Originally Posted by VillagesFlorida (Post 388800)

Just a thought: The main reason we are switching from the Advantage Plan to the Gold Plan is because of the possibility down the road that we might need chemo drugs. I am a 10-year breast cancer survivor and my husband is now 14 months out from prostate cancer surgery. At this point we are both doing fine. BUT, I started thinking about the "what-ifs" and decided to take a closer look at the coverage for chemo drugs, should we ever need them. The Advantage plan pays 80% of the cost of these drugs where the Gold plan pays 100%. I know that a 20% co-pay, if I stay with the Advantage plan could be a lot of $$$, as these drugs can be very expensive. For us, the peace of mind will outweigh the Medicare Part B premiums that we will start paying again, come January.

Originally Posted by VillagesFlorida (Post 388800)

Just a thought: The main reason we are switching from the Advantage Plan to the Gold Plan is because of the possibility down the road that we might need chemo drugs. I am a 10-year breast cancer survivor and my husband is now 14 months out from prostate cancer surgery. At this point we are both doing fine. BUT, I started thinking about the "what-ifs" and decided to take a closer look at the coverage for chemo drugs, should we ever need them. The Advantage plan pays 80% of the cost of these drugs where the Gold plan pays 100%. I know that a 20% co-pay, if I stay with the Advantage plan could be a lot of $$$, as these drugs can be very expensive. For us, the peace of mind will outweigh the Medicare Part B premiums that we will start paying again, come January.

Originally Posted by wendyquat (Post 388807)

I can not find any providers on their website that I have ever heard of so I am a bit leary of trying this plan. I also use WalMart and Sams pharmacies because of their availability while traveling and they don't seem to be listed in the network either.

Originally Posted by ajdeck (Post 388964)

I also was a cancer survivor but now back in some heavy duty stuff. Question is do you know how many Pet Scans can are covered in a year?

My insurance (just thru luck) covers all but the hospital just told us how lucky we were since most only cover two or three a year. I'm doing stem cell right now and Pet Scans are taken quite offten.

Thanks and good luck at beating your cancer and hope you never see it again.

aj

Originally Posted by JenAjd (Post 389096)

I'm interested in PCP...my healthcare provider currently isn't in the system. I saw him today and asked what was up with this. I was told that they had their paperwork in and were waiting to be accepted. That PCP only takes a certain number of providers in their enlistement period. I don't know if this is true or not...they had told me at the end of last year they'd submitted their paperwork (still waiting) and my chiro. had done the same thing and was already "in" a few months ago. I'm wondering if anyone here can shed some light on this??!!! It's kind of scarey to be already established with someone you trust and like then have to change into the "great un-known"!!

Originally Posted by Avista (Post 389011)

I am looking at the Gold book. I don't see any limit on Pet Scans. It does say for Pet Scans you will pay a co payment of:
0 at primary care physicians office
$100 at in network specialists office
$100 at freestanding in network diagnostic and imaging center
$150 copayment at an in network hospital facility as an outpatient

Remember there is a $3400 out of pocket limit with the Gold plan.

Originally Posted by Avista (Post 389106)

Sometime when you are in Sumter Landing, stop by the Prefferred Care office. They are near the AAA office. Maybe someone can answer your question about your doctor.