Kidney/Pancreas
Did anyone get Medicare after kidney/pancreas transplant?
September 13, 2022
in Kidney/Pancreas
The hospital informed me that I am eligible for Medicare after transplant since I received a kidney/pancreas. I called my insurance and they do not require it so now I have to figure out if its worth it to sign up and pay for Medicare. I know that Medicare can help with the hospital costs, and medication costs. Right now, my medication costs are very minimal. I also carry a supplemental hospital insurance policy. I can't decide if it will be worth the additional $170 a month for Medicare. Does anyone have any insight?
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hello,
I have Medicare plan A,B,D. I received this plans A&B when I was on dialysis before my two kidney transplant. I think you are also eligible for Medicare. Plan A is for hospitalization, and that's free. Plan B, you have to pay for the premium, this covers 80 percent of your bills. Plan D is for medication. I have a TCFL insurance to pick up the 20 percent. So, I have no outstanding bills after hospitalization or even doctors visits and no co-pays at the doctors office.
corrections; received Medicare plan B after my first kidney transplant.
My dialysis center suggested that I enroll in Medicare parts A/B, which I did, 9 years prior to transplant. Having retired from the military I was eligible for Tricare for Life (TCFL). Which I had been using as secondary insurance. I kept my insurance provided by my employer until after transplant when I then cancelled it
Since I reside close to a military base, I was eligible to pick up my prescriptions on base, after 90-day post-transplant, I transferred my prescriptions to the military base, providing me with a 90-day supply of each medication, every 3 months. This also removed my dealing with the specialty pharmacy which did not take any of my medical insurances.
My transplant surgery was lengthy at just under eight hours, the following morning during a 5:30am Ultrasound it was determined that a second surgery was required, and I spent an additional seven hours in surgery. I spent a total of 10 days in the hospital. Looking at the billing for surgeons, hospital etc. It was just under a million dollars. Thankfully, the insurance covered all. Since then, I have only Medicare and TCFL which between the two covers 100%. and have since had two additional surgeries, along with infections, etc.
For the cost of $170 dollars monthly (if you make less the $97K annually) this covers 80% of your medical expenses. I thinhk it well worth the cost.
What a great question! It really depends on your other insurance option. When I weigh this decision every year both before and after K/P Transplant, it takes itemizing predictable costs to make the actual calculation. For me, every year after factoring in my required specialist visits and prescriptions, my private insurance (Blue Cross/Blue Shield) prevails as the most cost-effective option. Through private, I hit my in-network deductible in month 3-4 on the year and everything is 100% covered afterward INCLUDING mental heath. In my case, this cost is less than Medicare plans which cost at least $170 per month with responsibility for a percentage of copays, specialists, and hospital/clinic visits.
The first year of transplant I was enrolled in Medicare by the transplant center. It worked with my Blue Cross/Blue Shield plan as a secondary. It was great to have my co-pays and miscellaneous costs covered the first year since there are so many visits. Through the middle years of the transplant, my out-of-pocket costs were minimal. But when I ran into my first rejection episode and lengthy hospital stays, I was sure glad I had a secondary. If something happens it can get overwhelming very quickly.