Here comes Medicare

Joined
Dec 28, 2011
Messages
637
Location
key largo,fl
Suggestion to OP

On Youtube, look at the playlist(s) for "david belk medicare"

We (family, relatives, neighbors) have just traditional/original Medicare A and B and separately purchased High Deductible Plan G - nothing else

Should a catastrophic illness descend upon us - the max out of pocket annual cost would be about 2,700

Should some exotic drug be required, the small penalty for late enrollment into Plan D (if even needed) is very reasonable.

Case example:
Our very savvy (shrewd and knowledgeable; having common sense and good judgment) corporate CPA recommended also same strategy when he initially turned 65. He had some years later in his early 70's hip replacement/knee replacement surgery with 6 figure invoices but paid inclusive of full physical therapy just under 2,700 for one year out of pocket. He never joined any Plan D as GoodRx discounts sufficient for his use.

Currently A+B+HD_G monthly cost is 170+70

Also, be aware that HSA account can be directly billed by Medicare for Part B (170) premium (the HD_G can not be paid from HSA) under current IRS rules.
 
Joined
Jul 10, 2012
Messages
7,218
Location
South Carolina
Yes, but, the employer's health insurance that I was on for 30+ years also required the use of their provider network. Most employer health insurance coverage is this way.
The one important thing that I wanted was a PPO, not an HMO, policy. I went through the HMO thing with our health insurance policy over 20 years ago and I didn't want to get into that trap again. A PPO lets you go directly to any doctor or specialist within their network without having a referral from your primary care doctor. The part C PPO plan that I chose was less than half the monthly cost of combined A+B+minimal D+minimal medigap plans, has zero deductible or copay for most services or tier 1&2 drugs, and includes dental and eye coverages.
We need to be careful with your explanation of an HMO. This is why in a previous post I state what I do about listening to advice, including my own and including brokers. I provided the links in a previous post.

That is not how it plays out with a United Health Care Advantage C HMO plan (aka as AARP UHC)
UHC Advantage HMO plan, my Advantage C plan does NOT require a referral to a specialist from my primary doctor.
It is interesting and I THINK maybe only UHC offers this, as they advertise it in BOLD type. You can go to ANY specialist at any time within the United Health Care Network in the United States which is by far the largest of all Advantage C plans.
It works no different than my excellent, excellent company health plan did and millions of other Americans health care plans. Except now I have no deductible! Love it!

Being it is an HMO, you do need to stay in United Health Care's network or you wont be covered, unless an emergency of course.
Its the largest network in the country, in my state EVERY single hospital and doctor in my area of South Carolina are in the UHC network. I mean, its United Health Care, the largest by far.
But its easy to check your area as well and I am sure it will be the same. I should also mention that others want to make sure they have coverage outside of the USA when traveling, some plans do not.


The above link will give plans for your area and costs, this is mine for my area
Regarding cost- with this plan I also get $300 every two years towards glasses or contact lens, $400 a year worth of over the counter items I order online and delivered free, everything from toothpaste to the new digital Kitchen scale we just got. plus dental which you do not get with Medicare A,B, D and Medigap insurance.
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Joined
Apr 22, 2016
Messages
1,230
I was put on SSDI at age 49. I too am on a BCBS TYPE F plan. But my monthly rate is 3.5X the rate you're paying at $140. I'm not happy about it but I have saved probably AT LEAST $150K of out of pocket expenses for the 20% Medicare doesn't pay for all of the operations I have had.
TYPE F is not available anymore. Those that had it before it was taken away can keep it-AKA-Grandfathered in.

Make sure as you are approaching 65 years you rewrite your supplement at the 65 rate.
 
Joined
Mar 21, 2004
Messages
27,420
Location
Near the beach in Delaware
My former employer uses VIA benefits as an advisor for Medicare and to manage the health care account they setup for retired employees.

I have a Medicare Advantage plan that covers the full cost of a Humana HMO. I pay only for Medicare Part B and D.

Two pieces of advice, sign up for Part B when you sign up for Medicare part A unless you are employed and your employer provides your health insurance as an employee. If you sign up for Medicare part B late you may pay a penalty.

If you are working and earn a decent salary and sign up for Medicare part B, expect to pay a surcharge for part B. I am paying over $400.

My employer offers health insurance but I have chosen to not sign up for it.
 
Joined
Jan 9, 2010
Messages
11,572
Location
Los Gatos, CA
That is exactly what we have. Our local hospital does not accept Medicare advantage plans so the only choice we have is finding the right broker and what Part B gap coverage we need. I have the G plan, but wife kept the F plan in line with her health. I think many, many individuals who switch to the advantage plans due to all the misleading media hype are going to regret their choice. There is no free lunch guys.
It depends on what area you live in. I have Stanford Medicare Advantage with access to world class care.
 
Joined
Jun 10, 2002
Messages
3,790
Location
Chattanooga, TN
From, my experience. At some point you will need expensive health care, umlike auto insurance health ins will be used.

Advantage plans, pros cheap may include some dental, hearing, etc.
Cons, travel, all out of network, must see doc in network, in you go into hospital it is more expensive than an advantage plan. Also, years down the road if you want to switch to supplement you will go through underwriting and probably not be accepted, yes, they can refuse your entrance into a supplement down the road for existing conditions. Locked into their pharmacy, thus no choice if your drug is not covered. More difficult to change advantage plans, Part D plans are very easy.

Supplements, pros, travel anywhere, see any doc that accepts medicare, don't worry about limits or co pays. Plan G, ded only.
Cons, will get expensive as you age. Also, if serious health issues you will be locked into the plan you select, underwriting will deny you a transfer.
No dental or hearing but IMO, these benefits have limits and are not worth the paper they are printed on.

My experience, went with supplement at 65 plan F (no longer offered) never see a co pay or deductible. Mine is with Anthem of VA, now live in TN, kept the plan and now, due to underwriting, cannot switch. BC of TN says no way. However, no complaints. Switched Part D plans at least 6 times over the years. my supplement started out reasonable, low $100/month now at 266/month. However, I have been in hospital twice, aortic valve replacement, no cost to me, last year in for 17 days, 2 valve replacements (well first one did not work so back in on day 2) , gross charge $506,000 (yes five hundred and six thousand) medicare paid $80,000 no out of pocket for me. No questions that as you age you will spend more in an Advantage Plan unless you die quickly. My opinion. There must be money in the Advantage plans because they are pushed by everyone, no ins company really pushes the supplements.

IMO, a supplement with Part D is the way to go and choose carefully, you may not be able to swithc in the future. They never inform you about underwriting until you cannot pass it. Part D is really really easy to change every year

Also, if you are a diabetic a supplement is the way to go, insulin pumps fully covered by A B and supplement, insulin and supplies with an Advantage plan have co-pays. Can be very expensive.
 
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Joined
Jul 10, 2012
Messages
7,218
Location
South Carolina
From, my experience. At some point you will need expensive health care, umlike auto insurance health ins will be used.

Advantage plans, pros cheap may include some dental, hearing, etc.
Cons, travel, all out of network, must see doc in network, in you go into hospital it is more expensive than an advantage plan. Also, years down the road if you want to switch to supplement you will go through underwriting and probably not be accepted, yes, they can refuse your entrance into a supplement down the road for existing conditions. Locked into their pharmacy, thus no choice if your drug is not covered. More difficult to change advantage plans, Part D plans are very easy.

Supplements, pros, travel anywhere, see any doc that accepts medicare, don't worry about limits or co pays. Plan G, ded only.
Cons, will get expensive as you age. Also, if serious health issues you will be locked into the plan you select, underwriting will deny you a transfer.
No dental or hearing but IMO, these benefits have limits and are not worth the paper they are printed on.

My experience, went with supplement at 65 plan F (no longer offered) never see a co pay or deductible. Mine is with Anthem of VA, now live in TN, kept the plan and now, due to underwriting, cannot switch. BC of TN says no way. However, no complaints. Switched Part D plans at least 6 times over the years. my supplement started out reasonable, low $100/month now at 266/month. However, I have been in hospital twice, aortic valve replacement, no cost to me, last year in for 17 days, 2 valve replacements (well first one did not work so back in on day 2) , gross charge $506,000 (yes five hundred and six thousand) medicare paid $80,000 no out of pocket for me. No questions that as you age you will spend more in an Advantage Plan unless you die quickly. My opinion. There must be money in the Advantage plans because they are pushed by everyone, no ins company really pushes the supplements.

IMO, a supplement with Part D is the way to go and choose carefully, you may not be able to swithc in the future. They never inform you about underwriting until you cannot pass it. Part D is really really easy to change every year

Also, if you are a diabetic a supplement is the way to go, insulin pumps fully covered by A B and supplement, insulin and supplies with an Advantage plan have co-pays. Can be very expensive.
You know, I started reading your post and was impressed with what started out as unbiased post. But then it went downhill and you started commenting on Advantage C plans in a negative way of which you dont have and therefore I dont think helps the OP and why I tell people to do research and I posted actual Advantage C plan I was referring too.

You are wrong about your assumption on dental, hearing and vision, you state "these benefits have limits and are not worth the paper they are printed on." That is not at all true, its the same good to great coverage I had with one of the largest banks in the country when I was working.
Your plan is costing you $436 a month ($170 + $266 = $436 is what I THINK you are referring too and not $436 + $170 = $606 and is for Hospitals, Doctors and Pharmacy.

The Advantage C plan I have with United Health Care (AARP) includes pharmacy, vision, hearing, dental, doctors and hospitals. No primary co-pay and $30 co-pay for a specialist. Total cost per month is $170 medicare + $25 UHC = $195 total cost per month and I am getting all those extras plus $400 a year in over the counter drug items and a $100+ a month premium gym membership at no cost for both. My total cost for health care is almost zero.

Now if I get sick like you have, then you WILL have to pay more then an Plan N or G but that cost is limited to a total of $4,500 out of pocket limit per year, so your half million dollar medical bill would have cost you at the most and VERY possibly not the full $4,500 and you didnt have the other perks of Advantage C. and with an Advantage C plan you are only paying $170 medicare and $25 UHC = $195 a month not $170 medicare + $266 BCBS = $436 a month that you are paying, one heck of a huge difference per month and the rate doesnt go up with the Advantage C plan I posted with age like many (or all )Plan \G or Plan N.

Yes, if you need drugs you cant switch drug plans like you can with Plan N or G unless you opt to switch the whole plan at the start of the year, or possibly go with a non drug C and elect a drug plan, one would have to look into if that can be done, I think so...so like I said, using the links its best to look up everything.

You also said incorrectly switching Advantage C plans is difficult, you can switch Advantage C plans any time at the start of the year with no underwriting. You also have the option to go to a medigap plan without under writing in the first year only, this is where one needs to be careful after that first year it would be hard to switch..

Choices are good, I LOVE this stuff! Options are great, you can pick and choose as you like, not everything is perfect for everyone. Family members of mine are in Medigap N, another in Medigap G. The one in Medigap G has heart issues and bypasses and all the related problems just moved into a Advantage C plan with a good drug plan to cover all his drugs, limited dental, vision, hearing services and $750 deductible, low out of pocket ($2500 if I remember correctly) Humana though, yet the plan and drug coverage cost him nothing. $170 = 0$ = $170 a month, he got tired of his Medigap G plan (which he loved) rate increases which were getting close to $170 + $190 = $360 a month.

Not every plan is for everyone, there are some VERY good things about Medigap plans G and N if you dont care about paying double the amount of money per month up front whether you need the services or not. I feel this is what is no said upfront all the time, Medigap N and G plus D is double the cost and depending how you use it can be way more than double the cost of an Advantage C plan so it really comes down to how much insurance does one want and what are they willing to pay for. One must, must keep in mind, ALL these plans are regulated by the government, Advantage C are one year contracts and can change year to year, I stress the word CAN, this is why you ALWAYS have the option every year to change Advantage C plans if you wish. All plans have to be approved by Medicare all Advantage C plans have to cover the same services as Medicare just like Medigap plans.

On last time dont choose a plan based on posts in a forum, including my posts, all these plans are good, you choose what you want to pay. I just provided in another post above this one what I use and why and Spector posted what he uses and why, both valid reasons, both are government approved Medicare health care plans.

I myself was torn, its attractive thought never having to pay a medical bill but it comes at a high cost to me. Im still in my first year window where I could switch into a medigap plan without underwriting but I know I am not going too.
So I went with what I think is an attractive plan, a AARP UHC Advantage C plan which is just like the plans I have had all my life and also from corporations I worked for, except the Advantage C is even better because there is no deductible...

SO whether a Medigap G or N plus D
Or all in one Advantage C
Its all an individual choice, I dont think there is any right or wrong. In my case I could get stuck with a $4,500 out of pocket limit each year for some over the top.
 
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Joined
Aug 19, 2020
Messages
14
Location
Finger Lakes
I have United Health Care Advantage Medicare with a small rider to bring down co pays…2-1/2 years ag I was diagnosed with a very lethal cancer…The co pays have added up to $15000 so far. We are just blue collar people but do have the money to pay the bills as they come due….I suppose always buying second hand junk instead of new has some advantages ,lol
 
Joined
Jun 10, 2002
Messages
3,790
Location
Chattanooga, TN
You know, I started reading your post and was impressed with what started out as unbiased post. But then it went downhill and you started commenting on Advantage C plans in a negative way of which you dont have and therefore I dont think helps the OP and why I tell people to do research and I posted actual Advantage C plan I was referring too.

You are wrong about your assumption on dental, hearing and vision, you state "these benefits have limits and are not worth the paper they are printed on." That is not at all true, its the same good to great coverage I had with one of the largest banks in the country when I was working.
Your plan is costing you $436 a month ($170 + $266 = $436 is what I THINK you are referring too and not $436 + $170 = $606 and is for Hospitals, Doctors and Pharmacy.

The Advantage C plan I have with United Health Care (AARP) includes pharmacy, vision, hearing, dental, doctors and hospitals. No primary co-pay and $30 co-pay for a specialist. Total cost per month is $170 medicare + $25 UHC = $195 total cost per month and I am getting all those extras plus $400 a year in over the counter drug items and a $100+ a month premium gym membership at no cost for both. My total cost for health care is almost zero.

Now if I get sick like you have, then you WILL have to pay more then an Plan N or G but that cost is limited to a total of $4,500 out of pocket limit per year, so your half million dollar medical bill would have cost you at the most and VERY possibly not the full $4,500 and you didnt have the other perks of Advantage C. and with an Advantage C plan you are only paying $170 medicare and $25 UHC = $195 a month not $170 medicare + $266 BCBS = $436 a month that you are paying, one heck of a huge difference per month and the rate doesnt go up with the Advantage C plan I posted with age like many (or all )Plan \G or Plan N.

Yes, if you need drugs you cant switch drug plans like you can with Plan N or G unless you opt to switch the whole plan at the start of the year, or possibly go with a non drug C and elect a drug plan, one would have to look into if that can be done, I think so...so like I said, using the links its best to look up everything.

You also said incorrectly switching Advantage C plans is difficult, you can switch Advantage C plans any time at the start of the year with no underwriting. You also have the option to go to a medigap plan without under writing in the first year only, this is where one needs to be careful after that first year it would be hard to switch..

Choices are good, I LOVE this stuff! Options are great, you can pick and choose as you like, not everything is perfect for everyone. Family members of mine are in Medigap N, another in Medigap G. The one in Medigap G has heart issues and bypasses and all the related problems just moved into a Advantage C plan with a good drug plan to cover all his drugs, limited dental, vision, hearing services and $750 deductible, low out of pocket ($2500 if I remember correctly) Humana though, yet the plan and drug coverage cost him nothing. $170 = 0$ = $170 a month, he got tired of his Medigap G plan (which he loved) rate increases which were getting close to $170 + $190 = $360 a month.

Not every plan is for everyone, there are some VERY good things about Medigap plans G and N if you dont care about paying double the amount of money per month up front whether you need the services or not. I feel this is what is no said upfront all the time, Medigap N and G plus D is double the cost and depending how you use it can be way more than double the cost of an Advantage C plan so it really comes down to how much insurance does one want and what are they willing to pay for. One must, must keep in mind, ALL these plans are regulated by the government, Advantage C are one year contracts and can change year to year, I stress the word CAN, this is why you ALWAYS have the option every year to change Advantage C plans if you wish. All plans have to be approved by Medicare all Advantage C plans have to cover the same services as Medicare just like Medigap plans.

On last time dont choose a plan based on posts in a forum, including my posts, all these plans are good, you choose what you want to pay. I just provided in another post above this one what I use and why and Spector posted what he uses and why, both valid reasons, both are government approved Medicare health care plans.

I myself was torn, its attractive thought never having to pay a medical bill but it comes at a high cost to me. Im still in my first year window where I could switch into a medigap plan without underwriting but I know I am not going too.
So I went with what I think is an attractive plan, a AARP UHC Advantage C plan which is just like the plans I have had all my life and also from corporations I worked for, except the Advantage C is even better because there is no deductible...

SO whether a Medigap G or N plus D
Or all in one Advantage C
Its all an individual choice, I dont think there is any right or wrong. In my case I could get stuck with a $4,500 out of pocket limit each year for some over the top.
I worked for Medicare for 15 years. Believe what you wish and believe the experts who say it is easy to switch. Ask them what happens if you become a diabetic, oh, that will never happen to anyone! Good luck
 
Joined
Jul 10, 2012
Messages
7,218
Location
South Carolina
I worked for Medicare for 15 years. Believe what you wish and believe the experts who say it is easy to switch. Ask them what happens if you become a diabetic, oh, that will never happen to anyone! Good luck
I dont have to switch and it is very easy to go to medigap in the first year if you want too.
It is easy to switch during the annual period, you simply sign up for a new plan, your current Advantage C plan is automatically cancelled.
AS you know, its almost IMPOSSIBLE to switch medigap plans without going through underwriting.

But my posts are not about switching, they are about me and my personal experience of not having to pay a premium for my health care costs except the required $170 a month (and $25 for drugs) for coverage equal to or better then most of corporate America. Including Dental, Vision, Hearing, free over the counter products and free premium gym. Which you said is not worth the paper its printed on, my point is that is not true.

Options are good and its great to have options, I selected the Advantage C at no cost except the standard medicare premium but I dont disparage plans for people who use Part A,B. D and Medigap (which is also private insurance) at a much, much higher price.
Its insurance, some people go all out and pay upfront IN CASE. Advantage C you keep your money unless its needed. Both good.

Knowledge is good, my posts are not to encourage of discourage anyone from any plan, they are all good government approved plans.
Advantage C plans have to be approved by government, each and everyone of them because government pays the insurance company for your coverage.
My post are to help, people need to do their own research on what is best for them, its a huge decision and so many people leave it up to chance on what they are buying. No question about it, if you dont care about spending an extra $200 a month (rough numbers can be more or less depending on age) over the Medicare B $170 cost for complete health coverage, than pick a medigap "G" plan with Part A,B & D. You will never have to barely ever lay out a penny for health care.
These plans do not include Dental, Vision, Hearing so you will pay those bills out of your savings and frills like some have with over the counter products and gym memberships.
If you are willing to accept some risk (I you can call it that) that you could be liable (much like any USA health plan in the Corporate world) You can pick an Advantage C plan which covers all the above including almost all have no deductible and at no cost except the standard Medicare B cost and possibly in worst case run up bills to your out of pocket limit. (mine is 4500 but there are plans up to 7000)
Information is good ... which ever one chooses.



If you choose no plan and just stay with Medicare A,B there is no cost other than the Part B $170 and most then buy also Plan D to cover prescriptions but you would have to pay 20% of all your medical bills which in your case as you know would have been roughly $100,000 (one hundred thousand) on your $500,000 bill.
Since you had Medigap you paid almost nothing and with the Medigap "G" it would have been less than $2000 if you had my Advantage C you would have been liable up to your yearly out of pocket limit of a max of $4,500. A far cry from $100,000

Its just matter of how much insurance someone wants and what features of a pan they want all from government Approved plans.
Both Medigap and Advantage C are private insurance plans approved by Medicare.

 
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