Moving out of state and need to chg Medicare Plans

RetiredTeacher

We are moving to NC from CA and must select a new medicare plan. We currently have a MC advantage plan but have heard switching to original medicare at this point, since we are able to switch with the move, might be the right choice. I believe there is no health qualifications to switch during this time. DH has VD with a history of strokes, abdominal aneurysms and atherosclerosis. I don't know much about original medicare and have been researching what is available locally back there. We will need a part D plan for prescription drugs and also a medigap plan. So many choices of medigap plans. Do any of you have experience with medigap plans or helpful info you can share? Resources? Ty in advance. I am interested in the GUIDE program for my husband.

blacksparky

We moved from Minnesota to California. We originally were from California and moved to Minnesota when I retired and before DW was diagnosed with EOAD. Had to move back for family support. Anyway my wife is on traditional Medicare and I’m on advantage plan with Kaiser. She had to go traditional to qualify for medi-cal. I really like Kaiser so didn’t want to go traditional Medicare. I believe your DH needs to be on traditional Medicare to get on the guide program. My DW is with the PACE program through Medi-Cal.

blacksparky

https://alzconnected.org/discussion/comment/273990#Comment_273990

PACE helps older adults who qualify for nursing-home-level care continue living at home and in their community. It provides comprehensive medical and support services through a single coordinated program.

What services does PACE cover?

PACE typically includes:

• Primary and specialty medical care
• Prescription drugs
• Hospital care
• Nursing care
• Physical, occupational, and speech therapy
• Adult day health services
• Transportation to medical appointments
• Home care and personal care assistance
• Social services and care coordination

Who is eligible?

Requirements generally include:

• Age 55 or older
• Living in a PACE service area
• Certified by the state as needing a nursing-home level of care
• Able to live safely in the community with PACE support

How is it paid for?

• If you have Medicare and Medicaid, most or all costs are usually covered.
• If you have Medicare but not Medicaid, you may have a monthly premium for the long-term care portion.
• Private pay options may be available in some areas.

RetiredTeacher

Ty for the information. I will research the avail of PACE in NC. I never considered that DH and I could choose separate medicare plans. We currently have Kaiser Sr Adv and really like it. I like the idea of continuing medicare advantage for me and having Original Medicare for DH with a part D and Medigap plan. I did find a resource in NC to learn more about those options. Tysvm for providing helpful information.

blacksparky

https://alzconnected.org/discussion/comment/273998#Comment_273998

The Program of All-Inclusive Care for the Elderly (PACE) is available in North Carolina, and the program has expanded significantly across the state. North Carolina currently has multiple PACE organizations operating from numerous locations and serving many counties.  

To qualify, a person generally must:

• Be 55 or older
• Live in a PACE service area
• Meet North Carolina’s nursing-home level-of-care criteria
• Be able to live safely in the community with PACE support
• Have Medicare, Medicaid, both, or be able to pay privately.  

Quilting brings calm

I would suggest you go with a Plan G for a supplement. Plan G covers the copays and deductibles of Medicare except for the plan B deductible - which is currently under $300 a year. All companies that offer a Plan G pay the exact same - so choose one whose name you trust and whose rate is among the lowest. If you and your spouse both choose the same company, many companies offer you a household discount.

It’s possible that you might be able to switch back to standard Medicare because of the move. I’d call an insurance agent in the area you are moving to though. We worked with one when we went to Medicare. We just felt better having that help.

It is also possible that NC may have a company that does guaranteed acceptance even if you would otherwise be underwritten.