62 replies to this topic

[Phil Smith]

Hopefully this doesn't get deleted as I would like to get advice from members that have experience with Medicare, which would be most members.

 

My 65th birthday is coming up which will make me eligible for Medicare. I currently have HMO insurance which sucks! I have to get a referral from my primary care doctor, which my insurance has to deem necessary and approve, before I can go see a specialist. Insurance also dictates what pharmacies I can and can not go to. All doctors, including my primary, have to be in the insurance's network. So the insurance company dictates my healthcare and makes it a way bigger hassle than it needs to be. Sometimes I have to request a referral two or three times before everyone gets on the same page. Every six months I have get new referrals, even for specialists I've seen for years. All of this for $900 a month with a $7,500 deductible. Which means they never pay for anything! What a bargain!

 

OK, Medicare. I've been watching YouTube videos (marginally helpful because they're made by people trying to sell you their services) and reading on Medicare's website. Surprisingly confusing.So here's where I'm at:

 

Get parts A, B, and D. This sounds like the best option.

 

Medigap - A bit confused by this. I'm not sure if I need or if I'm eligible for it.

 

Medicare Advantage Plan - Confused by this as well. Not sure if I need it. It requires me to see in-network doctors so I hope the hell I don't!

 

This is all I'm aware of. Maybe there's more?

 

TIA!

[mickey thumbs]

I went with a Medicare Advantage PPO and so far so good. I would avoid the Advantage HMO programs as they have the same restrictions as your current HMO. Be sure to sign up for something as their are is a financial penalty for dragging your feet. If you’re unhappy with your initial choice you can change during the annual open enrollment period. The only other option I seriously considered was Medicare A,B,D and a Medigap. Good luck. It is complicated so get plenty of input before deciding.

[Geary Carrier]

What Is Better, Traditional Medicare or Medicare Advantage?

[Ramcatlarry]

Corporate America is intending to squeze every dime out of everyone where ever they can. The advantage plans do vary. My Blue Cross version still does not want to recognise my Dentist who is one of their vendor 'specialist'......

[Ecurie Martini]

Been on Medicare for almost 20 years - I carry a Medicare Advantage Plan G from Transamerica - between the two everything is covered except a $185.00 annual deductible. MY premium is about $220/mo* paid quarterly. Rx separate - $22.00/mo.
 
No referrals needed - can go to any office that accepts Medicare
 
* This is an age related number - when I first enrolled (under the AARP United Health plan) it was about $120.
 
No complaints but I do live in an area (Baltimore) that has a plethora of high quality health care facilities.
 
EM

[Cheater]

I turned 65 last year so just went through this very confusing process.

 

The most disturbing part of turning 65 was the incredible number of people calling, mailing, emailing, and texting to try to sell me their plans. I'm told it never stops and that seems be the case, although the volume has diminished a bit.

 

The point to keep in mind is that whatever plan you select to extend your Medicare benefits is going to generate a commission for someone so anyone giving you advice has a vested interest in which way you go.

 

After trying to do my own research, the approach I took was to attend three or four free Medicare informational seminars and it was quite instructive to compare and contrast the advice given by the various presenters. Quite a difference between the seminars run by multi-person businesses working from offices and those given by individuals with no other staff.

 

I honestly doubt whether one can learn what one needs to know doing your own research. There's just too much info and too many 'gotchas.' And the Medicare landscape is not static; things change just about every year, not only with the plans themselves but with Medicare legislation.

[Ecurie Martini]

Second the above. I review my coverage, both Med and Rx, annually.

[Mr. M]

Greg,

 

What were the differences between the big offices and individual presentations?

[Cheater]

Chris,

 

Hard to be exact, but the individual presenter pointed out numerous things and gotchas that the other presenters did not.

 

For example, he pointed out that the United Healthcare plans that AARP promotes are more expensive because of what they have to pay AARP for their endorsement. He was also well-informed about forthcoming Medicare law changes and the others didn't seem to mention those aspects.

 

The guy whose Medicare advice seemed most valuable to me works by himself from a home office and utilizes rooms at local chambers of commerce as the sites for his seminars. His overhead has to be less than that of the others. He's also the only presenter who was upfront about earning a commission if we joined a plan through him and seemed most knowledgeable about the various plans' costs and coverages.

 

He always either answers my calls or almost immediately returns them. And every year, he reviews the changes to the various plans and calls all his customers with his advice as to whether they should switch to a different one; I don't have to call him to ask for that advice.

 

Probably what sealed the deal for me was when I asked him why I should take his recommendation regarding a Medicare supplement. His reply: "The plan I suggest you go with is the same one I recommended to my parents."

[Phil Hackett]

I used a health insurance agent to get my info. I have exactly what I wanted and I doubt his commission (which I don't see directly) makes much difference in what I pay. He's in his 70s and was most helpful when I called asking questions. His clientel is mainly in the SF Bay area (how I got connected with him is a long story).

 

I was advised to get the A, B and D. You automatically get A... but B and D you need to enroll. If you do not enroll at the start of Medicare (age 65) there is a penalty for each year you did not enroll and it can add up fast. Get them all at the beginning. I also have the Medicare "suppliment." The Advantage plans are very restrictive (my opinion) and I opted for the more flexible and generous (at a cost... hahaha) "Suppeiment" plan, which I believe is "Medigap."

 

I found the terminology used in the Medicare liturature confusing. After concentrating on which terms meant what I was able to decipher the information. The 200-page "Welcome to Medicare" explanation doesn't help at all so don't be ashamed for being confused... I use a professional who deals with very convoluted and arcane tax laws and she said the Medicare information was very confusing for her... Just imagine if the the Congressmen and Senators had to deal with this stuff *personally.* There might be some constructive changes and better clearer information.

[Phil Beukema]

I went with with Medicare parts A, B, and D.

 

I then added Health Net Part F so I don't pay a dime for any visit or procedure, with no referral process, deductibles or co-pays. ($162 mo)

 

Finally I added Hummana drug coverage to smooth out Medicare part D. ($34/mo)

[Dave Crevie]

I'm not going to express an opinion, but what everyone here has forgotten to mention is that by October of the year before you are eligible for Medicare you will receive, in the mail, a booklet titled "Medicare and You." This is a government-issued guide to selecting the direction you want to go. It lists the various plans available in your state, with the costs and benefits.It also has a detailed explanation on how to navigate the process of signing up for traditional Medicare. It will explain the costs and benefits to traditional Medicare. At the back of the book, are comparison charts that will detail specifically what each supplimental and Advantage plan provides. 

 

If you did not receive this booklet, contact your local Medicare office or 1-800-MEDICARE. 

[Mbloes]

... which would be most members.

 

Nothing to add, but I love the assumption here!

[MattD]

I'll echo what Phil said above. We have "F" supplements and as Alan pointed out they get higher the older you get. I don't think you can get "F" any more, but if you have it you are grandfathered in. I think "G" has the same coverage but you have a deductible. With "F" you pay nothing on anything Medicare approved. You have no paperwork to fool with, no bills to forward, no money paid when you go to the doctor of your choice. The cost may be prohibitive for some and that is understandable. We pay $140 a month each, but we pay nothing else for any medical stuff.  

 

I don't know about any other Medicare supplement plans, but I know Advantage plans are pretty cheap, but you are in a network and have deductibles and maybe co-pays.    

 

One thing to remember about the supplement is that if you get a Medicare approved plan, like "F" or "G", the coverage is 100% the same no matter which company you buy it from. The only difference is the cost, but plan details are exactly the same.   

 

Plan "D" for drugs does not have a good choice, there are several options and none make sense. The basic Silver Scripts or Walmart Humana plans are about the cheapest at $25 or so a month and they do OK, but nothing really covers it all or is easy to understand.    

 

The "D" insurance is just like new income tax forms, let the government create it and it will be complicated, no matter what they say. Seems it would have been much easier to create one plan for all people, but what do I know.    

[Phil Hackett]

I'm not going to express an opinion, but what everyone here has forgotten to mention is that by October of the year before you are eligible for Medicare you will receive, in the mail, a booklet titled "Medicare and You." This is a government-issued guide to selecting the direction you want to go. It lists the various plans available in your state, with the costs and benefits.It also has a detailed explanation on how to navigate the process of signing up for traditional Medicare. It will explain the costs and benefits to traditional Medicare. At the back of the book, are comparison charts that will detail specifically what each supplimental and Advantage plan provides. 

 

If you did not receive this booklet, contact your local Medicare office or 1-800-MEDICARE. 

 

My booklet came two months after I signed up for all the plans. It was useless.

[Phil Smith]

Nothing to add, but I love the assumption here!

 

Honestly I don't think it's an assumption. More a fact. Most of us had our first exposure to slot cars in the '60s. Some in the '50s. It's a "do the math" thing.

 

I'm at work and reading the thread as I have time. Great info! I really appreciate it. I'll post some questions I have later today.

[Cheater]

... a booklet titled "Medicare and You."

I didn't find this particularly useful and very difficult to get my head around. The seminars I mentioned above worked much better for me.

[Dave Crevie]

The booklet worked for me. Any seminars or webinars on the subject that I listened to were from people trying to sell me something. I

found the book far less confusing than the income tax laws. 

[Mike K]

Contact a broker. They can tell you what you need to know (at no additional cost to you) and tailor your plans to your existing doctors, health needs and medications.

[mickey thumbs]

Dallas,

 

You are getting lots of good advice here from these guys, as you expected. The plans offered by the different companies vary widely by state and even within a state. The good thing is that you get a do-over each year if you are unhappy with your choice. So relax, absorb the info, and take your best shot.

 

I’m a retired physician and still wonder if I’m making the right choice every year. Enjoy the extra cash you have left over each month compared to your current insurance expenditures and buy yourself a couple of cars for your birthday!

[Phil Smith]

Thanks everyone! My head is spinning worse than ever.

 

I hate getting advice from someone that's trying to sell me something. I mean, what are they gonna say? Are they going to tell you if there's better options available than the ones they're selling?

 

From what I've learned here and from researching, it seems that Medigap Plan G is an often suggested option. I can't get Plan F as was mentioned because it's not available to new enrollees. From what I keep reading Plan G is better anyway. Something you guys with Plan F might want to look into. Apparently the only difference between the two is Plan B's $185 deductible. Plan F pays it, Plan G doesn't. But Plan F cost more than $185 more than Plan G, so you come out ahead in the end.

 

From Forbes:

 

If Plan F is still viable until December 31, 2019, wouldn’t newly eligible beneficiaries want to get one? Probably not, for one simple reason. Plan F has lost its competitive pricing edge. Many plans now charge more to cover the Part B deductible than its value ($185 this year). Here are some examples from state websites.

    In Florida, one company charges an annual premium of $2,738 for Plan F and $2,496 for Plan G, a difference of $242.
    In Washington, a Plan F’s premium is $2,568 and the Plan G—$1,896, a difference of $672.
    Most striking is one company in North Carolina that offers a Plan F with an annual premium of $3,556. Their Plan G’s premium is $2,552, a difference of $1,004 to cover a benefit worth $185.

Why pay more than $185 for the Part B deductible?

 

https://www.forbes.c...g/#2b7b85e23cc3

 

Here's a chart that list the different plans.

 

[Mike K]

Dallas-

 

Our broker told us that your ZIP code also determines your Medicare supplement rates. Our ZIP code in Orange County, California, is cheaper than adjoining counties of Los Angeles and San Diego. A broker will know about all of the plans and will not charge you any fees.

 

My wife was Benefits Administrator for a corporation before she retired and even with her knowledge of health and retirement plans, the broker has the most current information. We met her at two seminars sponsored by a local hospital...

[Cheater]

To add to Mike's excellent advice, what drugs you take are also involved in plan costs and even whether a certain company's plan is available to you.

[DocSlotCar]

Most people can save using these sources for medications:

GoodRX which is a free service and not insurance, with zero cost to you to use. We use it because it saves money over even Costco or Walmart in most cases.

We do not use a supplement for Medicare or the Prescription plan because the cost of the monthly premium is not cost effective. Why pay another $150 plus your medicare for coverage? In my opinion the supplement plans are a ripoff and not worth the added expense anymore than the Medicare are prescription plan.

In some situations there are plans available to help pay the Medicare base premium if you meet the low income requirements. Check medicare or your state for information...

[MattD]

Phil, you are right about the premium cost differences between F and G. F is pretty much a non-starter anyway now. The premiums are $150 less in Indiana for G, but we figured it was worth the $150 a year difference not to have to fool with the copays and deductables. Looking at insurance and billing forms and at tax papers will make your head spin!    

 

The agents I talked to do have a formula they can enter your drug list in to see which plan is best for you with the meds you "currently"  take.

 

As to having no supplement and the long term cost comparisons, we are in the 65 and older age group, which mean a serious illness and death is pretty much in the books for most all of us. Maybe 10 years, maybe 15. The patient's share of costs for such things as heart bypass surgery and long-term cancer treatment can easily top $50-$100k. If your supplement costs $1,500 a year, it may cost you $30k till age 85, which is much less than the patient's share of hospital bills that can run into hundreds of thousands of dollars.    Even figuring in the annual increase due to age, it is a good safety net if you can afford it.