That’s the situation with my Eyelea. It is injected, so a medicare part B drug, which is medical and not pharmacy. It goes to the medical deductible. The manufacturer can’t help because they can’t give a discount for medicare. If I could pick it up at a pharmacy, I could use a co=pay card or discount and just not run it through medicare, but can’t do that with an injection.
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Husband called the rheumatologist and was told that any bio similar will be acceptable. That’s a relief, he also has a call into his patient rep with Humira and we can talk to their co pay assistance department and we will see what they say.
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Information is power! It helps to look at every option when it comes to treatments of medical conditions - before and after Medicare.
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Bumping this up
My husband’s turn is next month to sign up for Medicare.
We have a Medicare broker that we have to use because he has funding available.
They told him that he has to sign up for Medicare and then he has a call scheduled with the broker.
Does he have to call social security or is there a way to do it online? This is new and confusing. The rules seem to be changing so any guidance is greatly appreciated 
Is your husband already collecting SS?
No, will wait until 67
I believe he can apply for Medicare online.
I need to do this too, when we know when DH is retiring.
He can apply for Medicare online as early as three months before the start of the 65th birthday month. Once he has his approval, the broker can do his thing. If your H isn’t collecting SS yet, he’ll indicate that on his Medicare application. He’ll be able to set up a recurring payment online, but IIRC, he’ll need to make a payment for the first three months separately.
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Not sure what you mean by funding available. My husband still works. He’ll take SS at 70. He signed up for Medicare online, then we had an insurance broker sign us up for supplemtal insurance. We had our agent ready and we knew what plan we were going to do.
Do not go with the cheapest. Pick one of the big ones, preferably one that has a huge presence in your state. When you sign up originally, anyone has to take you. If the company goes out of business, or your doctors don’t take that insurance anymore, then you have to sign up with another company and they don’t have to accept you.
I went with Anthem, as they are huge presence in my state. It’s unlikely that any hospitals or doctors won’t use them.
Funding meaning, it’s a retiree benefit that he gets money to fund his Medicare as long as he uses their Medicare broker.
Glad to hear that it can be done on line and that he won’t have to make yet more phone calls.
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It was a little tricky to find where on the SS site to choose Medicare when you are not yet collecting SS. I had to start from a tab that said something like get retirement benefits (which was not intuitive). This was last year and the site might have been changed since then.
Note there are a few steps - create a SS account, get into that account, choose to get Medicare, create a Medicare account (need a Medicare number from SS once Medicare is approved), get on Medicare account to put in payment information.
Choosing the supplement was also a few steps. Needed Medicate approved to get a supplement. For BC/BS (which we chose) needed their insurance to actually start, then got BC/BS number to create BC/BS account online.
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Thanks! This is the information I was hoping for. How to do this.
Husband has a dot gov account from applying for global entry last year. I think all dot gov accounts are merged now. Let’s hope
I signed up last year, and I could swear I did everything right through Medicare.gov. But nope … it’s though SS. https://www.ssa.gov/medicare/plan/when-to-sign-up
He can initially sign up for Medicare A (which is free) - he will get a Medicare number. We did so for DH and he took out Medicare B later.
If he chooses to have a supplement (as Medicare broker will indicate choices if I am understanding your broker situation) he can add going to Medicare B.
We paid for Medicare B by the billing we had received for DH until he did take out SS. Once we had the billing we signed up for electronic payments out of our checking account.
I took Medicare and SS right at age 65, so all my stuff was easy.
We ran into a problem in that if one takes Medicare B in a window after age 65, there is a month where you have to begin the Medicare B enrollment either the month earlier or they can ‘back date’ for the month you wanted (with the reason of change to insurance coverage stopped). For example (our situation), DH turned 65 in June, and I turned 65 in October. To avoid a back date/mess, we had to enroll him for 9-1 (which overlapped with the coverage I had for him with my employer). Covid had limited contact with local office, and they ‘messed up his file’ - before we found out about that one month start date situation, and we actually got it straightened out towards the end of December – his file said “processing” but no one was doing anything on it. He needed that card! The supervisor of the local office had to talk the regional office through with getting his file correct, and we downloaded his new Medicare A & B card, and it was dated effective 9-1. We then got billed. If DH had needed medical services between Oct 1 and when we got the card, I would have needed to tell medical providers to ‘suspend billing’. We paid for our supplement starting Oct 1, and our drug plans (we use different ones, based year-by-year on our meds and the best plan for each of us).
DH started social security some months later, and then they automatically took the B payment out of his SS check.
All our SS checks were set up direct deposit.
My BIL/SIL also would have come into the Medicare snag - and I warned her. She thought everything was set up, and I told her to call and indicated the timing of her birth month (the initial enrollment rule) - and yes, they had to overlap a month too with her Medicare B and her employer health insurance coverage that was ending. SIL had turned 65, and BIL was working until his bonus (he had already turned 65 in earlier year). Her birth month was Feb - and although he wanted to start her Medicare right after his employment was ending, they also had to start her Medicare B a month earlier. His year-end bonus was after first quarter, and he absolutely was ready to retire (he was a retail store manager).
This ‘rule’ - one has to look specifically for it. It is an initial enrollment rule and it supersedes other rules. It is not in that Medicare & You book. It is online but you have to know how to ask for it to come up. It was a stressful nightmare for us all because his file got hosed up because people in the local office hosed up his file (in part giving us incorrect information on the phone and had us submit extra documents with drop off - due to Covid having their office closed to the public) and then ‘passed the buck’ and no-one attended to his file.
The problem with this Medicare enrollment rule and us having the problem probably has to do with how Medicare and SS have used merged info and patches along the way. Their system needs the timing gap for a period after age 65 (that one month period).
If you have not set up signing in with SS (to check your information, and when you are ready to enroll everything is set up) - if both your husband and you are eligible for SS, set up for each of you to sign in and look at your records. You can verify the wage summaries by year, and it will give you a snapshot of drawing SS at 62, 65 and if you wait until 70 (what your monthly payments would be estimated to be). Enough work periods and the explanation of how your SS payments are determined.
IDK if you can sign up for Medicare w/o first getting the log in with ssa.gov first. We had already had our ssa.gov sign ins before Medicare age. I worked enough periods, and enough money went into SS that I could draw my own SS payments (I worked a sunset career for almost 5 years and ended right at age 65).
For H, he waited until he was retired and 70 before signing up for part B. When he worked fulltime, BCBS was primary and we signed up for A because it was free. The SS agent refused to process H’s Medicare B but handed us back the form when we went in and asked why he hadn’t gotten his Medicare B card. H went the next day and had a more competent employee process his papers on the spot. We just avoided a penalty for late sign up because the 2nd worker was able to competently process the paperwork.
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My husbands firm had an agent they recommended to walk us through everything and what to do, with the understanding we would bring buying the supplement from her.
She walked thru each part, what we had to do. Answered several. Answered several more questions. I recommend you do that. It was so helpful.
We did something similar, but I found a Part G I liked better than what they recommended. The broker was able to sign me up for the same price I saw on medicare’s website. I also found a Part D for less on the website and they said I they couldn’t offer that to me (under $2/mo, I’m very simple). Easy enough to do it myself.
I suggest doing your own due diligence. The cynic in me wondered if they got a higher commission for their recommended plans.
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I signed up for Medicare A around my 65th birthday online. It was very easy. I received the card in few weeks. I will wait until I am ready to retire to sign up for supplements, and it will probably be G. I spoke with a Medicare specialist, but when he found out that I wasn’t going to sign up for an Advantage he lost interest.
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We never signed up for any supplement and gave Medicare A&B plus the medical coverage H retired with as a family plan. It works well for us.
We have been repeatedly warned against Medicare Advantage (MA) plans as they are very poor for reimbursing providers and many HI providers will no longer accept patients covered by MA plans.
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