Turning 65 soon,have to sign up for Medicare. Confused with all of the supplements, plans, etc.
Same here. I am on my wife's insurance from her employer. It turns out it was less expensive and better coverage for me to stay on her policy for part B so I just declined that coverage and of course just have part A.
"The democracy will cease to exist when you take away from those who are willing to work and give to those who would not."
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Do what i did. I'm sure you're mailbox has been full of stuff like mine was and continues to be. Gather it all up and take it to you're insurance agent and have him sort through it and get you what you need.
I wound up with Medicare and Blue Cross Blue Shield supplement. BC/BS has three level to their supplements. Get the cheapest one which is less than $30 a month. Why? Because if you find out you need to replace a knee or hip but it won't be done right away you can change the supplement to the higher package. You can do this at any time. Does not need to be a open enrollment period. I couldn't believe it. I asked my insurance guy how that could be? That's just how it works. But if you take the Blue Cross Blue Sheild prescription package with it then you are not allowed to jump between plan levels. Go figure. So I wound up with a Humana prescription plan.
This shit is convoluted go to you're insurance agent.
"Fixed fortifications are monuments to mans stupidity" - George S. Patton
I am 100% VA , so only my wife needs coverage. She has standard Medicare Part B & a USAA Supplement to cover the 20%. This is more expensive than using an insurance company for Part B & the 20% together. The advantage is she can be treated anywhere in the US by any doctor in the US. No searching for the "In Plan" shit!
If you can't dazzle them with brilliance, baffle them with bullshit!
Sigs Owned - A Bunch
Just call Joe Namath on his private line. FREE SHIT for all. Rides to the doctor, meals on wheels, silver sneakers and rock bottom medical care. Like everything else you get what you pay for. There is no free lunch despite what Joe says.
|Void Where Prohibited|
If you're still going to be working and covered by your employer, you don't have to do anything with Medicare enrollment.
"If Gun Control worked, Chicago would look like Mayberry, not Thunderdome" - Cam Edwards
Went through this 3 years ago. You're confused because it's confusing. Surprisingly, the gubmint website is quite helpful. I recommend starting here:
Two Basic ways to get Medicare coverage:
1. Original Medicare (Parts A & B) You must also have prescription drug coverage, either sold separately (Part D) or coverage under a spouses plan, or pay a penalty increasing with the number of months you go uncovered.
Everyone, especially long time state and municipal employees, should check with the SSA before they turn 65 to ensure they have paid 40 quarters of medicare taxes to ensure free Part A. Otherwise, it'll cost you plenty. I wept for joy upon learning that you can qualify for free Part A on your spouses work history.
Everyone pays a premium for Part B. If you do not enroll in Part B when you first become eligible, you will pay a penalty through higher future premiums.
Optionally, you may purchase Medicare Supplement/Medigap (the terms are usually synonymous) policies through private insurers that cover varying amounts of required deductibles and the 20% Medicare does not pay. These policies are standardized by letter (A-G)for easier comparison.
Original Medicare is accepted by most health care providers nationwide.
2. Medicare Advsntage Plans (Part C) Medicare approved and sold by private insurance companies, these plans provide basic Part A and B coverage and a host of additional benefits as well. Most include Part D prescription. Some include dental, vision, Silver Sneakers, transportation, home health care, etc. Many of these policies provide basic coverage at very affordable costs as advertised on TV and pushed by telemarketers. However, expect to be restricted to network or regional health care providers. Also expect managed care; some medical procedures may require review and approval.
I'm sure I left out some important detail so do your homework. Everyone's needs vary: You might not want to
fool with managed care if you have a chronic or progressive medical condition and/or frequent doctor visits. Similarly, you might not want to be restricted to a region or network for medical care if you travel frequently or dream of moving to sunnier climes.
Hopefully, this tome hasn't added to the confusion.
|His Royal Hiney|
Going through the government info is good. I started studying after July for my wife.
I have a lot of notes but this is what I understand so far taken directly from my notes:
Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
- Premium: Free
- $1,408 for each benefit period
- A benefit period begins the day of admission as an inpatient in a hospital of Skilled Nursing Facility.
- It ends day of discharge plus 60 days.
- Days 1-60: $0 coinsurance for each benefit period
- Days 61-90: $356 coinsurance per day of each benefit period
- Day 91 and beyond: $704 per each "lifetime reserve day." Each person has a total of 60 reserve days over their lifetime.
- Beyond lifetime reserve days: all costs
Part B (Medical Insurance)
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services
- $144.60 per month for 2020 based on $174,000 or less Joint 2018 Tax Return
- $202.40 per month for 2020 based on $218,000 or less Joint 2018 Tax Return
Part D (prescription drug coverage)
The above is not much. Following is what I have from memory.
If you have or will have prescription coverage, you can check if the medicines you use are generic and usually they are cheaper than the cost of paying for a Part D coverage. If you use brand name drugs, then you have to find a Part D policy that covers your brand.
Regular medicare lets you pick any doctor in the country that accepts Medicare. You do have deductibles and coinsurance. There are two kinds of medicare doctors. The first one will accept whatever Medicare pays them. The second one is allowed to charge you an extra 15% of what Medicare pays them. I have yet to look at the schedule but that would be good information. More on this part later.
The confusion is that companies will offer you some packages that says they will pay for your deductible and coinsurance and the 15% for the second kind of doctor. They offer two types of plans.
Medicare Advantage is HMO that offers you extra benefits and even pay for your part prescription drug. What you give up is the ability to go to any kind of doctor; like an HMO, you have to pick from their network. Some even have no premium.
The second is Medigap or Medicare supplement which is like a PPO which means you can go to any doctor. They have different pans that have cover which coinsurance or deductible they cover. These require a premium.
Now, I haven't priced the medigap policies but I also came across a series of youtube videos from a doctor who say that supplemental insurance policies are a "scam." I'll link to that below. What he says sounds reasonable. In that you're paying the insurance company to make payments you can do yourself plus a profit for them.
"It did not really matter what we expected from life, but rather what life expected from us. We needed to stop asking about the meaning of life, and instead to think of ourselves as those who were being questioned by life – daily and hourly. Our answer must consist not in talk and meditation, but in right action and in right conduct. Life ultimately means taking the responsibility to find the right answer to its problems and to fulfill the tasks which it constantly sets for each individual." Viktor Frankl, Man's Search for Meaning, 1946.
This is dependent upon knowing what drugs you might be placed on during the year. A drug like Eliquis or Xarelto cost a pretty penny even with GoodRX. A friend of mine who happens to be an orthpedic surgeon found out the hard way and for a year was trying to get his drugs from Canada. He then signed up for Part D. Pretty much any drug advertised on TV has no generic and is VERY expensive.
|Just because you can, |
doesn't mean you should
I have Part G through BC and a Part D that’s not too expensive.
I don’t take any drugs at this point but wanted to have something, just in case.
It helps to know your conditions, if any. Medications? Are you a gambler?...Any family conditions that might come up in you in the future.
If you are healthy and don't generally visit doctors then look at advantage plans.
If you want the ability to see any doctor you want and/or to change doctors, check out supplemental plans instead of advantage, in which case you would have to get Medicare parts A and B, and you would also get one of the supplemental, private plans.
Drugs are another story. I gamble on my drugs but purchase them at Costco. I get a small discount for being a Costco member but non members may also purchase drugs there.
Not all supplemental plans allow you visit any doctor you want or change doctors. You need to read those various plans.
You get ONE chance on pre existing conditions with a Part B supplement. If you have cancer or need a heart transplant they HAVE to take you. If you switch to an Advantage plan and then try and switch back they will either refuse you or charge you anything they want. This fact is often not disclosed.
When you turn 65 and sign up for Part B, you have a six month grace period to sign up for a supplement. During this grace period, the insurer cannot refuse you for any reason (pre-existing conditions, etc.) and must charge you the going rate in your state for the plan you choose. No extra fees for pre-existing conditions. If you sign up for a supplement after that six month grace period, the insurer can refuse you, or charge higher rates, (if you have diabetes, for example).
Medicare supplements are dictated by Medicare as to what each one covers. Plan F, for example, the "full coverage" plan, and the most expensive, has the same coverage in all states. Same for all the other plans. Rates can differ from state to state, though.
all your sig are belong to us
Yup, you definitely want to get everything done during the sign-up period. They cannot deny you coverage. Medicare will send you a large booklet (and they will every year thereafter) read it, it has all the info you need. The wife and I ended up going with a supplemental which was plan L. That pays 75% of the 20% that is not covered. Believe me, we are glad we did. I have had some pretty major surgeries the last eight years and I don't think we ever ended up paying more than a few hundred bucks once the smoke clears. I researched those Medicare Advantage plans and didn't like anything about them.
.....never marry a woman who is mean to your waitress.
henryaz, you are absolutely correct about the six month grace period with one exception. OP did not say if he was currently employed. I turned 65 last month and contacted several supplemental providers and there is an exception where if you are still working, you are not bound by the six month period. You get an exception if you are getting health insurance from your employer (I am as it is less than a supplemental).
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