Quote:
Originally Posted by paulascorpio
My husband and I were on UHA through The Villages starting January of last year. Great not having to pay anything. We were originally on Medicare with a plan F supplement but switched to the UA plan. Then in July last year he developed Multiple Myeloma. Within 4 weeks, we incurred $16,500 additional cost of co-pay bills. We immediately switched back to Medicare and a Plan F supplement as we were allowed to switch back within the year. The only bills incurred with his cancer from that point on, were those while on United.
I am so grateful that we were able to switch back.
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Having just switched to UHC MA from Plan F, could you please elaborate on just how this happens? The max out of pocket expense on option 1 is $4400/yr. and $1900/yr. on option 2, exclusive of drug cost, which is identical to plan F. There are co-pays on MA, but they are $15 and $30 in general, so $16,500 in 4 weeks is unlikely in co-pays. Did you include the cost of very expensive tier 5 drugs that you received in the first 4 weeks, in which case the cost would have been the same on plan F? Did the cost of drugs push you into the catastrophic phase and therefore the main cost fell on the MA plan? Was there a bone marrow transplant in the first 4 weeks? And finally, did you choose to utilize an out of network provider without prior approval? Since the formulary and terms of coverage are virtually identical in the 2 plans, the main difference is the network restriction.