WSJ - Big mistakes people make in Medicare

[FIREd_2015]

Good Wall Street Journal article for those getting ready to sign up for Medicare.

"The Big Mistakes People Make in Medicare - and How to Avoid Them" (subscription required)
https://www.wsj.com/health/healthcare/medicare-advantage-enrollment-risks-923e7952

"Seniors choosing Medicare coverage often fall into hidden, costly traps that can leave them stranded—and unable to get the healthcare they want...Medicare beneficiaries generally don’t know that they have a right to get Medigap policies only at certain times, and if they don’t jump then, they might not be able to purchase them later...For those going through Medicare open enrollment this fall, here are five of the biggest pitfalls—and how to avoid them...Medigap Trap...Medigap...doesn’t have the same rules as most health insurance...Your best chance to get Medigap is when you first join Medicare...after you turn 65.Then you have a six-month window when you can buy a Medigap policy, and insurers can’t turn you down or charge you more...Wrong Doctors...Another common trap...a lean menu of doctors and hospitals...Paperwork Problems...Medicare Advantage plans can sometimes delay or block access to care...Seniors often don’t focus on these issues, particularly when they are healthy...Drug Deficits...Biased Advise...

 

[pb4uski]

Yes! My neanderthal friend didn't sign up for Medigap during the six months open enrollment period after starting Part B. He was totally oblivious to the potential cost under Medicare if he had a costly health issue.

About a month ago I spent an hour of my life with him talking with Boomer Benefits to sign him up for a Plan G Medigap plan and go through underwriting.

There are two many uninformed seniors who think Medicare is free and don't realize what needs to be done to make sure you have comprehensive coverage and what it costs. Some of it is their fault for them not paying attention and some is misinformation out there.

 

[MarieIG]

Yes! My neanderthal friend didn't sign up for Medigap during the six months open enrollment period after starting Part B. He was totally oblivious to the potential cost under Medicare if he had a costly health issue.

About a month ago I spent an hour of my life with him talking with Boomer Benefits to sign him up for a Plan G Medigap plan and go through underwriting.

There are two many uninformed seniors who think Medicare is free and don't realize what needs to be done to make sure you have comprehensive coverage and what it costs. Some of it is their fault for them not paying attention and some is misinformation out there.

When I told DH Medicare was not free he was shocked.

 

[JoeWras]

Free link of referenced article: https://www.wsj.com/health/healthca...dofhrld0r4b&reflink=desktopwebshare_permalink

(OP, hit share to get the free link next time)

I'll summarize the article:

- Medicare advantage plans may have really limited networks
- Advantage plans commercials and sales tactics are just that
- Get medigap right away when you sign up for medicare

 

[Car-Guy]

I hear such horror stories all the time from some friends. It seems to me like the government should provide well trained/certified facilitators to help guide folks through the maze of options and pros and cons on a case by case basis and with "fiduciary" like responsibilities. Maybe they do, and I just don't know about them.

For me, I consider myself very lucky. My "ex Mega Crop" offers us retirees what appears to be a pretty good Medicare Advantage like plan along with a drug plan. It's partially subsidized, but I don't know how much. There are no networks of doctors or hospitals and the drug plan has some incredible financial assistance program benefits.

 

[FIREd_2015]

Free link of referenced article: https://www.wsj.com/health/healthca...dofhrld0r4b&reflink=desktopwebshare_permalink

(OP, hit share to get the free link next time)

Thanks! I didn't realize sharing meant free access for everyone.

 

[MichaelB]

I thought it was a well written article and one of the few that are useful for soon to be retirees.

 

[RetMD21]

Free link of referenced article: https://www.wsj.com/health/healthca...dofhrld0r4b&reflink=desktopwebshare_permalink

(OP, hit share to get the free link next time)

I'll summarize the article:

- Medicare advantage plans may have really limited networks
- Advantage plans commercials and sales tactics are just that
- Get medigap right away when you sign up for medicare

Thanks for the free link. I think the article is fair. Although many people are happy with their MA plans I think many folks don't recognize the problem of trying to get a supplement if you miss the initial enrollment period.

 

[Chuckanut]

I have several friends who brag about their FREE Advantage plan. When I try to mention the restrictions they assure me their plan is one that has a great network, and they have no concerns. I hope they are right.

 

[Dtail]

I have several friends who brag about their FREE Advantage plan. When I try to mention the restrictions they assure me their plan is one that has a great network, and they have no concerns. I hope they are right.

Well my DGF has that type of free plan and in our area there are no issues with a large range of doctors who accept her plan.
I have not checked out the major cancer centers acceptance of the plan.

 

[razztazz]

Well my DGF has that type of free plan and in our area there are no issues with a large range of doctors who accept her plan.
I have not checked out the major cancer centers acceptance of the plan.

Depends on where they live. My mother had an Advantage Plan. Had a multitude of problems from preexisting diabetes, then heart problems requiring a triple bypass. She was even able to get surgery done on her back to relieve pain, that her heart doctors advised against. Never paid a penny. Lived to age 88. But she lived along the I-95 corridor north of Philadelphia. A pretty economically dense area. An area that exemplifies the lyric "Anything you want we got it right here in the USA." Council Bluffs Iowa, maybe not so much.

 

[skyking1]

Free link of referenced article: https://www.wsj.com/health/healthca...dofhrld0r4b&reflink=desktopwebshare_permalink

(OP, hit share to get the free link next time)

I'll summarize the article:

- Medicare advantage plans may have really limited networks
- Advantage plans commercials and sales tactics are just that
- Get medigap right away when you sign up for medicare

If they can afford to bombard us with endless ads, there is money in it for them and it ultimately reduces my level of care.
I won't enroll with an advantage plan, and continue my union's Blue Cross Blue Shield, as it provides an excellent supplement.
To quote Heinlein:
TANSTAAFL

 

[Montecfo]

I hear such horror stories all the time from some friends. It seems to me like the government should provide well trained/certified facilitators to help guide folks through the maze of options and pros and cons on a case by case basis and with "fiduciary" like responsibilities. Maybe they do, and I just don't know about them.

For me, I consider myself very lucky. My "ex Mega Crop" offers us retirees what appears to be a pretty good Medicare Advantage like plan along with a drug plan. It's partially subsidized, but I don't know how much. There are no networks of doctors or hospitals and the drug plan has some incredible financial assistance program benefits.

Yes. Free advisors are out there. Not sure how you miss them. DW got contacted by a few.

It remains in my future.

 

[athena53]

It seems to me like the government should provide well trained/certified facilitators to help guide folks through the maze of options and pros and cons on a case by case basis and with "fiduciary" like responsibilities. Maybe they do, and I just don't know about them.
.

Medicare does have a help line; my friend is one of the people who answers questions from Medicare beneficiaries. Since he’s not a licensed insurance agent he can’t recommend a particular plan but I can tell you he does NOT like Advantage plans and is careful to spell out their limitations.

For me, the deal breaker was knowing that if I switched from Advantage to Traditional, supplement writers could surcharge me. I do know people who are happy with Advantage plans but didn’t like the consequences if I chose Advantage and wanted to switch later.

 

[Luvtoride]

I hear such horror stories all the time from some friends. It seems to me like the government should provide well trained/certified facilitators to help guide folks through the maze of options and pros and cons on a case by case basis and with "fiduciary" like responsibilities. Maybe they do, and I just don't know about them.

For me, I consider myself very lucky. My "ex Mega Crop" offers us retirees what appears to be a pretty good Medicare Advantage like plan along with a drug plan. It's partially subsidized, but I don't know how much. There are no networks of doctors or hospitals and the drug plan has some incredible financial assistance program benefits.

Very true. Without someone to explain and guide you through the options and timing of decisions it can be an expensive lesson to navigate on your own.
Having just retired in July (and planning it for several months) our private healthcare terminated that month.
Fortunately, my wife is a NYC retiree with full supplemental medical and drug benefits (which cover us both). We contacted their Retiree office months before I retired and they advised us of every step in the process starting with applying for Part B to be effective August 1 and adding the supplemental GHI Senior care plan as of that date.
All has gone fairly smoothly. However, There are even more nuances once Medicare becomes your primary healthcare insurance that you find out about later.
For example, we were both over 65 at the time of my retirement and already had Part A (for free). Once Part B was added, when doctors or other medical providers filed claims with Medicare they were rejected as Medicare had my prior Aetna Healthcare PPO as primary insurance. You MUST inform Medicare that you no longer have your prior medical (part B type) policy and they are now Primary. A simple step that now processes claims properly but one you just assumes happens automatically.

Good luck getting help.

 

[athena53]

Once Part B was added, when doctors or other medical providers filed claims with Medicare they were rejected as Medicare had my prior Aetna Healthcare PPO as primary insurance. You MUST inform Medicare that you no longer have your prior medical (part B type) policy and they are now Primary. A simple step that now processes claims properly but one you just assumes happens automatically.

Yeah, we got caught with that the first time we filed a claim for DH. We’d signed him up for Part B when I retired (I was 61 and he was 76 but had been on my employer’s policy) and they rejected the claim because they thought he was still covered by my employer. Easy enough to straighten that out.

We’d provided a letter stating that he’d had creditable coverage between age 65 and my retirement so weren’t surcharged for late enrollment.

 

[Z3Dreamer]

Here you go from Healthcare.gov: "State Health Insurance Assistance Program (SHIP)
A state program that gets funding from the federal government to provide free local health coverage counseling to people with Medicare."

I was a volunteer SHIP counselor for a few years here in NC. Help is available but we couldn't force people to come talk to us.

In many cases, Medicare Advantage is the right answer. It appears for many people on this forum, it is not the answer. Should 50% of Medicare folks be on MA plans? I will let y'all debate that.

 

[f35phixer]

turning 65 in Nov and working thru this. Being Fed Employee with FEHB's I am going to keep my BCBS Standard and sign up for B too.

Using Consumer Checkbook.org (site only has FEHB coverage plans) You are able to compare coverage etc. The big thing I'm seeing comparing Standard with Basic BCBS is that basic gets a $800 rebate? It costs more, why would they get a rebate?

 

[ShokWaveRider]

I smell a simple Poll. Do you have a Medicare Advantage or Medigap Plan?

 

[Car-Guy]

^^^^
There are no simple polls on ER.Org.

 

[Chuckanut]

^^^^
There are no simple polls on ER.Org.

I think we should take a poll to see if people agree with that.

 

[Car-Guy]

^^^
Let's see, to start, answers/responses could be:

Yes
No
Maybe
I don't care
None of your business
Other

 

[Silver]

^^^
Let's see, to start, answers/responses could be:

Yes
No
Maybe
I don't care
None of your business
Other

IMO, all poles should include 'I like bacon" as one of the possible responses.

 

[Teacher Terry]

I know 2 people that are still alive only because they could seek treatment anywhere in the country. One was told your cancer is too advanced and there’s nothing that can be done and gave her 6 months. MD Anderson in Texas said differently and many years later she is still alive.

 

[pacergal]

I have several friends who brag about their FREE Advantage plan. When I try to mention the restrictions they assure me their plan is one that has a great network, and they have no concerns. I hope they are right.

It depends on the Advantage Plan. We have Kaiser Advantage, and chose one with no premium. Kaiser is well known in the PNW, many options, and they outsource some also. Folks either Love or Hate Kaiser. I find no problem with them, but I am an RN and do well with self advocacy.

I hear such horror stories all the time from some friends. It seems to me like the government should provide well trained/certified facilitators to help guide folks through the maze of options and pros and cons on a case by case basis and with "fiduciary" like responsibilities. Maybe they do, and I just don't know about them.

Check your state SHIP program. Good info and assistance.