I am blessed to be approaching the 65 year mark. Medicare is something I will have to deal with since my Verizon retirement benefits end at that time. I understand that there will be an automatic rollover if I don't do anything which might be somewhat costly. I haven't signed up for medicare yet. Anybody have tips they don't mind sharing?

If you are applying for SS, they will automatically sign you up for Medicare at the same time. If you are not, call SSA.gov and have them do it separately. In either case, they will answer your questions surprisingly efficiently.

Just went thru this last year. Biggest thing for me was staying local vs traveling in retirement. If you're staying local, medicare advantage plans offer some pretty good deals. If you're going to travel a lot, you'll probably lean toward supplement plans. More expensive but in network not required in most cases. I travelled for a living. I don't anymore so med adv is right for me. Comes with vision and dental too. You still need to shop around to make sure your doctors and meds are covered either way you go.

Think about supplemental insurance to cover that which medicare doesn't pick up.

quote:

Originally posted by Cliff:
I haven't signed up for medicare yet. Anybody have tips they don't mind sharing?

I do know this: Start your research now, rather than later. Also: You have to sign up right away, when you become eligible. So have your ducks in a row when it's time to pull the trigger.

My wife did all the legwork. She's got more patience with bureaucracy than I

You will want supplemental insurance. There are two types: MediGap and Medicare Advantage. Here's the differences: Medicare Advantage vs. Medigap

We have MediGap Plan G, which has the best coverage. It's also the most expensive.

Between MediCare and MediGap our premiums are about what they were when I was employed, but the coverage is worlds better. E.g.: My arthroscopic knee surgery ended-up costing us less than $150 out-of-pocket. My emergency hospital stay for a stoke risk evaluation cost us nothing out-of-pocket.

Caution: When you first sign up for MediCare and whatever supplemental coverage is the only time they don't look at pre-existing conditions. After that: Anytime you want to make any change in coverage: They will.

So choose wisely.

Whether you choose MediGap or MediCare Advantage, what plan you chose if you go with MediGap, and with whom you go for MediCare Part D (prescription drug coverage) are all highly individual. What works for us or anybody else may not be optimal for you.

My wife spent literally tens-upon-tens of hours doing research and talking to a couple free advisors.

A word about dental insurance: Our dentist and my wife's research suggested dental insurance was a bad bet, so we didn't go with it. We do subscribe to a dental discount plan, which saves us quite a bit with those dental places that are participants. If you think you might need extensive dental work in the not-too-far-distant future you might choose otherwise.

Yes, travel is the only negative to Advantage plans. There are several levels of plans from most providers. The lower tier Advantage plans from most providers have no upcharge from the government supplied Medicare plan. The upper tier plans do cost more but of course offer better coverage. Also the Advantage plans have a yearly out of pocket ceiling. Mine is maxed at $4000, so no matter what expenses you encounter, no more out of pocket once you reach that. For example a couple of years ago I had major surgery. 22 days in the hospital. The total bill was over 1.5 million. I paid $2000 out of pocket. Don't know why they didn't collect the full 4K, but I didn't ask those questions. The government base plan has no ceiling, so what you encounter, will be subject to the deductible schedule with no stop. So, you probably need their supplement plan which I think is pretty costly.

quote:

Yes, travel is the only negative to Advantage plans

^^^^^^^^^^^^^
That is one negative. Several years back the one major hospital in town dropped ALL Medicare Advantage plans due low payment. Since most doctors were employed by the hospital patients were SOL. Medicare Advantage plans are cheaper for a reason.

quote:

Originally posted by pace40:
Just went thru this last year. Biggest thing for me was staying local vs traveling in retirement. If you're staying local, medicare advantage plans offer some pretty good deals. If you're going to travel a lot, you'll probably lean toward supplement plans. More expensive but in network not required in most cases. I travelled for a living. I don't anymore so med adv is right for me. Comes with vision and dental too. You still need to shop around to make sure your doctors and meds are covered either way you go.

This will be important for me, but I won't be eligible for another 1 1/2 years.

Here's what you need to do.

There's no automatic rollover as far as I know. You have to sign up for Medicare. You can go to Medicare.gov which is where I got the information I'm going to share with you below.

There are two kinds of Medicare. There's the traditional Medicare which consists of Part A, Part B, Part D, and an optional Medigap supplement coverage. The second kind is Part C Medicare Advantage which is the equivalent of getting an HMO.

I hope you understand what an HMO coverage is versus regular coverage. HMO is where you're locked in to the HMO network versus the regular coverage where you can go to any doctor/hospital in the country that accepts Medicare. It may be that Part C is cheaper but there are disadvantages just like an HMO. Like if you move out of state, you may have to change plans and if you're past the first year, you'll have to go through underwriting process to see if you're healthy enough that the new plan will accept you.

For the traditional Medicare, Part A covers your hospital stay. Part A is free if you've worked and paid 10 years of Medicare taxes. There's a deductible of $1556 for the first 60 days of staying in a hospital or skilled nursing facility.

Part B is your doctor visits, outpatient care, medical supplies, and preventive services. For 2022, if you made $182,0000 or less two years ago, then your premium is $170 a month. you'll pay more if your Modified Adjusted Gross Income from two years ago is higher than $182,000.

The deductible for Part B is $233 that you have to pay before you start to get benefits. After that, your coinsurance is 20% of what the Medicare approved amount.

If you normally take medication, then you need to take Part D which is Drug coverage. If you wait to enroll in a Part D plan, you'll pay a penalty in premiums depending on how long you hold out enrolling.

The following is the big decision point with regards to going with the traditional Medicare. As you can see, there are deductibles associated with Part A and Part B. The decision point is whether you want to buy a Medicare supplemental plan to help pay for your coinsurance. If you expect to be healthy and not really need to go to your doctor, then you may decide you may not need a Medigap insurance. If you're sickly and expect to have to pay 20% coinsurance on a lot of bills, you may decide you need a Medigap insurance plan.

If you decide you need a Medigap insurance plan, let me help narrow your choices for you. The only viable choices are Plan G Low Deductible or Plan G High Deductible. Plan G Low Deductible kicks in after you pay deductibles totaling a low amount and the Plan G High Deductible kicks in after the deductibles you paid for the year reaches a higher amount.

The Plan G Low deductible costs more in premiums and the Plan G high deductible cost less in premiums. If you're healthy and just want a cap of how much deductibles you pay each year, then go with the high deductible. If you're sickly, you may want to go with the low deductible.

I was going to tell you the method I used for deciding between the two but I'll have to rethink it through. I don't have the worksheet I used. I think it involved adding the Part B Deductible of $233 to the plan deductibles then dividing by 20%. This gives you the total amount of Part B billings for the year before each plan starts covering your deductible. Then you decide how healthy or sickly do you expect to be and make your decision accordingly.

----------------------

Cliff

I found the worksheet I used. You'll have to figure out the premium costs for you and replace my numbers.

Monthly Premium for Plan G High Deductible was $46.34 with a plan deductible of $2,370 after the medicare deductible of $233. The Regular Plan G premium was $188.13 with a plan deductible of $0 after the Medicare deductible of $233.

The Annual Premium of the regular Plan G was $2,257.56 ($188.13 x 12) and the Plan G High Deductible is $556.08. The difference in the two premiums is $1,701.48.

I divide $1,701.48 by 20% which results in $8,507.40. This represents the break even point of the total Part B Doctor's bills for the year. If I expect to incur $8,507.40 or more in doctor visit bills every year then I can go ahead and pay the higher premium for regular Plan G. If I expect to incur less than $8,507.40 in doctor visit bills every year then I save money by going with the high deductible while still being protected to pay no more than $2,926.08 each year in premiums plus deductible. If I actually don't use the Part B, I only spend $556.08 in premiums versus signing up to pay $2,257.56 in premiums each year.

This message has been edited. Last edited by: Rey HRH,

^^^^^ This. We’ve been retired for 7 years and subscribed to Part G low deductible. While we didn’t need it early on, our needs are increasing proportionally with our age. We generally travel 4-5 months of the year and it travels with us. Medicare will not cover you out of the country.
Mike

You have to sign up in Medicare before 65, I think 3 months or so.
As far as the medical insurance part- I have traditional Medicare and Part B plus a supplement (Part G in my case) that pays after your deductible. Once you pay the small annual deductible almost all providers accept the Medicare and supplement payments, not so with Advantage plans.
Part D, a drug plan is another decision and much depends on your present drug needs (a known) and your guess as to the future (mostly unknown)and how much risk you want to assume if you guess wrong.
After being self-employed the last 30 years and having to pay ever increasing insurance and deductibles, this is an incredible deal.

Many seem to like Advantage plans because they appear to offer additional benefits(such as vision, dental, etc.) with lower premiums.
They often are much more restrictive of who is the provider, have much larger deductibles when you do need care, and if you don't live in a large suburban or urban market with many different hospital chains and medical practices, that's a problem. Not to mention those provider agreements can and do change each year.

As a Verizon retiree won't you have some opportunity for company subsidized Advantage/PPO plans?

I hope so because after they RIFed me twenty years ago, we still get a pretty sweet deal.

I'm in the same boat of confusion. The 3 month period of time prior to 65th birthday is a few months away.

My biggest concern is traveling. I live in OKC and want to spend the winters in Arizona. That will probably work out to an even split, 6 months each.

I'd like to have the converage to get me covered in both locations, and have to select the plans and choices that will place me in a comfortable zone.

I'm not really worried, not too much, about costs, within reason, of coverage purchase.

And things get a bit complicated. I may want to spend a winter in South Texas, or possibly Florida. I've been in both and enjoyed them, but those 2 locations are not my favorites. Arizona is.

It's possible that in a few more years I might sell the OKC house and move permanently to AZ.

As far as me saying I may spend 6 months a year in OKC, it gets hot, and often times humid, so I may go spend some time in Colorado to Montana and northern Idaho.

If I'm in Arizona for the winter, and I decide to go to Southern California (San Diego and Palm Springs) to visit family for awhile I hope I still have effective supplemental coverage.

I know Medicare if valid anywhere, but the supplements and advantage plans may not, I think, and don't want to get screwed out of network and owe big money to providers.

Yeah, it's quite a mess to navigate all this.

BTW I will definitely get Part D, I've been informed if you do NOT select it at the start, and later you want to add it, you'll pay a hefty extra premium.

Why oh why can't things be less murky!!!

Thanks for this topic thread, and thanks for the advice from you guys who are there.

Go see your insurance agent. He will have all sorted out for you in a hour. One important thing he pointed out to me was do not take the part D which is prescription coverage. If you do not have that you can move between the other three levels of coverage anytime you need to. If you do have that you are locked in. He signed me up with with the low deductible Medicare and added a Blue Cross Blue Shield supplement that runs me about $25 a month and a Humana prescription coverage which is about $15 a month.

Seriously though go to a insurance agent who does this for a living. It's easy to get confused in all this trying to sort it out yourself. I remember how grateful I was that I went to him after leaving his office.

Do yourself a big favor and get a PPO, not an HMO. You get a lot bigger selection of Doctors and you don't need a referral to go to one.

Lastly, I wouldn't even consider anything but a supplement plan. That way if you decide later to travel a lot, you're set.

In my situation, I'm 68 now and signed up for Medicare Part A at 65. My wife is in her early 50's so I've continued on her work insurance plan (a PPO 90/10 Health plan, a PPO Dental plan, a pretty decent Vision plan). As a spouse on her employer plan this allows me to remain Medicare premium penalty free once I do sign up for the full meal deal Medicare plan at some time in the future.

I've often wondered if it would be better coverage and/or cheaper to just convert myself over to Traditional Medicare (not the Advantage plans) but haven't done it thinking staying on her employer plan for the Medical/Dental/Vision is the better way to go. I could be wrong but finding a quality/affordable Dental/Vision plan seems easier with the Employer plans than finding them with Traditional Medicare.

It depends on the Employer plan. Blue Cross/Blue Shield Federal, for example beats Medicare.

quote:

Originally posted by OKCGene:
I'm in the same boat of confusion. The 3 month period of time prior to 65th birthday is a few months away.

My biggest concern is traveling. I live in OKC and want to spend the winters in Arizona. That will probably work out to an even split, 6 months each.

Then you would want the Traditional Medicare as opposed to Medicare Advantage. It allows you to go to any doctor / hospital in the US that accepts Medicare. You want to confirm that the doctor accepts assignments which means they'll accept the price Medicare sets. If they don't accept assignment, then you'll be liable for the 20% of what medicare says the price is plus up to 15% over what medicare says the price is. If the doctor accepts assignment, then you're only liable for the 20% deductible of what Medicare says the price is.

If you're signing up for a Medigap plan, you'll have to apply based on your residence zip code. But once signed up, your medigap insurance is good anywhere unlike medicare advantage plans.

quote:

Originally posted by 2PAK:
In my situation, I'm 68 now and signed up for Medicare Part A at 65. My wife is in her early 50's so I've continued on her work insurance plan (a PPO 90/10 Health plan, a PPO Dental plan, a pretty decent Vision plan). As a spouse on her employer plan this allows me to remain Medicare premium penalty free once I do sign up for the full meal deal Medicare plan at some time in the future.

I've often wondered if it would be better coverage and/or cheaper to just convert myself over to Traditional Medicare (not the Advantage plans) but haven't done it thinking staying on her employer plan for the Medical/Dental/Vision is the better way to go. I could be wrong but finding a quality/affordable Dental/Vision plan seems easier with the Employer plans than finding them with Traditional Medicare.

Private insurance is usually better as it's subsidized by the company. You can do the math yourself. Figure out how much is your wife paying for you.

Then compare that to $170 a month for Medicare Part B plus 20% copay after your $233 deductible each year.

Tell me why are Medicare Advantage plans cheaper than traditional Medicare and supplements? Think hard about where the cost savings are coming from and you might think twice about an Advantage plan. Besides they have to pay for Joe Namath and now the guy from Good times see here: