Medicare

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Moemg

Gone but not forgotten
Joined
Jan 2, 2007
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I am not sure where this belongs so I posted it here . Since Gary is approaching Medicare and I'm a few years behind I started researching it . It is so confusing. Apparently if you have coverage through your former employer even the federal government your premiums will go up . Because not only will you still need your basic policy you will have to pay extra for part B . The good news is if your sickly you come out okay as your co-pays and non covered amounts will be covered . The bad news is if you are healthy you lose . The other thing that made me crazy is reading and figuring out the plans and what they cover . I have worked in health care for forty years and the literature on the medicare plans is enough to make me sip wine before Happy Hour . I have no idea how most people figure it out . Why can't they simplify this ?
 
Mr B just went through this exercise for his cousin, turning 65 in March. He had an insurance license a long time ago before he decided a BS in Accounting made more sense. :cool:

I tried to help him with fact finding in my capacity as resident expert Internet researcher. ;) I was astounded at the complexity of the Medicare site. :nonono:

I know he made a lot of phone calls to potential Plan B providers. Somehow he waded through all the mess and found an affordable Plan B option for his cousin.

Do you have a friend who was in the insurance biz?
 
I have Blue Cross hi-deductible, HSA. According to the annual fee schedule, the year I hit 65/MC, my premiums for the BCBS wrap-around policy drops almost 50% compared to my current policy. Of course MC premiums kick in but I still think I will see a major drop in premiums overall.
 
Rich_in_Tampa said:
I have Blue Cross hi-deductible, HSA. According to the annual fee schedule, the year I hit 65/MC, my premiums for the BCBS wrap-around policy drops almost 50% compared to my current policy. Of course MC premiums kick in but I still think I will see a major drop in premiums overall.
Click to expand...
Yes , People who privately insure do great with Medicare . The only ones that have increases are the people who already have insurance through their former employers because you still need that insurance and now you have an extra payment for Medicare B .
 
freebird5825 said:
was astounded at the complexity of the Medicare site. :nonono:

I know he made a lot of phone calls to potential Plan B providers. Somehow he waded through all the mess and found an affordable Plan B option for his cousin.

Do you have a friend who was in the insurance biz?
Click to expand...

The problem is not that I can not find a B plan it's that I am surprised I will be paying more for insurance at 65 instead of less . I will still need to have my BC/BS federal plan at $185 a month and then I will need a seperate plan B Medicare for more money . So basically my health care will jump by at least $150 when I am eligible for Medicare .
 
Moemg said:
The problem is not that I can not find a B plan it's that I am surprised I will be paying more for insurance at 65 instead of less . I will still need to have my BC/BS federal plan at $185 a month and then I will need a seperate plan B Medicare for more money . So basically my health care will jump by at least $150 when I am eligible for Medicare .
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I am not sure that I understand. There is only one Part B plan, the one sold to you by Medicare itself.

If your BC/BS plan drops to your 2ndary payer, I am surprised that the premium for it will not decrease. If your plan will not have to accept the strictures of Medicare, consider it a very good deal at the price you are paying.

Ha
 
Moemg said:
The problem is not that I can not find a B plan it's that I am surprised I will be paying more for insurance at 65 instead of less . I will still need to have my BC/BS federal plan at $185 a month and then I will need a seperate plan B Medicare for more money . So basically my health care will jump by at least $150 when I am eligible for Medicare .
Click to expand...

I don't understand the "less" comment.

When you are eligible for Medicare, your plan won't cover the Part B (doctors, labs, etc.), but may cover the donut hole -- if it still exists.

So based on the fact that you need coverage for Part B and it comes from Medicare and you are in an age group that has increasing medical expenses, your cost of coverage will go up -- not down.
 
Like Ha, I'm confused by your use of "Part B". These are the definitions I know:

What Is Part A (Hospital Insurance)?
Part A is hospital insurance that helps cover inpatient care in hospitals, skilled nursing facility, hospice, and home health care.

How Much Does Part A Cost?
Most people don’t pay a Part A premium because they paid Medicare taxes while working. This is called "premium-free Part A."

What Is Part B (Medical Insurance)?
Part B helps cover medically-necessary services like doctors' services, outpatient care, home health services, and other medical services. Part B also covers some preventive services. Check your Medicare card to find out if you have Part B.

How Much Does Part B Cost?
If you have Part B, you pay a Part B premium each month. Most people will pay the standard premium amount. Social Security will contact some people who have to pay more depending on their income. If you don't sign up for Part B when you are first eligible, you may have to pay a late enrollment penalty.

The OP seems to be talking about Medicare Supplement policies or "Medigap", which are sometimes provided by former employers.

"A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will pay both their shares of covered health care costs."
 
Moe, are you talking about those who had subsidized premiums while working now losing the subsidy plus picking up MC-B payments at retirement? That would definitely pinch but then again they had those subsidized payments up until then, so I guess it comes out in the wash.

Any way you look at it, it's a big hairy ugly premium.
 
Mo, I'm also confused how this works but I still have 3 years to worry about it. Maybe things will change in that time period. DW and I have a plan via her old job. We are lucky in that we only pay 10% or about $1900 at this point. We just had an increase of about $260 for the the full year bringing us to the $1900. I guess that this ins. will continue when I hit 65 but I have no idea what I'll need at that point. DW is 2 years behind me but we will most likely need to continue the ins when she turns 65 also.

I have no idea what we will need to purchase at that point, can anyone help?
 
Moemg said:
Yes , People who privately insure do great with Medicare . The only ones that have increases are the people who already have insurance through their former employers because you still need that insurance and now you have an extra payment for Medicare B .
Click to expand...

If you really believe this, couldn't you just drop your former employer's insurance? Not that I'm suggesting that you do that.........I find it hard to believe that (assuming your former employer is subsidizing the insurance) you could do better privately than w/ a group policy.

In my case, my former employer's insurance decreased from $81/mo. before Medicare to $57 after Medicare started at which point, it became secondary to Medicare which then cost something like $90/mo........so a net increase. Even though it cost more than just Medicare, I was happy to be a "loser".
Better that than to be in poor health and be a "winner".......isn't that how all insurance works. It is very comforting (your policy may differ) to have a max out of pocket cost in the 1-2K/yr range .

........and like others here, I'm a bit puzzled about your reference to the complexity of Medicare choices.........my impression is (your policy may differ) that I only had one choice....Medicare B. As others have mentioned, you may be mixing Medicare and Medicare supplement plans?
 
Sorry I caused some confusion .I have BCBS through the federal government . According to their web site I will still be paying the same amount at 65 . I will just pay an extra amount for Medicare B . The only choice I would have is to go to a lesser plan that way my premium would be reduced . While Gary who has private insurance will see a huge drop in cost at 65 mine will go up.Granted Medicare will cover my deductibles but they do not add up to the increase in cost. The other thing I discovered while researching Medicare is it is one confusing program . I can understand part A& B but then there is C& D and Medigap insurance . The booklet they send all the soon to be enroles is hundreds of pages long . You can see it online .
 
Moemg said:
I have BCBS through the federal government . According to their web site I will still be paying the same amount at 65 . I will just pay an extra amount for Medicare B . The only choice I would have is to go to a lesser plan that way my premium would be reduced . While Gary who has private insurance will see a huge drop in cost at 65. Granted Medicare will cover my deductibles but they do not add up to the increase in cost. The other thing I discovered while researching Medicare is it is one confusing program . I can understand part A& B but then there is C& D and Medigap insurance . The booklet they send all the soon to be enroles is hundreds of pages long . You can see it online .
Click to expand...
Just call HR and they will tell you what your setup will be. D is drug insurance, so with a good integrated plan from work you will have that covered. Your work plan must certify that your coverage is as good or better than the base Part D plan. C is also called Medicare Advantage, an alternate setup to a Medigap+ Part D insurance. With part C, although you still must pay your part B premium to Medicare, you get coverage directly from the Part C underwriter, and your doctors bill them only rather than Medicare and then your Medigap. However, all three do require that you be enrolled in Medicare Part A and Part B ("Original Medicare"), and and pay for part Medicare part B, at whatever rate your income and the year that you begin getting benefits dictates.

I think this is correct, but Gotadimple is the maven on these topics.

Ha
 
Moemg said:
Sorry I caused some confusion .I have BCBS through the federal government . According to their web site I will still be paying the same amount at 65 . I will just pay an extra amount for Medicare B . The only choice I would have is to go to a lesser plan that way my premium would be reduced . While Gary who has private insurance will see a huge drop in cost at 65 mine will go up.Granted Medicare will cover my deductibles but they do not add up to the increase in cost.
Click to expand...

Who has the better deal though (in absolute numbers)? Perhaps he is going from super high rates to high while you are going from super low rates to low?
 
Last edited by a moderator:
Luckily, I'm only 55. I'm sure they'll have this simplified and automatic by the time I get there.
 
haha said:
Just call HR and they will tell you what your setup will be. D is drug insurance, so with a good integrated plan from work you will have that covered. Your work plan must certify that your coverage is as good or better than the base Part D plan. C is also called Medicare Advantage, an alternate setup to a Medigap+ Part D insurance. With part C, although you still must pay your part B premium to Medicare, you get coverage directly from the Part C underwriter, and your doctors bill them only rather than Medicare and then your Medigap. However, all three do require that you be enrolled in Medicare Part A and Part B ("Original Medicare"), and and pay for part Medicare part B, at whatever rate your income and the year that you begin getting benefits dictates.

I think this is correct, but Gotadimple is the maven on these topics.

Ha
Click to expand...

Very Good, Ha! You've been to a Medicare Advantage sales seminar or two!

-- Rita
 
harley said:
Luckily, I'm only 55. I'm sure they'll have this simplified and automatic by the time I get there.
Click to expand...

Yes, it will be simplified and automatic by the time you get there harley. They'll automatically take possession of whatever weath/assets you own and provide you with a certificate for two aroma therapy sessions down at Louise's House of Happy Smells. You'll simply love it!
 
I went on Medicare last June. I was on my wives private insurance plan through her employer. It was a large group plan and I paid about $700 a month plus $20 when you visited a doctor or had lab work. I too felt overwhelmed by all of the various supplemental plans and Medicare Advantage plans. It did not take long to get past all of the smoke and mirrors.

I decided to go with the AARP supplemental and drug plan. My monthly costs are less then half of what the private plan was and I can see any doctor. The plan I had before was a HMO and I had to drive 70 miles one way to a doctor or hospital.

My monthly premiums are $110 to Medicare, $115 for AARP supplement and $40 for AARP drug plan. That totals $265 and I have yet to pay any copay's. I pay an average $8 for medications. Under my wives plan I paid $10 for medications. I now can see a local doctor and my drive is about 15 min same for a hospital or lab.

I LOVE MEDICARE!!!!!
 
The part D legislation implementation is horrible. It did provided drug coverage... but it was a giveaway to the drug companies (no ability to broadly negotiate drug prices) and the insurance companies had inconsistent coverage which resulted in a convoluted nightmare that was difficult to understand.
 
I am still confused about Medicare . If you have government retiree health insurance do you need Part B ?
 
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