Medicare Advice Please

[spanky]

Backstory... My 76 y.o. mom lives in Florida and is on a regional medicare plan (essentially an HMO). I need to bring her up to NYC for extended care at Sloan Kettering. Her FL plan won't cover her up here. To solve that problem, my thought is move her up to our home (full relocation with Social Security) and get a new Medicare plan in NJ. If this residence/insurance move is possible (I believe it is so far), she is still facing the 20% co-pay and being balance-billed for the amounts above and beyond what Medicare pays. My mom found that there are supplemental Medicare plans through AARP (Plan F or G) that would cover the co-pay and "Part B Excess Charges" 100%. What I am unsure of is if there are exclusions for pre-existing conditions on these supplemental plans or if the move out of her coverage area gives her "guaranteed issue rights". I see mention of both possibilities across the interweb.

I'm still learning the ins/outs about Medicare and I am even considering contacting a Medicare consultant/advisor. First thing tomorrow, I will call my State Health Insurance Assistance Program (SHIP). In the meantime, any advice/comments/words of encouragement and even +vibes would be greatly appreciated.

Oh yeah, and Fuck Cancer!

[Benny Profane]

Man, if she gets supplementary at her age and fighting cancer, please get back to us about it. That's like taking out an auto policy after you wrecked, or homeowners while your house is on fire.

[MTT]

I have head that Social security or Medicare provide free legal advice. State paid Representation.
To represent the elderly in cases where assisted living is involved. This from my 76 year old mom

[jfost]

Sign up for Medicare/medicaid in NJ or does she have too many assets?

[Cono Este]

I am a Meducare broker.

If she moves permanently, then Your Mom is leaving her MAPD service area. That entitles her to a special enrollment period to join another MAPD up north, or even buy a Medicare supplement guaranteed issue (no health questions). But she will be limited to a Plan F. You can only switch the 1st of the month so you should try and time it.

I was in the same situation with my mother last yr. nursing homes hate MAPD’s anyway. There is actually a separate, nursing home SEP to disenroll from them.

You probably want the Plan F and be done with copays and have no network.



PM me if you need an agent, I know a good one in NJ.

[bigdude2468]

I am a Meducare broker.

If she moves permanently, then Your Mom is leaving her MAPD service area. That entitles her to a special enrollment period to join another MAPD up north, or even buy a Medicare supplement guaranteed issue (no health questions). But she will be limited to a Plan F. You can only switch the 1st of the month so you should try and time it.

I was in the same situation with my mother last yr. nursing homes hate MAPD’s anyway. There is actually a separate, nursing home SEP to disenroll from them.

You probably want the Plan F and be done with copays and have no network.



PM me if you need an agent, I know a good one in NJ.

What he said. When there is a life changing event such as moving you can easily switch to a different Medicare Plan. We did it last August when we moved in state but out of coverage area for the plan we had. As far as pre exisitng conditions I would guess that a majority of people age 65+ have pre existing conditions of some kind. FWIW being able to switch to a more inclusive plan is a benefit.

[spanky]

What he said. When there is a life changing event such as moving you can easily switch to a different Medicare Plan. We did it last August when we moved in state but out of coverage area for the plan we had. As far as pre exisitng conditions I would guess that a majority of people age 65+ have pre existing conditions of some kind. FWIW being able to switch to a more inclusive plan is a benefit.

Thanks bigdude and Cono Este. This is reassuring. Cono, check your box.