collectorruger
Single-Sixer
Turning the big 65 in couple of months. Anyone have any suggestions on supplemental insurance and which plans are best. I'm being flooded with mail and calls.
medicare
- Thread starter collectorruger
- Start date
Me too. You can either go with straight Medicare plus a supplemental, or a PPO type of insurance through a major insurance group- you pay several hundred a month for that. Which way to go depends on your health or lack of health. I don't have all the info yet either, and haven't yet decided.
gramps
gramps
Bob Wright
Hawkeye
I have gone with United Healthcare through AARP. My plan is one that pays 50% of the balance unpaid my Medicare.
Previously my plan paid 100% of the 20% not covered by Medicare, but the monthly premium got way too high to be comfortable for me.
Be aware the prescription and supplemental plans do not allow dependents. You spouse will require a separated policy of their own. Be aware of that when being quoted premiums, as they quote one policy. In other words, when it sounds good, double the price.
Also some plans take your Medicare advantage, which is more stringent so far as doctor and hospital choices are concderned. They require you to remain in more narrow system of providers, "in the network" type of system.
Bob Wright
Previously my plan paid 100% of the 20% not covered by Medicare, but the monthly premium got way too high to be comfortable for me.
Be aware the prescription and supplemental plans do not allow dependents. You spouse will require a separated policy of their own. Be aware of that when being quoted premiums, as they quote one policy. In other words, when it sounds good, double the price.
Also some plans take your Medicare advantage, which is more stringent so far as doctor and hospital choices are concderned. They require you to remain in more narrow system of providers, "in the network" type of system.
Bob Wright
I pay $109 for Medicare and $153 for the Supplemental insurance. Just about a sideways move for me coverage wise , but a big savings in cost. My supplemental is a regional carrier I have had for 30 years or so. My wife is on an Obamacare version of the same coverage, same carrier. We are saving about $500 a month for the same coverage from pre-retirement years. My wife doesn't go on Medicare for another year. That will be an additional $100 or so in savings from now.
Glasstream15
Bearcat
I've had the AARP/United Health Care "Plan J", unfortunately NLA, for over 8 years. Fantastic. I don't know what's still available but, even though this is costing me $185 a month + $40 a month for "Part D", drugs, I have enough problems that it's worth it.11 surgeries, some very major, none minor, and so far my deductible and copay is $0.00. Check around carefully and think about your needs, now and future. Plan accordingly. Enjoy retirement. I do. But I need lots of people to keep working to pay my SS and Medicare. So don't quit working.
Hugh
Buckeye
If you are retired military you can sign up for Tricare for Life at age 65, at no cost to you. Then you sign up for Medicare Part B at the going rate; probably around $100 or so per month, that's where I've been for the last nine years. No further supplemental is needed; we get a letter from DOD each year reminding us of that.collectorruger said:
Medicare pays first, Tricare pays second. There is a small copay for medications, but I've never had a need. Flu shots are free.
SAJohn
Hunter
As Hugh hints, Tricare is the best deal out there. It shows that we still take care of our retired Military and their spouses.
Glasstream15
Bearcat
Deleted. Double post
Colonialgirl
Hawkeye
Well, I do pay for United Healthcare/AARP but I have been going to the VA fro my Medical services. Based on my income (SS and a small retirement), ALL I have to pay for is my prescription at $9.00 for a months supply no matter what. Free vision services and ONE free pair of glasses per year, Cataract surgery at ZERO cost except for the medications needed before and after and now a Lamenectomy also at no charge other than meds. Yeah, I'm not at the top of the priority list but the service here in Tampa is great.
JackpineWillie
Single-Sixer
about 2 weeks away and so far I'm going with Humana. I have no current drug needs so I will have a few reasonable co pays and zero to Humana, they are paid out of the part B that comes out of my check. Bonus is free gym membership and $50 per month from Humana's over the counter drug/ medical supplies.
speedsixman
Single-Sixer
I have read in several places over the years that medical providers can only charge the amount that medicare will pay, and aren't supposed to charge more than that, but I know that they do charge a lot more that has to be made up by someone else.
Can anyone shed some light on this subject for me? I'm going through the confusion of transiting from an employer-sponsored health plan to Medicare and the insurance my retirement system offers, and I'm thoroughly confused about this whole shuffle.
Myron
Can anyone shed some light on this subject for me? I'm going through the confusion of transiting from an employer-sponsored health plan to Medicare and the insurance my retirement system offers, and I'm thoroughly confused about this whole shuffle.
Myron
JackpineWillie said:
The free gym membership has made a big difference to me. Haven't felt better in a long time. So far, 5 days a week, 1 1/2 hours a day.
Dave
Big Old Boy
Hunter
I do everything through the VA and will not sign up for Medicare, I hope I made a good choice.
FastEd
Hunter
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You may want to check with your Doctor and have him tell you which companies he prefers to deal with.
You may be surprised.
You may be surprised.
When you turn 65 you automatically become eligible for Medicare Part A at no direct cost, but Part A is strictly for hospitalization and related costs. Part B is what covers outpatient care, lab and xray, etc. and if have Part B it will pay 80% of usual and customary charges, leaving you with 20% to pay directly. But be aware that 20% of a large number is still a lot of money. Those of you who have been well and fortunately not needed extensive medical care might be astonished at how costly outpatient care can be, easily running into several thousand dollars for a complex visit to the Emergency Department, or for the cost of diagnositic testing ordered by your physician (such as an MRI or CAT scan). Supplemental insurance normally covers the 20%, and you generally get what you pay for. Good coverage will be expensive since the insurance companies are not offering policies to be nice, they are looking to turn a profit. There's nothing wrong with that, just be aware that when it seems like you are getting a deal that is too good to be true its probably not true.
Another factor to consider is that Part B itself, at over $100/month deducted from your Social Security check, will be considerably more expensive based upon your overall taxable income. It has nothing to do with age or health or anything else except your income in the previous calendar year and in some cases will double or triple the monthly cost for Part B. If you are retired military you must have Part B or your Tricare for Life coverage will not be in effect.
Also be aware that some health care providers will quietly say that they will not bill you for the 20% of Part B that the government does not pay, but if they do this they are committing fraud. Should Uncle Sam find out that they are not making the effort to collect the 20% from you, they will recompute the amount Medicare pays by considering the 80% amount that they paid as now the full 100% charge. They will then reduce their payment to 80% of the 80% and you could be stuck for the difference. There's no such thing as a free lunch, so you have to make your own decision as to whether or not it is worthwhile to pay for a supplement which will cover the unpaid part of Part B.
Part D is totally separate and covers prescription drugs. However, if you choose to go with a Medicare Advantage plan offered by many of the large health insurers, typically it covers what would be covered by Part A, Part B and Part D as well. But there will be various co-pays and deductibles, as well as limitations of what physicians and hospitals you have to use with a particular plan. Its a complicated business with no absolutely right or wrong solution. The Medicare Advantage programs may involve a monthly premium for you to pay, or there might be no premium at all. And if you can't afford any of this, you might be eligible for Medicaid (which is run by each State with varying rules and limitations). If you are covered by Medicaid it will pay everything not covered by Medicare. The big negative of Medicaid is that payments are often so low to doctors and others that many health care providers will not accept Medicaid patients, so you might have coverage but not be able to actually find a doctor to take care of you.
And remember that as you age you become more likely to need the services of a nursing home at some point. Medicare only covers post-hospital rehab type skilled nursing home care, not long term care. Generally the Medicare coverage is only for 100 days maximum, and if the care you need is not deemed to be "skilled" (which has very specific requirements and not just your lay opinion that the care is indeed skilled) it will not cover you. Typically if the care can be rendered by less than a Registered Nurse it is not skilled. Paying for a nursing home privately varies greatly around the country but a good average estimate today is probably about $80,000 a year for nursing home care. If you can't afford that, you likely could be covered by Medicaid but first you would have to exhaust most or all of your savings and assets, then the State steps in. A further problem with Medicaid is that most quality nursing homes will not take you in directly on Medicaid because it pays so poorly. In many cases you would need to pay privately for a good nursing home to agree to admit you, then if the home is Medicaid certified you could or might be able to remain there when you run out of money. If the nursing home is 100% Medicaid certified (a less and less common situation) then once you are admitted, for any reason, you cannot be kicked out if you must be covered by Medicaid. If you have a living spouse in your home you might be able to retain the home and some assets while being covered by Medicaid, but legally the State could then take the home and assets after the death of the spouse to cover what it paid for you in the nursing home. Depressing, isn't it?
The best solution is to not get sick or hurt, live a long life then drop dead without any health care needed at all.
Another factor to consider is that Part B itself, at over $100/month deducted from your Social Security check, will be considerably more expensive based upon your overall taxable income. It has nothing to do with age or health or anything else except your income in the previous calendar year and in some cases will double or triple the monthly cost for Part B. If you are retired military you must have Part B or your Tricare for Life coverage will not be in effect.
Also be aware that some health care providers will quietly say that they will not bill you for the 20% of Part B that the government does not pay, but if they do this they are committing fraud. Should Uncle Sam find out that they are not making the effort to collect the 20% from you, they will recompute the amount Medicare pays by considering the 80% amount that they paid as now the full 100% charge. They will then reduce their payment to 80% of the 80% and you could be stuck for the difference. There's no such thing as a free lunch, so you have to make your own decision as to whether or not it is worthwhile to pay for a supplement which will cover the unpaid part of Part B.
Part D is totally separate and covers prescription drugs. However, if you choose to go with a Medicare Advantage plan offered by many of the large health insurers, typically it covers what would be covered by Part A, Part B and Part D as well. But there will be various co-pays and deductibles, as well as limitations of what physicians and hospitals you have to use with a particular plan. Its a complicated business with no absolutely right or wrong solution. The Medicare Advantage programs may involve a monthly premium for you to pay, or there might be no premium at all. And if you can't afford any of this, you might be eligible for Medicaid (which is run by each State with varying rules and limitations). If you are covered by Medicaid it will pay everything not covered by Medicare. The big negative of Medicaid is that payments are often so low to doctors and others that many health care providers will not accept Medicaid patients, so you might have coverage but not be able to actually find a doctor to take care of you.
And remember that as you age you become more likely to need the services of a nursing home at some point. Medicare only covers post-hospital rehab type skilled nursing home care, not long term care. Generally the Medicare coverage is only for 100 days maximum, and if the care you need is not deemed to be "skilled" (which has very specific requirements and not just your lay opinion that the care is indeed skilled) it will not cover you. Typically if the care can be rendered by less than a Registered Nurse it is not skilled. Paying for a nursing home privately varies greatly around the country but a good average estimate today is probably about $80,000 a year for nursing home care. If you can't afford that, you likely could be covered by Medicaid but first you would have to exhaust most or all of your savings and assets, then the State steps in. A further problem with Medicaid is that most quality nursing homes will not take you in directly on Medicaid because it pays so poorly. In many cases you would need to pay privately for a good nursing home to agree to admit you, then if the home is Medicaid certified you could or might be able to remain there when you run out of money. If the nursing home is 100% Medicaid certified (a less and less common situation) then once you are admitted, for any reason, you cannot be kicked out if you must be covered by Medicaid. If you have a living spouse in your home you might be able to retain the home and some assets while being covered by Medicaid, but legally the State could then take the home and assets after the death of the spouse to cover what it paid for you in the nursing home. Depressing, isn't it?
The best solution is to not get sick or hurt, live a long life then drop dead without any health care needed at all.
Glasstream15
Bearcat
VITO, thanks for that. A lot of people don't understand what is happening with Medicare. The individual MUST do a lot of research into what is available and what the potential needs will be. Not are, WILL BE! Right now I am paying, at 73 years old, somewhere around $100 for Part B, $185 for Supplement and $45 for Part D. That's every month. But. As I said above, 3 major back surgeries, one a week in the hospital, the second 3 days, the 3rd was overnight, Major shoulder surgery with 36 hours in hospital, Bicep reconstruction outpatient, UVPP (Sleep Apnea surgery) overnight and several other minor outpatient procedures plus MANY hours in Physical Therapy (Physical Terrorpy). Now I do have some co-pays for medications, but they aren't bad.
Overall, what I'm paying is a bargain to me because all of the surgeries, doctors and therapy has been $0.00 deductible and $0.00 co-pay. But I knew what was in my future when I reached 65. I planned ahead. And, because of all this, I'm still very active and working a part-time job. Gotta pay for this. And I'm able to keep the boat going, the fishing rods going and the trips to the range going.
Overall, what I'm paying is a bargain to me because all of the surgeries, doctors and therapy has been $0.00 deductible and $0.00 co-pay. But I knew what was in my future when I reached 65. I planned ahead. And, because of all this, I'm still very active and working a part-time job. Gotta pay for this. And I'm able to keep the boat going, the fishing rods going and the trips to the range going.
