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Old 02-07-2016, 08:14 AM   #21
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https://www.medicare.gov/Pubs/pdf/11579.pdf

For my 85 yo mother:

Part B $122
Part D 53
Medi-Gap 199

Total $374/month or $4,488/year
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Old 02-07-2016, 01:52 PM   #22
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Fidelity's software inflates healthcare costs by 7% so I would recommend something closer to that.
This makes sense. It may be that overall health care costs rise more slowly over the next decade, but at the same time the cost of Medicare is subsidized and some of that subsidy might be reduced, and the cost passed along.
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Old 02-07-2016, 02:05 PM   #23
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This is a timely thread as I have also been avoiding the details of Medicare costs, but it is my birthday next week and I realize that I'm now only 4 years away from decision time.

I did know about the income test which looks at the past 2? years of tax returns. The 2 years before I'm 65 I have to be careful with Roth conversions as they count as income in the MAGI calculations for Medicare purposes.

With standard Medicare, part B, does one pay 20% of all charges including visits to your primary Doc? My current insurance is also 20% coinsurance except for doctor visits which cost a co-pay of $30.

Is there a max OOP each year with Part B or is a Medigap insurance absolutely needed to avoid huge costs if one needs loads of treatment?

Can one have a Medigap policy one year, drop it for a year or more, then decide to have one again? (I ask because it is possible that we stay out of the country for a whole year, particularly the year I lose my retiree insurance and my wife is not yet eligible for Medicare).
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Old 02-07-2016, 02:18 PM   #24
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This is a timely thread as I have also been avoiding the details of Medicare costs, but it is my birthday next week and I realize that I'm now only 4 years away from decision time.

I did know about the income test which looks at the past 2? years of tax returns. The 2 years before I'm 65 I have to be careful with Roth conversions as they count as income in the MAGI calculations for Medicare purposes.

With standard Medicare, part B, does one pay 20% of all charges including visits to your primary Doc? My current insurance is also 20% coinsurance except for doctor visits which cost a co-pay of $30.

Is there a max OOP each year with Part B or is a Medigap insurance absolutely needed to avoid huge costs if one needs loads of treatment?

Can one have a Medigap policy one year, drop it for a year or more, then decide to have one again? (I ask because it is possible that we stay out of the country for a whole year, particularly the year I lose my retiree insurance and my wife is not yet eligible for Medicare).
I can't comment on what Medicare pays by itself as I have never put us in that position. It's complicated because of the various deductibles and whether or not all the services you use, including labs, accept pure Medicare.

But with Medigap policies (NOT Medicare Advantage plans), I understand that dropping one after you have signed on @ 65 will put you in a position to apply again and for the coverage with the possibility of having to "qualify" based on your medical history and any pre-existing conditions you may have. You may not get accepted or will be accepted with a higher premium or no coverage on pre-existing conditions.

There are ways around this and have to do with a change of permanent address and possibly other factors. Best thing to do is ask a sales rep or check in with the Medicare advocate in the area with questions. (Alan, PM me if you want another recommendation).
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Old 02-07-2016, 02:55 PM   #25
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DH has medigap plan F which is nice and simple. He got the the UHC plan F through AARP. It goes up a bit each year. He is 68 and currently pays about $184 a month for that.

Remember that things like glasses aren't covered by Medicare.
I'm confused about Part F. I thought part F was part of Medicare and purchased from Medicare just like part B. Is the UHC plan through AARP a sub-contracted part F? Or just a typical medi-gap plan? And....is part F underwritten so there is a chance that it could be denied due to pre-existing conditions?
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Old 02-07-2016, 03:08 PM   #26
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I'm confused about Part F. I thought part F was part of Medicare and purchased from Medicare just like part B. Is the UHC plan through AARP a sub-contracted part F? Or just a typical medi-gap plan? And....is part F underwritten so there is a chance that it could be denied due to pre-existing conditions?
Plan F is one of the Medigap insurance plans that covers what Medicare does not cover. Here is an explanation:

https://www.medicare.gov/supplement-...e-medigap.html
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Old 02-07-2016, 06:06 PM   #27
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With Plan F closing to new enrollees in a few years, I'd venture to guess that folks ought to avoid it now. Without fresh recruits, the existing members will get older and sicker and premiums will likely increase dramatically.
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Old 02-07-2016, 06:27 PM   #28
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With Plan F closing to new enrollees in a few years, I'd venture to guess that folks ought to avoid it now. Without fresh recruits, the existing members will get older and sicker and premiums will likely increase dramatically.
I've seen similar comments to yours and other comments saying concerns about big increases are overblown. What I have NOT seen is any information on whether or not the 'closed to new enrollees in 2020" also applies to the high deductible (HD) version of Plan F. Since the purpose of the change was to stop "first dollar coverage" provided by Plan F, and since the HD version requires you to pay $2,180 out of pocket before it kicks in, it would appear the change would not apply to the HD version. But I can find no information to confirm this.
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Old 02-07-2016, 06:27 PM   #29
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Plan F is one of the Medigap insurance plans that covers what Medicare does not cover. Here is an explanation:

https://www.medicare.gov/supplement-...e-medigap.html
Comparing plan f with plan g the difference is covering the part B deductible of $166. As various articles point out if the cost difference exceeds $13.90 or so then go with G as you are effectively just paying the deductible to the medigap plan. If the cost difference between f and g is less than 13.90 then you do need to think a bit more about it.
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Old 02-07-2016, 07:02 PM   #30
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Another point worth bringing up is that depending on your personal medical conditions, Medicare may pay more than you think.

I'm looking at the last three years (2013 through 2015) of medical bills for two of us, and I see the following:

Billed (by doctors, hospitals, etc.): $32,044

Approved by Medicare: $13,617

My responsibility (ignoring supplemental coverage): $3,216

I'm fortunate in that my supplemental coverage picked up virtually all of that, but still my share would only have been about 10% of the original billed amount (plus the cost of Part B, of course).
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Old 02-07-2016, 07:55 PM   #31
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Another point worth bringing up is that depending on your personal medical conditions, Medicare may pay more than you think.

I'm looking at the last three years (2013 through 2015) of medical bills for two of us, and I see the following:

Billed (by doctors, hospitals, etc.): $32,044

Approved by Medicare: $13,617

My responsibility (ignoring supplemental coverage): $3,216

I'm fortunate in that my supplemental coverage picked up virtually all of that, but still my share would only have been about 10% of the original billed amount (plus the cost of Part B, of course).
The hospital bill for someone on medicare will show an itemized bill and then the total zero it out and replace it with the reimbursement for the diagnosis related charge that medicare uses I was surprised when I say it on my mothers hospital bills, but that is the way it is done (mostly part A here). Then for part B if not on medicare advantage there is a max charge they can charge as well.
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Old 02-07-2016, 08:56 PM   #32
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Comparing plan f with plan g the difference is covering the part B deductible of $166. As various articles point out if the cost difference exceeds $13.90 or so then go with G as you are effectively just paying the deductible to the medigap plan. If the cost difference between f and g is less than 13.90 then you do need to think a bit more about it.
I've also see claims (e.g. in the video below) that annual rate increases for Plan G tend to be far lower than for Plan F so that's perhaps another consideration.

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Old 02-07-2016, 10:25 PM   #33
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I'm curious, does anyone here use Medicare Advantage plans (Part C, I believe)? How do those compare cost-wise (premiums + OOP) to Medigap/Part F policies?

We're currently with Kaiser in SoCal and my parents are nearing Medicare age.
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Old 02-07-2016, 10:53 PM   #34
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I'm curious, does anyone here use Medicare Advantage plans (Part C, I believe)? How do those compare cost-wise (premiums + OOP) to Medigap/Part F policies?

We're currently with Kaiser in SoCal and my parents are nearing Medicare age.
The problem of narrow networks affects medicare advantage plans. However in the case of traditional medicare almost all hospitals take it (because folks over 65 are their biggest customers). In addition the question of physicians and taking medicare is much clearer and more easy to frame than the problems folks have with networks.
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Old 02-08-2016, 07:34 AM   #35
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What I have NOT seen is any information on whether or not the 'closed to new enrollees in 2020" also applies to the high deductible (HD) version of Plan F. Since the purpose of the change was to stop "first dollar coverage" provided by Plan F, and since the HD version requires you to pay $2,180 out of pocket before it kicks in, it would appear the change would not apply to the HD version. But I can find no information to confirm this.
The bill failed to address HD-F. CMS is working on a resolution but it appears the more likely outcome will create HD-G. If so, the $2180 OOP is expected to provide a buffer and insulate HD-F from most of the premium increases experienced after Plans E, H, I, and J closed in 2010.
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Old 02-08-2016, 08:20 AM   #36
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With standard Medicare, part B, does one pay 20% of all charges including visits to your primary Doc? My current insurance is also 20% coinsurance except for doctor visits which cost a co-pay of $30.
I would think so. I can tell you that physical therapy visits are only covered 80% by Medicare part B. These charges can really add up when visits are 2 to 3 times a week for 2 or 3 months, typically. And as you get older, your need for rehab services can go up markedly, so it is imporant to plan for that. There always seems to be some kind of musculoskeletal injury or balance issue that crops up. I always felt bad for my patients who didn't have a Medigap plan. Many times they would refuse therapy or cut their therapy short due to the out of pocket costs they would incur.


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Is there a max OOP each year with Part B or is a Medigap insurance absolutely needed to avoid huge costs if one needs loads of treatment?
According to this reference, there is no maximum OOP for original Medicare Part A and Part B:

What else do I need to know about Original Medicare?
You generally pay a set amount for your health care (deductible) before Medicare pays its share. Then, Medicare pays its share, and you pay your share (coinsurance / copayment) for covered services and supplies. There's no yearly limit for what you pay out-of-pocket.


I do recall that some of my patients had a "managed Medicare" type of plan - I believe it costs less than original Medicare, but what I saw with these plans were (1) needing to get referrals from a primary gatekeeper doc and (2) more limits on what was covered and who you could see for your care. For example, some of them would be limited to a 60 day time period to receive "x" number of PT visits per diagnosis per year. Typically that would be sufficient, but not always (aka extensive rotator cuff repairs, etc.) I don't know what these plans are like now, this is based upon treating patients under these plans several years ago.
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Old 02-08-2016, 10:04 AM   #37
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Fidelity's software inflates healthcare costs by 7% so I would recommend something closer to that.
I'm also going to use Fidelity's RIP to see how my projections look with it, but I have a question about FIRE calc. Under the spending models tab I see that the default uses CPI for inflation adjustments. Does that work out to be more than the 3% option for inflation?

I'm asking because I am trying to figure out how much extra our total healthcare costs will be than basic Medicare inflated by the CPI over our total projected retirement years.
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(49, married; DH 53. I am fully retired as of 2015 (well ok, I still work part-time but only because I love the job and have complete freedom to call off if I want to travel with hubby for work), DH hopes to fully retire 2018 when he turns 55 to access 401K penalty-free...although he may decide to do part-time consulting)
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Old 02-08-2016, 11:49 AM   #38
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Check the medicare web site and be sure your income is below the limits where the premiums for parts B and D cut in 85k single and 170k married filing jointly. Note that the total includes any tax exempt interest as well. The premiums rise to 389 above 214/428k.
This is becasue parts B and D are already somewhat means tested.
From what I can find these amounts are not indexed. With a 4% inflation rate, our RMD will force us over the $170K limit in about 15 to 20 years. As we are in our 70's this is not much of a worry for us, but if I was younger and looking at 25-35 years of retirement it would be something I would look at planning around, if possible.
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Old 02-08-2016, 12:38 PM   #39
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Is there a website that compares coverage to all the options? I understand policy coverage is the same for the same type of policy, but how do we learn about a supplement vs medigap for example. We are a still a few years out, but it seems the learning curve on this to get educated for choices is huge!
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Old 02-08-2016, 12:45 PM   #40
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From what I can find these amounts are not indexed. With a 4% inflation rate, our RMD will force us over the $170K limit in about 15 to 20 years. As we are in our 70's this is not much of a worry for us, but if I was younger and looking at 25-35 years of retirement it would be something I would look at planning around, if possible.
According to this article:

Starting in 2020, the high income premium brackets will be adjusted for inflation, so that promises to keep some out of reach of the income surcharges. But donít count on it.


So, I guess we will see! I'm hoping me planning for a 7% increase in Medicare costs yearly will be enough. Too hard to plan for everything...but this is good to know. Thanks!
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