (that you also pay for and get penalized if you don't sign up in time) that helps pay for your deductible. The Original Medicare deductible is $200-something for 2023 meaning you have to pay that amount before Medicare even bothers covering 80%.

So for my specific circumstance, I still have Original Medicare and there's no issue with my govt disability payments either. I was auto-enrolled for Part D because I qualified for Extra Help (basically I am Extra Poor), but for some reason UHC gave me drug insurance for a state I don't live in. I called to correct it and they told me it was fine and they would just switch me to the correct state, except the contractor actually just cancelled the plan entirely without telling me that's what they were doing and also without signing me up for a new plan. Which I found out when I went to pick up from the pharmacy. If I did not qualify for Extra Help, which has Special Enrollment Periods, I would have had to go 4 months without drug insurance until Open Enrollment in October...I just lucked out so instead of waiting til Oct I only have to wait til next month.

#disability pride month #cripple punk #cripplepunk #medicare #disability #this is the bare bones of it too...not even talking about dual wielding Medicare/Medicaid #they send you basically a D&D player's handbook sized 'pamphlet' explaining it all #ask #anonymous