Medicare Costs?

[Perryinva]

There are so many individual variables, and many are based on where you live and age. @65, I pay $127 for G and D, but I have a pension benefit subsidy that reimburses $1000/yr (for each of us) towards that, as long as I use their approved broker, called Via Benefits, so net yearly cost is only about $500 vs $1500, added to the $165/mo Part B. For US healthcare insurance costs, I find ours palatable. Plus I can charge the supplement and get a few extra points, LOL.

 

[ERhoosier]

Medicare costs (premiums plus OOP) can come as a real shock to those who had generous employer-paid health insurance OR who mistakenly expect it to be almost free care. Especially for those who may be subject to IRMAA (which kicks in for single filers at as low as $97k MAGI- and that MAGI includes taxable and non-taxable incomes).


Having been on high-deductible employer-based plans, COBRA, and ACA over recent years, DW & I found total Medicare costs (traditional MC + G and D supplements, and OOP copays/non-covered items) to be somewhat lower. HOWEVER dental and vision costs went up significantly (still looking for decent dental & vision options that are cheaper than just paying directly OOP).

 

[FiveDriver]

We have the AARP Plan N. When we signed up, we were living in California, and the monthly cost difference was something like $95 for N and $150 for G. We were very healthy and might have 4 doctor visits a year, some of which had no copay as they were for "preventive" things. So we went with N.

We're now older and in Indiana, so I suspect the price difference is not so much. This plan is community-rated (preferable to age-rated) but there is a "discount" you get when you sign up at 65 that fades by a few percent every second year. Now at 72/74 we pay $282 per month total.

But the copay is not $20, it's "up to $20" and a lot of office visits are priced under $100, so the copay might be $14-18. Also, we have never seen an "excess charge" which is a 15% markup that some doctors are permitted to make, so that doesn't seem to be an issue.

So do the math. The other thing is that you are always permitted to change to a less-beneficial plan (e.g., G to N) but might need to undergo underwriting to go the other way, except in the states that permit it on request.

We have the cheapest (under $5 each) Aetna SilverScript Part D plan; 5 of our 6 meds are $5 for 3 months each. The other is a Tier 3 that is cheaper via GoodRx ($45), Amazon Pharmacy ($38), and now costplusdrugs ($18).

Thanks for posting this. That's solid information, with dollar figures attached for comparison. We're also looking at Plan N vs Plan G-HD.

Does the High Deductible piece throw any surprise bills your way ??

 

[ShokWaveRider]

I am not sure and have never understood why those of us at Medicare age try to save a nickel and a dime on their healthcare. Especially those on this site. It is the SINGLE most important thing we need in our dotage. AND, it is what it is, which is very rate for the USA with middlemen everywhere trying to get their hand on our stashes.

Real "Original" Medicare is the same for everyone, nothing more nothing less, you know in advance what all your health care service costs will be in any given year, especially if you have the Part G Supplement.

Drugs are another story, but we are getting better. Sooner or later, it will sort itself out and be beneficial for all.

Insurance Companies and the purveyors of the Faux Medicare Part C should not be allowed to use the name, it is NOT Medicare, it is outright deceiving.

 

[Gotadimple]

Insurance Companies and the purveyors of the Faux Medicare Part C should not be allowed to use the name, it is NOT Medicare, it is outright deceiving.

Just a point of clarification. Your government is here to help you.

Medicare Part C is a program of the U.S. Government and the 'purveyors' are approved by the Centers for Medicare and Medicaid to sell them. It is everything Traditional Medicare is but because the insurance companies are responsible for all costs they have some different rules they can use to manage the cost of care, and they are required to offer some services not included in Traditional Medicare. A Medicare Insurer cannot sell them or provide claims service without a contract with the government.

Part C was started when the CMC was looking for someone to take some of the cost of providing care - so they created this risk-based program where insurers get paid a part of the Part B premium for providing coverage and are on the hook for all costs.

Does it save money? Probably not, but something is better than nothing.

Still not happy with it? Write your representative and senators.

 

[Teacher Terry]

My plan F went up yearly and was costing me 200/month. Luckily my state has the birthday rule so I went to plan G with the same company and it costs 151/month. However, my employer gives me 195/month towards all my premiums so I’m only out of pocket 133/month. I totally forgot about my subsidy until others mentioned theres.

 

[Koolau]

There are so many individual variables, and many are based on where you live and age. @65, I pay $127 for G and D, but I have a pension benefit subsidy that reimburses $1000/yr (for each of us) towards that, as long as I use their approved broker, called Via Benefits, so net yearly cost is only about $500 vs $1500, added to the $165/mo Part B. For US healthcare insurance costs, I find ours palatable. Plus I can charge the supplement and get a few extra points, LOL.

We have a similar set-up from megacorp who gives us some money each year to be used toward any of our medical expenses (premiums or co-pays, OOP, etc.) Kinda nice but it's saving megacorp a bundle over the old method where they supplied our medicare supplement for a very discounted rate. I guess I can't complain except our "stipend" barely rises, year over year.

 

[athena53]

A previous employer (not one I retired from, unfortunately) stopped providing retiree health insurance but provided a stipend fixed at their costs in the year they stopped (around 2013). Better than my brother's previous employer, which just plain dropped it- including for current retirees.

 

[Koolau]

A previous employer (not one I retired from, unfortunately) stopped providing retiree health insurance but provided a stipend fixed at their costs in the year they stopped (around 2013). Better than my brother's previous employer, which just plain dropped it- including for current retirees.

Megacorp had a policy statement for as long as I can recall to the effect: "This benefit may be discontinued at any time..." As mentioned, I consider it a real blessing that they have continued to support empl*yees and retirees with medical insurance or assistance in obtaining insurance.

It's true that, over the years - as medical costs have steadily outpaced normal (and abnormal) inflation, Megacorp has slowly chipped away at the benefit. BUT, they have steadfastly striven to be certain that their people can get medical insurance at some price. I often give thanks for that. I hope it continues, though on MC, the heaviest lifting has been done. Between ER and age 65, medical insurance can be a killer without access. Making it a "benefit" to be able to obtain insurance is just about my most important legacy from megacorp IMHO.

 

[swabby01]

While you are looking at Medicare costs don't forget to calculate in the IRMAA - it can be a BIG adder if you managed to save for a revenue stream at retirement. Seems like BS to me in that I paid in the max for over 30 years and now pay more for the same coverage as others get

 

[Midpack]

Medicare costs (premiums plus OOP) can come as a real shock to those who had generous employer-paid health insurance OR who mistakenly expect it to be almost free care. Especially for those who may be subject to IRMAA (which kicks in for single filers at as low as $97k MAGI- and that MAGI includes taxable and non-taxable incomes).

I don't disagree with your statement at all.

But we're all adults here, and anyone who thought Medicare would be as cheap as most HC company contributions (typically 0-20% of actual cost) is willfully ignorant. We were certainly told what HC actually cost Megacorp while we were working, employees have access to EOBs, and there have been countless articles comparing the HC cost per capita of the USA vs other countries. Anyone who didn't bother to look into what HC would cost in retirement in advance, has only themselves to blame. Flame away...

 

[athena53]

Anyone who didn't bother to look into what HC would cost in retirement in advance, has only themselves to blame. Flame away...

No flames here but this Board is a different group. (It's the reason it's now the only one where I participate.) Too many people out there think Medicare is "free" or that they'll just wait till they get an expensive health issue and then sign up for B and D.

 

[MichaelB]

I don't disagree with your statement at all.

But we're all adults here, and anyone who thought Medicare would be as cheap as most HC company contributions (typically 0-20% of actual cost) is willfully ignorant. We were certainly told what HC actually cost Megacorp while we were working, employees have access to EOBs, and there have been countless articles comparing the HC cost per capita of the USA vs other countries. Anyone who didn't bother to look into what HC would cost in retirement in advance, has only themselves to blame. Flame away...

I think you are being too harsh. We learned with the ACA that most our our population is uninformed regarding the cost of health care and the complexities of health care insurance. I agree it is incumbent on each of us to learn the real cost of health care and the workings of insurance as we plan for our retirement but it isn’t easy, especially for someone who worked a lifetime with employer provided heavily subsidized coverage.

 

[CRLLS]

Frankly, both the corporate and ACA plans that I had over the years included up to a 20% copay on my part. If I wanted a lower copay I paid more for it. Medicare itself has a similar 20% Copay and is not limited to the often required networks that many corporate and ACA plans include. Medicare costs being tossed about here include some sort of Supplement that covers much or all of the copay. Of course that extra coverage comes at a price. In order to compare Medicare with Corporate or ACA one must keep the coverage the same to have any meaningful.

 

[Koolau]

I don't disagree with your statement at all.

But we're all adults here, and anyone who thought Medicare would be as cheap as most HC company contributions (typically 0-20% of actual cost) is willfully ignorant. We were certainly told what HC actually cost Megacorp while we were working, employees have access to EOBs, and there have been countless articles comparing the HC cost per capita of the USA vs other countries. Anyone who didn't bother to look into what HC would cost in retirement in advance, has only themselves to blame. Flame away...

I don't disagree with your statement either - except I never expected to have fear of IRMAA. Now it's a major concern to me as I attempt to "drain" my 401(k). It's true we're all responsible for our own situations (both paying taxes and UNDERSTANDING tax situations.) BUT, it's complicated and there are competing tax situations/thresholds, etc.

Did I mention it's complicated? Of course, some folks here live and breath this stuff and eat it for breakfast. I do not. Much of it is new to me though I've heard of it all before. YMMV


Oh, and I'm an adult.

 

[badatmath]

My employed and retiree insurance has always been 90/10. I think 20% copay seems high though I knew it was the case for Medicare. I have no idea what other employers used.

 

[teej1985]

Medicare costs (premiums plus OOP) can come as a real shock to those who had generous employer-paid health insurance OR who mistakenly expect it to be almost free care. Especially for those who may be subject to IRMAA (which kicks in for single filers at as low as $97k MAGI- and that MAGI includes taxable and non-taxable incomes).


Having been on high-deductible employer-based plans, COBRA, and ACA over recent years, DW & I found total Medicare costs (traditional MC + G and D supplements, and OOP copays/non-covered items) to be somewhat lower. HOWEVER dental and vision costs went up significantly (still looking for decent dental & vision options that are cheaper than just paying directly OOP).

https://www.physiciansmutual.com/web/dental

 

[CRLLS]

My employed and retiree insurance has always been 90/10. I think 20% copay seems high though I knew it was the case for Medicare. I have no idea what other employers used.

Correction in terms, I meant co-insurance not copay. Back when I was covered by an employer plan, the base plan's co-insurance was 20%. I could buy a higher coverage plan for higher premium or could get an HMO plan for less.

Even under ACA, the co-insurance is:

Bronze=40%
Silver = 30%
Gold=20%
Platinum=10%

I believe that both employer plans and ACA typically have a MOOP where traditional Medicare alone does not.

I read one report where the average Coinsurance for employer plans was 19%. I don't know what type or coverage those plans in their survey were.

 

[badatmath]

Oh I guess I meant coinsurance too. I pay 10% after the deductible is met so somewhat like a platinum I guess. I never used ACA (yet).

 

[Rianne]

I got a notice in the mail yesterday that my Part D perscription plan premium for 2024 will be $0. The deductible went up $45 and the benefits overall improved regarding various drug classes.

 

[TheWizard]

While you are looking at Medicare costs don't forget to calculate in the IRMAA - it can be a BIG adder if you managed to save for a revenue stream at retirement. Seems like BS to me in that I paid in the max for over 30 years and now pay more for the same coverage as others get

Your irritation is misguided.
I'm perfectly ok with letting low-income retirees have a discount on healthcare...

 

[grayv]

I got a notice in the mail yesterday that my Part D perscription plan premium for 2024 will be $0.

what plan / company?

 

[pb4uski]

$506/mo is ONLY for part A (when having less than 30 quarters working credits), Part B is on top of that. Add on medgap, and you're up to over $1000/mo plus quite a bit out of pocket costs.

I don't think $1000/mo is a bargain for these people that won't even have any SS income! Think about that.

I'm fortunate like most of this forum to have premium free Part A.....

Well, to begin with, we don't get "free Part A"... we prepaid for Part A over the 40 quarters + when we were paying payroll taxes. Your friends didn't prepay for Part A like we did which is why they don't qualify for "free Part A" like we do.

You have never been very transparent about why these friends of yours won't have SS or "free Part A" so it is hard to be sympathetic without knowing the facts of the situation. If they just immigrated to the US then they would not have paid in enough but at they same time they shouldn't expect anything. If they have been in the US for years but working under the table and didn't pay into SS then they shouldn't be surprised that they don't qualify for SS or for "free Part A".

 

[pb4uski]

....We were certainly told what HC actually cost Megacorp while we were working, employees have access to EOBs, and there have been countless articles comparing the HC cost per capita of the USA vs other countries. Anyone who didn't bother to look into what HC would cost in retirement in advance, has only themselves to blame. Flame away...

That and cost of employer-sponsored health coverage has been reported to employees on form W-2 for informational purposes since 2012, so employees have had a decade to appreciate what this benefit costs their employers.

 

[Happyras]

Thanks for posting this. That's solid information, with dollar figures attached for comparison. We're also looking at Plan N vs Plan G-HD.

Does the High Deductible piece throw any surprise bills your way ??

I think I posted this before, but we have HD plan G now for the past 2 years. The gotcha is when you have a $2700 deductible versus a $226 deductible, nothing else.

Since you will easily cover the $226 in one or two office visits it boils down to paying $150/month less for the HD G versus the G plan premium. That for us is $1800/year savings. The issue is when you eat up the savings in one ER visit or one hospital stay. You saved $1800 in premium but paid $2700-$226=$2474 more in OOP deductible. So the HD G costs you $2474-$1800=$674 more in that case.

My wife just went into the ER, Ambulance to another ER, then 6 nights in the hospital. The ER alone was billed at $8000 under part B, but should be billed under part A as she was admitted. All the docs are under Part B. The part A deductible along with Part B doc copays met the max $2700 deductible for part G.

Myself, I have only paid my first $200 of the $2700, but expect with a demotology visit and 20% copay, I may be under $1000 of the deductible this year. That saves me some, but you then I could end up in the ER and blow through any savings in one visit.

We will likely go back onto full plan G next year, the premium savings from HD G is not worth the general risk. My wife has ended up paying more with the HD G each year than just staying with the regular G deductible.

I might add that with the IRMAA we each pay, the Part B and D premiums for us exceed by far the Cobra costs pre-medicare so the Part G premium is pale in comparison to what we pay for basic medicare.