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-   -   It' that time....Medicare. (http://forums.pelicanparts.com/showthread.php?t=1113007)

Joe Bob 02-18-2022 07:11 AM

It' that time....Medicare.
 
Just got my Medicare package and my card in the mail. I'm eligible for service this June.

Need some advice. I was raised with Kaiser and when I worked for Santa Barbara County there was just one provider that had the whole County locked up.

So what are the pitfalls and so forth? My former agency will reimburse me for my Part B outlay. Private physician or Kaiser?

Crowbob 02-18-2022 08:17 AM

You will end up with your primary provider being Medicare and your secondary provider being whatever medical insurance carrier you choose. If you’re lucky, your prior employer still offers med. insurance in retirement.

Your SS check will be less your Medicare premium but your secondary carrier premium will go down. There are various levels of Medicare available and various levels of coverage from your private insurer.

If you’re pretty healthy, up your copays and annual deductibles. If your sick, depending on how sick, your healthcare costs are only temporary issues.

GH85Carrera 02-18-2022 08:27 AM

Be sure to own a good shredder. They will inundate you with page after page of printouts. And to be extra helpful to the paper industry, they will send you lots of pages in Chinese, and one page of several languages. You may get 10 pages of printouts listing every cost, and at the bottom line is you owe zero. Most of those pages have your personal information on them, so they have to be shredded.

Only the US government could waste so much paper, postage, and effort and time to tell me don't pay anything. With all the private information on there, email would never work. And of course the US mail is totally private and secure.

stevej37 02-18-2022 08:54 AM

And be prepared with your credit card....co-pays (small amts) on almost everything.

During my recent back surgery and the pre-tests....I think I had at least 8 different co-pays.
They didn't add up to much...but they want the co-pay at the time of visit.

My secondary provider is Priority Health @ $23/month. (which includes advanced dental and vision)

rfuerst911sc 02-18-2022 09:30 AM

My wife has been on " traditional " Medicare for about 6 months . She has a supplemental plan via Mutual of Omaha . So far all doctors appointments along with vision and dental have been no charge . Having said that she goes to physical therapy and none of that is covered .

My brother in NY has the Medicare " managed plan " . My understanding is his entire health benefit payout goes to the managed care network/provider I guess similar to an HMO . He says he likes it and has had no issues . But like an HMO you have to go to someone in network which could be an issue if you travel.

I have to make my decision later this year and still not sure which path I will take . I am curious to see what others have to say .

Evans, Marv 02-18-2022 09:57 AM

I had Kaiser for decades at work and transitioned into it with Medicare. It was seamless, and I notice almost no difference. The premium is taken out of my social security with $20 extra for the Advantage plan. Like some have said there are copays, but they are minor. One difference I notice is that when I was working, Kaiser ran all kinds of tests on me yearly. After Medicare, I get looked at once a year - other than if I have an issue that needs an appointment. I mentioned this to a nurse once at Kaiser, saying they were always running tests when I worked, but it seemed like when you went on Medicare, you got kicked to the curb. She replied i might be speaking some truth about that.

GH85Carrera 02-18-2022 10:29 AM

We have BCBS as the secondary. It is amazing to me any doctor accepts Medicare. I am sure happy they do. I recently went to my dermatologist to have him take a look at my sore spots on my face. I grew up in Hawaii, wearing shorts. No shirt, no shoes, and I even went to school dressed like that.

I have lots of spots that are precancerous, and need to get burned off regularly. I get the printout from Medicare. The doc charged $185 for a visit, but the immediately just tell him screw that, you only get 35 bucks. He has a staff of a dozen people, a full building and multiple rooms and lots of overhead. How in the heck can he afford to treat me for 35 bucks. If I call a plumber or electrician they charge $200 just to show up.

JackDidley 02-18-2022 10:46 AM

Not sure but I think different states offer different options. I have a medicare advantage plan. It has good vision and just ok dental. Never used it for much else but its time for some maintenance so I will soon find out more. One thing that ticked me off a couple years ago was after getting a steroid shot in my shoulder I got an extra bill from the specialist. He took my medicare + the $40 copay and then billed me for another $50. I did not think they could do that but I paid it because it was worth it, sort of.

Bugsinrugs 02-18-2022 01:02 PM

My supplemental is Kaiser. $19 a month. Co pays are minimal. They just added Delta Dental. I’m happy with Kaiser.

dmcummins 02-19-2022 04:07 AM

Just met with a guy this week. Went with G supplemental. Cost $220 per month, added $8 drug plan. So counting the $170 out of SS I’ll be paying $398 per month.

Currently the wife and I have been paying $1,700 per month, so when I drop off that plan I hope to see some savings.

Bob Kontak 02-19-2022 05:01 AM

Quote:

Originally Posted by dmcummins (Post 11611563)
Just met with a guy this week. Went with G supplemental. Cost $220 per month, added $8 drug plan. So counting the $170 out of SS I’ll be paying $398 per month.

Currently the wife and I have been paying $1,700 per month, so when I drop off that plan I hope to see some savings.

I pay $128 per month for gap insurance. United Health Care. And the $8 drug plan.

No co-pays to deal with but most of the visits I have are at the Akron City Hospital complex which is in the Summa network. Summa has their own supplemental plan ($20-ish) so I may switch to that for 2023.

I do like not having to deal with co-pays,

dmcummins 02-19-2022 05:41 AM

Quote:

Originally Posted by Bob Kontak (Post 11611584)
I pay $128 per month for gap insurance. United Health Care. And the $8 drug plan.

No co-pays to deal with but most of the visits I have are at the Akron City Hospital complex which is in the Summa network. Summa has their own supplemental plan ($20-ish) so I may switch to that for 2023.

I do like not having to deal with co-pays,

I’m in Florida, the “G” plans ran from $200-$300. I went back and forth as I believe it was the “D” plans that were around $145, but did not cover excess charges. My understanding is most doctors take what Medicare gives them, but in a emergency situation I didn’t want to worry about it.

jcommin 02-19-2022 06:12 AM

The difficulty/confusion is the supplemental insurance. And it it different for everybody. My package is based on my needs/requirements. The other issue is a prescription drug program - that largely depends on how healthy you are and what your are currently taking.

Medicare payments are usually deduct from your SS check. I'm still working (high income) but on Medicare so I pay a premium which is deducted from my SS check.

I was still working when I turned 65 and applied for Medicare Part A. I retained the company insurance because my youngest son was on my family plan. He was dropped when he turned 26. I allowed myself 4 months to investigate an insurance package that worked for me. When I did apply for Part B and supplemental insurance, I needed to provide a "bridge document" (there is a form for this), showing I had medical insurance from age 65 to present. Unfortunately my employer did not fill out the form correctly and this took about 4 additional weeks to get it straight. I'm still pissed off at my HR Dept.

There are so many options in Illinois, I reached out to a consultant who walked me thru options. Some plans are tailored to the area you live in or if you have a doctor pool you wish to stay with. I'm planning to move out of Illinois and I can take my supplemental plan with me without change.

It can be overwhelming at first but I find it better than my company sponsored insurance.

I have Aetna supplement $150/month
Silver scripts thru Aetna $10/month

Sooner or later 02-19-2022 06:18 AM

B $170
d $22
f $224

Baz 02-20-2022 09:53 AM

I'm 67 - will be 68 in June.

I started drawing my SS in 2018 when I turned 64, 2 years before full benefit....because I did the math and didn't want to forgo 2 years of retirement benefits for the small amount of gain over the remaining years of my life.

Drawing early allowed me to semi-retire and thus have a less stressful lifestyle. Not sure that can be equated into any monetary terms and will be different for everyone, but for me it made perfect sense and I have zero regrets.

Since I was already enrolled in SS, when I became eligible for Medicare 2 years later I sought out and retained a Medical Advantage plan from Humana. I was lucky enough to get signed up by the head manager of our local office in the area while I was at our Walmart. They set up a table in front so anyone can come up and discuss their needs, etc. I had already researched who I wanted as my provider well in advance by interviewing many folks I happened to know and run into and by far Humana was the prevailing favourite.

The whole sign up took about 10 minutes. Got my paperwork and ID card in the mail. I signed up for a HMO plan and one for people who don't bring with them existing health issues. This plan I signed up for doesn't take as much out of your SS to pay for your Plan B. My current deduction per month is only $75.00.

It's going to be different depending on which state you live in and which county in that state, as I understand it. So you will have to check it out. Humana on their website has a way to do that by just punching in your zip code.

Humana requires 2 checkups per year. I also get a blood test through Quest prior to each checkup. All costs of those are covered under my plan. The blood tests are easy to sign up for in the Quest website. I learned to do this at least 3 months ahead of time to get a morning appointment because you're supposed to fast 12 hours before the test and this way I'm not starving longer than necessary...lol.

Any prescriptions I have gotten so far have been covered. I did go to an orthopedic doctor and had to pay a small co-pay - like $20 maybe.

What I like is having these twice annual checkups now and also knowing I have a cap on medical expenses should anything serious develop. My doctor is great too.

Also, to go to a specialist my GP has to set it up --- except for dermatology --- which doesn't require that - I can just show up with my ID card without a note from my doc. Maybe it's because we're in Florida with a lot of potential skin issues.

Anyway - I hope this helps provide more data for whoever needs it.

I can't believe I'm this freaking old now - going on 68. But at the same time thankful I have some bennies to go along with it!

Crowbob 02-20-2022 12:31 PM

It really doesn't make much of a difference at what age you draw SS Retirement bennies. The bean counters have it pretty much figured out. It's a wash.

There are several reasons they encourage people to wait. One is the outgo stays smaller so the dire straights that the fund is in don't look so bad. Two is the more people who wait means there will be less of a payout because many of those people who waited will croak and end up collecting considerably less.

The argument to wait is always that your checks are bigger. Which is true. What they don't tell you is you get fewer of them in the long run.

There are many more reasons to collect ASAP. One is you get your hands on the money sooner so you can actually put it to work. The younger you are the longer it works instead of losing value due to inflation. Another is there is always the likelihood that they will increase the taxes owed on the benefits (which is what The White Bill C did thus creating the largest tax increase in the history of the nation) or raise the retirement age for full benefit or...RUN OUT OF MONEY forcing the benefits to become less. Also...if you have a 401K or other tax-deferred retirement account, you will be taxed at a higher rate because at some point you will be forced to start collecting on the account(s) while collecting a higher SS check which increases your taxable income. AND, even of you don't need the money now, you can sign up and give all or some of it to your kids (who are actually gonna pay for it) and look like a hero (which is what I'm doing)
except I don't look like a hero. I am one!

jhynesrockmtn 02-20-2022 03:20 PM

My understanding is medicare starts the month you turn 65. It is not dependent on when you draw your SS. One of the reasons many men wait to draw SS at full retirement is if you die, your wife will have a higher monthly income. If we can wait, I will. My wife is a few years older and took hers at 62.

I'd encourage anyone approaching medicare sign up age to see an insurance broker who specializes in it. The choices are state dependent and confusing. Their services are free and the good ones are worth spending a few hours with to pick the right supplements/drug plans and get you signed up.

Bob Kontak 02-20-2022 03:43 PM

Quote:

Originally Posted by jhynesrockmtn (Post 11612827)
I'd encourage anyone approaching medicare sign up age to see an insurance broker who specializes in it. The choices are state dependent and confusing. Their services are free and the good ones are worth spending a few hours with to pick the right supplements/drug plans and get you signed up.

+1 Yes, confusing as eff.

I asked a guy that was a little older than me 18 months ago what his thoughts were. Exactly this info was given and he turned me onto an agent. I turned 65 last August.

Their services are free out of your pocket but they are making money by selling a policy.

Every Tom, Dick and Harry will tell you what they have and every one of them will tell you theirs is the best.

I'm baffled older people can't be treated a little better in this country. I mean the confusion related to the supplemental stuff.

Crowbob 02-20-2022 05:27 PM

Exactly correct, Jerry.

Everyone’s situation is unique just like everyone else’s so the decision is personal.

I paid off my wife and never upgraded so, You poor old sot, you know it’s only me, Aqualung my friend.

I’m on my own.

GH85Carrera 02-21-2022 10:29 AM

Quote:

Originally Posted by jhynesrockmtn (Post 11612827)
My understanding is medicare starts the month you turn 65. It is not dependent on when you draw your SS. One of the reasons many men wait to draw SS at full retirement is if you die, your wife will have a higher monthly income. If we can wait, I will. My wife is a few years older and took hers at 62.

I'd encourage anyone approaching medicare sign up age to see an insurance broker who specializes in it. The choices are state dependent and confusing. Their services are free and the good ones are worth spending a few hours with to pick the right supplements/drug plans and get you signed up.

I am lucky, my wife was the HR director for her job at a local university for many years. She learned about all there is to know about retirement and insurance over many seminars she attended. She kept showing me insurance plans for me to loo at. I told her, you are the pro at this, you decide. I will take care of all the photography needs we have, you do the insurance stuff. She "lets" me mow the yard, and take out the trash as well! ;)


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