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12-21-2014, 06:45 AM
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#1
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Recycles dryer sheets
Join Date: Jul 2009
Posts: 68
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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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12-21-2014, 06:53 AM
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#2
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Thinks s/he gets paid by the post
Join Date: Dec 2014
Posts: 2,511
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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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12-21-2014, 08:07 AM
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#5
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Dec 2007
Location: Denver, Colorado
Posts: 6,258
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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."
__________________
"It's tough to make predictions, especially when it involves the future." ~Attributed to many
"In theory, there is no difference between theory and practice. But, in practice, there is." ~(perhaps by) Yogi Berra
"Those who have knowledge, don't predict. Those who predict, don't have knowledge."~ Lau tzu
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12-21-2014, 08:15 AM
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#6
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Moderator Emeritus
Join Date: Apr 2011
Location: Conroe, Texas
Posts: 18,727
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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.
__________________
*********Go Yankees!*********
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12-21-2014, 08:40 AM
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#7
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Moderator
Join Date: Apr 2012
Location: San Diego
Posts: 14,211
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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.
__________________
Retired June 2014. No longer an enginerd - now I'm just a nerd.
micro pensions 6%, rental income 20%
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12-21-2014, 08:46 AM
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#8
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Moderator Emeritus
Join Date: Apr 2011
Location: Conroe, Texas
Posts: 18,727
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Quote:
Originally Posted by rodi
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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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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*********Go Yankees!*********
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12-21-2014, 09:23 AM
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#9
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Thinks s/he gets paid by the post
Join Date: Aug 2006
Posts: 2,433
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Quote:
Originally Posted by engr
I know Part D is for prescriptions. Is there a maximum out of pocket expense for Part D?
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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.
__________________
I'd rather be governed by the first one hundred names in the telephone book than the Harvard faculty - William F. Buckley
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12-21-2014, 11:52 AM
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#10
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Apr 2003
Location: Hooverville
Posts: 22,983
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Quote:
Originally Posted by engr
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.
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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
__________________
"As a general rule, the more dangerous or inappropriate a conversation, the more interesting it is."-Scott Adams
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12-21-2014, 11:56 AM
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#11
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Apr 2003
Location: Hooverville
Posts: 22,983
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Quote:
Originally Posted by bingybear
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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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
__________________
"As a general rule, the more dangerous or inappropriate a conversation, the more interesting it is."-Scott Adams
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12-21-2014, 12:02 PM
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#12
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Thinks s/he gets paid by the post
Join Date: May 2006
Location: Orlando
Posts: 2,655
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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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12-21-2014, 06:08 PM
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#13
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Moderator Emeritus
Join Date: Apr 2011
Location: Conroe, Texas
Posts: 18,727
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Quote:
Originally Posted by Buckeye
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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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!
__________________
*********Go Yankees!*********
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12-21-2014, 06:11 PM
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#14
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jun 2002
Location: Texas: No Country for Old Men
Posts: 50,021
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Quote:
Originally Posted by aja8888
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. !
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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.
__________________
Numbers is hard
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12-21-2014, 06:28 PM
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#15
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Thinks s/he gets paid by the post
Join Date: Jan 2008
Posts: 1,495
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Quote:
Originally Posted by REWahoo
+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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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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12-22-2014, 08:19 AM
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#16
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Dec 2007
Location: Denver, Colorado
Posts: 6,258
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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.
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The Medicare Annual Election Period (AEP)
__________________
"It's tough to make predictions, especially when it involves the future." ~Attributed to many
"In theory, there is no difference between theory and practice. But, in practice, there is." ~(perhaps by) Yogi Berra
"Those who have knowledge, don't predict. Those who predict, don't have knowledge."~ Lau tzu
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12-22-2014, 09:39 AM
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#17
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Thinks s/he gets paid by the post
Join Date: Jan 2014
Posts: 1,181
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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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12-22-2014, 11:09 AM
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#18
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Moderator Emeritus
Join Date: Apr 2011
Location: Conroe, Texas
Posts: 18,727
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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.
__________________
*********Go Yankees!*********
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12-22-2014, 11:15 AM
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#19
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jun 2002
Location: Texas: No Country for Old Men
Posts: 50,021
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Quote:
Originally Posted by aja8888
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.
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+1
This is one of the last places I'd cut back on spending if times got tough.
__________________
Numbers is hard
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12-22-2014, 10:16 PM
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#20
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Thinks s/he gets paid by the post
Join Date: Aug 2009
Posts: 1,578
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Quote:
Originally Posted by aja8888
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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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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