How much is Medicare and all that goes with it?

I realize the answer can vary based on many factors and the specifics of the plans you purchase, but one thing I don't see discussed much is how much Medicare costs. Everyone talks about their healthcare costs until they qualify for Medicare, but there isn't nearly as much discussion about what happens once you're on it.


I'd love to see some real life example of what people are spending for basic Medicare, supplements, drug plans, and any other add-ons and bells and whistles that are out there.

Joint Income <$178K: - medicare - $148
Advantage Plan Plus Drug plan $14/mon for two of us.
The advantage plan is by my ex-employer Lucent/Nokia with United Healthcare.

The UHC Advantage Plan has max out of pocket/person is ~$3,300. The medical deductible is ~$295 and Drug Deductible ~$495/person/year. The drug has a donut provision but so far (75 and 74 years old) we have not reached that.

My wife did go through three cancer surgery and failed chemo but out of max out of pocket was ~3,000.
 
ivinsfan - My point was that I was promised in writing free healthcare for life and the US government reneged on it. I would use the Tricare Overseas but it is essentially useless. There are over 500,000 military retirees living as expats (that alone should tell you something) and all of us get this extremely sucky medical coverage when we leave the US. It is a disservice to us to deliberately make the service provided useless. It is much worse for retirees living in places like the Philippines where every visit has to be to a designated physician or service because of the massive fraud there. Same for Mexico etc.

This is all with a military budget (if you include blacks ops) higher than $1 trillion a year but not enough to provide promised healthcare to retirees who served their lives for this country fighting the never-ending wars. The same for the Veterans who didn't retire but have service incurred disabilities. So, yes the citizens must pay for this but in fact don't pay as they should. We give better coverage to illegal immigrants than veterans and also paid by the citizens. However, historically all militaries are treated like this throughout the ages so it is not new. The US is no different than anyone else with the exception of being the only modern country without a national health service and that will not change because of the way politics is run in the US.

What boggles my mind are the numbers provided here by others for medical coverage. Jeeez! Over $10k a year for a married couple and this is the cheapest medical coverage in the US just blows my mind. It seems to me Americans have been slow boiled to accept these costs as normal. The main reason I bagged using Tricare other than it being so awful, is it is too expensive relative to actual costs. We have had major medical problems and none ever exceeded $1,000 and our totals for a year including expensive prescrition medications for my wife's heart condition, never exceed $3k a year.

As an example, I just recovered from a calamitous bicycle accident where I crashed into a fence (my fault as my brakes failed I had to choose between a truck or the fence), broke a wrist, collar bone, 3 fingers and crushed my right leg causing massive hematomas. I went by ambulance to the local medical center, got tested for COVID, a series of x-rays, tetanus shot, treated and released all within 2 hours. The total cost was roughly $150. This is typical for us and we never have exceeded our costs for Part B and not even close to the TRICARE costs and deductibles. I will probably get Hungarian citizenship next year and can then purchase the National Health coverage for the $25 a month and has zero co-pays or deductibles. Our medications as non-citizens is higher than what Hungarians pay for the same medications but even so, it is 90% (or more) less than what you pay in the US.

I will add also that things you take for granted which are cost reduction (profit increases) that don't exist outside the US like using nurses and PA's in lieu of physicians. PA's don't exist outside the US at all. Here nurses do nursing for inpatient care and nothing else. Everything here is done by a doctor. All medical specialists have a PhD in their field and also do clinical research and are bonafide experts in their fields. It is very interesting. For example, you get an x-ray, CT scan, MRI, etc. a radiologist takes it and reads it on the spot. No waiting for someone to read it sometimes weeks later. My mother when she lived here with us (she died last year at 95) had chronic urinary tract infections all her life. I took her to the medical center here (no appointment as it is first come - first served) and she saw the Urologist on duty a woman physician of about 65 years of age (who spoke Russian as a second language as she was trained in Moscow). I speak a small amount of Russian as my wife is Russian and very poor Hungarian so we got by. The wait was maybe 45 minutes or so. The woman doctor examined her and did an abdominal ultrasound on the spot, then performed a suprapubic tap to get clean sterile urine, did the lab tests herself on the spot, then treated her. I was in the room the entire time. My mother was freaked out about the whole thing as it was fast and no-nonsense and I had barely enough time to explain what was going on. Something very unusual compared to American medical practices. The whole visit took maybe 20 minutes. Her prescription was a specific set of herbal teas we got filled at our local farmer's market that has an herbologist store in it. My mother was cured after that as long as she had this tea every day. The cost for the visit was under $20. The teas were maybe $10 a month. This is typical. This was a woman that was always on more or less permanently constant doses of antibiotics most of her adult life and something as simple as an herbal tea fixed her problems. I had a similar experience for gastric reflux disease and my treatment was special Hungarian natural alkaline mineral water that you can buy at any grocery store here for about $0.50 a bottle. You get heartburn then drink a small swig of the water and it is gone immediately. I was drinking maybe a bottle a week. It completely fixes the problem and has zero side effects, unlike American pharmaceuticals. My problem is now completely cured after going to a ketogenic diet. In Europe, they still practice natural health care and are very shy of prescribing anything pharmaceutical unless absolutely necessary. If you get injured or have surgery you won't get pain killers any stronger than Ibuprofin here and even then in small amounts. Europeans, especially eastern European ones, know how to suck it up and take it.
 
Old Micro, it sounds like all medical care is so cheap that it doesn’t matter if you have the military pay or not. In addition, I don’t see how the US can be expected to be easy to use their military insurance no matter what country you retired to because of all the differences between countries.
 
When an expat is on Medicare they don't get the same coverage either..being an expat has consequences .you might not like it but that doesn't change it
 
Old Micro, it sounds like all medical care is so cheap that it doesn’t matter if you have the military pay or not. In addition, I don’t see how the US can be expected to be easy to use their military insurance no matter what country you retired to because of all the differences between countries.

When an expat is on Medicare they don't get the same coverage either..being an expat has consequences. You might not like it but that doesn't change it

+1
 
Teacher Terry - I agree BUT we have military bases in 185 countries so this shouldn't be a big problem. We spend a lot of money at each base in local currency in local languages so shouldn't be a big problem to do the same for medical. They have to provide local medical anyway for soldiers and contractors stationed there as small bases have no intrinsic medical capabilities.

The problem for expat retirees is that they sub-contracted this specific service to a company International SOS in 2020 (maybe an improvement). From the contract: “International SOS has practical experience delivering quality-assured, patient-centered care overseas. Strengthened by its established relationships with U.S. Military leadership worldwide, International SOS is committed to ensuring force health readiness with access to safe, high quality, reliable care and a positive patient experience. Leveraging a strong, established network, combined with on-the-ground resources who are familiar with the local culture and medical practices in-country, beneficiaries will have a sense of comfort and assuredness from the beginning to end of their medical encounters, regardless of where they are receiving care overseas.”

So, the statement is entirely hype. I have made several Congressional complaints and got palliative replies and no improvement in service. Many (thousands) have complained and Congress has taken no steps to improve this problem.

My issue is to retain my retired military medical benefits I earned through 40 years of service I must pay for Medicare Part B. If I were to pay for both of us we would get zero return on our payments. But, if I don't I lose my retiree healthcare benefit for life. As you say, in our case medical is cheap and we decided to not pay the Part B and forfeit my retiree coverage for life.

Many people are unaware that prior to 1959 the military was not included in social security. Because the SSA was underfunded they included the military into it that incurred an obligation to provide these services to the military in addition to military retirement benefits. Later when the military claimed to be underfunded again (what a farce) they moved the military into Medicare to shift the costs to that program instead of coming out of the military budget. Prior to that, we received the exact same health care as active-duty soldiers without any copayments of costs. Senator McCain is who sponsored the Bill that caused these changes but it was Congress that voted it in. However, they "forgot" about all the military living overseas. Expat soldiers (and active duty dependents) had an insurance program called CHAMPUS that covered us very well but that was changed to TRICARE and the overseas component to TRICARE Overseas. There has always been a problem for medical coverage for soldiers and their families living and working in remote areas (including rural US) so they have an "insurance" system to cover these problems. It is not sufficient and is a serious financial drain on military families as they do not cover all costs at all. It is not the soldier's fault to be stationed in some isolated remote place but the burden passes to them which is IMHO unfair. Retirees are just an extension of this problem. Additionally, many people are unaware of this but military retirees are not actually retired. We are being paid for future service in the case of recall and we are subject to maintaining military standards to include obeying the laws in the Uniform Code of Military Justice (UCMJ) for the rest of our lives. Legally, it is not a pension (although in divorces it is considered as such). Case law is all over the place on this issue but basically, we are still in the military and subject to recall with 96-hour notice. I have been recalled twice since retirement. The first time was exactly the next day after I retired for an overseas deployment in a combat area. I was flabbergasted. Luckily, for me, we were recalled from Sicily en route to the ME 10 days into the deployment. I was the commander of that particular mission (Biowarfare agent aerosol detection). So, I maintain military fitness standards and obey military law. Happily, I haven't been recalled for the past 15 years so I think I am out of the woods now.
 
I can add that one huge problem is retirees are living longer. When I was an enlisted soldier on casual status (waiting for orders) in 1972, I worked as a technician in a research project determining the mean age of death and causal relationships for military retirees. In 1972 the mean age of death for a military retiree was 47 years old. The military was a hard life and this included veterans of WWI and II, Korea and Vietnam. Alcoholism and inadequately treated combat injuries plus suicides etc. had a severe toll on military retirees. Things improved dramatically when this was addressed systematically and veterans/retirees now have life expectancies close to regular civilians. The problem is the budgets were all determined based on lower life expectancies than reality as things improved. So, the number of retirees dramatically increased that stressed the system. It is for this reason that Congress felt the need to shift us to Medicare. But, our payments are ONLY Part B (nothing else and drugs can come from military medical facilities). In practice, this seems to work out in the US but not for anyone living outside the US.

As you say these are the choices we make which have consequences. That said I will never return to the US willingly.
 
me too Aetna Med ADvantage

This is going vary wildly from person to person depending on retirement benefits. For me:

148.50 - Part B
0.00 - Medicare Advantage PPO (retirement benefit)

Total for year - 1,782

me too 148.50 part B
-0- for my Aetna Med advantage
had an accident last year traveling .hospital visit , drugs etc my out of pocket was 50 bucks total well worth it .I get 200 $ free over the counter each year from any CVS so Im ahead
 
I can add that one huge problem is retirees are living longer. When I was an enlisted soldier on casual status (waiting for orders) in 1972, I worked as a technician in a research project determining the mean age of death and causal relationships for military retirees. In 1972 the mean age of death for a military retiree was 47 years old. The military was a hard life and this included veterans of WWI and II, Korea and Vietnam. Alcoholism and inadequately treated combat injuries plus suicides etc. had a severe toll on military retirees. Things improved dramatically when this was addressed systematically and veterans/retirees now have life expectancies close to regular civilians. The problem is the budgets were all determined based on lower life expectancies than reality as things improved. So, the number of retirees dramatically increased that stressed the system. It is for this reason that Congress felt the need to shift us to Medicare. But, our payments are ONLY Part B (nothing else and drugs can come from military medical facilities). In practice, this seems to work out in the US but not for anyone living outside the US.

As you say these are the choices we make which have consequences. That said I will never return to the US willingly.
Old, you have high jacked this topic. Start your own thread if you want to continue this rant.
 
I live in Mexico where Medicare is not accepted so we have private insurance here that runs about $3,500/yr for both of us. It nearly doubled with Covid and my turning 66. I have A free with $1500 deductible and pay $149 for B. I’m analyzing whether to have a hernia repair done here in Mexico or the US. I have very good doctors here btw. Does anyone have an idea what the Co-Pay would run? My deductible
In Mexico is $3,000 and 10% Co-Pay. I need to decide quickly as I leave for the USA in 2 weeks and my premiums is due in Mexico and I’m
Debating increasing the deductible to lower the price.
Thanks
 
The normal copay for Medicare in the US is 20% unless you have a Medicare supplement (the supplement covers the copay). If no Medicare supplement it would probably be less expensive for you to get the hernia surgery in Mexico because the doctor/hospital fees will be much less than in the US. You may want to wait to after you have the surgery to increase your deductible on your Mexican insurance.
 
Part B - Original Medicare $148.50 per month
Medigap Supplement Plan G $105.37 per month
Part D - Drug Plan $17.20 per month
 
Thanks &#55357;&#56911; I’m thinking the same & my agent just called to say my Mex deductible now is only $2,000 and 5% co pay on what would be about $3,500 total cost. There is a hernia specialist in Boston that I hope to meet with to get an opinion on mesh repairs.
 
Are medigap policies still considered to be "stress free"? As in everything is covered, no surprises, no denials of claims? I currently have a Medicare Advantage plan, and I am spending time to make sure everything is coded right, in network, needs pre-authorization, etc. The medical portion has worked out fine so far, perhaps due to my diligence. But the dental portion (Blue Cross Dental) screwed me over by saying something was covered, then denying it with fine print later. A big bill, of course. I'm thinking of changing over to a Medigap policy N, which was $105 per month for me 2 years ago. I remember seeing some complaints here about a medigap policy denying some medication claims, but not other medical claims. So my question again: is Medigap still considered "stress free".?
 
Not sure any medical insurance can be classified as "stress free". However, a medigap policy is reasonably straightforward in that if Medicare pays for something, a medigap policy will pay its portion, subject to the provisions of the plan of course (Plan N has $20 or $50 copays, for example). No denials due to fine print.
 
Thank you for this thread and info. Its crazy my ACA premium has been $0 the last 3 years with a high out of pocket maximum per year. I am healthy so I've done well. When the new covid bill went thru I now have a $0 deductible(but still high out of pocket maximum). I could have switched to a out of pocket maximum plan of only $1400 but it would have affected how much I convert to a Roth IRA so I didnt switch to that plan last month. I probably will take that plan next year if its available. The premium would have been 4 cents a month. LOL. And doctor visits and drugs free.
 
Where are you living currently and how is the health care there?



I can add that one huge problem is retirees are living longer. When I was an enlisted soldier on casual status (waiting for orders) in 1972, I worked as a technician in a research project determining the mean age of death and causal relationships for military retirees. In 1972 the mean age of death for a military retiree was 47 years old. The military was a hard life and this included veterans of WWI and II, Korea and Vietnam. Alcoholism and inadequately treated combat injuries plus suicides etc. had a severe toll on military retirees. Things improved dramatically when this was addressed systematically and veterans/retirees now have life expectancies close to regular civilians. The problem is the budgets were all determined based on lower life expectancies than reality as things improved. So, the number of retirees dramatically increased that stressed the system. It is for this reason that Congress felt the need to shift us to Medicare. But, our payments are ONLY Part B (nothing else and drugs can come from military medical facilities). In practice, this seems to work out in the US but not for anyone living outside the US.

As you say these are the choices we make which have consequences. That said I will never return to the US willingly.
 
I would be very interested in SHIP volunteering. I am a retired Certified Financial Planner living in Mexico. Navigating Medicare options for Expats is particularly challenging and something I am in the throes of leaning now as I have a surgery in the near future and need to decide quickly whether to have that here in Mexico or when I am in the USA next month. Medical Tourism is a “thing” here and for good reason, the medical professionals put “care” back into health care. Until recently we lived here full time with only a month or so in the USA visiting family, however we are now looking at spending 4-5 months up north and so I will have access to care in both countries more readily. A recommendation for many living outside of the USA is to have Medivac in I the event we have an emergency situation.
 
Are medigap policies still considered to be "stress free"? As in everything is covered, no surprises, no denials of claims? I currently have a Medicare Advantage plan, and I am spending time to make sure everything is coded right, in network, needs pre-authorization, etc. The medical portion has worked out fine so far, perhaps due to my diligence. But the dental portion (Blue Cross Dental) screwed me over by saying something was covered, then denying it with fine print later. A big bill, of course. I'm thinking of changing over to a Medigap policy N, which was $105 per month for me 2 years ago. I remember seeing some complaints here about a medigap policy denying some medication claims, but not other medical claims. So my question again: is Medigap still considered "stress free".?

In my experience my Medigap policy (AARP UHC plan G) is stress free--if Medicare pays then the Medigap policy pays after I pay the $200 Plan G deductible. However dealing with Medicare itself is not stress free. Medicare has denied several claims I have because they were coded wrong. Also some procedures (like MRIs ) still have to be approved by Medicare. There is also the issue that Medicare does not pay for an annual physical (they just pay for an annual wellness exam which in my opinion is worthless). Then there is the Part D prescription drug coverage which is very complicated and overall a pain to deal with. I don't take any prescription drugs so I rarely have to mess with my Part D but DH does and it appears to me that his Part D plan pays very little on his drugs.
 
Sorry to hear of your bicycle accident. Hopefully you're fully recovered.

It's not just retired military expats that have a problem with the US medical system. I've "had it up to here" with this system that squeezes such a high percentage of our GDP and delivers crap if you want to stay healthy. If you're about to die, they do a pretty decent job. If you want to keep healthy so you don't get sick, you're on your own.

Where are you living currently and how is the health care there?
He's in Hungary, and there's great health coverage for reasonable prices there. The problem is that the system set-up for ex-military expats is fraught with problems, making it essentially unusable.

Back to the topic, DW is now 64 and I need to start studying the situation. She's got no health issues, no Rx. I guess the main decision is whether to do the advantage plan or not. Interesting about the availability of medigap upon signup. Lots to learn, but nice to see so many examples in this thread.
 
There is no Family Plan on medicare... everyone is treated like single payer...

you double the number if its you and spouse... so around $1100 or more total per month...

be careful about how much you report to the IRS... medicare uses the figures from the IRS two years back.... so if you made lots of money before you turned 65 you could end up with a large monthly bill you didn't count on... my medicare $148/mo was actually over $500/mo for the first year... then I had to watch how much money I pulled from the retirement funds to keep medicare down to $148.... for some reason the government likes to fine you if you actually saved money while working...

We had this issue also. Had a year where income was over $xxx in 16 and DW started Medicare in 18. Since it was a one year only bump I filed a form and included just completed 17 taxes (just 1040) and they adjusted our AGI or MAGI so she only had no IRMAA that year. Worth a couple minutes of your time if last year your I come was below one of the cutoffs for IRMAA.
 
Are medigap policies still considered to be "stress free"? As in everything is covered, no surprises, no denials of claims? I currently have a Medicare Advantage plan, and I am spending time to make sure everything is coded right, in network, needs pre-authorization, etc. The medical portion has worked out fine so far, perhaps due to my diligence. But the dental portion (Blue Cross Dental) screwed me over by saying something was covered, then denying it with fine print later. A big bill, of course. I'm thinking of changing over to a Medigap policy N, which was $105 per month for me 2 years ago. I remember seeing some complaints here about a medigap policy denying some medication claims, but not other medical claims. So my question again: is Medigap still considered "stress free".?

Several points to consider:
Since you currently have an Advantage plan you will have to transition back to original Medicare to purchase a Medigap policy. Medigap policies are medically underwritten which means you may not be able to get a policy. Make sure that you will be accepted by the insurer that issues the Medigap policy before cancelling your Advantage plan (if you choose to go that route).
Medigap policies are secondary payers to original Medicare which does not include dental. Medigap will not pay for dental.
Medigap policies do not pay for Medicare Part D prescription drugs.
A comprehensive Medigap policy is pure insurance that is the secondary payer for valid Original Medicare claims. The processing of a claim between Medicare and a Medigap policy should be seamless to the beneficiary.
 
Sorry to hear of your bicycle accident. Hopefully you're fully recovered.

It's not just retired military expats that have a problem with the US medical system. I've "had it up to here" with this system that squeezes such a high percentage of our GDP and delivers crap if you want to stay healthy. If you're about to die, they do a pretty decent job. If you want to keep healthy so you don't get sick, you're on your own.

He's in Hungary, and there's great health coverage for reasonable prices there. The problem is that the system set-up for ex-military expats is fraught with problems, making it essentially unusable.

Back to the topic, DW is now 64 and I need to start studying the situation. She's got no health issues, no Rx. I guess the main decision is whether to do the advantage plan or not. Interesting about the availability of medigap upon signup. Lots to learn, but nice to see so many examples in this thread.

When an individual turns 65 they can sign up for a Medigap policy without regard to their health status. The situation is a little different if the individual is still working and is receiving health benefits. Medigap policies can only be used with original Medicare.
 
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