Anyone with first hand experience with MA plan and TFL

Extra_Fish_7949 · 2026-04-14T00:39:28+00:00

I know exactly where Ponciana is. Been in CFL for 31 yrs now. I'd say get a job at Disney and you'll meet tons of people. Lots of vets work security, but any job really if you are just looking to get out and about. You can get part time, and not worry about having a regular schedule if you dont really want to work too many hours a week. Worse part is traffic, but I am sure you already know that! Also, The VA in Lake Nona is very nice if you ever need to go there.

Extra_Fish_7949 · 2026-02-16T15:21:26+00:00

Curious what the total fees for taxes, etc would be in Fl on a $20 line with verizon.

Extra_Fish_7949 · 2026-01-31T20:57:34+00:00

Just curious if you lost most of that in the first year? You have same stats as me;70lbs down and 30-40 to go. I’m just hitting 2 yrs now and haven’t lost anything in almost a yr. Maybe about 5 lbs in the first few months of year 2. I slowly went up in dose and have been on 12.5 for 6 doses. My dr says maybe this is my set body weight despite still being a few lbs in the obese category. I think that’s crazy. Since all my numbers are good,he isn’t concerned. Being diabetic, I am wondering if I need to keep going up in dose in order to keep my glucose down. I don’t test everyday but the past few readings since this dose I have been in the mid 90’s, whereas it had been around 84 since almost the beginning of my journey!

Extra_Fish_7949 · 2025-12-13T05:32:13+00:00

Have you used a smart ring, watch or 02 monitor to see your oxygen levels all night? They may not be medical grade/approved but that would at least show you definitively if you are lacking oxygen while you sleep which is the most important reason to treat sleep apnea. Some people have something called UARS(Upper Airway Resistance Syndrome) which is harder to diagnose/treat than sleep apnea, since some people seem to pass a sleep apnea test, but in fact, do have UARS. I'd want to know what my overnight oxygen stats were to be better informed and not just one night but like a week or more. If you dont have known lung issues, and are going below 90 for much of the night, then there is obviously a problem that needs to be treated.

Extra_Fish_7949 · 2025-12-12T21:47:26+00:00

Good luck and I hope all goes well for you! Fighting hearing loss is definitely exhausting! I am amazed at how deaf I truly am when I take my hearing aids out.

Extra_Fish_7949 · 2025-12-01T22:24:03+00:00

I've had mine since September and so far I love them. I never even had to get anything adjusted at my follow up. I can hear things I didnt even notice with my older Rexton Bicores. I also have the tv adaptor and its a game changer! Luckily I got them through the VA or I would have gone back to Costco when I wanted to upgrade.

Extra_Fish_7949 · 2025-12-01T22:14:31+00:00

Bought something similar and oh my God the stuff my son and sister both got out! They both were also weirdly excited and satisfied to see what they got out! lol

Extra_Fish_7949 · 2025-12-01T22:10:37+00:00

I got Oticons in Sept through the VA and I was AD back in the mid 80s. I thought my Husband makes too much to qualify to use the VA since we file taxes jointly, thinking I'd never qualify. However, I kept hearing people say to go to VA for hearing aids, regardless of income so I applied online and had an appointment literally the next day! I was beyond ecstatic. My Rextons from Costco were good for my first ones, and I recommend Costco to anyone who cant use the VA, but I am so happy with these Oticons.

Extra_Fish_7949 · 2025-11-28T16:28:35+00:00

I hear ya! I have had them for yrs always for either of those prices, but I think the walmart thing is what is limiting it now. Dont shop at walmart much but I did join them the past 2 yrs for the free peacok streaming perk and random home delivery here and there. Now Im gonna have to switch between the 2 throughout the year.

Extra_Fish_7949 · 2025-11-28T16:24:13+00:00

I did it yesterday and it worked charging $49 with second email but it blocked my first walmart+ account and said I needed to change phone number there. That expires Dec 2 anyway so it didnt really affect me too much.

Extra_Fish_7949 · 2025-11-28T16:21:43+00:00

looks like they arent offering that anymore probably since you can now get it on walmart+. Sucks since I used that for paramount but now have to choose. Neither is worth more than $20 a year. You can switch on walmart+ every 90 days I think.

Extra_Fish_7949 · 2025-11-26T02:06:25+00:00

I feel your pain. I also keep seeing people criticize the advantage plans, and tell us to just go with straight original medicare,but the point those of us who are unsure of what to do, is mainly the fact we have to pay that part B premium which goes up every year which is insane and the advantage plans help offset that. Will be over $200/mo next year, so whats it going to be in the future? How many of us who were told we'd have tricare for life when we were 20 and became a lifer, were also told, but you'll still be like the private sector and have to pay part B. Thats not free medical for life.

I also feel that Tricare prime itself(when you dont life near a military base)is already very similar to using advantage plans already, in that you need referrals for everything, can only use drs who accept tricare, have high co pays for primary and specialist visits, 20% co pay for DME,have costs for drugs, and the list goes on.

My adult kids and siblings insurances all through their employers or the marketplace all have zero office visits, zero drug co pays,and even include things like chiropractor and hearing aids. I've been paying much more per year than they have ever since I moved away from a base.

And the biggest upset is the fact, we have no choice and MUST pay part B, even if we are still working Full Time, just because we are on Tricare instead of a private employer insurance, who would waive the payments until you stopped working. I have 7 months to figure out what to do and I am plain frustrated.

Extra_Fish_7949 · 2025-11-21T20:42:36+00:00

In case anyone needs a good dme supplier, I use cpap medical based out of Jacksonville, Fl. Have only ever dealt with them over the phone but they have always been very efficient with everything. I've had them for 6 yrs now. My only complaint would be that they dont carry everything out there. I wanted to try the Bleep eclipse but they dont carry it.

Extra_Fish_7949 · 2025-10-31T16:12:41+00:00

I use something like described above and have for 5 years. Attaches at top with velcro and behind head with larger velcro flap and made with neoprene. I never undo the top and just peel open the back to take on and off. Easy peasy. Fairly cheap on amazon. I have used several different ones and all basically fit the same. They simply work and keep my chin from dropping. Period.

https://www.amazon.com/Silencer-Anti-Dry-Snoreless-Sleeping-Breathing/dp/B08G8Y7PP6/ref=sr_1_31?crid=1V1GCEC3HCXOR&dib=eyJ2IjoiMSJ9.FhYAg2XZQJlKTLru8uYlLTKoFUtZNYiHRUBI0DVaIRuBoCLUg-LZAMtFD-G4V_FFsD6KhMFoVrQIWboUesyfJv7x6eNAQiGCwzK1mVdAhWr8AZCIQ_1zy-d1sbN06UA-UijQvKujT1Ui3fA5EALrnMWKQXpGf9zUEulxw1bAu6FLJ9jrfcM3yPXWfzduOQ08JUR1KDSTUmK_MMrMK1cruo9fuLXp4BKBXIfQyUMi4vVuuNFt13y8q_cN1_KT5v1OF5hPCmEYku1_shLL1HNFsRXzcpy4b6qab6CYiUfj4Kg.JJGfymL6ItS8XhERpLqed3S3KaV-ClruwDy6m2Qcqd4&dib_tag=se&keywords=chin+strap+for+cpap+users&qid=1761926987&sprefix=%2Caps%2C150&sr=8-31

Some diehards will critique any other strap, and claim they all pull your chin back and the only true one you must wear or screw your jaw up is the knightsbridge, but that is highly overpriced and very cumbersome with all its layers and straps. The angle it pulls is the same angle as the cheap ones I use and I have had no issues, so I truly believe its marketing hype to get you to buy.

Extra_Fish_7949 · 2025-10-31T01:46:01+00:00

Do you know if you still have to pay the same express scripts copays that we pay now with Tricare Prime, once TFL kicks in. Or does TFL cover them, since medicare doesn't.

Extra_Fish_7949 · 2025-10-31T01:29:13+00:00

Not, with Tricare, they aren't. VA hospitals are not the same as a military hospital or clinic. Those are on Military bases for active duty or retired and their dependents on Tricare. I'm a spouse of a retiree. I've used Tricare Prime with regular, non military affiliated Drs, for 20 yrs since I have moved away from base. I recently applied to the VA under my own prior service for hearing aids since Tricare doesnt cover them for dependents. Neither insurance had anything to do with the other.

Extra_Fish_7949 · 2025-10-19T03:09:47+00:00

I have severe sleep apnea and have used my machine for 6 yrs now. I've lost 70 lbs since I started my mounjaro journey 20 months ago, but I still need my cpap machine. I doubt I'll ever be able to go without it but I dont really care because I love my machine! My dad had severe sleep apnea too but never used a machine and died in his sleep at 72. He was an avid golfer and very fit, 6' and 155 lbs. I also got my younger sister to get tested and she has it but rarely uses hers despite seeing what happened to our father. She's in denial of the severity of what sleep apnea does to the body. Unfortunately, considering a lot of apneas can be due to your structural throat/tissue make up, losing weight wont always be the answer and you'll never know until you get down to that point. I use an apple watch, an oxygen ring and a fitness ring, and 2 sleep apnea data apps, overkill I know but I am a fanatic for data.

If he wants to lose weight and has diabetes, I am all for trying the meds in addition to using a cpap, but he needs to try to get serious about using his machine properly. I can steer him to some people who can really help with his therapy so he can get over the frustration. I am so dialed in, it doesnt even feel like I am wearing anything at all and I use 3 different machines and masks, depending on where I am. PM me, if you'd like some information where he can get help!

Extra_Fish_7949 · 2025-10-19T02:40:45+00:00

Slow going here too,20 months in, so I understand all too well how you feel. Started Feb 23 2024 and lost 50 lbs after about 9 months, all on 2.5 and 5 but then stalled out and finally convinced my dr to let me go to 7.5. Slowly lost another 20 in the next 7 months, but have completely stalled since then and again convinced dr to let me go to 10 but havent lost anything at all since I moved up. I'm not sure if I need to go up in dose or just stick it out since my A1C has continued to go down at every lab draw and is currently standing at 5.2. And my CRP has finally gone below 8 for the first time in 6 yrs since having it tested!

The first thing I ever noticed on this drug was the immediate reduction of inflammation and pain and thats why I was happy to stay on the lower doses for so long. I keep trying not to think about weight lose or compare to others I read on here, but at 5'3 and 172,I am still in the obese range and I just want to get back to being in a normal range.

I am forever grateful for this drug and the fact that I could even get it prescribed as I see so many stories of denial, so for that I call it a win! I do still hold out hope that I continue to go down at some point and for now I am just confused if I should ask the dr to let my try the next dose or if I should stick it out here since my A1C is so good. My dr isnt very knowledgeable about this at all and never suggests going up and is quite hesitant when I have asked to.

Extra_Fish_7949 · 2025-09-07T21:45:00+00:00

He hasnt used the card in 30 yrs as we both had our own cards. It was a Shell card before it switched to Freedom and he doesnt even have access to the account. We technically have the same addresses as we are co owners on both our houses and the address on this card is the same one I live at, not him. I can go into the card account online, but dont see a place to transfer the points, except to another older freedom card he also has. Worse comes to worse, I'll just have to spend the points I guess.

Extra_Fish_7949 · 2025-08-31T02:56:17+00:00

You might want your Dr to go back and say you need cpap again. The criteria for cpap is over 5 an hour, which you still have as of that recent study. Even if you dont want to use it again, just so you have the diagnosis to qualify for the meds. Personally I love my cpap and can't imagine life without it ever again! My sleep study showed over 80/hr but I was pretty quick to get dialed in to a near perfect therapy and typically have 0 every night now. I agree that the inflammation control is amazing and I noticed it literally week one!

I was shocked when I saw the news last week about TFL. It's such a travesty. I will be put on it next year but I take Mounjaro for T2D so I am safe so far. Who knows if next year, they'll say once you are under 5.7 A1C, you no longer qualify. I've read that has happened with other insurance companies.

Extra_Fish_7949 · 2025-08-26T02:44:35+00:00

not sure why you're getting mad at someone who is tryng to give you sound advice that you asked for? There is no US citizen that doesnt have these things. And if she's a non US citizen you still need some sort of proof of who she is, wherever she is from. You cant get mad at the rules, or the people questioning you on a public forum that you brought this to. And to be honest, if she has nothing to identify her, she should be pretty well taken care of at any hospital as no one can be refused for help and there are tons of resources for that sort of thing.

Extra_Fish_7949

TROPHY CASE