Welcome to the wonderful world of Medicare - long rant

[ivinsfan]

Medical Underwriting for one - that basically forces people to buy expensive supplemental insurance when they probably don't need it.

Well there is no medical underwriting for health insurance...Medicare a little different and does means you sometimes pay more now for more complete coverage later...I agree that part is not ideal.

 

[Midpack]

Yes but if you look at all the studies, other countries spend a much lower percentage of their GDP on health care and with much better outcomes.



Plus, it's so simple even I can understand it.

Very true, but that has nothing to do with the relatively low cost of Medicare versus any other true cost option in the USA. Comparing Medicare to another highly subsidized plan isn’t valid. Lots of threads already on the high cost/poor outcome of US health care versus all other developed countries.

 

[Mr._Graybeard]

The problem I'm having is deciding which of these three is the best option:


Original Medicare, Part D Prescription and Plan G Supplemental
Original Medicare, Part D Prescription and Plan G Supplemental HD
Medicare Advantage - 3 different plans to consider


They all work out better in different circumstances but I have no way to predict what kind of coverage will actually be needed.


I'm thinking of going with the first option which has the highest base cost but the lowest possible maximum cost.

Talk to a health insurance broker or two. They really can help counsel you on the options that fit you best. They get paid by insurance providers (medigap and/or advantage), so it pays to get a couple of opinions at least.

I think the prevailing opinion on the board is to choose conventional Medicare over Advantage. But one size does not fit all.

 

[Chuckanut]

What plan did you go for?

I have Plan F which is no longer available. If I had to do it today I would go with Plan G.

 

[ERObjd]

if anyone is on here is retired military and on medicare or close to medicare age of 65, they can get Tricare for life which is the wraparound coverage plan for medicare and is no cost for retired military. You still have to pay medicare part B every month, but Tricare for life is free and picks up bill after medicare pays it's portion.

 

[JARON46]

Well there is no medical underwriting for health insurance...Medicare a little different and does means you sometimes pay more now for more complete coverage later...I agree that part is not ideal.

If you change your Medigap plan to a different company there is Medical underwriting. I don't know about every state but it is in Ohio.

I changed my plan G from one company to a different company and they asked me every medical question they could think of.

They accepted me at the new company because I did not have any medical issues.

 

[ivinsfan]

If you change your Medigap plan to a different company there is Medical underwriting. I don't know about every state but it is in Ohio.

I changed my plan G from one company to a different company and they asked me every medical question they could think of.

They accepted me at the new company because I did not have any medical issues.

I'm aware of this and was the point I made in my post//Medical insurance ACA is not Medicare. I clearly said Medicare is a little different.

 

[harllee]

My DH wanted to change from one Medicare Supplement Plan G to a Plan G with another company because his premium went way up but he was denied because of a preexisting condition. Now he is stuck with the higher premium.

 

[JARON46]

My DH wanted to change from one Medicare Supplement Plan G to a Plan G with another company because his premium went way up but he was denied because of a preexisting condition. Now he is stuck with the higher premium.

That is why I changed, I saved a little over $30 per month for Plan G with a different company.

 

[CardsFan]

My DH wanted to change from one Medicare Supplement Plan G to a Plan G with another company because his premium went way up but he was denied because of a preexisting condition. Now he is stuck with the higher premium.

Different states have different rules. In MO we a "birthday rule" allowing you to changes providers, at the same level, with no underwriting. I have not used it yet, as I just went on MC last August.

 

[REWahoo]

Harlee, medigap insurance companies are notorious for "closing the books" after a few years and no longer accepting new insureds on a particular plan, then raising rates, sometimes significantly. If this is the case for your DW, there is a one-time "get out of jail free card" your husband might be able to use to bypass this restriction provided 1) his current insurer has actually "closed the books" and is no longer accepting new insureds on his current plan 2) he has never been on an advantage plan and 3) his preexisting condition isn't end stage renal disease.

This thread discusses how it works in detail: https://www.early-retirement.org/forums/f38/medigap-underwriting-loophole-101243.html

 

[Poopycat]

My DH wanted to change from one Medicare Supplement Plan G to a Plan G with another company because his premium went way up but he was denied because of a preexisting condition. Now he is stuck with the higher premium.

Medicare supplement plans can deny people due to pre-existing conditions??

 

[CardsFan]

Medicare supplement plans can deny people due to pre-existing conditions??

Short answer, Yes. Or at least charge a premium.

BUT, it depends on what you have, what you want to go to, and your state.

If you have a Medigap plan, say Plan G, and want to go to a Medicare advantage plan, usually no problem. The other way around, underwriting can be involved, depending on your state and timing of the change.

Changing between Medigap plans is very state dependent.

NOTE: this does NOT apply to your first enrollment. In that case you must be accepted, with no underwriting or evaluation of pre-existing conditions.

FWIW, I am not an expert on this, but the above has been my experience. If I am wrong, please correct me.

 

[Katsmeow]

Honestly, I was ecstatic when I became eligible for Medicare. I was on a good retiree plan before. If I was still on that plan, my premium cost would be $1263 a month (pre-retiree subsidy) which would cut that about $543 per month. So net would be $8640 a year after retiree subsidy.

Right now, on Medicare I pay $148.50 a month, plus about $150 per month for supplement and $19.50 for Part D. So total is about $319 a month. I have a deductible of a little under $200 on medicare and $435 on the Part D. After retiree subsidy of about $181 per month, my net annual is about $1656.

So Medicare is far cheaper. Also that good retiree plan had a much larger deductible and had a network. Things I don't have to worry about at all any more.

DH has been on original Medicare for 8 years. Most years he has zero out of pocket costs. He doesn't take any regular prescriptions so that helps. He has had the occasional prescription. Yes, he has to pay for glasses and we have a separate dental plan.

The problem I'm having is deciding which of these three is the best option:


Original Medicare, Part D Prescription and Plan G Supplemental
Original Medicare, Part D Prescription and Plan G Supplemental HD
Medicare Advantage - 3 different plans to consider


They all work out better in different circumstances but I have no way to predict what kind of coverage will actually be needed.


I'm thinking of going with the first option which has the highest base cost but the lowest possible maximum cost.

I would look at the first two options. Personally I went with the first one you list. I don't have any health problems requiring a lot of care so a HD plan might have saved money for me now. But I remembered my late mother (died at 94) and how complicated she would have found it to have to chase after and manage a high deductible in her later life. Just having the one small deductible was much easier to manage. So I went with that just thinking of later life.

I looked at the Medicare Advantage plans but they had so many negatives of what I was happy to get rid of with Medicare. I don't have to work about net works (even if they allow out of network doctors). I don't want co-pays, etc. When my mother was in her last illness she was in a rehab facility. I could pick any one that Medicare would accept. Another family member needed to be in a rehab facility at the same time. She was on Medicare Advantage. She wanted to go to the same facility my mom was at (it had a good reputation) but it wasn't in the network so she had far more limited choices.... I didn't like that.

 

[samm]

....

• It's not free, there's a $148/month charge.
• There's a $1400 deductible every time you go into hospital and if you stay too long they charge you more.
• $200 deductible for healthcare coverage.
• 20% coinsurance
• Part B extortianate excess charges.
• No annual limit on out of pocket, but at least once you've exhausted your life savings and are too sick to work you can get help paying the costs.

That's OK though you can buy another insurance plan that covers all the deficiencies of Medicare and then you'll be completely covered! There are lots of plans to choose from - Plan A, Plan B, Plan C discontinued, Plan D, something, something, discontinued, Plan G both expensive and cheapskate versions, Plan 9 from outer space Plan K, Plan L, Plan M, Plan N. All with multiple providers charging different amounts for the exact same coverage. Also, the provider can increase the cost of the plan every year but if you choose the wrong plan - tough - because outside of the 6 month window you can't switch because we don’t want people like you on our plan of medical underwriting.

But at least everything's covered. EXCEPT PRESCRIPTION DRUGS!!! Oh and you still have to pay a $200 deductible.

Don't worry though you can buy a 3rd insurance plan to make up for the deficiencies of the two insurance plans you already have.

This will completely cover all your prescriptions. There are lots of plans to choose from and they all cover different drugs and charge different amounts for each one. That's great there are 17 plans to choose from in my area and let's see - only one of them covers both of her insulin prescriptions and it just happens to be the most expensive one. Also the prescription costs increase after 6 months because of - donut hole (??).

Well at least after spending $5-6,000/yr she'll be completely covered except for.

• $200 deductible
• Potentially unlimited drug costs
• No Vision
• No Dental

Fortunately, you can choose a Medicare Advantage plan instead. That must be better right because it has the word "advantage" right there in the name and that's a good thing, right? Well...

• Can't choose any doctor
• $50 to see a specialist
• $375 a day for hospital visits
• $30 for lab tests
• $50 X-rays
• $90 emergency visit
• $30 urgent care
• $250 ambulance ride
• $40 physical therapy
• $6,700 out of pocket - excluding drug charges
• Once you check into Medicare Advantage you can never leave because medical underwriting

......

Well said. I was looking forward to Medicare until I learned about this.

 

[ivinsfan]

Well said. I was looking forward to Medicare until I learned about this.

rest assured there is a good deal of embellishment in the post you quoted...

 

[CardsFan]

rest assured there is a good deal of embellishment in the post you quoted...

Maybe just a little?

Who knew? Medicare is not free?

 

[Raygun99]

Plus Dental programs that rarely pay full or even 80% on big ticket items.

 

[ychuck46]

Better than we thought

The wife and I had excellent coverage through her public employee when we were working, so good that I never had coverage through the three large IT companies I worked for during my career. When she retired early and I followed her a few years later we continued to have excellent coverage, so much that when we got closer to required Medicare enrollment we were dreading it. So how did it work out:

Phenomenally. Medicare combined with our continuing secondary policy from the wife's former employer takes care of nearly everything. Yes, I also pay for dental and vision coverage from my prior employer who allow us to be in those for a reasonable charge, but most of our needs are covered. Our fears were definitely unwarranted.

 

[leyland]

For many people, Plan G is a better choice. The only difference is the $200 Part B deductible that is covered by Plan F but not Plan G. However, the difference in premium between Plan F and Plan G may be greater than that. For example, in my case, the difference in premium between Plan F and Plan G is $360 per year but the maximum savings is only the $200 Part B deductible. If the premium difference makes Plan G a better deal and you don't have any underwriting issues with the switch, it may make sense to do so.

Yes, I hear you loud and clear about that.

FWIW, I decided to go with Regular Medicare and Plan F (replaced by plan G these days). I decided to not use the Advantage plans since going back to regular Medicare might be an issue if one has health issues. You can always go to Advantage, but you may not be allowed back into Medicare later.

After a few years in regular medicare and one expensive surgery, I decided that regular was best for me. YMMV.

While my experiences are different, I will defend your right to rant to the end. Rant on!

 

[Caskem]

Get a Medicare advisor! Their advice is based on experience and they are free! We did very well using our advisor.

 

[leyland]

Absolutely. Listen to this guy/gal. We have a gem of an advisor.

Get a Medicare advisor! Their advice is based on experience and they are free! We did very well using our advisor.

 

[14thMed]

Maybe just a little?

Who knew? Medicare is not free?

Bingo!

 

[14thMed]

I have trouble following this thread, I, after talking to a few of my friends that I wanted a plan that covered everything.
I get a EOB, no bills. I wanted something that I didn’t have to think about when I got too old to figure it out.
Have no idea what plan it is.
Yes it costs a bit more.

 

[BoodaGazelle]

not free

In most other Western countries the cost of healthcare is essentially free. The rest of the world is laughing at us. You may be tired of people whining about the cost but I'm equally tired of privileged people not giving a damn about how unaffordable it is for the average person as long as they can afford it.

Long ago, I looked into working for a high tech company in Germany. Taxes were 50%, probably higher for
high earners like us.

So it isn't "free" there, either.