Health Care Switch

I am 73, Medicare Advantge with a $16 extra a month to bring down copays…Despite not having the risk factors, 2-1/2 years ago I was diagnosed with a very lethal cancer. since then I have has several nasty surgeries, chemo and radiation..and for the last 1-1/2 years it‘s a stage 4 requiring chemo treatments every three weeks plus daily oral chemo…I mention this due to the co pays, we have actually paid about $16,000 out of pocket…The total cost of treatment would buy a nice Italian sports car with the horse logo… Always try to have some cash on hand because you never know about tomorrow …Oh,I can still work on and ride my motorcycles and hug my wife, it could be worse ,LOL
Yeah, sorry to hear about your health issues. I would stress to anyone to check the out of pocket limit on any Advantage C plan.
Its why in my long post I tell people to do research, hard to cover it all in a forum.
You bring up a good point, it sounds like you have a high out of pocket limit of around $6000 to $7000. if you paid out about $16000 in 2.5 years.

When I signed up for my medicare C plan, I treated it like I would have coverage like my company gave me.
SO I made sure to get a plan with low out of pocket. My Out of Pocket expense can not exceed $4,500 a year and I have no deductibles so my coverage is just as good as most corporations give employees. My plan is through Untied Health Care

My brother with heart issues and other issues just switched from an A,B,D,G plan to a Advantage C PPO plan through Humana with a deducible of $750 a year and an out of pocket limit of 2450. which is amazing. Plus the deductible also is part of out of pocket expenses.
Another good thing with C plans is you can switch around.

You make a good point that I should have in my long post. If you dont have a lot of money saved make sure to choose a plan with a low out of pocket of $4500. and my brother $2450. I would never be comfortable having a higher out of pocket.

WIth that said, if you only had Part A and part B it sounds like your $16,000 would have been more like $106,000
At the same time, if you had A,B,D,G it would have been more like $4000

Choices are good.
Glad you can still get on your bike and I wish you the best.
 
Yeah, sorry to hear about your health issues. I would stress to anyone to check the out of pocket limit on any Advantage C plan.
Its why in my long post I tell people to do research, hard to cover it all in a forum.
You bring up a good point, it sounds like you have a high out of pocket limit of around $6000 to $7000. if you paid out about $16000 in 2.5 years.

When I signed up for my medicare C plan, I treated it like I would have coverage like my company gave me.
SO I made sure to get a plan with low out of pocket. My Out of Pocket expense can not exceed $4,500 a year and I have no deductibles so my coverage is just as good as most corporations give employees. My plan is through Untied Health Care

My brother with heart issues and other issues just switched from an A,B,D,G plan to a Advantage C PPO plan through Humana with a deducible of $750 a year and an out of pocket limit of 2450. which is amazing. Plus the deductible also is part of out of pocket expenses.
Another good thing with C plans is you can switch around.

You make a good point that I should have in my long post. If you dont have a lot of money saved make sure to choose a plan with a low out of pocket of $4500. and my brother $2450. I would never be comfortable having a higher out of pocket.

WIth that said, if you only had Part A and part B it sounds like your $16,000 would have been more like $106,000
At the same time, if you had A,B,D,G it would have been more like $4000

Choices are good.
Glad you can still get on your bike and I wish you the best.
Everyone needs to sign up for Medicare Part B when they sign up for Medicare unless they have an approved alternative like an employer provided health insurance. If you do not then you get hit with penalties that are not trivial if you latter sign up for Part B. If super rich and you will never need Medicare, then no need to sign up.
 
So if the plan you're looking at has pre-existing exclusions, what's the lifetime cap on the plan? Some of those used to be a million. A friend of mine did end up with a heart transplant, the insurance negotiated a 1 million cap on the transplant. Now he takes drugs every day too, who knows what his total costs of having the transplant is.
Was sorting out the details
This plan will not cover heart attack issues that require hospitalization for 1 year.
You get 20 doctor visits free a year- no deductible and it can be any type of doc- even heart
Next you get two ER visits yearly no fee
Now everything else has the yearly $2500 deductible
After that "in network" is 100% coverage
The yearly cap is one $1M. and no lifetime cap.

The rider I have is not from this company...so that is separate.
I am still looking as I am 7 years out from my last heart surgery
Most private insurances have a 5-year exclusion, so I am beyond that.
 
One correction. The base cost of Medicare Part B is $170. If you work and depending upon your salary it can be a lot more. I am paying $450 (about).
I know this isnt a medicare thread but one thing bothering me.
I am past being there. I signed up for a Medicare Advantage Plan. The actual plan is an HMO and seems pretty decent. But if I got really sick and wanted to got to Mayo Clinic for example it would probably not be covered. Local hospital in Delaware would be covered.

The employer I retired from uses Via Benefits to help navigate the choices with Medicare. That was a big help for me.

I pay just under $500/month for Medicare Part B because I still work. Not the basic $180/month.

As more people over 65 continue working what I see missing is a plan from your employer that pays for Medicare Part B or a plan that works with Medicare. My current employer would provide normal health insurance for me where they pay a portion and I pay a portion as if Medicare was not in the picture. But the cost per month was not that much different than what I pay for Medicare Part B. Hassle to switch and switch back when I retire for good.
You know, I was thinking about your posts and then this one too.
I think you are under the wrong impression or I am somehow reading your posts wrong but I am sure I am not, more so on this most recent post of yours.
You are upset that you are paying medicare $450 to $500 for health ins because your company doesnt offer a MEDICARE PLAN.

Then in this post you are saying = "what I see missing is a plan from your employer that pays for Medicare Part B or a plan that works with Medicare."

This is incorrect. You do not have to pay for Medicare part B if you have company health insurance. Heck you dont have to ever pay if you dont want Part B.
You dont need a company that "works with Medicare"
If you have company provided health Insurance you can keep your company health Insurance and opt out of medicare Part B. Your company continues to pay your health insurance and you pay nothing to Medicare.
Once you leave your job you THEN pick up Medicare part B and any option that you want. You just need to do it within 60 days of terminating your employment and company health insurance. "(check actual amount of time, I believe its 60 days)
 
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It annoys me that I have to pay extra. It also annoys me my employer doesn't have a health plan for people of retirement age who signed up for Medicare.
I also posted above this post more details. Your employer has a health plan, that health plan is for everyone, it makes no difference what age you are. If you wanted to keep it, your mistake was signing up for medicare. But no one size fits all and I am jsut going on what I read in your posts.
 
I also posted above this post more details. Your employer has a health plan, that health plan is for everyone, it makes no difference what age you are. If you wanted to keep it, your mistake was signing up for medicare. But no one size fits all and I am jsut going on what I read in your posts.
My point is many people are working past the age when you are eligible for Medicare. It would be cheaper for an employer to provide a a plan that works with Medicare than a normal medical plan.

I would use my employers medical plan but my doctor does not accept Aetna which is all my employer offers and not looking to change doctors.

And I don't plan on working too much longer so changing and then changing back when I retire seems like a hassle.

I also get the Medicare Part B cost reimbursed by a health account setup by my former employer.
 
My point is many people are working past the age when you are eligible for Medicare. It would be cheaper for an employer to provide a a plan that works with Medicare than a normal medical plan.

I would use my employers medical plan but my doctor does not accept Aetna which is all my employer offers and not looking to change doctors.

And I don't plan on working too much longer so changing and then changing back when I retire seems like a hassle.

I also get the Medicare Part B cost reimbursed by a health account setup by my former employer.
Ok, I understand but maybe this would clarify it for others not quite "there" yet.

Just so others know they can keep their current employers coverage and put off paying for Medicare Part B with no penalty until they leave the workplace if they chose too, its cool to have the choice, more so if its cheaper that way.
 
I think AARP can also help with Medicare decisions.

The decision I haven't been able to find help with is how to decide when to retire. The money is pretty good, bonus is great and for the most part I get to tell my boss what security projects we should work on. And get super hotel discounts for entire family as I work for a major hotel corporation. I pay the bills with Social Security and former employer pension. And the employer previous to that pension.
 
In my opinion, it's pretty wrong to do the Health Care Switch. It's not convenient for workers and for people who hire caregivers. I've had to deal with it myself. My mother has a terminal illness and needs special care. Once a Health Care Switch caregiver was built to work, she could not care for my mother properly, and I rushed to hire a senior caregiver in palm beach. She was already more compliant with her tasks, and I decided to keep her as the permanent caregiver and kick the first caregiver out. At this point, the doctors were not giving me a very comforting prognosis. I try to be with my mother as much as possible, as there is almost no time.
 
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I am past being there. I signed up for a Medicare Advantage Plan. The actual plan is an HMO and seems pretty decent. But if I got really sick and wanted to got to Mayo Clinic for example it would probably not be covered. Local hospital in Delaware would be covered.
the word "probably" is a bad word. You assume without knowing. Since all Mayo Clinics in the country accept medicare as payment it's way more likely that not a Medicare HMO would be covered. Best part its easy to find out, all one needs to do is check doctors and hospitals in any area with a simple search at the providers website before you sign up. Easy to do.
 
the word "probably" is a bad word. You assume without knowing. Since all Mayo Clinics in the country accept medicare as payment it's way more likely that not a Medicare HMO would be covered. Best part its easy to find out, all one needs to do is check doctors and hospitals in any area with a simple search at the providers website before you sign up. Easy to do.
So the employer who provides my retirement benefits switched things around for 2023. Instead of a bunch of plans that were location specific they offer only one Medicare Advantage Plan with two levels of coverage for the entire US. It's United Healthcare. There are articles in the news about issues people have with some Medicare Advantage Plans but I think those tend to be individual plans rather than a group plan. Their network of doctors is nationwide.

I still work and could get coverage from them but they only offered 5 flavors of Aetna and my current primary doctor take all health insurance but Aetna. And in southern Delaware because of all the retirees moving in it can take awhile to find a doctor who takes new patients. And I do not plan on working that much longer (I keep saying that)!
 
There are two plans that co-ordinate with Medicare:

Advantage Plans: The cheapest plans. Monthly costs are very very low. Free in some cases. They do cover druge. The disadvantage is that they have copays and don't fully cover serious issues.

Supplemental Plans: More expensive and you need a separate drug plan. The advantage is if Medicare recognizes the need for treatment (covered expense) the Supplemental Insurance (Part "F" is the best) covers 100% with no limits, co-pays or choice of providers. It makes sleeping much easier.

As pointed out get education but make sure that "education" is sponsored by Advantage Plans.

We are 75 and the total cost of our plans is about $650/month + medicare cost.
 
So the employer who provides my retirement benefits switched things around for 2023. Instead of a bunch of plans that were location specific they offer only one Medicare Advantage Plan with two levels of coverage for the entire US. It's United Healthcare. There are articles in the news about issues people have with some Medicare Advantage Plans but I think those tend to be individual plans rather than a group plan. Their network of doctors is nationwide.

I still work and could get coverage from them but they only offered 5 flavors of Aetna and my current primary doctor take all health insurance but Aetna. And in southern Delaware because of all the retirees moving in it can take awhile to find a doctor who takes new patients. And I do not plan on working that much longer (I keep saying that)!
Yes, let me say I don’t know how it works with your company but one thing I like about United Healthcare is they are by far the largest provider of Medicare Health Plans in the nation and have the largest network in the nation so you can pretty much guarantee wherever you are you have in network services.

Now, with that said, I tend to be like that and want to feel comfortable, but in reality, in any emergency, you’re covered, no matter what.
It’s really not much different from corporate health insurance. Meaning you need to be in network, but in an emergency you could be treated anywhere.

By the way, if you choose a (non advantage C) Medical policy, such as Medigap, G or N you’re covered at any facility that accepts Medicare in the country but of course you pay a lot extra for that plus the cost of a drug plan (D) plus your own dentist plus your own vision services.

One other thing to keep in mind that I think is more important is to make sure your plan covers out of country emergency services. It’s here that many advantage C plans are better than some Medigap plans. It’s an important thing to look for if you ever travel out of the country. The united healthcare plan I have is actually better than the Medigap plans for out of the country coverage.
 
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So the employer who provides my retirement benefits switched things around for 2023. Instead of a bunch of plans that were location specific they offer only one Medicare Advantage Plan with two levels of coverage for the entire US. It's United Healthcare. There are articles in the news about issues people have with some Medicare Advantage Plans but I think those tend to be individual plans rather than a group plan. Their network of doctors is nationwide.

I still work and could get coverage from them but they only offered 5 flavors of Aetna and my current primary doctor take all health insurance but Aetna. And in southern Delaware because of all the retirees moving in it can take awhile to find a doctor who takes new patients. And I do not plan on working that much longer (I keep saying that)!
IM not sure if you saw this, my total cost as of Dec 18 2022 for the year.
It's in another thread. Well over $100,000 in medical bills this year, my out of pocket cost less than $1000. but I get so many extras that it doesnt even cost me that.

Click on this;
 
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So the employer who provides my retirement benefits switched things around for 2023. Instead of a bunch of plans that were location specific they offer only one Medicare Advantage Plan with two levels of coverage for the entire US. It's United Healthcare. There are articles in the news about issues people have with some Medicare Advantage Plans but I think those tend to be individual plans rather than a group plan. Their network of doctors is nationwide.

I still work and could get coverage from them but they only offered 5 flavors of Aetna and my current primary doctor take all health insurance but Aetna. And in southern Delaware because of all the retirees moving in it can take awhile to find a doctor who takes new patients. And I do not plan on working that much longer (I keep saying that)!
one more that I posted in another thread, it cost me $295 for a heart procedure last month with a bill over $100,000
IMG_0809.JPG
 
Well the bills the providers send out are fictitious. They charge $1000 give the insurance company a $800 discount, the insurance company pays $175 and you pay $25.

So does anyone really pay $1000. I doubt it.
Don't all the insurance companies get a $800 (or close) discount?

Why not charge a real amount like $200?
 
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