Medicare in 3.5 more years...this Humana plan looks pretty good....

[Baz]

I'm 62 and in practically perfect health.

But I am concerned about what the future may hold as I continue to age and shelf life begins to fade, so I've been doing some informal inquiries into various health care provisions from friends and acquaintances.

Which brings me to the point of this thread.....

This morning I had a brief discussion with my friend Hardy, who is in his 70's and is recovering from prostrate surgery. He told me today his checkup came out good except the doctor found 2 hernias so now he'll have to have those fixed.

I asked him how he is handling the expense and then he shared with me his Humana Gold plan Medicare coverage - he carries a card with him like a credit card with info on both sides. I was amazed at how little he has to pay.....zero for some things even.

So I just looked up on the Humana site and found this plan offered here in Florida that looks similar to the one he has:
https://www.humana.com/medicare-secured/plan-details

I'll be eligible for Medicare in 2019 and feel this type of coverage would go a long way to help with any health care issues I may incur.

Interested in any thoughts from those in similar shoes as mine.....

[Tobra]

Excellent chance that plan will not even exist at that point. Things are changing fairly fast.

[wdfifteen]

Welcome to the hellscape of Medicare. There are a variety of Medicare Advantage plans available. That site lists 6, plus some drug-only plans and Medicare supplement plans, so which one are you looking at?
I've been on Medicare for 1 1/2 years. In addition to what I paid into it via payroll deductions over the years, I'm now paying about $7645 a year for Medicare, Medicare part B, Medicare part D, a drug plan that covers what part D doesn't, and a Medicare Advantage plan that covers what part B doesn't. Or something like that I guess, figuring out what you need and what it costs is like sorting snakes in a bucket.
Medicare itself doesn't help you much unless you have a catastrophic illness. The amount you have to pay over and above what has been taken from your paycheck over the years depends on how much money you make now.
The health insurance and the health billing industries in the US have been disasters since I went into business 30 years ago and it's about to get even worse.
My wife and I were in a car accident 10 weeks ago. She is not on Medicare and she has been billed by 6 different entities. Her most recent bill arrived 9 weeks after the service. I am on Medicare and never received a bill - all were paid transparently, I never saw them.
It's insane. As Tobra said, the Medicare/health insurance landscape now will likely not be the same by the time you are 65.

[Tobra]

It has been going on for longer than 30 years. You should have gotten an EOB(Explanation of Benefits) for everything they paid after your wreck.

Straight Medicare is an 80/20 deal, they pay 80% after you meet your deductible, which is a few hundred dollars if I remember right. Medicare with a decent secondary insurance will be pricier than one of the HMO Medicare plans(Medicare Advantage) but will give you much greater latitude on who and where you can go to for care.

[greglepore]

There are PPO Advantage plans available as well. My pet peeve is that open season to choose is Nov/Dec, but all of the plans can change pricing and benefits on Jan 1 of the following year, so its a pig in a poke.
Everything is going to change anyway with the ACA going away and something maybe replacing it...

[John Rogers]

One of the biggest things I never thought about was health coverage when I was a young hell raiser in the US Navy. After I retired we had Tricare which we never used as my wife had her Civil Service insurance. Then I turned 65 and along with Medicare......here came Tricare For Life! It is GREAT. I would hope you have that? If not my neighbor swears about Humana.

[wdfifteen]

Originally Posted by john rogers

One of the biggest things I never thought about was health coverage when I was a young hell raiser in the US Navy. After I retired we had Tricare which we never used as my wife had her Civil Service insurance. Then I turned 65 and along with Medicare......here came Tricare For Life! It is GREAT. .

We need single payer health insurance for everyone.

[Noah930]

Originally Posted by wdfifteen

We need single payer health insurance for everyone.

As someone who is in the healthcare industry, I don't think that's a good answer for America. Americans will not be happy with that.

[Tobra]

Patrick, you have no idea how mistaken you are.

[dennis in se pa]

These supplement plans are BS. First you have to pay extra for part B. But you still have co pays and deductibles. So you are supposed to buy a supplement plan as well. Well those also have deductibles and so called "donut holes", so you are still not really covered. You can insure yourself into bankruptcy. what they get from part A and B is going to have to do. They don't need the co pays or deductibles anyway. They won't be getting them from me.

[gatotom]

Tobra is right on about Medicare, myself been on it for 3 yrs.

The landscape is changing in the twist that Docs are leaving in droves from the profession and from accepting insurance. I don't have the time or care to write a book on the subject on how the insurance co's are screwing us. Not only to Chiropractors but to all health care professions.

When a major ins co now is paying me what I made for the same procedure in 1990 now, is a joke and a insult. The small office practitioner days are over.

When the costs to get that degree is approaching 250K and when that new person realizes the small amount of pay they will receive due to ins co greed, the schools will lose students in droves.

I feel fortunate to be were I am in my work cycle, I should have retired a few yrs ago but I love what I do and I care for my patients. I give away free about 40% care to people now, will that next guy do that fresh from school?

[RKDinOKC]

Changed my Mom to Generations. The way they explained it to me she was no longer on Medicare she was 100% on Generations. Medicare paid Generations. The only time she had to pay anything was if she went out of the Generations Network. She also only paid $4.00 for any medication an a lot of them were 3 month supplies. It was what they called a gateway system. He primary care physician would get things cleared with Generations then they would pay 100%.

I started looking because her doctor retired and I was having trouble finding another doctor that would take medicare or said they had as many medicare patients as they could handle. There were a lot of local doctors taking Generation and were happy to take new patients. The one we picked said the average age of his patients was 80.

[wdfifteen]

I had a conversation about this just this afternoon. I understand exactly what my doc was talking about. You pay a lot of money to get the education, learn the skill, turn it into a craft, and some bureaucrat insurance executive turns it into a number. All the work and passion the doc puts into being good at what he does is reduced to performing a #14998 procedure that to the insurance co. is no different than a #14998 performed by anyone else in the business.
I wouldn't do it. If the work I did could be described by a number, I'd find another line of work. Health care has been turned into a commodity by the insurance companies.
The money in medicine isn't in providing health care, it's in the insurance industry. When insurance company CEOs make over $10 million a year - far more than the doctors and nurses who actually provide care - there is a fundamental problem that isn't going to be solved by the free market any more than the bank you choose is going to affect the salaries of the CEOs. There is collusion at the top that consumers can't do anything about.

[Baz]

Originally Posted by RKDinOKC

Changed my Mom to Generations. The way they explained it to me she was no longer on Medicare she was 100% on Generations. Medicare paid Generations. The only time she had to pay anything was if she went out of the Generations Network. She also only paid $4.00 for any medication an a lot of them were 3 month supplies. It was what they called a gateway system. He primary care physician would get things cleared with Generations then they would pay 100%.

I started looking because her doctor retired and I was having trouble finding another doctor that would take medicare or said they had as many medicare patients as they could handle. There were a lot of local doctors taking Generation and were happy to take new patients. The one we picked said the average age of his patients was 80.

This is what my friend, Hardy, told me.

He signs up with HUMANA.........and they take all the Medicare money. I think he quoted $1K per month.

I will be seeing Hardy again and will ask about the supplemental coverage he has.

He did stress to me that he loved the way HUMANA went about everything.

Thanks for all the input so far....many of us are in the same boat on this stuff.....

[Noah930]

Originally Posted by wdfifteen

If the work I did could be described by a number, I'd find another line of work. Health care has been turned into a commodity by the insurance companies.
The money in medicine isn't in providing health care, it's in the insurance industry

Health care has been turned into a commodity by the federal government (via Medicare). All the insurance companies just follow the rules/precident set by Medicare.

The money isn't in providing medical care. It's in the ownership of the modalities providing the care. The insurance industry is just one of those ways (albeit the biggest one) of "ownership."

[Tobra]

Keep in mind that the way reimbursement is determined is changing. I don't think anyone knows what lay just over the horizon. I just treat my patients they way I would want my family to be treated and figure it will all shake out okay. Used to be that I thought everyone practiced about the same way. I have come to know that there are not a lot of doctors that handle their business the way I do.

[DaveE]

I think Medicare is on its way out, per the Ryan plan.

[Crowbob]

Originally Posted by wdfifteen

I had a conversation about this just this afternoon. I understand exactly what my doc was talking about. You pay a lot of money to get the education, learn the skill, turn it into a craft, and some bureaucrat insurance executive turns it into a number. All the work and passion the doc puts into being good at what he does is reduced to performing a #14998 procedure that to the insurance co. is no different than a #14998 performed by anyone else in the business.
I wouldn't do it. If the work I did could be described by a number, I'd find another line of work. Health care has been turned into a commodity by the insurance companies.
The money in medicine isn't in providing health care, it's in the insurance industry. When insurance company CEOs make over $10 million a year - far more than the doctors and nurses who actually provide care - there is a fundamental problem that isn't going to be solved by the free market any more than the bank you choose is going to affect the salaries of the CEOs. There is collusion at the top that consumers can't do anything about.

Well somebody is making a bundle somehow. Who owns all these hospitals, surgery centers and clinics that are sprouting up like mushrooms and expanding like there is no tomorrow?

[jyl]

Medicare will be privatized by the time you are eligible, so today's plans are irrelevant.

[Don Ro]

Baz, you're 62? I would have guessed more like early 40's given your spirited levity.
Good health?...good for you, just don't spit, swear, 'n tell lies.

.
FYI -
My quad by-pass in 2011 cost me less than $1,000...medicare took care of the rest of the $160,000+ bill.