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Medicare expenses
Old 12-21-2014, 07:45 AM   #1
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Medicare expenses

Good morning,

I am trying to come up with a reasonable line item estimate for when I get to 65 and apply for Medicare. Presently, I'm paying for Cobra at $1735/month, I am 61 years old.

I know Part A is "free" , Part B is approx. $105/mo.

The medicare supplement plan is variable. Looks to me that Plan F is probably the best choice (?) since it appears to be the most expensive. Is there anything better? I'm not a veteran.

My DW has a chronic condition so I need to have very good medical coverage.

I know Part D is for prescriptions. Is there a maximum out of pocket expense for Part D?

I'm a beginner at understanding Medicare. For now I estimated $11K/year but this is a WAG (wild a** guess).

What is a reasonable dollar amount use for estimating my yearly Medicare line item expense (max out of pocket)?

Thanks for your input.
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Old 12-21-2014, 07:53 AM   #2
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I'm not near the medicare time of life, but listening to my MIL.. part B and maybe D may be means tested. Thus you would have to take your tax situation into account for estimates. This would include RMD when you get to that point
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Old 12-21-2014, 08:01 AM   #3
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Quote:
Originally Posted by engr View Post
I know Part D is for prescriptions. Is there a maximum out of pocket expense for Part D?
Naturally, there is not a simple answer for that.
Costs in the coverage gap | Medicare.gov
Doughnut Hole Calculator - Calculator for Medicare Part D Drug Coverage Gap, Online Tool, Info for Seniors - AARP
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Old 12-21-2014, 08:49 AM   #4
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see here: https://medicare.oneexchange.com/med...medicare-plans

A 65 yr old today would pay roughly $50-150/mo. for a medicare supplement plan which is a bit less than COBRA.
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Old 12-21-2014, 09:07 AM   #5
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There is a plethora of help online but you probably should start at Home - Centers for Medicare & Medicaid Services to get it "straight from the horses mouth."
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Old 12-21-2014, 09:15 AM   #6
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Supplemental Plan F (not the high deductible version) is the best, especially if you or your wife has a chronic health problem (ask me how I know).

Part D varies in cost and typically has a $325 deductible to start, then there is the doughnut hole encounter for those that need a lot of meds. Read about it.

Search here or on Bogleheads as there are a lot of threads on Medicare.
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Old 12-21-2014, 09:40 AM   #7
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Is your plan to get an ACA plan between the end of COBRA and the beginning of Medicare? Also, is your wife the same age as you? Unless you have birthdays in the same month - one of you will go on Medicare prior to the other.
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Old 12-21-2014, 09:46 AM   #8
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Is your plan to get an ACA plan between the end of COBRA and the beginning of Medicare? Also, is your wife the same age as you? Unless you have birthdays in the same month - one of you will go on Medicare prior to the other.
Good point, I wonder if the OP understands that Medicare coverage is per person and not like a dependent type insurance plan.
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Old 12-21-2014, 10:23 AM   #9
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I know Part D is for prescriptions. Is there a maximum out of pocket expense for Part D?
IMO, this is probably where the greatest exposure under Medicare lies, since there is no out-of-pocket maximum on prescription drugs. There is a catastrophic phase after you pass through the doughnut hole at which point you pay a maximum of 5% of the cost of the drugs for the remainder of the year. If you are on an expensive cancer drug that costs $10,000 a month, it will cost you $500 a month while in the catastrophic phase. By the time you reach the catastrophic phase, you will have spent about $2,700 out-of-pocket on your drugs.
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Old 12-21-2014, 12:52 PM   #10
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Originally Posted by engr View Post
Good morning,

I am trying to come up with a reasonable line item estimate for when I get to 65 and apply for Medicare. Presently, I'm paying for Cobra at $1735/month, I am 61 years old.

I know Part A is "free" , Part B is approx. $105/mo.

The medicare supplement plan is variable. Looks to me that Plan F is probably the best choice (?) since it appears to be the most expensive. Is there anything better? I'm not a veteran.

My DW has a chronic condition so I need to have very good medical coverage.
Know that your Medicare coverage will not cover your wife. Medicare is for the individual receiving it, and each individual is separately covered. You wife can qualify based on your work record, but she must be 65 and any supplement programs will be separately applied.,

Ha
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Old 12-21-2014, 12:56 PM   #11
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Originally Posted by bingybear View Post
I'm not near the medicare time of life, but listening to my MIL.. part B and maybe D may be means tested. Thus you would have to take your tax situation into account for estimates. This would include RMD when you get to that point
This is correct. Both B and D will increase if your income 2 years earlier is above certain non-inflation adjusted levels, There are some exceptions that can be applied for.

Ha
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Old 12-21-2014, 01:02 PM   #12
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A supplemental policy for DH in the Tampa Bay area is $183. Moderate range drug plan is $49. Since he is such a low consumer of healthcare, he decided to go with an Advantage plan. Costs only the $105 Part B premium and max out-of-pocket annually of about $6,000. Dr. visit co-pay $15, specialist $60.
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Old 12-21-2014, 07:08 PM   #13
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A supplemental policy for DH in the Tampa Bay area is $183. Moderate range drug plan is $49. Since he is such a low consumer of healthcare, he decided to go with an Advantage plan. Costs only the $105 Part B premium and max out-of-pocket annually of about $6,000. Dr. visit co-pay $15, specialist $60.
There are reasons why Advantage plans are so cheap. Switching to a Supplemental plan later if one really needs good healthcare, etc, may be a big problem, and you may only get in with medical exclusions, if at all. MY BIL just had a heart transplant. Try that with an Advantage plan. Good luck!
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Old 12-21-2014, 07:11 PM   #14
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Originally Posted by aja8888 View Post
There are reasons why Advantage plans are so cheap. Switching to a Supplemental plan later if one really needs good healthcare, etc, may be a big problem, and you may only get in with medical exclusions, if at all. !
+1

I view Medicare Advantage plans as a one way transaction: once you get in you better hope you're happy with it because it may be almost impossible to get out.
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Old 12-21-2014, 07:28 PM   #15
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+1

I view Medicare Advantage plans as a one way transaction: once you get in you better hope you're happy with it because it may be almost impossible to get out.
My mother has been on MA plans since 65, and she is 82. She recently had a very mild stroke and they're all over her with care. She's happy with the care she's received. Then again, up until the stroke, she had almost no utilization other than routine check-ups and tests.
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Old 12-22-2014, 09:19 AM   #16
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Medicare Advantage vs. Medicare Supplement

Quote:
Do benefits change? Is the plan renewable?

Medicare Advantage:
Benefits may change yearly. You usually remain in a plan unless you disenroll during the Annual Election Period (AEP).

Medicare Supplement:
Benefits don't generally change. Guaranteed renewable as long as you pay the premium and the application was correct. No Annual Election Period (AEP) for Medigap plans. However, if you drop this plan, you might never get it again.
The Medicare Annual Election Period (AEP)
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Old 12-22-2014, 10:39 AM   #17
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The Medicare Advantage Annual Election Period (AEP) comes with "guaranteed issue rights" only during the first year of enrollment. This is known as the "trial right." If you attempt to go back to Medigap during a later AEP, you can be subject to higher premiums, pre-existing condition exclusions, and refusal to sell a policy. At that point, the person would need to qualify for a Special Enrollment Period (SEP) to retain their guaranteed issue rights.

guaranteed issue rights | Medicare.gov

Medigap & Medicare Advantage Plans | Medicare.gov
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Old 12-22-2014, 12:09 PM   #18
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One message for the Medicare Advantage plan people here to remember is that even though you are in good health at 65 when you sign on for the $104.90/month, everything's covered special plan is that you will get older and you will get sick, and maybe very, very, sick. And you will die at some point.

Having the ability to choose your doctors and procedures at age 65 and beyond is far more important that saving a few bucks each month on insurance costs.

At 65 is the time in your life, healthy or sick, to sign on and get the absolute best coverage and that would include the best Medigap policy available.
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Old 12-22-2014, 12:15 PM   #19
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Having the ability to choose your doctors and procedures at age 65 and beyond is far more important that saving a few bucks each month on insurance costs.
+1

This is one of the last places I'd cut back on spending if times got tough.
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Old 12-22-2014, 11:16 PM   #20
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There are reasons why Advantage plans are so cheap. Switching to a Supplemental plan later if one really needs good healthcare, etc, may be a big problem, and you may only get in with medical exclusions, if at all. MY BIL just had a heart transplant. Try that with an Advantage plan. Good luck!

Could you elaborate on this? I don't understand..do you mean that you get better healthcare access on a supplement plan than on the advantage plan? Aside from paying more out of pocket? Thanks.


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