Primary Care Doctor

[Blues]

On 1/18/2020 at 5:14 PM, Barbaraok said:

I had a cough I couldn't get rid of.  Went to a community clinic, physician assistant took history, listens to my breathing, ordered a CBC and a swab for strep before determining whether or not an Rx was in order.  Also saw the physician who directed the clinic who explained that the results were negative for a bacterial infection, asked whether I wanted a cough expectorant with codeine so I could sleep, I declined, so he told me which expectorant/cough suppressant would probably work best, gave me a copy of my results so if it didn't clear within about 10 days,  I could seek additional care.  

Did it end up going away on its own? 

[Barbaraok]

Yes, it was viral and cleared on its own.   The older I get the longer it takes to get over colds. 

[whj469]

A am not sure what an F Plan is?

[Kirk W]

1 hour ago, whj469 said:

A am not sure what an F Plan is?

Medicare supplements come in different categories called plans with a designated letter. Plan F covers all expenses that are not covered by Medicare. 

[Barbaraok]

F Plan is a grandfathered in Supplement plan for Medicare

[TXiceman]

My wife and I switched to a G plan this year after having the F plan for about 5 years.  With the F plan no longer offered to new enrollees the charges per year are sure to accelerate faster than they have been with the plan pool shrinking rather than growing.  With G you are responsible for the part B deductible.  For us, the reduced G plan premiums save considerably more than the deductible for G plan.

But everyone needs to look at the options for their particular situation and location.

Our other reason to change was we also changed Part D coverage.  Optum Rx is horrible and we finally had enough of dealing with their mail order system.  We switched to Silver Script and we can now get our 90 day supply at Walmart.

Ken

[docj]

11 minutes ago, TXiceman said:

My wife and I switched to a G plan this year after having the F plan for about 5 years.  With the F plan no longer offered to new enrollees the charges per year are sure to accelerate faster than they have been with the plan pool shrinking rather than growing.  With G you are responsible for the part B deductible.  For us, the reduced G plan premiums save considerably more than the deductible for G plan.

FWIW assumptions about how insurance companies calculate their "risk pools" are entirely without any evidence.  It's just as likely that, since the supplements are mostly based on "attained age" that the companies will use attained age claim data from recipients regardless of what supplement they have.  The internet is full of assumptions about which there is no evidence.

15 minutes ago, TXiceman said:

Our other reason to change was we also changed Part D coverage.  Optum Rx is horrible and we finally had enough of dealing with their mail order system.  We switched to Silver Script and we can now get our 90 day supply at Walmart.

Even though it's now too late for this year's "open enrollment" I strongly urge people to use an online calculation tool to assist with making their Part D choices.  Your cost for an entire year, including premiums and copays, can vary tremendously from carrier to carrier and even from plan to plan from the same carrier.  Your lowest annual cost isn't always the plan with the lowest monthly premium.

As a simple example, this year the calculator we use recommended that I use an AARP United Healthcare plan called the Walgreens Plan.  I was curious why that plan was not recommended for my wife even though the calculator recommended United Healthcare for her, but had selected a different plan.  So I examined the detailed info and discovered that one of her numerous meds wasn't covered by the Walgreens plan even though it was covered by the one that had been recommended.  Furthermore, the premiums for the two plans were only pennies apart.  But the two plans don't share the same Rx formulary.  Therefore, there was a substantial difference in annual cost between the two of them even though one would never have known it from a cursory examination of premiums or benefits.

Through the use of an online calculator we change Part D plans nearly every year.  The application process is easy and acceptance is guaranteed if you had a plan in the previous year.  My philosophy is to make the change if the annualized difference is >$100.

Joel (AKA docj)

[RV_]

If you're a vet the VA has hospitals and clinics all over. We were retired Military with 30% disability and traveled with what was then Tricare Standard, and could choose civilian Docs and get emergency care anywhere. When we had the rare issues like when I fell off the top of the ladder stretching while waxing the RV at Sutherlin OR CoOp, or when I got a white sock bite that swelled my arm wrist to elbow enormously in Soldotna Alaska in 1999 when we did Alaska for the season, I saw the local Doc there who knew what I was there for. They call them white socks because that's what they look like under a microscope. They're gnats, no see ums, and this one got me under my watch band. But we went full-time for seven years when I retired from 27 years USAF at age 45. So we were in great shape compared to now at 67 and 65. We don't get colds or flu much. the last time I got the Flu was because my roomie had it in 2007 when we went to a contractor convention and shared a room. We started getting allergies in our early 50s. I quit smoking and drinking because while drinking wasn't an issue, I smoked three or more packs a day. When I quit Smoking I took a month to start to clear my lungs and within another month my allergies were "miraculously" cured. That was 2010 and I've had the sniffles. I don't get headaches not even when I had infected sinuses in my 20s, just a feeling of pressure not pain. My wife still smokes and still has allergies, taking Claritin and inhalers as needed. She knows but does not want to quit having her scotch and a half to one pack a day smoking in the garage or outside, not in the house. But we are slowing a bit and getting the frame aches. No cholesterol or heart or diabetes issues. Just feel it when we overdo it. So Tricare standard was fine when we didn't need a doctor in the year, which was most years, we paid zero. My maintenance drugs are naprosin for the cervical and lumbar and Flexeril for the spasms. I'll be trying CBD and a hint of THC to replace the Flexeril but not to feel it or be high, so I can drive. Point being vets have other options that complement Medicare, Tricare, or Tricare For Life with Medicare.