Another Medicare Question ?????? What is your coverage and cost ????

[frayne]

After reading through the plethora of medicare coverage options and gaining what I think is a fairly decent understanding of the different iterations of options, I am just curious as to what the folks here have for coverage and the cost.

I am going to be the big 65 in June of 2016 and think I am going to go with an advantage plan. I have no major health issues that I know of and am not taking any prescription drugs. Any suggestions, warnings or words of wisdom ?

I appreciate in advance any and all responses.

 

[REWahoo]

I'm not a fan of Medicare advantage plans as they have far too many disadvantages for my liking. Having to see only doctors in their plan rather than any doctor/specialist who accepts Medicare is a real concern for me.

Age 68 with no major health issues and taking no prescription drugs, I have basic Medicare ($105/mo) a low cost Plan D ($18/mo) and a high deductible Plan F supplement ($51/mo).

 

[omni550]

I'm turning 65 this month. I just signed up for Plan G with Aetna for $113.12/mo and Plan D with Humana-Walmart for $15.70 (Non-smoker, no Rxs, healthy, female).

Here's a good video that explains why a frugal person would choose Plan G instead of Plan F with the exact same coverage benefits.

I elected to go with a Medigap Plan G instead of an Advantage Plan to have the greatest selection of doctors and hospitals, no copayments, no excess fees over and above what the policy covers, and, as I often travel domestically and internationally, coverage outside my geographic area (including foreign travel emergency @ 80%).

YMMV

omni

 

[REWahoo]

Omni, check your link. Not working for me.

 

[omni550]

Fixed link in Post #3.

Here's a flowchart I put together for friends who are a few months behind me age-wise.

omni

 

[Walt34]

I just started Medicare last spring and kept my BCBS PPO plan from my old job and that coverage is now secondary to Medicare. I pay 30% of the premium, a hair over $600/month for the two of us. Last year when I had two stents put in a heart artery, the initial bill was over $45k, the insurance co. paid $35k, and my OOP was..... $0. So it's pretty good insurance and I consider myself very lucky to be in a position to have it. All those midnight shifts are paying off.

 

[REWahoo]

frayne, I wanted to point out to be sure to check out the high deductible version of Plan F. For those of us with no big health problems that option can be a cost saver due to low monthly premiums. I've saved $ four years running compared to a "regular" Plan F or Plan G policy.

 

[omni550]

I just started Medicare last spring and kept my BCBS PPO plan from my old job and that coverage is now secondary to Medicare. I pay 30% of the premium, a hair over $600/month for the two of us. Last year when I had two stents put in a heart artery, the initial bill was over $45k, the insurance co. paid $35k, and my OOP was..... $0. So it's pretty good insurance and I consider myself very lucky to be in a position to have it. All those midnight shifts are paying off.

Walt,

Sounds like you are well-covered.

Is this plan considered a 'Cadillac plan' subject to taxation going forward?

omni

 

[Walt34]

Is this plan considered a 'Cadillac plan' subject to taxation going forward?

Not that I'm aware of, I've never heard of any other retirees mention it nor any of the HR people mention it when I retired.

At the time an option was to pay 20% of the premium and I (and DW) could keep the coverage for one year after retirement for every year of county service (29 years) or I could pay 30% and keep it for life for me and her. That one was a no-brainer.

 

[grasshopper]

I hit Medicare next spring, no Advantage and no supplemental G or hi deductible F in my county. Looks like supplemental F and Humana/WalMart D for me.

 

[MBSC]

Even with Original Medicare, you can end up with an HMO network if you choose a Medicare SELECT medigap plan.

Everyone's situation is different so it's difficult to paint with a broad brush. In my location, no deductible Plan F is better in the long term than Plan G. The 'F' has community-rated premiums while all the 'G' plans use attained-age premiums.

Age 65-70: 'G' has lower premiums
Age 71-75: Premiums are about the same
Age 76+: 'F' premium only rises by inflation, 'G' premium increases for both age (ouch!) and inflation.

Community-Rated Pricing for Medicare Supplement Plans

 

[gauss]

Even with Original Medicare, you can end up with an HMO network if you choose a Medicare SELECT medigap plan.

Everyone's situation is different so it's difficult to paint with a broad brush. In my location, no deductible Plan F is better in the long term than Plan G. The 'F' has community-rated premiums while all the 'G' plans use attained-age premiums.

Age 65-70: 'G' has lower premiums
Age 71-75: Premiums are about the same
Age 76+: 'F' premium only rises by inflation, 'G' premium increases for both age (ouch!) and inflation.

Community-Rated Pricing for Medicare Supplement Plans

Does this vary on a state-by-state basis or are all 'F' Medigap/supplemental plans in all states community rated?

Thanks
-gauss

 

[MichaelB]

My understanding Medigap policies can be rated by geographic location or age, but not both.

Medicare Advantage plans receive subsidies from Medicare, so future pricing is not certain and could conceivable rise faster than traditional Medicare. Medigap policies are also guaranteed issue only when you first reach age 65. From then on you are not guaranteed access to a policy unless you meet specific criteria (see here)

 

[Gotadimple]

Medicare Advantage plans receive subsidies from Medicare

Medicare Advantage plans get passed your Medicare Part B premium plus a small amount to manage all the risks of your care except for kidney dialysis.

so future pricing is not certain and could conceivable rise faster than traditional Medicare.

Part B premiums are capped by inflation factors, and Medicare Advantage premiums, if any, are negotiated with CMS. What isn't certain about Medicare Advantage plans is whether the plan will continue to operate in your state. They sign a contract with CMS, if they don't like the terms of payment, they just don't renew the contract. On the other hand, if CMS doesn't like how you've been treated by the plan, the plan's contract doesn't get renewed.

What is true in all of this is that the government believes that MA costs them more than Traditional Medicare, but the coverage is broader. Not a fair equation, in my mind, as CMS doesn't have the risk for costs that are higher than premiums with Medicare Advantage plans - they passed the responsibility for cost along with your Part B premium to the carrier.

- Rita

 

[kaneohe]

Does this vary on a state-by-state basis or are all 'F' Medigap/supplemental plans in all states community rated?

Thanks
-gauss

My impression is that community rating is rather rare. Most are the other two.....age attained or issue age. Could vary by state.....I only know CA.

 

[W2R]

I have Medicare Part A, which is free, and Part B, which costs $104.90/month.

I also have federal retiree medical insurance, which is the same as federal employee medical insurance and costs the same. This is secondary to Medicare, and covers what Medicare doesn't.

The drug coverage is the same as it was for me before I retired, so I still have to pay part of the cost for drugs. Still, it is as good as Part D so I don't have Part D coverage.

 

[MBSC]

Does this vary on a state-by-state basis or are all 'F' Medigap/supplemental plans in all states community rated?

Attained-age 'F' plans are also offered in my neck of the woods.

When comparing only attained-age Medigap plans, 'G' wins for me for the reasons explained in the video above.

However, when the community-rated 'F' is thrown into the mix, the savings offered by 'G' between ages 65-70 is lost during ages 76+ for plans available to me. It's like finding the break even point of taking SS early or later. YMMV.

Age: CR-'F' AA-'G'
65 $200 $120
70 $200 $190
75 $200 $210
80 $200 $250(*)
(*) Illustrated purposes only, not actual rates.

 

[HadEnuff]

Omni, thank you for the video link and the flow chart. Very helpful. I am a few years out from being eligible, and trying to decipher this puzzle is a challenge. Your information is very helpful. One question: in your flowchart, regarding Medigap, you cite a range in premiums from $40/month to $450/month...is that for the exact same coverages?

 

[kaneohe]

Fixed link in Post #3.

Here's a flowchart I put together for friends who are a few months behind me age-wise.

omni

Very nice flowchart. The only thing I might consider changing is the part about reviewing the medigap cost during open enrollment each year. Person might get the idea that you can change at will during open enrollment each yr but this may not necessarily be true.

 

[HadEnuff]

Very nice flowchart. The only thing I might consider changing is the part about reviewing the medigap cost during open enrollment each year. Person might get the idea that you can change at will during open enrollment each yr but this may not necessarily be true.

are you saying that you can't change carriers during the open enrollment if you find a carrier with the same plan for less money?

 

[Gotadimple]

are you saying that you can't change carriers during the open enrollment if you find a carrier with the same plan for less money?

Yes, you can - assuming you can pass the new company's medical underwriting. See here:
Medicare Supplement Underwriting Guidelines - What You Need to Know | Medicare-Supplement.us

The alternative to Medigap is a) nothing i.e., Traditional Medicare only, or b) Medicare Advantage Plans. With either there is no medical underwriting.

 

[MBSC]

are you saying that you can't change carriers during the open enrollment if you find a carrier with the same plan for less money?

With Medigap (Medicare Supplements), there is no annual open enrollment at the federal level, only your initial enrollment period. You can change Medigaps anytime and as often as you wish as long as you pass medical underwriting.

Some states are GI (guaranteed issue) year round, like NY. Some states, like CA, have an annual period where you can move laterally (same plan letter with different company) or downgrade (choose a plan with fewer benefits).

 

[kaneohe]

are you saying that you can't change carriers during the open enrollment if you find a carrier with the same plan for less money?

see Got a Dimple's great link above............for Medigap supplement (medigap) plans, you should choose w/ some thought during your initial enrollment period when you probably won't be subject to medical underwriting. After that initial period, you can change anytime (not only during open enrollment)......provided you can pass the medical underwriting exam for the plan you are trying to get.
There are some big events in that link that give you that guaranteed enrollment but under normal circumstances, don't assume you can change at will. There may also be applicable state laws in some states that give you some additional choices but again, they may not give you unlimited freedom to pick your plan.

 

[Badger]

We pay $105/month each for Medicare and then the rest is covered by TriCare for Life. Prescriptions are usually $5-10 to fill or free if available at the military base.

It has come in real handy these past 6 years with 3 back and 2 rotator cuff surgeries.

Cheers!

 

[mickeyd]

We are enrolled in part A and part B of Medicare which costs about $105/month each. Also are enrolled in Tricare Plus which grants DW and I access to a local Military Treatment Facility (MTF) and has no added fees or expenses that are payable, including drugs, deductable and copay. It has proven to be an excellent arrangement for us so far.