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Selecting Medicare Options
Old 10-13-2011, 09:48 PM   #1
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Selecting Medicare Options

Hi..... It's "not 2 late " joining you folks . I am 64 , married , 2 married children and 4 g'kids. My wife and I were previously small business owners
and have just shut down . Economy finally caught up with break even volume to survive . The ride was a real live experience and we are grateful.
Should turn out to be good timing and knowing me , I might have never quit otherwise. I ' m seeing there really are more important things in life . Sometimes those rides are hard to get off of .

As I approach 65 early next year , I must make decisions on Medicare which I know very little to nothing about . I can find plenty of material to read but I hate wasting time . Also afraid I 'll miss some small point and get burned . Is anyone aware of a simple run down .... let's say , something where you can answer a few questions or many and depending on answers it tells you the best options and why . Or , maybe
a more simple approach than trying to digest 200 pages of some times confusing data and still overlook something .

Basicly , I'm in good health , eat right , exercise enough , have a little high blood pressure which I take a small dosage of BP meds . My biggest concern , by far , is any big financial hit out of my pocket . High deductibles are fine and I 'm guessing would be preferable.

I get a little nervous thinking I may check the wrong option and get wiped out with a hit I could have otherwise avoided .

OK . If I'm just lazy and looking for the easy answer .... I don 't mind being scolded . A good kick in my rear may be what I need . But if there are some better approaches in making option decisions , or better and clearer info than the govt puts out , I would appreciate your input .

I 'll take any info or directions from this forum because I have observed
the wisdom yall present .

Thanks again
not 2 late
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Old 10-13-2011, 10:09 PM   #2
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Originally Posted by not 2 late View Post
OK . If I'm just lazy and looking for the easy answer .... I don 't mind being scolded . A good kick in my rear may be what I need . But if there are some better approaches in making option decisions , or better and clearer info than the govt puts out , I would appreciate your input .
I do believe you are the first new poster who has shown up to ask for a spanking.

I go on Medicare in a few weeks and understand where you are comimg from. Actually, some of the Medicare info supplied by the govt is pretty good and you'll get a lot of reading material from both the govt and insurance companies (trying to sell you medigap or Medicare Advantage coverage) 90 days or so before you turn 65 - about the same time you get your Medicare card (welcome to Geezerhood!).

The brochure that accompanies the Medicare card is probably the best, most concise single source of info I've run across. The Medicare website isn't too bad either if you want to get a head start, but there is no real reason to do a bunch of advance research unless you feel compelled. You'll get plenty of advance notice and reading material as you get close to your birthday.
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Old 10-13-2011, 10:13 PM   #3
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Welcome! I know a little about Medicare but am not an expert.

Medicare Part A is for hospitalization. You pay no premium for this.
Medicare Part B is for doctors visits. The premiums are based on your income. The rates are posted on the Medicare webpage and the base rate for 2012 is about $115/month adjusted yearly, I think.
Medicare Parts C and D are the tricky ones. There are some plans called Medicare Advantage plans and Medicare Supplement plans. I do not have a clear picture of what the differences are but others on here certainly do.
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Old 10-14-2011, 12:21 AM   #4
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ReWahoo and gsparks2

Thanks . Spankings are OK. Stupid decisions affecting financial matters is what I want to avoid . Have always been suspicious of any contracts , insurance and legal documents with all that fancy legal B.S. The stuff that takes getting a lawyer to explain and when you walk out you 're still fuzzy on what it really says . There 's usually a reason for not being short , simple and straight forward ...... and it 's not in my favor .

Are there options people over look that come back and bite ?
Are there things to look out for ? Avoid ?
Am I making something out of nothing ? I 'm just one of those nuts who doesn 't trust and when it comes to the govt. .... well I should stop here.
Isn 't some of the elective coverage with insurance companies and do all of these offer exactly the same options at the same cost ? Or is this more reading and wrestling over choices ?


Anyone seen a test or a list of questions that when answered could tell a person their best and 2 nd best option .

Hey , us folks making these decisions at 65 ...... I can 't be the only one a little concerned about over looking something . I 'm not in my prime anymore and don 't always trust myself .

I 'll appreciate any and all input .... yall are much more pleasant to read than the junk lawyers write / review .


Thanks
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Old 10-14-2011, 05:29 AM   #5
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Just going through this decision process as well. Medicare A is a no brainer so sign up. Medicare B is almost required or they will charge you a penalty in the future. C & D are where it gets interesting. There are always salesman trying to sell you on what they offer. Some have no premiums and some even refund a portion of the part B premium. ALL, 100% have some type of reduced coverage. They are great about telling you what extras you get and why the plan is so great, but they never tell you what you lose so read the fine print closely. They limit which doctors you can use, even more so then standard Medicare, they limit referrals, they limit out of network, have higher deductibles, some way they make a profit on your lack of service.

My recommendation is to go with Part A and B, buy a medi-gap policy to cover C & D and avoid Medicare Advantage plans. You can always make changes later. Once you take a Medicare Advantage plan and have or develop a pre-existing condition, it can be a challenge to go back. Join some type of senior group that has a blog, meetings, counseling, or other support in this area. Read, learn, listen, then make those decisions. Not sure what state your in, but many have Medicare counseling available. As an example, Florida has the "Sunshine Florida" group that provides this counseling service free.
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Old 10-14-2011, 08:00 AM   #6
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My recommendation is to go with Part A and B, buy a medi-gap policy to cover C & D and avoid Medicare Advantage plans. You can always make changes later. Once you take a Medicare Advantage plan and have or develop a pre-existing condition, it can be a challenge to go back.
Medicare Part C is an Advantage plan (Combines Part A, Part B, and usually Part D). See page 15 of your 2012 "Medicare and You" booklet.

Between October 15-December 7th (this year) and you are in a Part C Advantage plan, you can drop it and join/rejoin original Medicare. If you do, you will have until February 14th, 2012 to join a Drug Plan (part D). See page 78 for further details. Also, there is no refusal for getting original Medicare having pre-existing conditions, unlike a commercial health insurance company.

There are a lot of references to this on the web, but here's a quick one for reference:

Medicare Has No Pre-Existing Condition Clause

FWIW, my (disabled) son has been on Traditional Medicare and on two different Advantage plans (should be reviewed every year, since they are offered via a commercial health organization, such as the Blues and things change) for more than a few years. In his case (only), the Advantage plan worked out better since it also covered services such as eye exam/glasses, which Traditional Medicare does not.

You have to really investigate your options, not only during the first year but every year thereafter IMHO, to ensure you get the plan that makes sense for your situation (just like investing)...
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Old 10-14-2011, 08:35 AM   #7
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Between October 15-December 7th (this year) and you are in a Part C Advantage plan, you can drop it and join/rejoin original Medicare. If you do, you will have until February 14th, 2012 to join a Drug Plan (part D). See page 78 for further details. Also, there is no refusal for getting original Medicare having pre-existing conditions, unlike a commercial health insurance company.
While this is true for Parts A, B, and D, it is my understanding that you may still have to be underwritten for a Medigap Supplemental Policy.

Additionally, switching from one Medigap policy to another may also require underwriting, especially if it is one offered by a different insurance company. Hence, IMO, it is wise to be very careful in choosing your first Medigap policy.
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Old 10-14-2011, 08:48 AM   #8
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Anyone approaching 65 with military service in their background should check and see if they are eligible for VA health care. Check the VA website or with your County Vet Service person, if you have one.
My DH is in the VA system and will be 63 in Jan. My limited understanding is that with VA health care and Medicare Part A and B, you are pretty well covered. This is not an expert opinion as he is not 65 so he has not signed up for Medicare yet.
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Old 10-14-2011, 08:58 AM   #9
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While this is true for Parts A, B, and D, it is my understanding that you may still have to be underwritten for a Medigap Supplemental Policy.

Additionally, switching from one Medigap policy to another may also require underwriting, especially if it is one offered by a different insurance company. Hence, IMO, it is wise to be very careful in choosing your first Medigap policy.
True, but the question (Post #5, and the statement "Once you take a Medicare Advantage plan and have or develop a pre-existing condition, it can be a challenge to go back.") IOW, "can I run back to Traditional Medicare" if everything turns to sh** and I have an Advantage (Part C) plan.

(Yes, you can )...

Now, if you are talking about acquiring an additional Medigap policy, then that would be in the underwriting requirements of that company's policy, which is just a bit more of a challange to setting up a plan (that only exists for 365 days, until the new year's rules are in place).

IMHO, the entire system is designed to get the elderly to exercise their brain ...
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Old 10-14-2011, 09:10 AM   #10
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If you are considering moving or traveling, take a look at Part F. It appears that it offers more flexibility when out of your original area. It is not clear to me, but I think Part F can replace Part B.
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Old 10-14-2011, 09:58 AM   #11
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If you are considering moving or traveling, take a look at Part F. It appears that it offers more flexibility when out of your original area. It is not clear to me, but I think Part F can replace Part B.
Pt F (like all the other lettered plans A,C,N etc) is a medicare supplement plan. As the name implies, it supplements Pt B (it does not replace it). I am not sure you get any more flexibility domestically but it does give you emergency foreign coverage that some other plans might not (original Medicare pt B does not cover foreign situations )
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Old 10-14-2011, 12:51 PM   #12
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Thanks, kaneohe,

It appears that (in my case) I should get Part A, Part B and Part F.

I will have to research this properly.
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Old 10-14-2011, 01:04 PM   #13
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It appears that (in my case) I should get Part A, Part B and Part F.
Not to nitpick, but the proper terminology is Medicare Parts A, B, and D and Supplemental Plan F.
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Old 10-14-2011, 01:34 PM   #14
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Not to nitpick, but the proper terminology is Medicare Parts A, B, and D and Supplemental Plan F.
No problem. Thanks for the correction. I have found that correct terminology is important.
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Old 10-14-2011, 04:03 PM   #15
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BTW, if you are not yet on Medicare, here's a link to the 2012 on-line booklet:

http://www.medicare.gov/publications/pubs/pdf/10050.pdf
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Old 10-14-2011, 09:53 PM   #16
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Very interesting topic. I am also 64 and will sign up for Medicare soon. I have asked local people here and never get an answer that I think is correct. I think most just do not know exactly what they pay. I am a veteran having served from 66-70 in the USAF. I read on the site and from what I understand I would not qualify because of my net worth?? I know plenty of people that use the VA but not sure how they qualified. I have never signed up so I cannot say for sure on that. I would like to retire and not have to worry about health care prices that I cannot afford. You would think that if I served during the Viet Nam war the government should thank me so way. I know back in those days we got very little thanks from the the people when we returned. oldtrig
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Old 10-14-2011, 10:34 PM   #17
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I am a Fed retiree over 65 w/medicare. Today I received a notice from my Fed health care provider cautioning me against dropping my Fed health care insurance in lieu of a medicare advantage program. Humm... first time I that has happened (for me or my parents who were similarly situated).

I probably will stay put but I wonder if OPM will offer medicare advantage plans in the future maybe with a lower 'contribution' on the part of the tax payer. This will distort the historic philosophy of Federal employee health insurance where that group constitutes its own 'community rated' universe. Actuaries will start pushing the numbers.
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Old 10-15-2011, 11:14 AM   #18
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Very interesting topic. I am also 64 and will sign up for Medicare soon. I have asked local people here and never get an answer that I think is correct. I think most just do not know exactly what they pay. I am a veteran having served from 66-70 in the USAF. I read on the site and from what I understand I would not qualify because of my net worth?? I know plenty of people that use the VA but not sure how they qualified. I have never signed up so I cannot say for sure on that. I would like to retire and not have to worry about health care prices that I cannot afford. You would think that if I served during the Viet Nam war the government should thank me so way. I know back in those days we got very little thanks from the the people when we returned. oldtrig
I peeked as well, and I have too much $$.

That is OK with me. I do not want to take resources away from more needy vets than me.

More than that, I can help. There is a need for volunteer drivers to drive a shuttle down (and back--for most) to the VA hospital in Seattle. I bet there are similar needs all over the country. Something to get me out of the house when I am no longer earning the oil dollar.
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Old 10-15-2011, 11:37 AM   #19
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As to the VA health care issue, it's almost as confusing as Medicare.
However, generally speaking, a vet who was "boots on the ground" in Vietnam, will be admitted in the system and given care with NO means testing, your assets are not considered.
Are you taking care away from "needy vets", I feel if they let you into the system, they think they have the resources to take care of you.
Every ex-serviceman or woman needs to do their own research on this. I would again point you to the VA.gov site or your local Vets service office if you have one. Also VFW, Amer Legion, and DAV may be of some assistance.
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Old 10-15-2011, 03:03 PM   #20
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My brother is a Vietnam vet and has modest income. He used the VA for health care for several years. Now that he qualifies for Medicare he signed up for a Medicare Advantage program while still using VA program for some services. He doesn't want to disappear from their system because if he needs recuperative care at some point he doesn't think he can manage the paperwork again.
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