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Help with Medicare decision
Old 03-16-2016, 10:33 AM   #1
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Help with Medicare decision

Situation: I am 60, DW is turning 65. Plan to retire in 2 years. DW is on my insurance for $70 per month with relatively high deductible.

Should she sign up for Medicare with supplement and Plan D or wait and stay on my insurance. It would be cheaper on my insurance but what are the downsides of doing Medicare later?

Things I have “heard”:
1. You should at least sign up for Part A when you turn 65 even if you are covered by other sources.
2. You get a grace period for Plan F (supplement) for pre-existing that would not be there if you try to go buy that later.
3. We had a one-time income event in 2014 that would make part B expensive, at least until that look-back is off the records.

What ramifications should I be considering in this decision? Anyone have any experience with this?
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Old 03-16-2016, 10:47 AM   #2
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Not sure when it kicks in but each year you don't have part D the cost when you do get it goes up as a penalty for not having had it. DW and I got cheapest we could only for that reason as we rarely get scrips.
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Old 03-16-2016, 11:09 AM   #3
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Originally Posted by Jack_Pine View Post
Should she sign up for Medicare with supplement and Plan D or wait and stay on my insurance. It would be cheaper on my insurance but what are the downsides of doing Medicare later?

Things I have “heard”:
1. You should at least sign up for Part A when you turn 65 even if you are covered by other sources.
True -
Quote:
Originally Posted by Jack_Pine View Post
2. You get a grace period for Plan F (supplement) for pre-existing that would not be there if you try to go buy that later.
You have a window of opportunity to sign up for Plan F (which is going away) WITHOUT medical underwriting
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3. We had a one-time income event in 2014 that would make part B expensive, at least until that look-back is off the records.
You can delay signing up for Part B, but there is a premium increase that goes along with that delay.

Try Medicare.gov it has many answers.
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Old 03-16-2016, 11:28 AM   #4
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OK, have been all over Medicare.gov and other sources...........

So Plan F is going away to be replaced by G which only diff is you have to pay deductible from Plan B. Ok with that.

Still not sure if she should sign up and use Medicare. That cost would be several hundred dollars (A,B,D + Suppliment) compared to my insurance of $70. However, am willing to do it if better in long run. Still digging.....................
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Old 03-16-2016, 11:42 AM   #5
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If your wife is covered by Medicare she won't pay for A, everyone pays extra for B & D and if you haven't been covered by a B & D qualified plan you will be required to make up that amount when you buy a Medicare + policy. My husband was covered by my qualified plan well into retirement, we didn't pay extra when we switched to a Medicare Advantage plan a couple years ago.
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Old 03-16-2016, 12:35 PM   #6
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If your wife is covered by Medicare she won't pay for A, everyone pays extra for B & D and if you haven't been covered by a B & D qualified plan you will be required to make up that amount when you buy a Medicare + policy. My husband was covered by my qualified plan well into retirement, we didn't pay extra when we switched to a Medicare Advantage plan a couple years ago.
This. DH and I married when I was 50 and he was 65. I put him on my employer's plan and he was continuously covered by my employer's plan till I retired when he was 76. He hadn't interacted with Medicare at all till I retired. Because we were able to provide proof that he'd been adequately covered in the years between age 65 and my retirement, we didn't have to pay penalties. There's a specific form called (I think) "Letter of creditable coverage" that the HR people from my two previous employers supplied.


Edited to add: if she has health issues that cause you to go through the deductible every year, Medicare might be cheaper overall. My last employer had a $2,500 family deductible, which we blew through in late 2013 when DH had an endoscopy and then again in early 2014 when he had a follow-up. In retrospect, Medicare would have been cheaper.

They want the assurance that you didn't just go without coverage till Medicare was available, since people who are healthier, on average, might do that to save on premiums and then you have a pool of really sick people covered by Medicare.
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Old 03-16-2016, 12:36 PM   #7
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We will probably not do an advantage plan as we are going to snowbird and have been told that most advantage plans are not very transportable.

What does "make up the difference" mean? If she enrolls for Part A and then two years later adds B and D, is there a penalty she has to pay. What about adding F or G two years later as well?
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Old 03-16-2016, 12:43 PM   #8
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This. DH and I married when I was 50 and he was 65. I put him on my employer's plan and he was continuously covered by my employer's plan till I retired when he was 76. He hadn't interacted with Medicare at all till I retired. Because we were able to provide proof that he'd been adequately covered in the years between age 65 and my retirement, we didn't have to pay penalties. There's a specific form called (I think) "Letter of creditable coverage" that the HR people from my two previous employers supplied.


Edited to add: if she has health issues that cause you to go through the deductible every year, Medicare might be cheaper overall. My last employer had a $2,500 family deductible, which we blew through in late 2013 when DH had an endoscopy and then again in early 2014 when he had a follow-up. In retrospect, Medicare would have been cheaper.

They want the assurance that you didn't just go without coverage till Medicare was available, since people who are healthier, on average, might do that to save on premiums and then you have a pool of really sick people covered by Medicare.
Thanks, that is helpful. Great point about deductible. If she has another hip surgery it would probably be cheaper, but she is probably good (with know factors) for a couple of years.
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Old 03-16-2016, 04:16 PM   #9
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We will probably not do an advantage plan as we are going to snowbird and have been told that most advantage plans are not very transportable.

What does "make up the difference" mean? If she enrolls for Part A and then two years later adds B and D, is there a penalty she has to pay. What about adding F or G two years later as well?
Yes for parts B and D if she has not had comparable coverage through your plan. Ask your benefits manager, obtain a certificate annually if at all possible. Remember, corporations merge, division get sold. Tomorrow's benefits manager may not be able to certify plans in the past.
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Old 03-16-2016, 04:51 PM   #10
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Just going through this myself. As Athena has posted above, if you have had coverage through a decent employer plan, there will be no penalty to pay when you sign up for Medicare B.

You need two forms: CMS-40B, and CMS-L564. 40B is just the normal application, while 564 gives details of your employer plan coverage. There is a section on 564 that the HR department needs to complete.

I visited the local SS office with both forms, and was enrolled there and then. Took about 5 minutes once I reached the head of the line!
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Old 03-16-2016, 05:19 PM   #11
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I am surprised that companies let one put a medicare eligible person on their plan a couple of years ago I got a form asking if anyone on my policy was medicare eligible. I expect companies to gradually ban the practice since it does cost them money. I have read that many companies send forms out now asking if dependents on health policies have other insurance available. Some have even taken to saying that if a spouse under 65 could get health insurance thru their job, they are kicked off the employers policy.
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Old 03-16-2016, 05:28 PM   #12
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I am surprised that companies let one put a medicare eligible person on their plan a couple of years ago I got a form asking if anyone on my policy was medicare eligible. I expect companies to gradually ban the practice since it does cost them money. I have read that many companies send forms out now asking if dependents on health policies have other insurance available. Some have even taken to saying that if a spouse under 65 could get health insurance thru their job, they are kicked off the employers policy.
What some companies are doing is making employees or dependents 65 or older "Medicare Primary." This makes their coverage more of a "Supplement" with Medicare paying the first 80%.
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Old 03-16-2016, 05:44 PM   #13
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I am surprised that companies let one put a medicare eligible person on their plan a couple of years ago I got a form asking if anyone on my policy was medicare eligible. I expect companies to gradually ban the practice since it does cost them money. I have read that many companies send forms out now asking if dependents on health policies have other insurance available. Some have even taken to saying that if a spouse under 65 could get health insurance thru their job, they are kicked off the employers policy.
Our company already does that for spouses under 65.
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Old 03-16-2016, 07:03 PM   #14
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I am surprised that companies let one put a medicare eligible person on their plan a couple of years ago I got a form asking if anyone on my policy was medicare eligible. I expect companies to gradually ban the practice since it does cost them money.

Yeah, it surprised me, too and I agree it will gradually disappear.

Good advice, BTW, from an earlier poster about getting a letter verifying coverage annually. I worked for a GE sub when DH and I married. Three years later it was sold, so we needed certifications that covered the company under two different owners. Fortunately the current HR had records going back pre-acquisition but it would have been a pain if a previous employer had gone out of existence.
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Old 03-16-2016, 08:20 PM   #15
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When I went on Medicare last year, it saved me about $320 per month. My wife and I have a really great supplement through MegaCompany. We buy drug coverage on the open market.

Our only problem is that my wife is heavily medicated, and she has often been going into The Gap. We have to pay much more for her drugs the last 2-3 mos. of the year. You have to be very careful not to overspend the amounts allotted for pharmacies. Sometimes you have to ask the doctor for alternative, cheaper drugs that do the same thing.
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