Medicare

[M19]

Are you currently making any contributions to an HSA (in your name)? Medicare does a 6 month "look-back" from your application date and allows no HSA contributions in that window. I had to "uncontribute" some deposits.

Since I was covered by a qualifying plan at my work, I didn't apply for A and B until I was retired, past 66. That is OK (no penalty because of the qualified plan) but you have to jump through a bunch of additional hoops. It was not fun.

One oft-unmentioned benefit of a good Medicare Advantage policy is that they handle ALL the paperwork (for ongoing medical services and expenses, NOT for Govt. sign-up). You don't have to deal with the Feds at all.

Finally, if you ever have to talk with someone at CMMS (and Social Security) and they help you out, be sure to get their direct number and/or extension so you can bypass the 2-hour wait for an unhelpful generalist if you have an issue in the future.

[rokdog49]

My strongest advice:
Beware of well-meaning folks who tell you “Medicare Advantage” supplemental insurance plans are not advisable. This is simply not true in all cases.
You need to find out for yourself what is available and what these plans offer and most importantly what your wants and needs are.
The companies vary by state and the doctor networks can be excellent as in our case.

We pay zero premiums for our Medical Mutual Advantage Plan. ZERO
Our out of pocket for prescription drugs including my wife’s various meds are free with the exception of her cancer hormone which costs a whopping $13 for 90 days. Our coverage is very good and my wife had major surgery from which our out of pocket was pennies on the dollar of a $35,000+ bill.
If you wish to buy a private policy that covers more, you will pay in the form of premiums for that and depending on what you wish to cover, it could be a lot.

Do your own research and do not rely on other people’s experiences, period.
As others have suggested, start with the Medicare website.

[Bob from Brooklyn]

You appear to have some time to wrap your head around Medicare. I found this book very helpful.

https://www.amazon.com/Costly-Medica...xpY2s9dHJ1ZQ==

[SCVJ]

In a post upthread dealing with the feds is cited as a disadvantage. Signing up for A and B can be done online, and I consider it easily done, assuming one can handle most internet tasks. In my six year experience, I've never once had to speak with or visit any government office. I'm pretty sure that a Medigap policy and Part D if you chose that route are both bought through private companies, not the government.

[Heroditus]

I’m 68 so I went through this a few years ago. I ended up with a Medicare Advantage plan that is owned by the largest hospital in the area.

Though they have a few plans one can sign up for, I chose the plan with a $0/month charge. Pretty basic, but then I’ve always been very healthy…..until last summer when I landed in the hospital with urosepsis and a few related difficulties. This plan paid for almost every bit of what turned out to be a $36,000 bill. I paid less than $1000 of it. I was very pleased with that.

Advantage plans may not be for everyone based on the state of their health but for me I like having everything bundled together. Yes, you need to stay “in plan” to get the best benefits of the plan, but I’ve not found that to be a problem.

[fretfile100]

Straight Medicare A + B and a medigap supplement. You may find all those other Medicare part c may limit your healthcare.

[DCCougar]

Originally Posted by Cypress Knee

Mike, you are required to enroll in Medicare Part A at age 65. The current cost is $0. You can stay on your wife's plan and not purchase for Part B and all the other extra plans. If your wife leaves her job (and coverage) then you will be required to purchase Part B or face long-term financial penalties.

Right! I had that situation. Stay with your wife's plan. When that ends, get and start paying for Part B. (You'll need a statement from your wife's plan to show you have been covered for those years, thus avoiding the penalty.) Then a supplemental or advantage plan -- your choice. Those are not really required, but highly recommended.

[Mary]

With newspapers diminishing I agree that we still need ANN LANDERS


Dear Medicare and insurance companies,

Are you serious? Why is it so difficult for common sense intelligent people who worked all their lives to figure out the system and feel good about it? Please simplify.
~~~~~~~~~~~
Our town has a medicare senior advisor. They are free. Call your local guy and let him maul your needs over with you.
~~~~~~~~~~~

[rllink]

I've never trusted myself to navigate things like Medicare and Medicare supplements. I don't do my own taxes either. When I retired I had to find my own health care insurance so I found an independent health care insurance agent to help me sort through it. When it came time to go on Medicare she was all over it. She knew me and my situation quite well and was able to set me up. Honestly, I don't even know what I'm enrolled in. I'm still with her and her agency. She reviews everything every year and stays on top of it for me. She has one agent who specializes in Medicare/Medicade. I'm happy to let them take care of it and I recommend going that route. Why try to figure it all out when someone who understands all the ins and outs can do it for you? I don't know who pays her, but someone other than me does.

[DavidE]

Originally Posted by mike o

Good day

I’m hitting 65 in November so, will need to sign up for Medicare soon. I think I’m in the right place to ask for any suggestions. Please share any recommendations and mistakes you made going through this process. I’m a blank slate relying on good info from you. Thanks in advance.

Find an agent to walk you through all the advantage and supplement plans. You'll need one. It doesn't cost you any extra to go through an agent, but make sure they know medicare plans specifically.

[DavidE]

Originally Posted by rokdog49

My strongest advice:
Beware of well-meaning folks who tell you “Medicare Advantage” supplemental insurance plans are not advisable. This is simply not true in all cases.
You need to find out for yourself what is available and what these plans offer and most importantly what your wants and needs are.
The companies vary by state and the doctor networks can be excellent as in our case.

We pay zero premiums for our Medical Mutual Advantage Plan. ZERO
Our out of pocket for prescription drugs including my wife’s various meds are free with the exception of her cancer hormone which costs a whopping $13 for 90 days. Our coverage is very good and my wife had major surgery from which our out of pocket was pennies on the dollar of a $35,000+ bill.
If you wish to buy a private policy that covers more, you will pay in the form of premiums for that and depending on what you wish to cover, it could be a lot.

Do your own research and do not rely on other people’s experiences, period.
As others have suggested, start with the Medicare website.

I have a Humana Medicare advantage plan this year. I was in the hospital for 24 days starting 1/31/23 and had 3 surgeries. My total out of pocket? $275 a day for the first 5 days. Under $2k. The bill was over $340,000.

[rokdog49]

Originally Posted by DavidE

I have a Humana Medicare advantage plan this year. I was in the hospital for 24 days starting 1/31/23 and had 3 surgeries. My total out of pocket? $275 a day for the first 5 days. Under $2k. The bill was over $340,000.

My wife’s surgery was $117,000. We have Medical Mutual of Ohio Advantage.
Our out of pocket including her hospital stay of one day was a bit over $2000. We also qualified for assistance from Ohio Health Care based on our combined SS income which surprised us because that number is pretty high.
If all you paid out of pocket for everything including your surgeries was under
$2k, you did very well. Do you pay any premiums to have your Advantage Program?
We don’t.

[Dotneck]

Originally Posted by The Watchman

Start the process now. Dont wait. I think the recommendation is to apply 6 months before 65.

Yes, this ^^^.

I didn't know this and started late. It was a real PIA to get resolved.

[mike o]

Thank you everyone for posting you thoughts. A lot to digest. I did down load book recommend for reading this weekend!

[nitram]

As a 75-year-old Canadian I am so glad that I don't have the issues that you in the States have to navigate.Socialist or not - there's something to be said for universal health care. I'm not trying to start anything here, I'm just perplexed by the complexities of the health system south of us up here.