ArcaMax

Dear Readers: This week, I received a text message from a local Toni Says Medicare client that I would like to share with you:

Toni, I need to put together a 24/7 home care recovery plan after a liver transplant. The surgery is over a year out, but I would appreciate tips on how to plan for this medical event. Thanks in advance.

--name withheld

To My Readers:

This text made me realize that America is not prepared for a life-changing medical need such as a transplant.

Luckily, my client has Original Medicare with a Medicare Supplement, allowing him and his medical team to pick together which skilled nursing/rehab facility and home health agency he will use while recuperating from his liver transplant.

Page 52 of the 2024 Medicare & You handbook under “Transplants & immunosuppressive drugs” states that you must have Part A in place at time of the covered transplant and that you must have Part B at the time you get immunosuppressive drugs. You pay 20% of the Medicare-approved amount for the drugs and the Part B deductible applies. Medicare drug coverage (Part D) covers immunosuppressive drugs if Part B doesn’t cover them.

I would advise Toni Says readers to enroll in Medicare Parts A, B and D (Medicare’s prescription drug plan) when not working full-time and covered under your or your spouse’s employer benefits.

Have a complete Medicare Part D prescription drug planning consultation before enrolling in a Medicare Part D plan whether applying for Original Medicare for the first time or changing your Part D plan during Medicare’s Annual Enrollment Period, October 15-December 7 every year.

Be sure that the Part D plan you choose covers all your transplant drugs as well as prescriptions you take daily. If your Part D plan does not cover your transplant prescription drugs, then who will pay? You will! (Chapter 5 of Toni’s Medicare Survival Guide Advanced edition explains Medicare Part D in depth and how to enroll properly.)

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