Medicare ?

[Boaz]

Well I Have to sign up for Medicare in bout a month . Honestly don't know the details , the doughnut hole , supplemental insurance so forth and so on . You old guys got any recommendations , tips , 'tricks' , what NOT to do ?

Thanks !

[square butte]

I just signed up last month - I won't be too much help cause I'm still trying to figure it all out myself. I know one thing - they believe in multiple and redundant paperwork. I think I've gotten 3 or 4 pieces of mail for each issue. I have a stack of probably 20 pieces of mail so far. I signed up for Part A,B, and D. Even though I take no meds now. The penalty for not signing up for part D is 1 percent for every month you don't sign up - That's 12 percent per year cumulative. I think the penalty for not signing up for part B is even worse. Haven't tried to use any of it yet. I'll be listening for all the rest of you old guys. Aint life grand . . .

[Freightman]

I got my supplement through the NRA it is a good one. the prescription supplement is the most important unless you go to the hospital a lot. I don't use many prescriptions so I took the one with a deductible, my wife hits the doughnut hole by June so a non- deductible is for her. Sit down with a pencil and paper and figure all ways then pick.
I only got my $350 deductible paid for the last month of 2016. and I am a young 77. Good luck and welcome to the "Old mans club" :drinks:

[elk hunter]

I'm on Medicare and I bought supplemental coverage when I went on Medicare. I have what is called a "Medicare advantage" plan. The private/supplemental plan deals with Medicare directly, so I never see any thing that is billed to Medicare. I do get a periodic notice from the insurance company detailing what they have been billed by the Doctors, hospitals, clinics, pharmacy's etc and what they have paid out and what my portion of the bill is. I do have a $20.00 copay for Doctor visits and pay a small amount for covered medications, not all medications are covered so I have paid out a few hundred dollars for medications over the years. While supplemental insurance may seem expensive I wouldn't go without it. Last year between the Doctors and hospitals the supplemental insurance was billed $292,000, I paid $2500, my maximum out of pocket for one year, plus a few other Doctor and hospital copay's that may have been $1000. If I only had Medicare I would have paid out a whole lot more than the premiums for the supplemental insurance would be for the rest of my life.

If you can, I recommend that you talk your Doctor's or clinic's billing department about their experience with different insurance company's and then talk with a couple of different people that sell insurance and buy what you can afford. It will only take one serious illness to cost you more than you would ever pay in premiums. Modern health care is unbelievably good but unbelievably expensive also.

There is a movement to repeal Obama Care, if that happens hopefully Congress will come up with something better but, I wouldn't count on it.

None of us plan on getting seriously ill but, most of us will at some point.

Stay well people.

[leadman]

My wife went on Medicare in June, me in Nov. And yes, tons of advertisements had to be waded thru. There are 2 ways to get coverage.

A Medicare Advantage plan is similar to a commercial or employer offered healthcare plan. My wife has Blue Cross Advantage and they take care of everything. You assign your government Medicare benefits to them and they handle all of you healthcare and medications. You do have to use doctors, hospitals, and pharmacies in their plan except for out of network emergency care if you are out of the plan network. There are deductibles that vary with each company that offers these plans. The Blue Cross card is all my wife uses when she get healthcare.

For original government medicare you use your Medicare card for doctors and hospitals, x-rays, etc. There are deductibles with this plan that can run into a good bit of money. For this you can buy a Supplement plan to pay what Original Medicare does not. The coverage varies with the company. So you use 2 cards whenever you go to the doctor or hospital, get x-rays, etc.
Then you can, and should, buy a drug coverage plan from a commercial plan, part D. The benefit of going this way is you can see any doctor or go to any hospital that takes Medicare. This is the way I went do to my many health issues. I have used my benefits 3 times so far with no out of pocket cost. The cost for a Supplement plan is usually higher then an Advantage plan.

When looking for a drug plan you can enter the drugs you use and it will give you an estimate of what your cost will be for a year. The drugs vary with company as well as which tier they are on. The different tiers are different cost to you for the drugs. Not all drug plans cover the same drugs so it is important you find one that does cover what you take and to also check status when the doctor gives you a new scrip. My mother's doctor's were always writing her scrips that her plan did not cover and it can get expensive very fast.

Getting enrolled can be a stressful event but it helps to decide which way you want to go for coverage and then getting quotes from several companies online. The companies I contacted after narrowing down the choice to just a couple were very helpful.

If you are new to Medicare and make a wrong choice you do have a grace period in which you can change companies but it is short, 3 months I think.

[fecmech]

I am fortunate living in the western NY area as we have a number of Medicare Advantage plans available and the local Doctors and Hospitals accept them all. If you have access to Advantage plans in your area I would recommend looking in to them. If not then find a Part D drug plan that fits your medicinal needs the best to go with your medicare. Good luck and welcome to the club.

[Preacher Jim]

Talk to your doctor and find out what insurance he accepts and which one pays best.

[Lloyd Smale]

ive been on it for 10 years. Youd think id know more then I do. Only thing I can say is like others I have blue cross advantage. My wife works in billing in the hospital and told me that blue cross is about the only supplemental insurance they don't have problems with. There was three tears of coverage when I signed up. More you paid the less deductables ect you incure. I chose the middle ground most likely because I don't know **** and the middle is usually the smart choice. Ive had two major surgerys since and lots of doctor visits and my co pays and deductables are less now (as is my percription copay) then they were when I worked.

[frkelly74]

We were hounded by all kinds of offers from insurance companies. They are all weasels as far as I am concerned. The thing I concluded was that there must be a ton of money to be made from keeping things so complicated that you can not possibly make an intelligent decision. I would rather go to Vegas than gamble with weasels who are looking to take advantage. And I have no plans to go anywhere near Vegas. We have part one and part two and I am signed up with Samaritan Ministries, a faith based health care sharing organization that I am really happy with. They state that they are happy to act as medigap insurance and that suits me. They do not use my money for share holders pay outs or big impressive buildings or new cars for all the high powered executives with big salaries and bonuses. The money I send goes directly to a family who has a need and If I have a need other members will send me money. We personally know people who have benefitted and are comfortable.

[popper]

Advantage plans are inexpensive, part of premiums come from your medicare payments. It's a bulk payment system, Gov. pays medicare, medicare plan providers, hospitals and TPA (third party accountants/payers). TPAs pay the medical providers on a usage basis and you get an EOB (explanation of benefits). HMO has a 'gatekeeper', (your primary care doc.), PPOs don't but you still need to be 'in-plan'. The trick is to stay 'in-plan' as that changes frequently. You also have to verify that non-emergency procedures are covered under any plan. Yes, it's like filing taxes, very sticky wicket.

[Char-Gar]

I have been on Medicare A and B for 12 years now. I have carried a supplemental police with the NEA (Yea, I know) as well. I have yet to pay a dime for medical care. My Medicare part D has also been good. There is a web site where you can go and list your medications and it will give you the Part D plans in your state that will cover your meds.

Getting started on all of this may be a big daunting, but things will smooth out with time.

[buckwheatpaul]

Charlie, My wife went with Mutual of Omaha on the recommendation of a friend. She has yet to get a bill from the doctors or hospitals. She is on Plan F .... I signed up for Plan G. My bill is $97 per month and the drug supplement is through Humana.....another $17.00 per month....we did get a discount for bundling my wife and my plan with the same company......Paul

[shoot-n-lead]

Charlie, My wife went with Mutual of Omaha on the recommendation of a friend. She has yet to get a bill from the doctors or hospitals. She is on Plan F .... I signed up for Plan G. My bill is $97 per month and the drug supplement is through Humana.....another $17.00 per month....we did get a discount for bundling my wife and my plan with the same company......Paul

I have had similar experience with Mutual of Omaha. My employer had a healthcare insurance buffet that employees could choose from. I chose Mutual of Omaha based on what others said. I kept it the entire 36yrs that I worked and brought it with me into retirement 8 months ago...it has always been fantastic...except for ONE thing...my plan has NEVER paid for flu shots.

[aspangler]

If you are a vet and are not TOO far from a VA center, then opt out of medicare. I did and it saves me well over 120 a month. Not for everyone and you have to watch about the copays but it may be an option. YMMV

[mold maker]

This year is #10 for me and I wouldn't attempt to give advice. Each person's health condition and the likelihood it will get worse determines the coverage you need. Since there is no accurate crystal ball, it's just a SWAG estimate, at best.
In the 10 years since I retired, I've hit the "Donut Hole" all but the first year, and several times by midyear. That gives you incite as to what the drug portion is worth.
My best advice is, talk to those who have similar age and health issues, and help each other decide.

[shooter93]

Make life easy.....look around your area and I'm sure there are companies or individuals who will walk you right through it and it's free. That is what I did. He came over one evening and had a list of hundreds of plans. He pointed out which one was best for my situation. So I have Medicare....a supplement and a prescription plan. Both plans are 125 bucks a month each which I thought was fine. Prescriptions are 6 6 bucks after a yearly 82 dollar co-pay. EVERYTHING else has been covered.....no charges at all ...and I had a prostate cancer surgery with all the back up treatments....a quadruple by-pass recently and some valve repairs and I need another back surgery. Trust me....it's very easy....everything will be explained and you will get the best deals for you.

[phonejack]

Humana Advantage has worked well for the wife and me. She needs a lot of meds, I don't need any, yet!

[Ken in Iowa]

I just became eligible last month. Luckily my wife is still working and I am able to keep my commercial coverage.

I have stage 4 cancer. Part D would be a bottomless pit for me even before reaching the doughnut hole. Two of the drugs that I use or have used are not covered AT ALL even though they are FDA approved. Other cancer drugs would have seriously drained our savings when we dropped into the hole.

Plan F (F for Full) would have been my choice. My care is better covered by far with my wife's insurance.

All the best to you Boaz!

[skeettx]

Not much help here

I have Medicare and TriCare for Life and VA Disablility

Mike

[Boaz]

Doughnut hole ! Can you explain ?

[MaryB]

Doughnut hole is the medication copay kick in. I forget the levels but once you hit x amount you pay a LOT more for medications. I am exempt from it due to income levels(aka POOR). Advantage plans vary by state and a friend in TX said don't bother because the coverage was bad. You need to talk to someone in your state to see what is best. Many pharmacies will go over plans with you also.

[Hick]

I've been on medicare five years. I also have a medicare supplement policy (Humana) and a drug policy. We pay a little over $100 each per month. This is higher than some, but my wife has had lots of health issues so I went with a premium plan-- more coverage. I do think that its a good idea to go with a good copany-- either directly or through AARP, or NRA, or somebody. With the effort to repeal the ACA I'm inclined to believe the established insurance companies will just keep on going, and be happy to keep their customers.

[Boaz]

I thank you for your input and suggestions . Next step is to talk to the insurance folks I guess. Would rather take a beatin than to deal with a car or insurance salesman . You have given me more than I knew .

[dverna]

I believe if you plan to travel the F supplemental plan is worth considering

d
Don Verna

[popper]

I was on AARP advantage (UHC), very low premiums but changed to a PPO (Aetna) this year. I did OK for major procedures but they moved all my cardio docs out of plan, with NO notice. If you don't carry drug ins., you get penalized in your premiums - all plans. I will NEVER be an AARP member.

[dbosman]

Well, this is the most depressing thread for me today. Mandatory paperwork.
One more fact of aging I didn't know. <sigh>
Seriously, though, Thanks for the insight and forewarning.

[shooterg]

Advantages of a younger wife - still on her plan, and no penalties if I sign up later as I'm still on her plan with good insurance(she works at a hospital). I did try to read the stuff that came from literally dozens of companies trying to get you to take their supplement - gobbledegoop to me . If I live until she retires, guess I'll come back here and have y'all 'splain it to me !
Gotta believe it would be cheaper if it was simpler - lot of people filling out paperwork on payroll.

[OBIII]

I've been on Medicare since April of 2015. Still haven't figured it out, but I do know this: If you are poor, as MaryB said, you can apply for extra assistance. SSA then pays your premiums for a prescription plan. Your state may also have assistance available.
OB

[Digger]

I was on AARP advantage (UHC), very low premiums but changed to a PPO (Aetna) this year. I did OK for major procedures but they moved all my cardio docs out of plan, with NO notice. If you don't carry drug ins., you get penalized in your premiums - all plans. I will NEVER be an AARP member.

With that said , which is better ? ... aarp or Amac ?
understand amac is a more conservative group .
Turned 65 last august , still working under group plan .. anthem blue cross but the day will come.
some people say I should sign up for medicare as a secondary ... like most here , "deer in the headlights"