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Cost of 6 month lupron

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Posted 2/26/2021 11:34 AM (GMT -5)
JNF
I now have medicare B. The cost of my next injection out of pocket is about 300 more reasonable. I was added to the advisory board. LOL I placed a go fund me page, received about 6 bucks, enough for a cup of joe.
Posted 2/26/2021 12:56 PM (GMT -5)
Howard, which Medicare supplement plan do you have? If it is G, then your cost will be the Medicare B deductible of $203.00, unless you meet some or all of the annual deductible before your next shot. Where are you getting the $300.00 amount?
Posted 2/27/2021 11:17 AM (GMT -5)
You say you are in Wisconsin. You are long over due to talk to these folks.

https://www.dhs.wisconsin.gov/benefit-specialists/medicare-counseling.htm
Posted 2/27/2021 5:33 PM (GMT -5)
JNF - There are K & L plans in WI so anything is possible. MN, WI, & MA do not follow national "rules".
Posted 2/27/2021 8:44 PM (GMT -5)
Yes, probably N also. Of course, F is no more as it was taken away last year so every plan now has a deductible.
Posted 3/1/2021 7:00 PM (GMT -5)
Pirate, my understanding of the High Deductible Plan F is that for 2021 your annual deductible is $2,370 and applies to both Medicare A (hospitalization) and B (non-hospitalization) expenses, but not self-administered prescription drugs (Plan D) which have separate deductibles and co-pays). So, expect to pay whatever your unused deductible amount up to $2,370 as your share of the next shot.
Posted 3/1/2021 8:38 PM (GMT -5)
The nice part is there is no medical cost for the year after the deductible is satisfied so if you have some medical things on your to-do list, now is the time. Drugs are another story.
Posted 3/1/2021 11:13 PM (GMT -5)

Pirate74 said...
JNF... actually, my Lupron is administered in the MO office in their infusion suite with a nurse injecting into my hip. The MO office told me that it will be handled under B and not D. I will double check.

Though I prefer to pay very little, the $2300 will be lot less then the $2400+ a month both my wife were paying for medical coverage. When she went on Medicare last May my portion was $1200 per month.

Thanks for giving me the heads up to double check, sure don't want to be surprised come May.

In office injections are covered up Part B.
Posted 3/2/2021 6:58 AM (GMT -5)
Yes, Pirate, that is what I explained. Lupron is an injectable by a medical professional, not self administered, so it is Part B. If you were admitted to the hospital and received it, then it would be Part A. Of course it is not Part D since it is not self administered.

Your Plan F High Deductible supplement plan covers Parts A and B and imposes a yearly deductible of $2,370. The deductible is set for all Plan F plans and changes each year when the Medicare A and B deductibles are re-set by the CMS. This is done in the fall of each year.

As to lower total cost, I have never favored nor suggested the High Deductible F plan due to the high deductible unless someone absolutely expected receiving very little or no medical treatment. Usually not the situation for Medicare age people. In my situation Plan G has been the lowest total cost. My Plan G supplement insurance premium is about $145 per month, $1,740 per year. Plus I will pay the $203 Medicare B deductible. All in that is $1,943 per year. For Plan F you pay the $2,370 deductible plus your premium.
Posted 3/2/2021 11:05 AM (GMT -5)
Thanks Pirate. The Medicare B deductible of $203 is Medicare. In the past we had Plan F that paid that deductible for you. That is no more and everyone in traditional Medicare now has to pay the Medicare B deductible regardless of the supplement plan chosen. For most people regular Plan G provides the lowest total cost as your math shows. Your supplement plan deductible includes the Plan B deductible.

Regarding the EOB it will basically show you the billed amount, then any adjustments down to meet Medicare limits, then the Medicare payment, then any supplement coverage net of the deductible and then the amount you will pay out of pocket.

Remember Medicare B reimbursement is 80% of the approved cost. You are responsible for the remaining 20% with no limit. It is to cover that 20% plus the gaps in Part A that your supplement insurance covers.
Posted 3/2/2021 12:37 PM (GMT -5)
Thanks,

On to important stuff. While never really a Pirate fan (other than Jack Sparrow) my favorite World Series was 1960 when the Pirates obliterated the Yankees in seven. I was in fifth grade and my astute teacher, a Yankees fan, decided to devote afternoon class to current events and the media. He brought his TV to class and we watched the Series. Then, and to this day, I had no use for the Yankees so I sat on the Pirate side of the room and cheered rowdily. Roberto was stellar and if I recollect hit over .300. A great time.

I also remember that Mazeroski and others were real party animals. During the series a few of them got loaded and somebody cut his foot and had to get stitches without letting the coaches or media know about it and still played well. It was several years later that I read about it in SI, but don’t recall the details.
Posted 3/2/2021 1:09 PM (GMT -5)
JNF,
When I was in junior high at least some of World Series games must have still been played during the day. I remember our social studies teachers, most of whom were also coaches, would bring in a TV and the class would watch the games. I suppose, with a wink, the event could be thought of as a "social study."
Posted 3/2/2021 1:35 PM (GMT -5)
Jimmy is a Pirate I support, as well.
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