Educate me on Medicare

[flatbutt]

Originally Posted by Steve F

What to do if you stay employed and under the company plan?


Thanks

Beyond 65 yo? I'd guess that the employers plan becomes secondary...but I'm just supposing.

[Zeke]

You can defer Medicare if you're still employed. However, there is a time limit on applying after you quit, retire (or get fired and you're not sure about the next job). There is some paperwork involved. I know this because I was under my wife's work health ins until she retired. I was 70 when I first started Plan B. (Plan A is automatic no matter what at age 65.) All we had to do was have the former employer state that we were covered by the company plan until the date of termination and have them send a letter giving that exact date.

I can't tell you off hand how many weeks you have but don't miss it because late enrollment (unless differed as stated) carries a lifetime penalty expressed in %'s.

[Steve F]

Thanks guys, still a young 63, just planning ahead

[Baz]

Updating our thread.

So this is the year I am eligible and will be doing some more homework over the next few months.

One thing I discovered is it looks like no matter what plan you sign up for - everyone pays for Part B.

Last year it was $134/mo.....this year it will be $135.50/month.

Will post more as appropriate. Thanks as always for any input going forward!

[dan88911]

There is a lot of information here.
https://www.kiplinger.com/fronts/special-report/medicare/index.html

[wdfifteen]

Whatever you do, DO NOT call any of those numbers that advertise information about Medicare plans. They will hound you to death. I’ve been on Medicare for 3 years and called one of those numbers for information before I started. I still get 3 or 4 robo calls a week. It’s worth it to speak directly to your insurance agent, and ONLY to your agent. I did a lot of research and this thread is more informative than 90% of the web sites out there.

[JackDidley]

Cost can be different depending on what state you live in. I did a lot of reading and I got a ton of stuff in the mail from every insurance company. A year later I still get mail from them. Ended up joining AARP because I got what I felt was the best deal through them.

[flatbutt]

Originally Posted by Baz

Updating our thread.

So this is the year I am eligible and will be doing some more homework over the next few months.

One thing I discovered is it looks like no matter what plan you sign up for - everyone pays for Part B.

Last year it was $134/mo.....this year it will be $135.50/month.

Will post more as appropriate. Thanks as always for any input going forward!

The monthly premium for Part B is subject to income. If you make more than 85K you pay more, above 107K you pay double.

[74-911]

These are the Medicare Part B premiums for 2019. They are based on your income in 2017 and note: income is not AGI from your 1040, it is Modified AGI which is AGI + certain other deductions added back in, i.e. tax exempt interest income

[wdfifteen]

^^
FYI, this does not include the Part D MAGI premium. I don't know anyone who doesn't have Part D.


Medicare has a screwy way of determining what your premium is and collecting payments.

They look at your tax return from two years before to determine what your premium is, then apply it to the previous year. ie:
To determine the premium for 2018 they look at tax returns for 2016. During the year 2018 they charge whatever they charged in 2017. At the end of the 2018 they look at tax returns for 2016 and decide what you SHOULD have paid, if it's more than you paid, they bill you the difference in one lump sum. If it's less than you paid, they lower your premium for the following year (2019 in this example).

My income is variable, some years I pay the minimum and then get hit with a big bill in January, other years I pay less than the minimum (because I overpaid the previous year).

You can appeal their decision if your income drastically changed, but you have to stay on top of it.

[Hugh R]

My medicare MAGI was based on my 2017 tax return, I went in with an estimate from my CPA for 2018 and they changed it to zero within a week.

[wdfifteen]

Hard to imagine Medicare doing anything within a week.

[Baz]

Originally Posted by dan88911

There is a lot of information here.
https://www.kiplinger.com/fronts/special-report/medicare/index.html

Thanks for that link, Dan.....lot of good information there.

FYI: I received an information packet from the Dept. of Health and Human Services regarding Medicare yesterday and started reading through it.

I'm automatically enrolled in Part A & B beginning June 1, but have the option of bailing out on Part B if I elect to do so.

My plan is still to get an Advantage plan but have yet to make the final decision. I have time to research it.

Pretty cool though to get all this information in the mail. Very informative, I have to say.

Will post again when appropriate. Thanks again for the thread and input.....

[dan88911]

You are welcome Baz,
My wife is a few yrs. young than I and still working.
So I enrolled in Part A and postpone Part B while covered by her employer health plan till she retires.
If you do this you have visit the SS office and inform them.
Once she retires we will each get a Advantage plan.
By the way with the Advantage Plan one must still pay the cost for Part B .
The Advantage Plan comes with extras , meds, dental, vision etc.
You maybe limited to its network of doctors.
So you have to figure out what work best for you.
.

[gchappel]

I just enrolled this month. A couple of things I have learned- or think I learned.
Supplement plans part F- they are all the same. Prices may vary a little between different providers.
Part F will no longer be available after 2019. If you have it you can keep it, but no new enrollments. Congress or someone passed a rule that supplements can no longer pay your deductible, which part F does.
IMHO, if you can get part F now, get it.

I have been involved in hospital based cancer conferences for over 20 years. After sitting and listening to the issues- I personally would never use an advantage plan. Medicare pretty much allows the oncologists to treat as they see fit. Some of the advantage plans limit access to drugs, and actually control dose amounts they will pay for. Like all insurance, you only know how good it is when you need it. I have no personal experience in this at all- but from years worth of discussions I know I would prefer my chosen doctors choose my exact care plans- not have them chosen by my insurance carrier.
My opinion
Gary

[Baz]

Originally Posted by gchappel

I just enrolled this month. A couple of things I have learned- or think I learned.
Supplement plans part F- they are all the same. Prices may vary a little between different providers.
Part F will no longer be available after 2019. If you have it you can keep it, but no new enrollments. Congress or someone passed a rule that supplements can no longer pay your deductible, which part F does.
IMHO, if you can get part F now, get it.

I have been involved in hospital based cancer conferences for over 20 years. After sitting and listening to the issues- I personally would never use an advantage plan. Medicare pretty much allows the oncologists to treat as they see fit. Some of the advantage plans limit access to drugs, and actually control dose amounts they will pay for. Like all insurance, you only know how good it is when you need it. I have no personal experience in this at all- but from years worth of discussions I know I would prefer my chosen doctors choose my exact care plans- not have them chosen by my insurance carrier.
My opinion
Gary

Thanks, Gary.

Great information and head's up about the Part F going away for new enrolees.

I will continue to research.

My situation may be a little different from others as I do not go to a doctor and haven't except for twice to get Z-pacs for chronic bronchitis several years ago.

I go to a dentist and optometrist.

Other than those two I don't even have a GP.

I suppose at some point now that I'm approaching middle age I should think about getting a checkup at least. Probably happen after I get signed up.

Yes, I recognize that as I continue to age, stuff will likely wear out a little and I may need health care.

So for me, maybe I don't need the Part F Medigap option.

[Zeke]

Originally Posted by Baz

Thanks, Gary.

Great information and head's up about the Part F going away for new enrolees.

I will continue to research.

My situation may be a little different from others as I do not go to a doctor and haven't except for twice to get Z-pacs for chronic bronchitis several years ago.

I go to a dentist and optometrist.

Other than those two I don't even have a GP.

I suppose at some point now that I'm approaching middle age I should think about getting a checkup at least. Probably happen after I get signed up.

Yes, I recognize that as I continue to age, stuff will likely wear out a little and I may need health care.

So for me, maybe I don't need the Part F Medigap option.

It's not that expensive and the alternate can bankrupt you. Medical costs are not fair by any means. My shoulder replacement probably cost 40K no ins. Medicare pays a negotiated fraction of that and my medigap picks up where they leave off. For a lot of it, Medicare pays only 50% of that negotiated price and you pay the other, plus any deductibles due. That could still be in the 1000'$ for me w/o medigap.

Don't run the risk as you could get injured many ways. Or really sick. It's a hell of a lot better to be on the hook for 50 bucks for an ER visit rather than what they would otherwise bill you. Figure that ER visit would start at about a grand and if they did anything, you bet billed right down to the smallest bandaid. I think a bandaid is 5 bucks and the alcohol used beforehand is called some kind of preparation procedure, likely 20 bucks. Just a WAG but I'm not far off.

[sammyg2]

Originally Posted by Joe Bob

Yes, which way u old phart?

Who you calling old phart, .......

there are a bunch of em here!

[Baz]

Quick update for the thread......

This morning I enrolled with Humana and am going with this plan:
Humana Gold Plus H1036-157

I was shopping at Walmart and a company rep was in front with his table all set up and after about 15 minutes of conversation, I was able to choose a plan that I/we thought made sense.

This rep has been with Humana for 12 years and is not an independent, FWIW. Company man. Very easy going but also very intelligent about their product line.

This plan is the only one that 'pays you back' $85 per month. In other words, instead of taking out the full $135.50 - they only take out $50.50. Slightly higher co-pays, but for someone like me who never sees a doctor anyway....it made a lot of sense.

Also, since I do not have an existing GP, and you are required to have one when you sign up, we were able to get the one here locally whom I had in mind. My rep already knew he was accepting new clients and plugged him right in.

The whole thing only took about 15 minutes.

So as of June 1, I will be on a Humana Advantage plan and my SS will only be dinged $50.50.

I'm relieved this is now taken care of!

[Zeke]

Originally Posted by Baz

Quick update for the thread......

This morning I enrolled with Humana and am going with this plan:
Humana Gold Plus H1036-157

I was shopping at Walmart and a company rep was in front with his table all set up and after about 15 minutes of conversation, I was able to choose a plan that I/we thought made sense.

This rep has been with Humana for 12 years and is not an independent, FWIW. Company man. Very easy going but also very intelligent about their product line.

This plan is the only one that 'pays you back' $85 per month. In other words, instead of taking out the full $135.50 - they only take out $50.50. Slightly higher co-pays, but for someone like me who never sees a doctor anyway....it made a lot of sense.

Also, since I do not have an existing GP, and you are required to have one when you sign up, we were able to get the one here locally whom I had in mind. My rep already knew he was accepting new clients and plugged him right in.

The whole thing only took about 15 minutes.

So as of June 1, I will be on a Humana Advantage plan and my SS will only be dinged $50.50.

I'm relieved this is now taken care of!

I'm surprised they are taking 50 bucks. The ones I considered (HMO's) were no cost to the patient, $10 or $20 doc visits and 5 dollar scripts. Since I didn't select an HMO over a PPO, I pay the original Medicare plus another slightly higher fee for the Medigap.

Above I speculated that my shoulder surgery would have been 40K out of pocket. Surprise, it was ONE HUNDRED AND NINETY FIVE THOUSAND $$$!!! So far I have been billed $185 for the anesthesiologist(s) which was about 6K on the sheet. No word yet on the rest. Surgery was 1/4/19.