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Old 08-12-2014, 10:23 AM   #21
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The key to the $400/mo puzzle is that zero deductible/copay Medicare Supplemental Plans can get very pricey as you age. Like you, I recently turned 67 and my BCBS plan F supplemental plan went up to $174/mo. I'm informed that I can look forward to continuing increases as I age.

Currently for me: Part B = 104, Supplement = 174, Part D = 49, Total = 327. I'm planning on the Supplement going up significantly with age so it's just a matter of a few more years until I reach the $400 amount being discussed.

I'm glad for Medicare coverage and, so far, it seems to be working fine. But I can see where someone living on a modest retirement income would describe it as "expensive." An elderly couple living on, say, $40k/yr sounds like a satisfactory situation until you factor in $800/mo (combined) for Medicare. Then, at least to me, the situation sounds pretty tight.
The issue with this is what's the alternative to Medicare/Supplemental/ Part D?

I have a neighbor on a Medicare Advantage plan and he is considering trying to switch to a supplemental pan, even though it costs significantly more.

In Texas, those plans are not good (especially around Houston). He is stuck with their doctor choices, pays co-pays, deductibles and some part of various procedures. I originally looked at Texas MA plans and was not impressed as to how they decided your medical needs and choices. Not a good deal if you are not healthy. In some part of the country, MA is reportedly pretty good. But with the gov planning to cut back funding to MA plans, who knows what will happen.

Granted, as you get older, the cost of supplemental plans go up (age group ratings). Those who can't afford the combined costs are faced with difficult choices to make, for sure. Even if someone switches to an MA plan, they will still have significant costs if they need medical care.
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Old 08-12-2014, 10:37 AM   #22
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This varies from state to state. In my state, everyone who has a Plan F, for example, pays the same regardless of age.


Ha
Didn't know that. Thanks! I wish it worked like that here since I'm hard pressed to completely understand my future costs under the Illinois situation.
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Old 08-12-2014, 10:40 AM   #23
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In Texas, those plans are not good (especially around Houston). He is stuck with their doctor choices, pays co-pays, deductibles and some part of various procedures. I originally looked at Texas MA plans and was not impressed as to how they decided your medical needs and choices. Not a good deal if you are not healthy. In some part of the country, MA is reportedly pretty good. But with the gov planning to cut back funding to MA plans, who knows what will happen.
Another potential time bomb in Medical Advantage plans is if you have to go on an expensive drug that is not in the plan's formulary. I don't think you are allowed to buy a stand-alone Part D plan if you are in a MA plan. At least with a part D plan, you can switch once a year to another part D plan that covers that drug.
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Old 08-12-2014, 10:43 AM   #24
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This is OT but it drives me nuts about medicare.
Our plan F HD comes with free silver sneakers,wife goes to the gym for Zumba 15-20 days a month. Medicare pays the gym 5 bucks a day, so if she would go 20 days a month that is 100 bucks, in 4 months they could just buy her a year membership,and save the other 800. Of course others may only go 2 times a month so not worth a year membership.
Regardless still drives me nuts when I see the EOB from ins company.
She was lucky enough that Aetna cancelled here MA plan and we could go to
plan F HD,without underwriting. I was thrilled when this happened.

Also part D is a bit tricky,for instance if you are on an expensive drug not in the formulary, too bad no help for you even in catastrophic coverage. But at least you can change plans once a year to another that might have the drug,but of course it will most likely be a more expensive plan.
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Old 08-12-2014, 10:45 AM   #25
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I have a neighbor on a Medicare Advantage plan and he is considering trying to switch to a supplemental pan, even though it costs significantly more.

In Texas, those plans are not good (especially around Houston).
When Illinois cancelled retiree health insurance for retired teachers, DW switched to a Medicare Advantage plan and, so far, it seems to be working fine. All of her current docs and preferred hospitals and labs are in the network, there is good nation-wide coverage, etc.

I'm using a Plan F Supplement with zero deductibles and co-pays. She has an annual deductible and co-pays capped by an out of pocket max. Interestingly, her out of pocket max is almost exactly equal to the difference between the much lower premium she pays and my Part B + Part D + supplement premiums. That is, if she goes all the way to the out of pocket max, her total cost (premium + out of pocket max) is about equal to my premiums for the year. She'd be ahead if she doesn't go to the out of pocket max.

One advantage she has is that her drug coverage has no "doughnut hole."
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Old 08-12-2014, 10:46 AM   #26
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Didn't know that. Thanks! I wish it worked like that here since I'm hard pressed to completely understand my future costs under the Illinois situation.
I believe it also depends on the provider. Here in Virginia, the AARP plans are community rated, but other company plans may not be. I believe AARP plans are community rated nationwide.
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Old 08-12-2014, 12:02 PM   #27
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This is OT but it drives me nuts about medicare.
Our plan F HD comes with free silver sneakers,wife goes to the gym for Zumba 15-20 days a month. Medicare pays the gym 5 bucks a day, so if she would go 20 days a month that is 100 bucks, in 4 months they could just buy her a year membership,and save the other 800. Of course others may only go 2 times a month so not worth a year membership.
Regardless still drives me nuts when I see the EOB from ins company.
She was lucky enough that Aetna cancelled here MA plan and we could go to
plan F HD,without underwriting. I was thrilled when this happened.

Also part D is a bit tricky,for instance if you are on an expensive drug not in the formulary, too bad no help for you even in catastrophic coverage. But at least you can change plans once a year to another that might have the drug,but of course it will most likely be a more expensive plan.
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Have you priced gym memberships? Especially where Silver Sneakers is offered. Best I could do was $45/month plus sales tax or $50 per month/$600 per year. You need to understand, that Silver Sneakers is not available to people on Traditional Medicare, just those with Supplement or Medicare Advantage plans. So, Medicare doesn't pay for it, your Supplement/Medicare Advantage plan pays for it. Or, rather, you do through your premium payment if you have one.

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Old 08-12-2014, 01:18 PM   #28
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When I asked the ins company they said they get reimbursed from medicare from there MA plans for silver sneakers,so they also give it to the supplement people.
At any rate someone is paying quite a bit for silver sneakers,where there is a high use
person like my wife. I suppose that the theory is that people who exercise more will stay in better health,and cost the system less in the long run.
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Old 08-12-2014, 10:39 PM   #29
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Please keep all your Medicare Advantage & supplements premium amounts coming!

I'm learning a lot here. Only recently have I started thinking about Medicare. The standard stuff, like the $104 for Part B is fixed and easy to find. Of great interest is what people are actually paying for the other areas.

Just a few years ago, I assumed that our medical premiums would take a big drop when we turned 65, that getting on Medicare would be arriving at medical cost "easy street". Now, I'm wondering if our medical premiums may go up!

Many of us pre-Medicare people may have a poor or mistaken understanding of real-world costs of being on Medicare. Which makes this thread a learning experience.
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Old 08-12-2014, 10:54 PM   #30
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Please keep all your Medicare Advantage & supplements premium amounts coming!

I'm learning a lot here. Only recently have I started thinking about Medicare. The standard stuff, like the $104 for Part B is fixed and easy to find. Of great interest is what people are actually paying for the other areas.

Just a few years ago, I assumed that our medical premiums would take a big drop when we turned 65, that getting on Medicare would be arriving at medical cost "easy street". Now, I'm wondering if our medical premiums may go up!

Many of us pre-Medicare people may have a poor or mistaken understanding of real-world costs of being on Medicare. Which makes this thread a learning experience.
Telly:

I wouldn't worry so much about costs if you are a bit away from Medicare, time wise. What is more important is understanding what your options are and why to choose what you do. Here are some important thoughts:

1. Understand what Medicare covers and what it pays (and doesn't cover). Get a 2014 "Medicare and You" handbook if you can and study it.

2. In addition to Medicare, understand the differences between Medigap insurance and Medicare Advantage plans. Also understand switching between both programs and how it's done (or not done).

3. Review the different Medigap plans (A. B, C ...F..etc) and see which one will meet your needs.

4. Learn about Part D drug plans and what the tiers mean and how to pick a plan. You can go on Medicare's site with a drug list and run different cost scenarios.

Some questions to ask yourself:

1. Do you want to have the ability to pick your own doctors?

2. Do you want coverage for Medicare deductibles? (check the hospital stay deductible and see what it is, and it's not annual)

3. Will you need coverage outside of your home state? Out of the country?

Good luck. The above are some basic questions you should get familiar with.

Tony
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Old 08-13-2014, 04:02 AM   #31
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Also remember for dental and eye care you are pretty much on your own,unless the
problem would be a medical condition.
Regular teeth cleaning,cavities,root canals and such are not paid for,these can
get quite expensive. By the time I am done with a cleaning,xrays,oral exam, close
to 200 and I get teeth cleaned every 4 months. Root canals around 1100 or so.
So between my wife and myself cost about 1000/yr just for cleaning which is more
than I pay for my medicare supplement.
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Old 08-13-2014, 05:25 AM   #32
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Just a few years ago, I assumed that our medical premiums would take a big drop when we turned 65, that getting on Medicare would be arriving at medical cost "easy street". Now, I'm wondering if our medical premiums may go up!
Unless your current policy is heavily subsidized, your assumptions a few years ago were correct. When DW went on Medicare, her premiums dropped to about $250 per month for parts B and D plus a plan F supplement, which gave her zero deductible or copays for major medical. Prior to Medicare she was paying $500 per month for a poiicy with a $5,000 deductible on major medical, and a 20% copay for prescription drugs after a $250 deductible. My savings were considerably greater since I had been in a high risk pool due to pre-existing conditions.

As a "rule of thumb" I would say your premiums will drop 50%, and you will have better coverage. The only restriction is that you must go to doctors/hospitals who accept Medicare, which for us so far has included all of our providers, and from what I have seen of many Obamacare networks, a much broader choice of providers.

As aja8888 has said, it is extremely important to diligently do your homework prior to turning 65, since a bad initial choice is very hard, if not impossible, to rectify.
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Old 08-13-2014, 05:57 AM   #33
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Please keep all your Medicare Advantage & supplements premium amounts coming!

I'm learning a lot here. Only recently have I started thinking about Medicare. The standard stuff, like the $104 for Part B is fixed and easy to find. Of great interest is what people are actually paying for the other areas.

Just a few years ago, I assumed that our medical premiums would take a big drop when we turned 65, that getting on Medicare would be arriving at medical cost "easy street". Now, I'm wondering if our medical premiums may go up!

Many of us pre-Medicare people may have a poor or mistaken understanding of real-world costs of being on Medicare. Which makes this thread a learning experience.
Here in MA, a couple under 65 can pay upwards of $1500-$2100 a month for HC. Paying $800 a month for Medicare will be money in the bank!
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Old 08-13-2014, 11:58 AM   #34
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Also remember for dental and eye care you are pretty much on your own,unless the
problem would be a medical condition.
Regular teeth cleaning,cavities,root canals and such are not paid for,these can
get quite expensive. By the time I am done with a cleaning,xrays,oral exam, close
to 200 and I get teeth cleaned every 4 months. Root canals around 1100 or so.
So between my wife and myself cost about 1000/yr just for cleaning which is more
than I pay for my medicare supplement.
Old Mike
This has been a big surprise to me, and a considerable expense. I eat very little carb, so tooth decay does not seem to be a current problem, but all my childhood before I was old enough to make up my own mind about diet made some filled holes in enough teeth to keep a dentist working just to maintain my inventory. Recently I had to find a new dentist, which I always hate considering that they guard their price lists with their lives. I hate it! I took a free exam offer from an office not far away, but didn't follow up on his recs as he impressed me as having too few patients for the years he claimed to have been in his location, too much obvious overhead, and the "exam" was inadequate IMO.

I have no dental insurance, but a storefront opened in my neighborhood which has kind of a doc-in-the-box business plan. They offer an annual "membership" for $129 which gets you free x-rays and exam yearly/ Then the prices for most procedures are in their brochure, and these prices are less than I am used to paying. If you don't take the membership. you pay more. A clerk told me that most people without insurance buy the membership, which I did.

The exam seemed more thorough than any I have ever had. So far I have had one filling replaced, and the base of one tooth where the enamel is being worn away built up with a "porcelain" veneer, which he referred to as a filling, but there was no anchor made, just the surface roughed up. I read the CVs of the owner and the other dentist. They both seem excellent, and their manner is to the point but quite satisfactory. They employ assistants but no hygienists, do the dentist does all the scraping of a cleaning, and techs do polishing. It's less than a 30 minute walk, and I like going to the district anyway, so if I continue to be satisfied they will be my dentists. By scheduling my appointments in the certain time zone, I get mostly the owner which I hope will give me better continuity. The clerks and hygienists are all cute young Asians who are very friendly and seem well trained. Plus, anytime you schedule something they print out what you are having done, and the price, AND ask for a $100 deposit which can be forfeited if you no show. This last part was not too thrilling, but I plan to show up so I guess that is not a deal killer.

Ha
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Old 08-13-2014, 01:07 PM   #35
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This has been a big surprise to me, and a considerable expense. I eat very little carb, so tooth decay does not seem to be a current problem, but all my childhood before I was old enough to make up my own mind about diet made some filled holes in enough teeth to keep a dentist working just to maintain my inventory. Recently I had to find a new dentist, which I always hate considering that they guard their price lists with their lives. I hate it! I took a free exam offer from an office not far away, but didn't follow up on his recs as he impressed me as having too few patients for the years he claimed to have been in his location, too much obvious overhead, and the "exam" was inadequate IMO.

I have no dental insurance, but a storefront opened in my neighborhood which has kind of a doc-in-the-box business plan. They offer an annual "membership" for $129 which gets you free x-rays and exam yearly/ Then the prices for most procedures are in their brochure, and these prices are less than I am used to paying. If you don't take the membership. you pay more. A clerk told me that most people without insurance buy the membership, which I did.

The exam seemed more thorough than any I have ever had. So far I have had one filling replaced, and the base of one tooth where the enamel is being worn away built up with a "porcelain" veneer, which he referred to as a filling, but there was no anchor made, just the surface roughed up. I read the CVs of the owner and the other dentist. They both seem excellent, and their manner is to the point but quite satisfactory. They employ assistants but no hygienists, do the dentist does all the scraping of a cleaning, and techs do polishing. It's less than a 30 minute walk, and I like going to the district anyway, so if I continue to be satisfied they will be my dentists. By scheduling my appointments in the certain time zone, I get mostly the owner which I hope will give me better continuity. The clerks and hygienists are all cute young Asians who are very friendly and seem well trained. Plus, anytime you schedule something they print out what you are having done, and the price, AND ask for a $100 deposit which can be forfeited if you no show. This last part was not too thrilling, but I plan to show up so I guess that is not a deal killer.

Ha
Yes, the lack of dental coverage can very much be a suprise. I've always taken exceptional care of my physical body, with the exception of my teeth (up until 15 years ago). Please don't ask what I was thinking as I don't know. Even though I've since taken great care of my teeth, I'll probably be paying for the first 45 years of poor dental care for the rest of my life. Hence, have factored in additional dental costs into the healthcare budget.

Something else to think about: while the majority view is that SS can be fixed without radical reductions, Medicare is a disaster. It might be a good idea to account for higher Medicare shared costs in the future (I am).
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Old 08-13-2014, 01:50 PM   #36
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Please keep all your Medicare Advantage & supplements premium amounts coming!

I'm learning a lot here. Only recently have I started thinking about Medicare. The standard stuff, like the $104 for Part B is fixed and easy to find. Of great interest is what people are actually paying for the other areas.

Just a few years ago, I assumed that our medical premiums would take a big drop when we turned 65, that getting on Medicare would be arriving at medical cost "easy street". Now, I'm wondering if our medical premiums may go up!

Many of us pre-Medicare people may have a poor or mistaken understanding of real-world costs of being on Medicare. Which makes this thread a learning experience.
+1. My understanding of Medicare total annual costs are like Churchill's quote about Russia - a riddle, wrapped in a mystery, inside an enigma.

I'm budgeting $10K in today's dollars for post 65 health care expenses for 2 and I hope that is enough. If they get too much more than that I think either we would move to another country or the general retiree populace in the U.S. will get out the pitchforks and rates will some how come down.
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Old 08-13-2014, 02:32 PM   #37
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+1. My understanding of Medicare total annual costs are like Churchill's quote about Russia - a riddle, wrapped in a mystery, inside an enigma.

I'm budgeting $10K in today's dollars for post 65 health care expenses for 2 and I hope that is enough. If they get too much more than that I think either we would move to another country or the general retiree populace in the U.S. will get out the pitchforks and rates will some how come down.
Actually, figuring out what Medicare and the back up programs will cost is quite easy, but you have to decide what you want.

Part B is (right now) $104 plus change

Medigap Insurance (supplemental), NOT MEDICARE ADVANTAGE can be looked up on the medicare site by program need ( A, B, C....F..N, etc).

Part D (drug plan) is also easily researched and can be tested based on your drug needs on the Medicare site.

For Medicare Advantage (sometimes called Part C), the cost to enroll is just the cost of Part B ($104.00/month). However, you get what you pay for IMHO. Signing up for this means you don't pay for supplemental and Part D costs as they are in MA, but you will pay deductibles and co-pays.

As an example, for what I consider is the Holy Grail of Medicare coverage (Part B, Plan F (Not High deductible) and Part D, it currently costs us each about $350/month. However, the Plan F cost goes up with age. Then add in your part of drug costs...whatever Part D does not cover. For us, DW is high cost and we spend on her about $3500/year beyond what Part D covers.

So we are at $11,900 annually, not including my drug cost which is about $300/year (I am healthy).
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Old 08-13-2014, 03:04 PM   #38
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Have you priced gym memberships? Especially where Silver Sneakers is offered. Best I could do was $45/month plus sales tax or $50 per month/$600 per year.
DH is on Medicare and his supplemental policy is Plan F through United Healthcare (AARP plan). We recently joined the Y. His membership is through Silver Sneakers and doesn't cost him anything (beyond his Plan F cost of course). He gets a facility membership card at no extra cost. I am paying $39 a month for my membership. I think that two person membership is around $55 to $60 a month so the Silver Sneakers is a nice savings.

At 66, he is currently paying about $170 a month for his supplemental plan. His Part D coverage is paid for by the megacorp he retired from. He is paying extra on medicare this year because we had income high enough to pay extra this year. After this year he should just be paying the standard charge.

We are currently paying $780 a month for retiree coverage for the kids and me with a $3000 deductible and 20% co-pay for in network stuff.

He has been on Medicare almost 2 years and he has yet to have any provider not accept Medicare. While I've heard of providers not accepting Medicare (and I'm sure that happens), for him it has been a non-issue.
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Old 08-13-2014, 03:37 PM   #39
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....... We recently joined the Y. His membership is through Silver Sneakers and doesn't cost him anything (beyond his Plan F cost of course). He gets a facility membership card at no extra cost. I am paying $39 a month for my membership. I think that two person membership is around $55 to $60 a month so the Silver Sneakers is a nice savings............
Do you remember the steps involved in activating this feature ? Do you just walk into the gym with your insurance card and say "sign me up" ?
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Old 08-13-2014, 03:43 PM   #40
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Actually, figuring out what Medicare and the back up programs will cost is quite easy, but you have to decide what you want.

Part B is (right now) $104 plus change

Medigap Insurance (supplemental), NOT MEDICARE ADVANTAGE can be looked up on the medicare site by program need ( A, B, C....F..N, etc).

Part D (drug plan) is also easily researched and can be tested based on your drug needs on the Medicare site.

For Medicare Advantage (sometimes called Part C), the cost to enroll is just the cost of Part B ($104.00/month). However, you get what you pay for IMHO. Signing up for this means you don't pay for supplemental and Part D costs as they are in MA, but you will pay deductibles and co-pays.

As an example, for what I consider is the Holy Grail of Medicare coverage (Part B, Plan F (Not High deductible) and Part D, it currently costs us each about $350/month. However, the Plan F cost goes up with age. Then add in your part of drug costs...whatever Part D does not cover. For us, DW is high cost and we spend on her about $3500/year beyond what Part D covers.

So we are at $11,900 annually, not including my drug cost which is about $300/year (I am healthy).
Thanks for the reply. Maybe I am dense or simply too lazy to read through all the various plan options that will surely change before I am old enough to apply. I am just trying to get a ball park of a total figure to budget for healthcare including vision, dental and co-pays for two post 65.

The Consumer Expenditure Survey has average 2011 total health care costs of $4,769 for a 1.7 consumer unit household, or $2,805 per person on average per year. Maybe average means some go without or have poor quality care so that number could be low.

Fidelity's latest study results estimate a retired couple will need $225K over retirement, so I guess that would be around $11K a year for a couple assuming a 20 year retirement, or $5,500 a person. The FIDO RIP says a 65 year old should budget at least $673 a month and to click on the link for a detailed breakdown of costs, and the detailed breakdown has $722 a month for one 65 year old, which would be $8,664 per year, or 3 times what the Consumer Expenditure Survey lists as average 65+ health care spending currently.

For your $11,900 + 300 would be $6,100 a person. Do you have vision, dental and other costs besides that figure?
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