shopping, and disability/medicare update

[redbird]

I went to REI today in search of a fall-weight jacket. I now have a jacket that will do, but that I am not delighted by, so I may try another store or two next week. The new jacket's fit is OK but not great, and it's black, so it can easily get lost among all the other black coats in that closet. I also bought a pair of gloves; again not great, but I've given up on finding gloves I actually like.

My retroactive disability benefits were deposited in my bank account a couple of days ago. It's more than I expected, because I'd forgotten that the lawyer gets a percentage "or $7200, whichever is less," so instead of 25% he got about 15%.

I'm spending a bunch of time looking up different Medicare Part D (prescription drug) plans. This morning, I identified the three plans available in this county that have Kesimpta, my expensive MS drug, in their formularies. The Kesimpta costs enough even with insurance that I will hit the $2000/year out-of-pocket maximum that I'd have to pay in January or February, so what's in the formulary matters more than my copay for other prescriptions.

My next project is to compare the available "Medicare Advantage" plans. The disadvantages of those plans are that they limit my choice of doctors, and require referrals for some doctors. Possible advantages are that I think I'd have a smaller copay per visit, that this may be the only way to get them to keep covering telemedicine appointments with my regular doctor, and one or more of those plans may cover something else I would use. Basic Medicare will stop covering telemedicine for most people at the end of 2024 (the exceptions are a few specific medical conditions I don't have, and people living in rural areas).

Comments

[ethelmay]

My husband is going to do Medicare Advantage because it means he can continue with Kaiser, which he likes and has been with a long time. Outside that kind of situation, from what I have heard, usually classic Medicare is better if you can swing it. But that’s very worrying about telehealth coverage going away. I had assumed it was such a cost saver that it was bound to stay, and might even be overused.

[redbird]

I looked for more information about telehealth coverage, and mostly found things from years ago, but also there are people who want to extend it. This seems to be a consequence of careless rule-making: it was written for the pandemic, and then extended from the end of the state of emergency, but the extension was only through 2024. And getting Congress to do anything substantive in the next few weeks looks unlikely. I should contact my congresswoman's office about this, because it can't hurt to ask, though a bill sponsored by someone other than a member of the Squad might have a better chance of passing.