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posted
Pretty comprehensive article about open enrollment for folks turning 65.

It is Medicare open season. And, let’s face it, nobody has any idea what to do.

The other night, I got a call from a friend who works in the long-term care advocacy world. She will soon turn 65 and is confronting the reality of enrolling in Medicare. She has been doing diligent research and creating detailed spreadsheets. And she is baffled.

Some choice is good. So is competition. But needless complexity is something else entirely. And we know from behavioral science that, faced with too many choices, humans often make poor decisions or …do nothing.

Hence, Medicare—the poster child for choice overload:

The rules


If you have just turned 65, you need to enroll in Part A, even if you still are working and have insurance through your job. If you don’t have employer-sponsored health coverage, you need to decide whether to go with Medicare Advantage managed care (Part C) or with traditional Medicare (Part B), also called original Medicare. If you pick traditional fee-for-service Medicare, you also should choose a Part D drug plan (basic Medicare doesn’t pay for most drugs) and decide whether to buy a Medicare Supplemental (Medigap) policy to cover costs basic Medicare doesn’t.

If you decide to buy a Medigap policy, you have to choose between 10 different plan designs (lettered A-N). Each letter represents a different benefit package. And, of course, you need to remember that Medicare Supplemental plans A,B,C, and D are different from Medicare Parts A,B, C, and D.

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You could simplify your life and enroll in a Medicare Advantage plan. Because these generally provide comprehensive benefits, including drugs, you won’t need a Part D plan or a Medigap policy. But once you get into MA world, it is hard to get out. You can go back to traditional Medicare, but you may not be able to buy an affordable Medigap policy if you have pre-existing medical conditions.

More rules

Deciding which version of Medicare you want is just the first step. You still need to pick specific insurers. Where I live, there are 25 Part D plans, 10 managed care plans, and 29 plans that offer, for instance, Medigap F policies. Different carriers offer other policies for other letter plans.

And which plan you choose matters—a lot. The benefits for each letter plan are identical, no matter whose insurance you buy. But provider networks may be very different and so are the premiums. In Maryland, premiums for those Part F plans vary from $151-$344 a month—for identical benefits.

And there is more.

If you are already getting Social Security benefits, you will automatically get Part A and B coverage starting in the month you turn 65. But if you are not yet taking Social Security, you need to sign up for Part A. If you don’t have other insurance, you also need to sign up for Part B during your initial enrollment period, which starts three months before your turn 65 and lasts for three months after. If you don’t sign up in that window, you will owe penalties when you finally do enroll. Congress has been trying to fix this mess but has yet to act.

More rules

The rules are similar for Part D. If you don’t sign up when you are first eligible, you may owe a penalty.

As long as you are still getting insurance through work or another group policy, you won’t owe a penalty if you wait to enroll in Medicare Part D. But once you lose coverage, you must sign up for Medicare during a special enrollment period or you will have to pay a penalty.

The rules are different still if you are getting individual insurance through the Affordable Care Act health exchanges. In that case you may want to drop your individual coverage and switch to Medicare.

There’s more. What if you have Medicare but want to switch plans?

I won’t even try to describe those rules. Here is how Medicare explains it:

When you first become eligible for Medicare, you can join during your Initial Enrollment Period.

If you get Part B for the first time during the General Enrollment Period, you can also join a Medicare drug plan from April 1–June 30. Your coverage will start on July 1.

You can join, switch, or drop between October 15–December 7 each year. Your changes will take effect on January 1 of the following year.

If you’re enrolled in a Medicare Advantage Plan, you can join, switch, or drop a plan during the Medicare Advantage Open Enrollment Period, between January 1–March 31 each year.

If you qualify for a Special Enrollment Period. See the next page.

Medicare tries to explain all this in its Medicare & You handbook. This year’s version is 122 pages long.

Or you can try to sort it out through the Medicare.gov website. Or you can contact a counsellor from your local State Health Insurance Assistance Program (SHIP) program. Or, you can just pour yourself a stiff drink.

Medicare is insanely and needlessly complicated. Different enrollment rules and periods for different plans, complex and restrictive rules for switching plans, and penalties for poor choices all discourage older adults from buying the most appropriate coverage. They make people like my advocate friend pull out their hair in frustration. And that’s no way to celebrate your 65th birthday.

LINK:
https://www.forbes.com/sites/h...xplode/#35bb80d948ed
 
Posts: 17176 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
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There are many companies which, for a fee, will work with you and provide recommendations and guidance specific to your individual situation. The wife and I went this route and, while we still had to make certain decisions, it wasn’t that difficult as the pros and cons for each choice were well laid out.

I’d recommend this approach in lieu of trying to figure everything out on your own, particularly since there can be lifelong costs if you get it wrong!
 
Posts: 1169 | Location: NE Indiana  | Registered: January 20, 2011Reply With QuoteReport This Post
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If you have just turned 65, you need to enroll in Part A, even if you still are working and have insurance through your job.


I just turned 67, am working full time and have coverage through my employer. I have not signed up for any sort of medicare.




You can't truly call yourself "peaceful" unless you are capable of great violence. If you're not capable of great violence, you're not peaceful, you're harmless.

NRA Benefactor/Patriot Member
 
Posts: 2857 | Location: Peoples Republic of North Virginia | Registered: December 04, 2015Reply With QuoteReport This Post
I believe in the
principle of
Due Process
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I was lucky. When I turned 65, years ago, I was contacted by an insurance salesman in San Diego. I’m pretty tough on salesmen usually, but something in this fellow’s manner, the way he approached this, got me to pay attention, and boy was that lucky! We had good coverage through the company I was happy with. He came to my office, explained the basics, guided me through the labyrinth of impenetrable verbiages, and got me set up in a deal I have been grateful for ever since.

Those of you in Whackyland would do well to contact Dan Daniels http://danthemanhealthinsurance.com 858 225 7688.

I haven’t had a chance to name a grandkid after him, but I might.




Luckily, I have enough willpower to control the driving ambition that rages within me.

When you had the votes, we did things your way. Now, we have the votes and you will be doing things our way. This lesson in political reality from Lyndon B. Johnson

"Some things are apparent. Where government moves in, community retreats, civil society disintegrates and our ability to control our own destiny atrophies. The result is: families under siege; war in the streets; unapologetic expropriation of property; the precipitous decline of the rule of law; the rapid rise of corruption; the loss of civility and the triumph of deceit. The result is a debased, debauched culture which finds moral depravity entertaining and virtue contemptible." - Justice Janice Rogers Brown
 
Posts: 48369 | Location: Texas hill country | Registered: July 04, 2005Reply With QuoteReport This Post
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quote:
Originally posted by fpuhan:
quote:
If you have just turned 65, you need to enroll in Part A, even if you still are working and have insurance through your job.


I just turned 67, am working full time and have coverage through my employer. I have not signed up for any sort of medicare.


We went to a seminar and they recommended signing up at 65 otherwise the will be a penalty paid every year once you do sign up. You might want to check it out.
 
Posts: 7523 | Registered: October 31, 2008Reply With QuoteReport This Post
Tinker Sailor Soldier Pie
Picture of Balzé Halzé
posted Hide Post
quote:
Originally posted by fpuhan:
quote:
If you have just turned 65, you need to enroll in Part A, even if you still are working and have insurance through your job.


I just turned 67, am working full time and have coverage through my employer. I have not signed up for any sort of medicare.


I'm surprised your employer allows that.


~Alan

Acta Non Verba
NRA Life Member (Patron)
God, Family, Guns, Country

Men will fight and die to protect women... because women protect everything else. ~Andrew Klavan

"Once there was only dark. If you ask me, light is winning." ~Rust Cohle
 
Posts: 30297 | Location: Elv. 7,000 feet, Utah | Registered: October 29, 2012Reply With QuoteReport This Post
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Many of the Medicare Advantage plans hold free seminars on a regular schedule, especially during open season. These give you an opportunity to ask as many questions as you like and get answers right away. We went to several before settling on the Coventry Gold Medicare Advantage Plan ($0 premium).
 
Posts: 693 | Location: E. Central Missouri | Registered: January 05, 2011Reply With QuoteReport This Post
Baroque Bloke
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My last employer had UHC for health care insurance. I was very happy with the service, so I selected UHC Plan N when I retired, and continue to be satisfied. Not the least expensive choice though.



Serious about crackers
 
Posts: 8854 | Location: San Diego | Registered: July 26, 2014Reply With QuoteReport This Post
Muzzle flash
aficionado
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Since I'm well past that point, I don't know what the current rules are, but when I retired at age 67 I signed up for Social Security, and Medicare Part A was automatic with that. When I left the company my health insurance with them stopped, and I enrolled in Medicare Part B in order to qualify for the military's Tricare For Life (TFL) supplemental coverage. Although I also qualify for VA medical assistance, I've never found it necessary to avail myself of it--Medicare B and TFL pretty well handles it all.

Since current rules seem to be much more complex than when I retired, I suspect it would be useful to avail yourself of one of the counseling services being provided before making final decisions.

flashguy




Texan by choice, not accident of birth
 
Posts: 27902 | Location: Dallas, TX | Registered: May 08, 2006Reply With QuoteReport This Post
Nature is full of
magnificent creatures
posted Hide Post
quote:
Originally posted by JALLEN:
He came to my office, explained the basics, guided me through the labyrinth of impenetrable verbiages, and got me set up in a deal I have been grateful for ever since.

Those of you in Whackyland would do well to contact Dan Daniels http://danthemanhealthinsurance.com 858 225 7688.

I haven’t had a chance to name a grandkid after him, but I might.


That has to be the highest recommendation I have ever read you give. What exactly did he do for you?
 
Posts: 6273 | Registered: March 24, 2008Reply With QuoteReport This Post
Victim of Life's
Circumstances
Picture of doublesharp
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I'm 67 and I signed up for medicare prior to turning 65 but elected to keep my coverage on my wife's cadillac city employee policy. She retires in 2019 and then we must choose. I had no idea it was so complicated. Timely thread and I appreciate the discussion.


________________________
God spelled backwards is dog
 
Posts: 4683 | Location: Sunnyside of Louisville | Registered: July 04, 2007Reply With QuoteReport This Post
Just because you can,
doesn't mean you should
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I turned 65 a few months ago.
We have a good independent insurance agent and between her and reading online I could figure it out.
A (hospitalization) is free to you and you sign up at 65 or within 3 months of 65.
B is sort of like your regular policy and costs something like $140 per month.
Then the Medigap part G that covers the stuff regular medicare doesn't cover with a $183 deductible.
Then, depending on your needs there are several drug plans.
If you are buying your own insurance now, they all look very cheap and probably offer much better coverage.
This seems to be one of the few benefits to getting older.

There are lots of other potential choices plus Medicare Advantage plans but if you do what I did you will have a pretty good plan. I'd do this for the first year to see what your needs are and learn the system.
At the end of each year you have open enrollment and can change plans once you figure it out.


___________________________
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Posts: 9456 | Location: NE GA | Registered: August 22, 2002Reply With QuoteReport This Post
Baroque Bloke
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quote:
Originally posted by 220-9er:
<snip>
B is sort of like your regular policy and costs something like $140 per month.
<snip>

Persons with larger incomes pay more than twice that monthly rate.



Serious about crackers
 
Posts: 8854 | Location: San Diego | Registered: July 26, 2014Reply With QuoteReport This Post
Happily Retired
Picture of Bassamatic
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Went through it six years ago and I thought the whole thing was actually pretty simple. You do have to sit down and read the book they send you and really the only thing left is to decide if you want any supplemental insurance. I did want it and decided on Plan L provided by UHC/AARP.

I've used these plans a lot over the last six years, including some pretty major surgery, and everything ran really smooth.

The wife turned 65 about two years ago and she signed up for pretty much what I have and I bet the whole thing did not take an hour.

If you want to PM me I would be glad to answer any questions.



.....never marry a woman who is mean to your waitress.
 
Posts: 5024 | Location: Lake of the Ozarks, MO. | Registered: September 05, 2005Reply With QuoteReport This Post
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I turn 65 in a couple weeks. I work full-time and ‘plan’ to work until 70. I enrolled only in Part A. Everything else is on hold until I stop working. If that were not the case, I would have also enrolled in a Medigap ‘F’ plan and Part D. I believe I would also have been required to enroll in Part B.
 
Posts: 1447 | Location: Western WA | Registered: September 11, 2006Reply With QuoteReport This Post
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I’m up to three mailers received this week alone including offers to attend free seminars..
 
Posts: 1447 | Location: Western WA | Registered: September 11, 2006Reply With QuoteReport This Post
goodheart
Picture of sjtill
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Now if only we had Bernie’s “Medicare For All” we could all be so confused.
Except it isn’t it single payer, so really you would have no choice at all. Would you like that better?


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“ What all the wise men promised has not happened, and what all the damned fools said would happen has come to pass.”— Lord Melbourne
 
Posts: 18017 | Location: One hop from Paradise | Registered: July 27, 2004Reply With QuoteReport This Post
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I am 56 and my Social Security full retirement age is 67. Does that mean I sign up for Medicare then or is it still at 65??
 
Posts: 868 | Location: Alabama | Registered: January 05, 2005Reply With QuoteReport This Post
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?!?!?
OK, so I am 68 and have been just continuing to work and covered by my work Health Plan. I haven't even thought about Medicare and I am lucky enough to be really healthy. I WAS SUPPOSED TO SIGN UP ?!
Can somebody direct me to a link where this is really explained in detail ?
Thanks.


"Crom is strong! If I die, I have to go before him, and he will ask me, 'What is the riddle of steel?' If I don't know it, he will cast me out of Valhalla and laugh at me."
 
Posts: 6641 | Registered: September 10, 2007Reply With QuoteReport This Post
Speling Champ
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quote:
Originally posted by Crom:
?!?!?
OK, so I am 68 and have been just continuing to work and covered by my work Health Plan. I haven't even thought about Medicare and I am lucky enough to be really healthy. I WAS SUPPOSED TO SIGN UP ?!
Can somebody direct me to a link where this is really explained in detail ?
Thanks.


“Medicare & You” it is a book/pamphlet/journal put out by Social Security every year. You can also download a PDF of it as well. This is the Bible where Medicare is concerned.

If you are still working and have creditable medical (Part B) and creditable drug (Part D) then you are not required to enroll in Part(s) B and D. Part A (hospitalization) enrollment is usually required upon eligibility. Most employers will drop that portion of an employee’s group plan as well. Talk to your benefits advisor if you have one.
 
Posts: 1603 | Location: Utah | Registered: July 06, 2011Reply With QuoteReport This Post
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