Medicare Supplements

[Jimbo357mag]

I have not heard much talk about Medicare and I don't want to open a can of worms but I thought some opinions, advise and experiences might be helpful for anyone looking for a plan or someone like myself that is turning 65 in a couple of months. I am being bombarded by companies that want to sign me up for Medicare supplement insurance or an advantage plan. I recently made a decisions and picked the plan that I thought would suite my wife and I for the future and I was wondering what you 'all might think.

We decided to go with 'Plan F' coverage for both of us from United American Insurance. It is a smaller company but they have a good rating and reviews and the rates were good and they don't seem to raise the rates very much or very often. Their pharmacy coverage is about average with almost complete coverage of generic drugs but not so hot with some of the name brand drugs of which I take. They did recommend a prescription advocate program that we might qualify for that supplies reduced price name brand drugs for $35/mo.

Any comments, companies you like, experiences? I may have gotten more coverage than I need but too much is better than not enough when you need it.

 

[Captain America]

I did the math with my mom years ago, the supplemental plans were fairly expensive so she started putting the money she would have paid for supplemental insurance into a separate account. She was lucky and didn't need to use her Medicare very much until the last couple of years(she's 79 now) and she now has a very nice slush fund...however...when she tells the doctors that she has no supplemental policy they usually just accept what Medicare pays and waive the rest. This works well for her because the insurance that my dad had wasn't an all encompassing policy so Medicare is very similar to what she had for years, my mother-in-law is accustomed to having a Cadillac plan so she buys the supplement to Medicare because she would rather have the insurance with little or no chance of a copay....FWIW, I just spoke to my mom, she had a total knee replacement in September, she had three main bills that she was responsible for, the hospital stay, the surgery, and two weeks in rehab, her out of pocket expense for those three things came to about $2200.

 

[mhblaw]

I have been on MC plus a BCBS supplement for 11 years now. Both MC and the supplement go up in price as you get older, but, KOW, being pretty healthy have not had any out of pocket expenses yet. Going in for total knee replacement next month so that will be the test.

 

[pete44ru]

.

There are a couple of friends of mine that are constantly driving themselves crazy, always puzzling over the various medical & Rx supplemental coverage offers they receive from a zillion providers - so, we elected to not go that way (constantly choosing/examining offers to seek a better deal).

Both my wife & I have been retired for over 12 years now (her=16 years, me=12 years), have long ago made our choices, and are content with them. (peace of mind is more valuable to us)

In addition to the both of us being enrolled in Medicare Part A & Part B, the corporation I retired from supplies both medical & Rx coverage (with co-pays) for the both of us as my retirement benefit - and I also have VA (Veteran's Administration) coverage (I am a "Vietnam vet").

My wife carries a separate Dental Plan from the employer she early-retired from. (I haven't required dental care for longer than I've been retired - please don't ask).

There's been pretty much "no fuss, no muss", even though I have (or have had) a heart attack, cancer 3x, ongoing diabetes, and organ surgeries - all including various treatments & short hospital stays, of no more than a week each.

Our major periodical tests (MRI's, CAT scan's, colonoscopy's, endoscopy's, Ultra-sound's, etc) have all been 100% covered by one or more of our providers, so we're fairly happy with our coverage (and solvent, to boot ).


.

 

[Bull Barrel]

Don't forget many "name" brand drugs can be had at little or no cost through the maker.

 

[Jimbo357mag]

Thanks for the comments so far. Interesting perspectives.

 

[gramps]

I tried the F plan, paying $145/month, and still buying my own meds. This year I went with Amerigroup. No monthly payment, but should I go in the hospital, I pay the first $6,750! Pay now or pay later essentially. They only pay for certain diabetic supplies. I buy my own, cause it takes too much time and trouble to get a waiver. IMO. I will be shopping again for another company come December. Good luck.
gramps

 

[Bull Barrel]

Dont forget health care is free now thanks to barry o.

 

[ronto]

I took the highest deductible possible, something like $2,500. I don't take any drugs so I'm not enrolled in Part D.

 

[Jimbo357mag]

Dont forget health care is free now thanks to barry o.

Just blowing hot air again? The ACA has nothing to do with it. The Gov does make it easier to compare plans. They now require the insurance companies to offer standardized plans and you can be accepted with no health question during 'open enrollment'. There are 'Advantage' plans and there are 'Medigap' plans.

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

 

[Bull Barrel]

I'm not the one who blew hot air. Think of your messiahs in DC.
According to them we should be saving a lot of money and everyone would have health insurance.

Or did you forget that?

 

[Bear Paw Jack]

I took the highest deductible possible, something like $2,500. I don't take any drugs so I'm not enrolled in Part D.

For military retirees If you take Part D, you loose your Tri-Care. For me I'd rather have Tri-care even with it's down side.

 

[BearBio]

Currently still a Federal employee with Blue Cross and Medicare (turn 66 on Tuesday). Looking to retire in 4 more years (but, maybe in 6 months?). We can carry our medical into retirement, with Medicare as our primary coverage. Our drug coverage remains what it is now, so I can't help you.

HOWEVER, I have two trips to the ER since I got medicare (The week I turned 65)=one last summer with cellulitis and the other with heart failure earlier this year. The one with cellulitis, they asked if I wanted a priest. Before those, my health was fair (diabetic but no real other problems). So, things can go downhill fast as you get older.

Total out of pocket was maybe$1000 on each, including ambulance.

 

[Cholo]

Keep the thread going. I'm getting all that Medicare supplement mail as I turn 65 this year. I don't know what to do other than lower my $815 per month (thanks socialists) premium for my health insurance right now. I'd sure like to hear what others have done.

 

[Trucker]

We decided to go with 'Plan F' coverage for both of us from United American Insurance.

In my opinion you went the right way when you chose Plan F ... but to each his own. Not sure about your choice of providers since the premiums will vary a lot from one provider to the next. You won't have any deductibles with plan F and that is my preference since I don't like surprises. The premium will go up as you age. The "Advantage" plan may be the best for some but we attended a [high pressure] presentation/dinner and they could not match what we have for the premium we're paying. [But the dinner was great!]

You may also wish to look into Part D [prescription drug coverage]. But as I said, to each his own. If you or your wife are not taking meds you can go with a high deductible Part D and practically no premium and then if/when you situation changes and lots of meds are needed you can change to a low or no deductible with a correspondingly higher premium if you would like to.

In my own experience I would never recommend the mail order meds. I've tried 'em and, yeah you can save a little but the hassle isn't worth it unless you happen to live a loooooooong ways from a pharmacy. We have a great 24 hour a day pharmacy about 10 miles from home and between us and our family doctor. I will say that before I went on Part D I was getting my meds mail order from Canada and never had a problem of any kind PLUS my meds were costing me less that way than they cost me now with Medicare Part D when you consider the premium I'm paying. Same drugs, same manufacturer, A LOT LESS YANKEE DOLLARS! Go figure!

 

[Jimbo357mag]

Keep the thread going. I'm getting all that Medicare supplement mail as I turn 65 this year. I don't know what to do other than lower my $815 per month (thanks socialists) premium for my health insurance right now. I'd sure like to hear what others have done.

I picked an agent in my area to help me compare companies and pick a plan. You can do some comparisons online but they will result in more calls from agents/brokers. You should expect to pay much less for Type F coverage than what you pay for private insurance and that will cover all your deductables and co-payments for doctors and hospital bills. If you and your wife are healthy and don't currently have a lot of medical bills, a different less costly plan with some deductables, might be enough for you. Right now I have my supplemental insurance arranged but have yet to sign up for Medicare. Parts A, B and D + an 'Advantage' or 'Medigap' plan are almost a given unless you have some other insurance like Tri-Care.

'Advantage' plans are usually like an HMO or PPO plan with restrictions on doctors and hospitals.
'Medigap' plans are like private insurance, the more you pay the more you get. Coverage will be the same for the same plans but costs can vary with the company.

 

[jeffmb]

Dont forget health care is free now thanks to barry o.

Just blowing hot air again? The ACA has nothing to do with it. The Gov does make it easier to compare plans. They now require the insurance companies to offer standardized plans and you can be accepted with no health question during 'open enrollment'. There are 'Advantage' plans and there are 'Medigap' plans.

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

Baloney. Health insurance was easy to compare for at least a decade before Ogarbagecare. Ehealthinsurance.com was awesome. The government had nothing to do with it. You are correct in that the government requires "standard" things but it results in "one size fits all" policies and has driven up the cost of insurance 3-4 times for those who are actually paying for insurance themselves.

 

[jeffmb]

I found this VERY interesting.
http://truecostofhealthcare.net/medicare-supplemental-insurance/

 

[Jimbo357mag]

I found this VERY interesting.
http://truecostofhealthcare.net/medicare-supplemental-insurance/

from the comments section

Kathryn Thomason Cleveland • a year ago
Thank you, Mr. Beck, for explaining how medicare works. I agree with you that supplemental plans are not very sensible for someone who has the resources to cover emergencies and someone who is willing to risk a large bill now and then. But for someone with little reserves, do you agree that having a $150/month supplemental plan might offer him some peace of mind? Also, as health deteriorates in the elderly and as hospitalizations and the need for medical intervention increases, someone with little cash reserve might find it beneficial to have the plan?
• Reply•Share ›
Avatar
David Belk Kathryn Thomason Cleveland • a year ago
$150 is far more than what you would spend on health care most months while you have Medicare. In fact, if you can afford $150 a month, you can probably afford any medical bills that come your way while you have Medicare.

So the good Doctor thinks paying for a Medicare Supplement is wasting money until or by chance you happen to get a catastrophic medical expense. ....well yeah, that is the way insurance works.

 

[steveodtw]

I'm on Medicare, plus a Michigan BCBS individual supplement for $122.00 a month. In July I spent 3 nights in the hospital for a mild heart attack, Heart Cath. and a stent in a heart artery. The bill was $58,000, not counting individual Drs. In 2017 that BCBS will double. I don't see how there's a good alternative. Unless I had an extra quarter Million $$ or so laying around.

 

[jeffmb]

I found this VERY interesting.
http://truecostofhealthcare.net/medicare-supplemental-insurance/

from the comments section

Kathryn Thomason Cleveland • a year ago
Thank you, Mr. Beck, for explaining how medicare works. I agree with you that supplemental plans are not very sensible for someone who has the resources to cover emergencies and someone who is willing to risk a large bill now and then. But for someone with little reserves, do you agree that having a $150/month supplemental plan might offer him some peace of mind? Also, as health deteriorates in the elderly and as hospitalizations and the need for medical intervention increases, someone with little cash reserve might find it beneficial to have the plan?
• Reply•Share ›
Avatar
David Belk Kathryn Thomason Cleveland • a year ago
$150 is far more than what you would spend on health care most months while you have Medicare. In fact, if you can afford $150 a month, you can probably afford any medical bills that come your way while you have Medicare.

So the good Doctor thinks paying for a Medicare Supplement is wasting money until or by chance you happen to get a catastrophic medical expense. ....well yeah, that is the way insurance works.

Watch it again. In his one example the deductible for a 60 day hospital stay is $1184. That would be about 3 months of supplemental insurance premiums. His point is that after adjusting for what healthcare providers charge, your copay or 20% of what is left won't come close to how much you would have spent on premiums. Food for thought. Most seniors don't even look at the reality and just assume they HAVE to have a supplement.

 

[DGW1949]

I've got MC parts A & B, and nothing else.
My daily "meds" consist of a vitamin pill & 1/2 aspirin.
A tooth brush serves as my dental insurance.

Works for me.

DGW

 

[jeffmb]

I've got MC parts A & B, and nothing else.
My daily "meds" consist of a vitamin pill & 1/2 aspirin.
A tooth brush serves as my dental insurance.

Works for me.

DGW

I'm with you. The money you're saving by foregoing a supplemental will more than likely far exceed any costs you might incur in the future.

 

[gramps]

I found this VERY interesting.
http://truecostofhealthcare.net/medicare-supplemental-insurance/

from the comments section

Kathryn Thomason Cleveland • a year ago
Thank you, Mr. Beck, for explaining how medicare works. I agree with you that supplemental plans are not very sensible for someone who has the resources to cover emergencies and someone who is willing to risk a large bill now and then. But for someone with little reserves, do you agree that having a $150/month supplemental plan might offer him some peace of mind? Also, as health deteriorates in the elderly and as hospitalizations and the need for medical intervention increases, someone with little cash reserve might find it beneficial to have the plan?
• Reply•Share ›
Avatar
David Belk Kathryn Thomason Cleveland • a year ago
$150 is far more than what you would spend on health care most months while you have Medicare. In fact, if you can afford $150 a month, you can probably afford any medical bills that come your way while you have Medicare.

So the good Doctor thinks paying for a Medicare Supplement is wasting money until or by chance you happen to get a catastrophic medical expense. ....well yeah, that is the way insurance works.

Watch it again. In his one example the deductible for a 60 day hospital stay is $1184. That would be about 3 months of supplemental insurance premiums. His point is that after adjusting for what healthcare providers charge, your copay or 20% of what is left won't come close to how much you would have spent on premiums. Food for thought. Most seniors don't even look at the reality and just assume they HAVE to have a supplement.

The deductible for a 60 day hospital stay is $1184? I don't think so! My "Medicare plan", I pay $6750, before Medicare kicks in. Even if you have plan F, you will pay a minimum of 20% of the total. I.e. $58,000x .20= $11,600.00
gramps

 

[jeffmb]

The deductible for a 60 day hospital stay is $1184? I don't think so! My "Medicare plan", I pay $6750, before Medicare kicks in. Even if you have plan F, you will pay a minimum of 20% of the total. I.e. $58,000x .20= $11,600.00
gramps

According to Medicare it is. https://www.medicare.gov/Pubs/pdf/11579.pdf

 

[Jimbo357mag]

How many people can 'put away' the money they would spend on insurance for that emergency that might come up in the future? I can't.

 

[jeffmb]

How many people can 'put away' the money they would spend on insurance for that emergency that might come up in the future? I can't.

By that logic, you can't afford the insurance either.

 

[pete44ru]

.

As an addendum to my previous post, I'd like to comment on the cost of Rx/prescriptions.

Mail-in/Home-Delivery insurance plans generally require a 1yr Rx for each medication, which they fill in four spaced refills of 90-days each time.
Ergo, each refill = three (3) single month's supply.

Insurance Rx plans (generally) deliver on-going maintenance medications to the policy holder's home, but require the policy holder to obtain one-time Rx perscriptions (anti-biotics, test preparation concoctions, etc) locally, then submit the Rx's receipt for a partial refund.

Most medical insurance pharmacy plans also have a co-pay involved, that differs plan-to-plan (VA=$27, Insurance=$25/whatever, etc, etc).

However, I've found that SOME Rx prescriptions may be had less expensively - given that Rx coverage is NOT a "take one, take all" situation.
It's still a free country, so any person may choose to have their different Rx/prescriptions filled at various pharmacies.

SHOP AROUND ! !

I made a list of all my meds, including the name, dosage & frequency before I went around to various pharmacies (WalMart, CVS, etc, etc) for a 30 or 90 day quote (free).

As a result I have some Rx prescriptions filled by my Home Delivery insurance, some by the VA, and others at a discount pharmacy (like WalMart) - I fill my one-time Rx prescriptions at yet another local pharmacy that's very convenient to my home.

The upshot of my method is that I pay a very small amount for some medications that would cost a lot more @ other vendors.

A few examples:

1) I take a generic Synthroid (Levothyroxine) daily to replace what my surgically-removed thyroid gland once provided.(the thyroid regulates all the body's various functions)

The various co-pays for a 90-day supply of the Levothyroxine, IME, are:

VA: $27
Insurance: $25
WalMart: $12

2) As a diabetic, I need to take my blood glucose readings daily, requiring a meter, lancets, and test strips.

VA: no charge (free)
Insurance: IDK, since it's hard to beat "free".
WalMart: (ditto)

3) Medicare will pay for one (1) pair of special footwear for diagnosed diabetics per year (with a co-pay).



Bottom line: God helps those who help themselves.........


.

 

[opos]

Ok, I'll again mention one nasty little possibility with Medicare since ACA came into being...you can verify all of this on Google...those of you that don't want to believe anything...I've lived part of it and while your mileage may vary...you can at least look into what I'm going to post and get some information.

We have Medicare Senior plan F through Anthem Blue Cross and also our prescription plan through them as well...we do not penny pinch nor "audit" every penny and I'm certain our plans are not the very cheapest but they have worked fine through several very major surgeries and my Wife's breast cancer treatments...I have not comparison shopped.

First ...how it used to be when we started with Medicare nearly 15 years ago. You could choose any doctor or hospital you wanted and as long as they agreed to take you and your "gap" insurance you were good to go...might be some balance due in special cases but normally just covered most or all without problems...In my case I'd go to my GP (had him 30 years) and he could not just give me a physical...I had to spell out things that were suspect...so I'd say "I've been coughing" and he'd order a chest x ray...I'd say "I get up at night a lot" and he'd order a PSA test...I'd say my throat sort of hurt and he'd do whatever procedure seemed right...in other words you would get a physical but had to "lead"" him into each test....kind of a hassle but once I understood the deal it was no problem.

Along comes ACA and the doctors began to find they had a huge amount of work to convert all their records to computer...they also had to reprogram the whole diagnostic system in their office..they also were placed under very strict reporting procedures that often required an extra person or outside group to just do medicare billing and checking...worst part was their payments were delayed up to 2 months.

My doc has mostly older folks...and he is older...2 years ago I went for my "physical" and he said "I've put you and all the other Medicare patients I see into the "Annual Health Care Review program"....it's all spelled out in Google but to net it out...it does not have hardly any actual testing or hands on procedures that a physical would entail and those things are often not allowed and require the GP to send you to another doctor..The initial Wellness "welcome " review is a bunch of questions...lots about family and your life style...you will probably be asked your hobbies and may be asked if you shoot or have any firearms...it is not under oath....The doc will "look you over"...listen to any complaints...do some very simple tests (pulse rate, b/p, urine sample, base blood panel ) and that's it...he may also ask you to take a cognitive test to test your mental state.

After the initial welcome you will be placed on an annual "update" schedule that is nothing more than about 20 minutes of chatter..pulse, bp and another cognitive test may be suggested.....if you got any aches and pains the chances are you are off to see a specialist if the specialist will see you...I opted out on the cognitive test as it's just a way to get you on the government rolls and track things that might keep you from driving or shooting or owning guns, etc.....the raw results of those tests are sent to the government and put in your file..as you age you change and of course slow a bit in many areas....if they see enough change they suggest to the GP that you begin to see a geriatric specialist or "head doc" to follow your progress..they are looking for dimentia or alzeimers..I figure my family will have a clue if that becomes any form of an issue and I'll be damned if I'm having some 20 year old guy with an ear lobe with a huge hole in it...decide who and what I might do.

Turns out I have a couple of specialists in my life (pulmonary and orthopedic) and they both know me well...I see the pulmonary doc every 3 months and she will gladly check any things that I might question..she and other specialists are not goverend by the wellness review .. only the GP.

If you go into Medicare and the GP starts to talk "annual wellness review" you might dig a bit further and see if you have options....They might allow other alternatives...just letting you know you might think it provides a great deal...their web site makes it sound great...and I guess if you have never seen a doctor nor had health care it might be appealing but for folks that have had to be involved with health care for a long time...it might be really odd and difficult..

This has been around since 2011 and is only now becoming more and more popular..the feds are sort of forcing it by making it hard to get paid if the review is not part of the doctors plans..good luck

 

[jeffmb]

.

As an addendum to my previous post, I'd like to comment on the cost of Rx/prescriptions.

Mail-in/Home-Delivery insurance plans generally require a 1yr Rx for each medication, which they fill in four spaced refills of 90-days each time.
Ergo, each refill = three (3) single month's supply.

Insurance Rx plans (generally) deliver on-going maintenance medications to the policy holder's home, but require the policy holder to obtain one-time Rx perscriptions (anti-biotics, test preparation concoctions, etc) locally, then submit the Rx's receipt for a partial refund.

Most medical insurance pharmacy plans also have a co-pay involved, that differs plan-to-plan (VA=$27, Insurance=$25/whatever, etc, etc).

However, I've found that SOME Rx prescriptions may be had less expensively - given that Rx coverage is NOT a "take one, take all" situation.
It's still a free country, so any person may choose to have their different Rx/prescriptions filled at various pharmacies.

SHOP AROUND ! !

I made a list of all my meds, including the name, dosage & frequency before I went around to various pharmacies (WalMart, CVS, etc, etc) for a 30 or 90 day quote (free).

As a result I have some Rx prescriptions filled by my Home Delivery insurance, some by the VA, and others at a discount pharmacy (like WalMart) - I fill my one-time Rx prescriptions at yet another local pharmacy that's very convenient to my home.

The upshot of my method is that I pay a very small amount for some medications that would cost a lot more @ other vendors.

A few examples:

1) I take a generic Synthroid (Levothyroxine) daily to replace what my surgically-removed thyroid gland once provided.(the thyroid regulates all the body's various functions)

The various co-pays for a 90-day supply of the Levothyroxine, IME, are:

VA: $27
Insurance: $25
WalMart: $12

2) As a diabetic, I need to take my blood glucose readings daily, requiring a meter, lancets, and test strips.

VA: no charge (free)
Insurance: IDK, since it's hard to beat "free".
WalMart: (ditto)

3) Medicare will pay for one (1) pair of special footwear for diagnosed diabetics per year (with a co-pay).



Bottom line: God helps those who help themselves.........


.

The two most important points you make are "SHOP AROUND" and "God helps those who help themselves....". Most people find it easier to just pay for more insurance rather than analyze for potentially more cost effective alternatives. I'm sure insurance salesmen love this.