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#1 Mike Patterson

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Posted 12 November 2017 - 10:02 PM

I'm not sure if this is the proper forum for this topic, but it is a general question. I'm getting ready to sign up for Medicare. Any thoughts on the differences between supplemental insurance vs. an Advantage plan?

 

I am hoping some of my fellow Olde Farts on here who have been there and done that, can offer some advice or warnings.


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#2 Dennis David

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Posted 12 November 2017 - 10:31 PM

Not an easy question.

Have you seen this LINK at CR?


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#3 Richard G With

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Posted 12 November 2017 - 11:04 PM

My advice is for you to meet with an insurance agent who handles one or more of the supplemental plans in your state. If you have an agent who already handles your insurance that would be a good starting point.

 

This stuff can present some pretty complex challenges and varies state to state.


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#4 Mattb

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Posted 12 November 2017 - 11:11 PM

We have plan "F' and like them. We pay nothing to go to any doctor of our choice, no referral needed. We are covered for any hospital charge above the Medicare payment amount. Basically we never have to pay any medical bill.     

 

The bad side is that F plans raise their cost with age. We are at $200 on one of our plans now. I have figured to stay with the "F" plans as long as the expense is acceptable with our income. If it becomes too much then we will switch to an Advantage plan and start doing co-payments, deductibles, and network doctors.   

 

If you can afford it, the "F" plans cover everything. We all know that a major medical event is probably going to happen to each one of us and the expense can be in the thousands of dollars if you are not fully covered by your supplement. It's a gamble, do you bet a major medical  event happens to you before you are 75 or so and the plan F pays a big bill for you, or do you bet that you stay healthy till  80s or 90s and by using an advantage plan yo have saved thousands of dollars.

 

I think it comes down to how comfortable you are with the monthly payment.

 

Plan D prescription insurance is even harder to figure!!


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#5 Mattb

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Posted 12 November 2017 - 11:13 PM

One other thing about "F" plans, they all have the exact same coverage. No matter how much you pay, the coverage is identical, so premium price and service are both important.


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#6 Ramcatlarry

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Posted 13 November 2017 - 12:53 AM

If you are poor enough, Medicare is OK. Many 'supplemental' plans are all scams to tax you out of your savings.

 

Any hospital or insurance that is 'for profit' is part of the problem.


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#7 Ecurie Martini

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Posted 13 November 2017 - 01:22 AM

I have been on Medicare for 16 years. In addition, I have a supplemental plan (coverage F) through AARP. I have never had a problem with it - no co-pays, co-insurance, or hassles.

 

EM


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#8 Tex

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Posted 13 November 2017 - 07:55 AM

My urologist forewarned me about the advantage plan offered by my former employer; specifically, he said his office didn't take that particular insurance as administered by Humana. He didn't elaborate on what beef his office may have with Humana.

 

Since I want to continue seeing my urologist, I signed up with the other plan offered by my former employer (which my urologist does accept).


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#9 Ecurie Martini

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Posted 13 November 2017 - 08:58 AM

Humana started as a for-profit hospital management operation in Louisville, KY. I was teaching in the U of L medical school at the time.  Among my colleagues at the school, it was referred to as Inhumana.

 

EM


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#10 Uncle Fred

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Posted 13 November 2017 - 09:14 AM

I originally signed up for an Advantage plan through UHG AARP but just changed to Humana because my new doctor won't take the UHG plan.  I suspect that these Advantage plans do not pay as much or as quickly as others. With these Advantage plans the government is basically buying you insurance with a major health insurance company.  With the Supplemental plans, Medicare still handles A and B coverage but Aetna, UHG, Humana, etc., handle everything else.

 

You have to check with you doctor's office manager to see which specific plans they accept. And don't think your doctor knows any more than you do. 

 

Why did I have to change doctors you ask? My doctor went to a "Concierge" plan where you had to pay $2,000 per person per year just to keep seeing him. His practice was too large, about 2,000 patients, so he was looking to cut back to 500. What does that mean? No waiting for appointments, 24/7 access to a doctor by phone, less work for him and his staff, and... $1,000,000 upfront for him every year!


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#11 Neckcheese

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Posted 13 November 2017 - 09:19 AM

A small beep from far away. :-)

 

In Denmark we have high taxes on everything and even 25% purchase tax, also on food. Cars not included as the taxes on these are 110-180%!!!

 

But I dont whine, because I had a major heart surgery when four years old and the state paid everything, I have since been visiting both "normal" and mental hospitals on several occasions, last time when I was diagnosed with prostate cancer (due to another checkup in December) - and again this is paid via the taxes. So I am a happy tax-payer and grateful for living in this small, weird, but wonderful country. :-) 

 

But everything is not rosy here all the time, I lost my job 12 years ago due to prolonged illness and that cost me both money and property, but still, due to state pension (and an insurance scheme), I was able to have a decent life afterwards.

 

I have now been retired due to my illness for 10 years and in spite of all the misery before that, I have now been able to obtain and move to a very small, old house on the Danish West Coast, 1,300 meters from the North Sea and 750 meters from Ringkøbing Fjord, partly thanks to an additional health insurance provided by LEGO where I spend my last four years in a job. Again, I am grateful.

Therefore it really hurts me, when people on this forum are forced to sell everything dear to them, to be able to pay medical bills, when they get seriously ill - so please get some insurance, even if it's expensive - when you get ill, you have enough to fill up your mind - you don't need serious economical worries on top of that.  

 

Niels, DK (Denmark)


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#12 Racer36

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Posted 13 November 2017 - 11:18 AM

I read some of this stuff and frankly I am terrified for you guys. I am extremely fortunate to have been born in Canada where none of this is a concern, and frankly we take it for granted until we read what you guys have to navigate through. We buy supplemental insurance as well, but only to cover prescription drugs and things like physiotherapy and chiropractic.

Best of luck in finding plans that work well for your specific situations
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#13 Half Fast

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Posted 13 November 2017 - 11:56 AM

Why did I have to change doctors you ask? My doctor went to a "Concierge" plan where you had to pay $2,000 per person per year just to keep seeing him. His practice was too large, about 2,000 patients, so he was looking to cut back to 500. What does that mean? No waiting for appointments, 24/7 access to a doctor by phone, less work for him and his staff, and... $1,000,000 upfront for him every year!

 
What happens when you need to see a specialist other than the concierge doctor?
 
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#14 Cheater

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Posted 13 November 2017 - 11:59 AM

I read some of this stuff and frankly I am terrified for you guys.


The healthcare situation in the US is an international embarrassment IMO.
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#15 Gator Bob

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Posted 13 November 2017 - 12:12 PM

:bomb:  "Do Not Light Fuse"

 

Greg,

Let's not start getting all political... please play nice. :)  :sarcastic_hand:


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#16 Uncle Fred

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Posted 13 November 2017 - 12:14 PM

What happens when you need to see a specialist other than the concierge doctor?

 
He refers you to a specialist just as before.
 

The healthcare situation in the US is an international embarrassment IMO.

 
I just returned from Europe and spoke with several people about this situation and what you say is true.
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#17 Gator Bob

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Posted 13 November 2017 - 12:17 PM

A small beep from far away. :-)

 

In Denmark we have high taxes on everything and even 25% purchase tax, also on food. Cars not included as the taxes on these are 110-180%!!!

 

But I dont whine, because I had a major heart surgery when four years old and the state paid everything, I have since been visiting both "normal" and mental hospitals on several occasions, last time when I was diagnosed with prostate cancer (due to another checkup in December) - and again this is paid via the taxes. So I am a happy tax-payer and grateful for living in this small, weird, but wonderful country. :-) 

 

But everything is not rosy here all the time, I lost my job 12 years ago due to prolonged illness and that cost me both money and property, but still, due to state pension (and an insurance scheme), I was able to have a decent life afterwards.

 

I have now been retired due to my illness for 10 years and in spite of all the misery before that, I have now been able to obtain and move to a very small, old house on the Danish West Coast, 1,300 meters from the North Sea and 750 meters from Ringkøbing Fjord, partly thanks to an additional health insurance provided by LEGO where I spend my last four years in a job. Again, I am grateful.

Therefore it really hurts me, when people on this forum are forced to sell everything dear to them, to be able to pay medical bills, when they get seriously ill - so please get some insurance, even if it's expensive - when you get ill, you have enough to fill up your mind - you don't need serious economical worries on top of that.  

 

Niels, DK (Denmark)

 

Good to hear you're feeling better.

 

Insurance - It's a crazy game, selling dear treasures to pay for the insurance isn't a fun bargain ether.

A $100,000 hospital 'visit' is like 'chump change' these days.  

 

Pick your poison.


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#18 Dave Crevie

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Posted 13 November 2017 - 03:19 PM

I have regular Medicare. An Advantage plan might be nominally better, but it means dealing with an insurance company. My

experiences with insurance companies has not been good. I did opt in for a supplement and Part D.



#19 Phil Hackett

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Posted 13 November 2017 - 04:17 PM

Insurance (doesn't matter what it's written for) is a bet. Sometimes you're required to have it. Many times it's optional.

 

No matter what... the casino....errr.... the insurance company wins in the long run and they do everything possible (sometimes illegally) to keep that edge/hedge.


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#20 Mattb

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Posted 13 November 2017 - 04:33 PM

 Kind of hi-jacking this, hope that's OK. 

Our system has many problems, but I think most are because it's not simple and profit is the goal of most of the participants.      If we had  one basic type of supplement, one part "D" for drugs and the same plan for all,  it would make it better across the board and the cost about the same for everybody.    Of course, with many for profit insurance companies, medical supply and equipment manufacturers, many for profit hospitals,   for profit drug companies, lobbyists at every level, there is no way to rein this in.   We are stuck with with the system we have.   Any talk of  anything related to universal coverage and a segment of the gov't  yells communism and tells us how bad med care is in other countries.

 

I always like to hear the input from guys in other countries.   The guys here can talk about how it really is and won't shade it depending on their political party.   I had heard that in Canada, you are covered very well, but your surgery or appointment might be 3 months or more in the future.  I'd like to know if this is the fact or just an fake news.   I have heard from a guy in Oz quite a few years ago and he said insurance wasn't common there and most people had medical savings accounts.   How is  it down there guys?    Thanks to Niels for his input.

 

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#21 Uncle Fred

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Posted 13 November 2017 - 05:09 PM

I spent some time with a Canadian couple while in Europe and they said they had no problem with getting healthcare quickly.  If you need a surgery you get it. 

 

One thing that has not been mentioned in our Medicare discussion is, concerning medications, the dreaded "Donut Hole".......   The drug coverage will only cover a certain amount before it stops and does not start up again, as catastrophic coverage, until you have paid out $4950.  If you are on a variety of meds some are very expensive like Insulin for example might be $500 a month. This eats up the money allotted for meds very quickly and you enter the Donut Hole. 


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#22 Dennis David

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Posted 13 November 2017 - 06:15 PM

Yep and that's what you'll be living on as well, donuts.


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#23 Gator Bob

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Posted 13 November 2017 - 06:37 PM

Doesn't the 'donut hole' get filled (jelly, apple or cream?) if you order up some  "Part D" ?


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#24 Uncle Fred

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Posted 13 November 2017 - 06:46 PM

Dumpster donuts........   


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#25 Half Fast

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Posted 13 November 2017 - 06:50 PM

Doesn't the 'donut hole' get filled (jelly, apple or cream?) if you order up some  "Part D" ?

 

Nope the donut hole is part of Part D, it does not take much to get to it, if you have any non generic meds.

 

Cheers


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#26 Gator Bob

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Posted 13 November 2017 - 07:11 PM

Dumpster donuts...

 
If you like your donuts, you can ____ your donuts.
 
The whole thing is broken for those who need it and rigged for those who sell it.
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#27 Racer36

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Posted 13 November 2017 - 09:52 PM

I have read a bunch of stuff about wait times and difficulty getting care in Canada. I will only speak from personal experience here.

My dad had a number of major health issues in the last 10 years of his life and the care was nothing less than remarkable. He was diagnosed with cancer purely by accident while in for vascular surgery and he was undergoing treatment within five days. He eventually succumbed to lung cancer but the healthcare system here helped him put up a hell of a fight.

I had elective surgery 18 months ago for a snoring issue and that whole proceeds from referral by my family doctor to surgery was about three months.

I am sure there are horror stories here, but nobody close to me has ever had one.
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#28 Mike Patterson

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Posted 13 November 2017 - 11:06 PM

Thanks for all the replies. I didn't realize this post might veer into (the verboten!) political territory, and I'm glad Greg hasn't shut it down.

 

Right now, I'm leaning towards a Medicare plan G. I'm still looking into Part D coverage.


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#29 Mattb

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Posted 14 November 2017 - 12:03 AM

This kind of discussion is a chance for everybody to learn something that may help them.


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#30 Gator Bob

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Posted 14 November 2017 - 01:49 AM

I'm still trying to verify what I was told by a AARP/UHC agent.
 
What - Coverage for, Post transplant anti-rejection meds. In my situation, end stage renal disease ESRD,
         Regular Medicare Part B covers 80% of two specific meds only. 
If I sign up for a 'supplement / medigap' plan with a Part D component they will pay for that med at 80% through the Part D component in place of it getting paid for under Part B. You would think it wouldn't make a difference if they both pay 80% but it becomes a 'one way off ramp' if I make that move. The lady told me a 'secret' and said that once you go to a D plan there is no way back to back to get those meds covered under the current 'automatic' B plan. If it comes down to getting dropped or missing a payment for the D coverage and no way back to B it doesn't end well without coverage for those two meds. Name brand cash or credit = $3,960 and $1,840 for 90 days worth. Generic is about a third of that. They just came out with the generics recently.
 
So watch closely choosing... This type of minor detail is not in any written documents available to the public and potentially hazardous to ones health.
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#31 Mattb

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Posted 14 November 2017 - 09:13 AM

Bob, tell us a bit more. You say a "supplement with a part D component". Possibly it is different in different states, but I don't think in Indiana you can get a supplement with a part D component. Your part D and  your supplement are two different plans.   

If you have a Medicare Advantage plan, then I think the part D is part of the plan.
 
Tell us a bit more or explain a little clearer to me, as I have a hard time trying to understand this stuff.    
This is the problem  with all these different plans and formulas, typical US gov't program, no simple one plan, or a clear description for everybody.
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#32 Gator Bob

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Posted 14 November 2017 - 11:50 AM

My bad...
 
The terminology is confusing.
I was inquiring about AARP/UHC 'Advantage' not 'Supplement / Medigap.'
That's where the Part D one way street for my meds issue came up. 
 
Matt, you're not the only one having a hard time understanding "this stuff." :dash2:
 
SOB, they made this stuff a total mess. Might be best to just pay the 'tax' (fine) at the end of the year. :diablo:
 
Or... might be better to leave and come back as an illegal alien. :crazy:
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#33 Dave Crevie

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Posted 14 November 2017 - 03:40 PM

The confusion is written into the law intentially. Both Medicare and Socialist Security are grossly underfunded, and the feds would rather you give up trying to unravel the mess than file claims. So far, I have only had to pay 20% of some meds, but I expect that at the end of the year I will fall short of the out-of-pocket amount, and owe more money. Time will tell.

One thing that is sure. You are better to not carry insurance than to sign up late. The late penalty is heavy, and you pay it every month until you die, whether you get insurance or not. They deduct it from your S.S. payout.

#34 Dallas Racer

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Posted 14 November 2017 - 06:33 PM

I have four years to go before I'm eligible for Medicare. I'm not looking forward to it, as this thread is making my head spin.

What Bob has posted is especially concerning.

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#35 Mike Patterson

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Posted 14 November 2017 - 09:48 PM

I signed up for Medicare and SS today, and discovered another gotcha: they deduct your Medicare Part B insurance premium from your SS check. Every month. That means you don't receive as much cash as SS tells you you'll get. That sucks.

 

I'm still looking at supplemental/part D vs. Advantage plans. No change from post #28.


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#36 Uncle Fred

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Posted 15 November 2017 - 08:34 AM

Yes about $125 a month. Keep in mind that, depending on your income level, your Social Security is taxable. You may want to elect to have taxes withheld.
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#37 Mark Crowley

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Posted 15 November 2017 - 12:04 PM

Medicare is very complicated with a lot of gotcha's.  What is cheap now based on your health may break you if you get sick.  Hard to change plans if you get something serious.  Go to a seminar or class by an independent agent as it will cost you nothing.  Start looking at least 6 months before turning 65.  You only have a set amount of time to obtain Medicare without pre-existing conditions coming into play.  Check into requirements to defer medicare if you are still working and have insurance.  When looking at a plan ask what it will cost if you have a heart attack, stroke or god forbid cancer.  The big events are where the differences show up.

 

That said I got Plan G which is a new plan that is similar to F with a $150 or so deductible.  For me G was $35 less a month so it is now the sweet spot.  F is going away in 2020.  In Missouri we can change providers (not plans) every year.  All Plan G providers provide the same coverage.

 

Do your homework.  Your are probably not going to get healthier the older you get.

 

Mrk


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#38 Dave Crevie

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Posted 15 November 2017 - 02:33 PM

You only pay tax on half of your S.S. payout, but they withheld tax on the whole amount the first year I was on it. I got

the money back on my 1040, but they get to use the money interest free until then. Pay your Federal tax a day late and

see what they charge you. So it is better to have to pay the shortage than to get money back. So I dropped the witholding,

which was an ordeal in itself. 

 

They withhold money from your monthly S.S. check based on how much money you make in a month. You are supposed 

to file an estimate for each month if your income might be over your limit. Since I worked part time in an "as needed" role,

there was no way to accurately estimate how much I would make, so they deducted the maximum amount plus the penalty

for not filing the estimate. Supposedly I will get all that back at the end of my S.S. run, assuming I live until then.


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#39 Uncle Fred

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Posted 15 November 2017 - 07:07 PM

As much as 85% is taxable.

 

 

Must I pay taxes on Social Security benefits?

Some people who get Social Security must pay federal income taxes on their benefits. But, no one pays taxes on more than 85 percent of their Social Security benefits.

 You must pay taxes on your benefits if you file a federal tax return as an “individual” and your “combined income” exceeds $25,000. If you file a joint return, you must pay taxes if you and your spouse have “combined income” of more than $32,000. If you are married and file a separate return, you probably will have to pay taxes on your benefits.


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#40 Gator Bob

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Posted 15 November 2017 - 08:41 PM

 

As much as 85% is taxable.

 

 

Must I pay taxes on Social Security benefits?

Some people who get Social Security must pay federal income taxes on their benefits. But, no one pays taxes on more than 85 percent of their Social Security benefits.

 You must pay taxes on your benefits if you file a federal tax return as an “individual” and your “combined income” exceeds $25,000. If you file a joint return, you must pay taxes if you and your spouse have “combined income” of more than $32,000. If you are married and file a separate return, you probably will have to pay taxes on your benefits.

 

Yes true, but I think if you have deductions like mortgage interest, prop tax, unreimbursed med exp., etc and you go below a certain $ amt.  I guess that's the 85% of the 32k ..you can claim an 'earned income credit'. Gets you back about $500 married file joint.

 

That's how dear 'ol  Mrs. Account dids it for us. I give her $60, :buba:  ..she gets me $500  :hi:

Then exit her office and break out in to my happy dance  ....  :dance3:  :laugh2:


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#41 Gator Bob

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Posted Yesterday, 02:04 PM

I signed up for Medicare and SS today, and discovered another gotcha: they deduct your Medicare Part B insurance premium from your SS check. Every month. That means you don't receive as much cash as SS tells you you'll get. That sucks.

 

I'm still looking at supplemental/part D vs. Advantage plans. No change from post #28.

 

Working with SHINE was told -  'F' goes away but if you get in now you're 'grandfathered' in. 

Advantage 'C' looks like $0 prem. here in FL (?)

AARP/UnitedHealhCare plan # H1045-030-0

 

Can't see how they could make this anymore effing complicated.

 

$ zero cost ? - I always thought, "not for nuttun, ya get nothin' for notin'"


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#42 Bryan Warmack

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Posted Yesterday, 03:37 PM

  A Medicare representative I was on the phone with a while back described Medicare as a  "Ratsnest"........ :wacko2:



#43 Mike Patterson

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Posted Yesterday, 09:45 PM

Well, I ended up with a "C" supplement plan, and a separate drug plan. I ruled out an Advantage plan (at this time) because I would have to use the doctors in their network and they seem to have a lot of co-pays.

 

And Bob's right, the whole process is too effing complcated!


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