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Medicare - H E L P ! !

PostPosted: Mon Oct 17, 2016 6:09 pm
by mitch5252
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I am starting to look into Medicare (JULY).
What's the difference between Original Medicare and Medicare Advantage?
Which did you choose and why?
I read that you can't use supplemental insurance when you use a Medicare Advantage plan??

Part A = hospital
Part B = doc visits, tests, etc.
Part D = prescription drugs ? ? ?

From looking at the Medicare site, the Part A premium is $105/month; the Part B is $166/month, and then I have to add a drug coverage - Part D?

$105 + $166 = $271/month, or $3,252/year + drugs (which Medicare is estimating will cost ME $4,200/year. I don't pay anywhere close to that now...)

And then I'd have to add a Medicare Supplement plan on top of all that? Here I was looking forward to Medicare...

My, there's a lot to this. I have a headache and I just started this stuff...
I gotta be missing something, considering how surprised I am at the unexpected high cost?
(Beth is facing these same challenges next year, too.)

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Re: Medicare - H E L P ! !

PostPosted: Mon Oct 17, 2016 6:58 pm
by gypsyrose1126
I am not sure why that is so high. I will have to check mine. I pay $90 per month for Humana. Make sure you take the part d for prescription, even if you don't have any medication, as they will penalize you for not having it. I don't have dental or vision, but have been looking at adding dental.

Re: Medicare - H E L P ! !

PostPosted: Mon Oct 17, 2016 7:02 pm
by Bethers
Rosemary, does your $90 cover everything? Are you willing to share the breakdown?

Re: Medicare - H E L P ! !

PostPosted: Mon Oct 17, 2016 7:43 pm
by mitch5252
gypsyrose1126 wrote:I am not sure why that is so high.

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It is so high because I'm an idiot...I had to enter all the drugs I take and somehow the 90 for 3 months got turned into 270 for 3 months. I must have fat fingered the key. The prices are much more reasonable!!

It's still overwhelming, though.

So, your $90/month is for what? Drugs only? Or Parts B & D?

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Re: Medicare - H E L P ! !

PostPosted: Mon Oct 17, 2016 8:00 pm
by OregonLuvr
OK I have medicare A & B it is taken right out of my SS check I think I pay $105 but goes up for anyone signing up in 2016. Then I have AARP supplement for $157 per month. United Healthcare is their insurance. I also have AARP prescription $34.40 per month I dont take any oral meds but have to sign up or you get penalized so I did. Now let me tell you how much I think this is worth it.

I get an infusion for Rheumatoid Arthritis every 6 months 2 weeks apart then not again for 6 months. $12000.00 an infusion so $24000.00 twice a year.
Plus I have labs drawn also. I pay ZERO

I had surgery last year had to stay an extra day due to Nausea and Vomiting 2 days
Was home a week and readmitted by ambulance for a bowel obstruction...4 day stay
Again I paid ZERO

I chose AARP supplement because I can go to any doctor anytime I want without a referral. I can go anywhere in the country that I happen to be at. I think I have plan F seems to be working just dandy for me.

Re: Medicare - H E L P ! !

PostPosted: Mon Oct 17, 2016 8:44 pm
by Olive6001
I just did the Medicare thang. Take a deep breath; it's easier than it sounds at first. It took me awhile to understand the lingo.

About three months before you turn 65, you'll get some info from the Medicare people. It spells out everything you need to know.

I was surprised at the costs, too. I thought Medicare would make insurance cheaper. What it does is give you some hospital coverage for "free". Actually, most of us pay for it throughout our working lives. That's Part A. There's no premium for Part A. This is from medicare.gov:

"You usually don't pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes while working. This is sometimes called "premium-free Part A."

Part B has a premium. Mine is about $121 a month.

You'll want to understand the difference between Advantage Plans and MediGap plans.

https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html

I have the same Medigap and Plan D insurance Karen has and am very happy about it. More expensive but much more coverage than I had before. You can get cheaper policies, but you'll have out of pocket expenses if and when you're hospitalized. I don't take prescription drugs.

I pay out about $300 a month for Medicare Part B, 100% hospitalization coverage, and Part D. (I don't remember right now what the situation is with doctor visits.) I can't imagine what that would have cost me before Medicare.

Re: Medicare - H E L P ! !

PostPosted: Mon Oct 17, 2016 9:07 pm
by mitch5252
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Definitely sounds like AARP is worth a good look. Thanks!

Eighteen months ago, I paid $920/month for George's COBRA.

Then I had to go to Obama Care. My premium is $630 (I believe it's $790 without subsidy) + a $2,000 deductible.
So, $630 x 12 + $2,000 before they pay anything...so, just under $10,000/year for insurance.

Think of all the traveling gas moo-lah I'll save...(maybe)!!

Thanks for all the input!
Good stuff.
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Re: Medicare - H E L P ! !

PostPosted: Mon Oct 17, 2016 9:53 pm
by cnq50b
Thanks for all the info.

I'm still covered by my employer but keep trying to come up with a budget for when I eventually cut the ties. And it's been almost impossible to get rates without getting involved with some of the insurers themselves. I know each person will be differnt but these numbers help give me ballpark figures at least.

I also appreciate knowing if you've been satisfied with your choice - or if you'd do things differently in retrospect.

Re: Medicare - H E L P ! !

PostPosted: Mon Oct 17, 2016 10:20 pm
by Bethers
I planned to check AARP, now I know I will. And I think I'll wait till the three months before, then go nuts lol. Thanks ladies.

Re: Medicare - H E L P ! !

PostPosted: Tue Oct 18, 2016 12:52 am
by snowball
we had AARP supplement for Larry what a life savor that was!!! financially speaking
haven't picked up the supplement keep telling myself I need to but am always afraid I can't afford
it...but at the same time I don't go to the dr unless I'm drugged there by kids...so far it's been doable
but think I need to check into it more ....I understand there are free tests that they will run
haven't done that yet because I wasn't sure if it was free...for sure ....
as to which ones I get I opted for the part b I think ...they pay 80 % after my deductible...and how are you penalized
if you don't get the prescription one? I don't and haven't heard of anything ...at this point in time I don't
take meds...unless an occasional antibiotic
sheila

Re: Medicare - H E L P ! !

PostPosted: Tue Oct 18, 2016 1:01 am
by JudyJB
You don't want an Advantage Plan unless you intend to sit in your rocking chair in the old folks home for the rest of your life, which I don't think applies to any of us. An Advantage Plan requires you to use a group of hospitals and doctors, etc. although you do get some extra benefits.

For Part C, which is the supplement that pays for stuff the original Medicare does not pay, I have had AARP's United Health Care's Plan F for the past four-and-a-half years and have not paid a penny of deductible!! Not for doctor's visits or surgery or anything. And in that time, I have had a lithotripsy for kidney stones, two hand surgeries, and just recently rang up $25,000 worth of various tests and a needle biopsy for a suspicious thing on my breast. (It was negative.) Anyway, I chose the most expensive plan because I tend to have medical issues and knew it would be worth it for me.

The best thing is I don't need to get approvals for specialists or pre-approval for anything. I had the kidney stone lithotripsy and two hand surgeries in California and just called a doctor and made an appointment--no referrals needed and no runarounds. The recent slew of tests and procedures were in Michigan. I've also stopped at a bunch of urgent care facilities across several states and had no problems getting it accepted. They also have a nurses line you can call to get advice. Anyway, I pay $192/month for this.

I am not sure, but I think I pay about $57 per month for the prescription Part D. When I first got it, I thought I had to use their mail order plan, which was not true, so now I just get stuff filled at Walgreens. I have copays and have a lot of prescriptions, maybe 12-13, but have never reached that donut hole they talk about.

One last thing, some of the plans pay for medical care in Canada if you plan to travel there.

The good news is once you get through this first filing, the rest will be easy. It took me hours and hours to figure this all out the first time. And Sheila, you really should get some supplement plan. It can only take one thing, like a fall or surgery or serious illness, to really cost you. 20% of that $25,000 I recently spent would be $5,000!! When I had pancreatitis 8 years ago, my hospital bill alone was $120,000 for 11 days in the hospital. 20% of that would have been $24,000. :o And for me, the REALLY expensive stuff will probably happen in a few years.

Re: Medicare - H E L P ! !

PostPosted: Tue Oct 18, 2016 1:08 am
by snowball
so wouldn't be be better to get the part C even though it costs more?...or do you have a supplemental with it?
if not the supplemental is apox 160 the amount taken out of SS is 105 equals to more than the 195...
and yes I do need to do it...
sheila

Re: Medicare - H E L P ! !

PostPosted: Tue Oct 18, 2016 10:34 am
by chalet05
Well, you ladies got me thinking especially when you mention specific plans. AARP's Plan F costs more than my current plan, but thinking at this stage of life, it's probably a better option. Only drawback will be losing my extra dental since I know I have to have a crown replaced next year.

I have had an Advantage plan since day one and have never had an issue on the road. My doctor is in Kansas, my plan is in Washington, but all are connected through Blue Cross.

Dread going through the application process again, but I think that's what I will be doing! Thanks for the info!

Re: Medicare - H E L P ! !

PostPosted: Tue Oct 18, 2016 10:38 am
by JudyJB
Sheila, not sure I understand your question, but I have Medicare A, B, C, and D. The United Health Care is the supplement, or Medicare C, and covers everything Medicare A and B do not cover. Plan F is the name of the C plan I have. Each provider provides several plans at varying costs, and I chose their F plan. I know it is confusing to have a Plan F within Medicare C.

Re: Medicare - H E L P ! !

PostPosted: Tue Oct 18, 2016 11:16 am
by mitch5252
JudyJB wrote:Sheila, not sure I understand your question, but I have Medicare A, B, C, and D. The United Health Care is the supplement, or Medicare C, and covers everything Medicare A and B do not cover. Plan F is the name of the C plan I have. Each provider provides several plans at varying costs, and I chose their F plan. I know it is confusing to have a Plan F within Medicare C.

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And now, on to my confusion...

I'm getting lots of my info from medicare.gov (note the emphasis, which I added, on the word OR):

There are 2 main ways to get your Medicare coverage— Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Use these steps to help you decide what coverage you want:

Medigap & Medicare Advantage Plans
Medigap policies can't work with Medicare Advantage Plans. If you have a Medigap policy and join a Medicare Advantage Plan (Part C), you may want to drop your Medigap policy. Your Medigap policy can't be used to pay your Medicare Advantage Plan copayments, deductibles, and premiums.


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