Implant Dr. EID - Best Insurance plan - Blue Cross or Medicare

[treetop]

I have made my decision to move forward with getting an implant.
After decades of pills, and 1 decade of Trimix. It's time. I turn 65 next year in May, and the company I work for is switching to Blue Cross.

So.. gentlemen.. is Blue Cross a go / no-go? and if so, then Medicare. But what plan for Medicare.... I am getting mailers now to enroll, but seems there are many choices. One that did interest me was 'Clever-Care'. Any opinions on that one??

I probably have to pay a co-pay... so maybe a plan to minimize that....

I sent an email to Dr. EID website, so hopefully they can also assist.

I am in So California, so hoping that is ok. Can fly to NY for the procedure, and get post-op care locally in Riverside County.

Any advice is appreciated !!

[JetAirliner]

Tree Top
Check to see if the Blue Cross covers the procedure… Some insurance companies have exclusions (I.e. Implants, Specialty Pharmecuticals etc.) … In my case , I was denied 3 times because Implants as well as some Specialty Pharmecueticals were not included in my companies current insurance plan … Enough of us bitched and we got all of these procedures added to our current plan in July

I received my Implant on 9/1 … Had the procedures not been added, I was prepared to sign up for Medicare effective 01/24 .. If you end up going the Medicare route, make sure that you get a Medicare Supplement program added as some of the traditional “Medicare Advantage Programs” have exclusions

I have made some nice decisions/investments in my life - but my Implant decision was the best decision that I ever made … Your going to love your new Mazzeratti race car in your pants! Good Luck!

[treetop]

Thank you .. that is the plan.

i will just plan for either. If Blue Cross will cover it, then I can do the surgery sooner. if not, in February or March I will apply for medicate, and do surgery in June or July.

Supplements….. like what supplements ?? You are talking about pain killers, etc.?

I want to retire in either Philippines or Thailand. I have people in both. But I was stressing over taking Trimix with me, and having enough, but now that is not working well. So its time to go ballistic!! Lol.

Looking forward to the ‘other side’….

[JetAirliner]

Supplemental Insurance programs that cover Medicare Parts C & D .. Additional costs are about $200 - $300 per. Month .. BTW - looking at planning a trip to Thailand next year

[atul21]

I have made my decision to move forward with getting an implant.
After decades of pills, and 1 decade of Trimix. It's time. I turn 65 next year in May, and the company I work for is switching to Blue Cross.

So.. gentlemen.. is Blue Cross a go / no-go? and if so, then Medicare. But what plan for Medicare.... I am getting mailers now to enroll, but seems there are many choices. One that did interest me was 'Clever-Care'. Any opinions on that one??

I probably have to pay a co-pay... so maybe a plan to minimize that....

I sent an email to Dr. EID website, so hopefully they can also assist.

I am in So California, so hoping that is ok. Can fly to NY for the procedure, and get post-op care locally in Riverside County.

Any advice is appreciated !!

I had blue cross of California PPO and that was approved for surgery by Dr. Eid’s office. In fact they did not need an Authorization also from the insurance as it was pre approved. I finally could not do surgery with him as he fell ill. But it was approved. His team is very efficient.

[treetop]

ok... that is great news. That will be my first effort, as I will have Blue Cross as of January 1.

Maybe I can have the surgery before my birthday in May !!

TY for the info.

[Old Guy]

When you turn 65 you are automatically enrolled in Medicare Part A. That insurance covers medical for things like a heart attack, stroke, falls with broken bones, etc. Medicare Part B is optional coverage but costs around $165 a month. Part B covers additional medical expenses such as elective surgeries, doctor visits, etc. Co-pay is 20% until you hit max out of pocket.

If you have Medicare Part A & B and the Blue Cross policy your implant should be a zero cost surgery.

Whatever doctor you choose have their billing department deal with insurance. They do that all the time and will get the best coverage because that means more $$ for them. Good Luck.

[Floridaspeedo]

Be careful with Blue Cross or any other provider. There are many different plans and some employers add exclusions so be sure to check and have your doctor get a pre-approval.

[treetop]

Roger that. Good advice. My guess is the staff at EID will handle that.

But yes,... will definitely verify.

[Flounder]

My implant surgery with Dr Eid was 100% covered collectively by;
Medicare + my plan G supplement + part D (drug) plan.
Medicare B paid 80% of their approved amount for the outpatient surgery. My Plan-G supplement paid everything else not covered by Medicare. The prescribed drugs were all generic so there was no co-pay through my part D plan.
The only out of pocket costs I had were for travel, hotel, food, and comfort items.

There are no simple answers to your question. Saying Blue Cross is meaningless without knowledge of your specific plan coverages. Dr Eid’s staff can and will obtain pre-approval from your current insurance provider and advise your out of pocket costs. For me this was done early in the process well before scheduling a procedure date.

Generally, Medicare B coverage is the same across all states but only covers 80% of approved costs. There are some excursions which supplement or advantage plans may pickup. Implants are covered by Medicare if deemed medically necessary and every good Doctor understands what meets those requirements. With Medicare and good supplemental insurance, my out of pocket cost was zero but your costs will depend on your choices between Supplements vs Advantage plans plus the part D drug plan you select. Like everything, the better supplement coverages come with higher premiums.