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Old 08-18-2020, 05:38 AM   #41
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No Medicare Part B? I’m just starting to look into the combination of Medicare +FEHB for when I turn 65. I guess I’m a bit annoyed that the FEHB premium isn’t reduced. Maybe I’m starting to understand why DB refused to sign up for Medicare but need to verify if he at least signed up for Part A.

I think we are ~8-12% with the higher percentage including some extraordinary dental expenses.
This is a tough call. Most Feds take Part B (I have read about 70%). But, years ago I was at a session with the guy who writes the annual FEHB checkbook and he recommended that most Feds would be better off financially skipping it. The carriers are certainly happy to get 80% of their physicians costs picked up by Medicare - they will waive all deductibles and co-pays, and cover the extra charges for out of network (Medicare covered) care. Without Part B you will pay the same for care as you did when employed. The big plus is that you will not pay Part B. I ran the numbers. We already would pay more than the minimum Part B charge. When DW's RMDs kick in a few years from now, we would pay a lot for Part B. It just isn't worth it for us. One caution - there isn't any going back. If you waive Part B (except when you are covered by a working spouse's plan) you will pay a 10% per year surcharge if you later add Part B.

As for Part A, I can't see any downside since it is free and will cover hospitalization at out of network hospitals.
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Old 08-18-2020, 05:43 AM   #42
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This is a tough call. Most Feds take Part B (I have read about 70%). But, years ago I was at a session with the guy who writes the annual FEHB checkbook and he recommended that most Feds would be better off financially skipping it. The carriers are certainly happy to get 80% of their physicians costs picked up by Medicare - they will waive all deductibles and co-pays, and cover the extra charges for out of network (Medicare covered) care. Without Part B you will pay the same for care as you did when employed. The big plus is that you will not pay Part B. I ran the numbers. We already would pay more than the minimum Part B charge. When DW's RMDs kick in a few years from now, we would pay a lot for Part B. It just isn't worth it for us. One caution - there isn't any going back. If you waive Part B (except when you are covered by a working spouse's plan) you will pay a 10% per year surcharge if you later add Part B.

As for Part A, I can't see any downside since it is free and will cover hospitalization at out of network hospitals.
Don; Have you priced taking B in conjunction with Aetna Direct with the HRA kickback, described above? Or perhaps it's too late for you if you have already decided.
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Old 08-18-2020, 06:56 AM   #43
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Don, Golden....thanks for the extremely helpful responses.
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Old 08-18-2020, 08:22 AM   #44
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I think I MAKE 2% of my annual spending rate on healthcare.

My logic and math might be off, so check me on this. I get HDHI through the ACA and the PTC equals the premium (no out of pocket). We don't see any doctors or take any prescriptions. Then, I put $9K on the first page of the Federal income tax form (HSA deduction) because we have the high deductible policy, which saves me money on taxes, thus making money. I treat the HSA as a "super Roth" and plan to use it on Medicare premiums, when those days come.
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Old 08-18-2020, 08:26 AM   #45
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Don, Golden....thanks for the extremely helpful responses.
No problem; Don't consider taking Aetna Direct though until you are actually 65 and have B. The plan is offered to anyone, but it is not nearly as good a plan unless you are also on Medicare. We were on BCBS High Option until turning 65 when we switched to BCBS basic. Then when Aetna Direct began being offered around 4 years ago we switched. and never looked back.
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Old 08-18-2020, 08:34 AM   #46
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Don; Have you priced taking B in conjunction with Aetna Direct with the HRA kickback, described above? Or perhaps it's too late for you if you have already decided.
I don't believe it was available when I went on Medicare 7 years ago. It does look interesting but its about $53 more per month than my self+1 GEHA plan so about $600 of that $1800 fund would be lost there and our Part B would be high so I'm still happy with my choice. It does look like an interesting plan. I had Aetna decades ago and like them. Then they dropped from the program for a while IIRC. I can enroll in it in open season and pay the copays and deductibles. I will take a look to see how it compares with GEHA for other benefits. All of the plans have excellent networks here in DC so it comes down to expected out of pocket expenses. A lot of people take BCBS just because they think its "safe" but the costs are out of line compared to other plans and the networks are about the same (at least here).
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Old 08-18-2020, 11:55 AM   #47
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I don't believe it was available when I went on Medicare 7 years ago. It does look interesting but its about $53 more per month than my self+1 GEHA plan so about $600 of that $1800 fund would be lost there and our Part B would be high so I'm still happy with my choice. It does look like an interesting plan. I had Aetna decades ago and like them. Then they dropped from the program for a while IIRC. I can enroll in it in open season and pay the copays and deductibles. I will take a look to see how it compares with GEHA for other benefits. All of the plans have excellent networks here in DC so it comes down to expected out of pocket expenses. A lot of people take BCBS just because they think its "safe" but the costs are out of line compared to other plans and the networks are about the same (at least here).
Yeah. One thing to consider is, your doc's/providers have to be in network, if you don't also have B. I imagine they probably all are if you are in DC. I think they would be in my area as well, as they are very mainstream. DH and I will get whacked starting next year by jumping from no IRMAA all the way into the second tier of IRMAA, which effectively doubles the premium. I think we will still keep to this plan, as I'm a chicken about dropping Part B. I just don't like that you can't get back in. I worry about future changes.
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Old 08-21-2020, 04:53 PM   #48
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I would estimate our healthcare premiums run about 7-8% of our typical annual expenses. I do itemize our taxes so we get some back.
Except for this folks on military or some other amazing plan. For most of us it is kind of a crap shoot. Where you live, what is your level of health what meds you take. Based on last year (a low income year) premiums, Meds and out of pocket expenses we about 8%. Which isnít bad. All things considered with my history....
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Old 08-21-2020, 05:31 PM   #49
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For all the planning to ER, I completely missed a chance to actively avoid IRMAA (which I only heard about recently) based on Medicare 2 yr look back. I think Iíll miss it by luck but may well hit tier 1 in subsequent years. Thatís another significant reason to Roth concert but I totally missed.

I assume there is minimal added value to any Medicare supplement plans if you have part B plus FEHB.
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Old 08-22-2020, 05:57 AM   #50
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For all the planning to ER, I completely missed a chance to actively avoid IRMAA (which I only heard about recently) based on Medicare 2 yr look back. I think Iíll miss it by luck but may well hit tier 1 in subsequent years. Thatís another significant reason to Roth concert but I totally missed.

I assume there is minimal added value to any Medicare supplement plans if you have part B plus FEHB.
Correct. Certainly no need for a supplement policy if you have B and FEHB. There is no OOP, other than prescription copays on the major medical. Dental is about it for any major other expenses. Implants and caps are only covered at 60%.
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Old 08-22-2020, 08:19 AM   #51
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We have been on Medicare For six years. It costs us $250/month each for Medicare + a high deductible MediGap F + the cheapest Part D Drug plan. No copays, deductible (never reached) for MediGap & Part D is ~ $2600. Generics drugs & a couple of annual office visits are not tracked.

So, the max would probably be less than $500/month if we hit the deductible.

Of more concern is that the aggregate Medicare premiums have risen 33% in six years.
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Old 08-22-2020, 09:59 AM   #52
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I'm 63 and Sept will be my last month of Cobra. Then I will purchase insurance off the marketplace for the rest of the year and next year. DH is 74 and on Medicare and AARP plan F.

We currently spend about 15% on medical / dental / vision, with medical premiums at a little over 1K per month. The rest for co-pays and pharmacy. The amount will go up once I'm off Cobra. We don't qualify for any subsidized plans.
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Old 08-22-2020, 10:29 AM   #53
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Since retirement premiums have been 6.7% of our expenses. This includes 18 months on COBRA for 3 of us from July 2018 through December 2019.

This year for just the two of us, premiums should end up just over 10% of spending. But this is more because of the reduction in our discretionary spending due to the pandemic. If we did our "normal" spending it would be around 8%.

Family deductible is $3,000, max out of pocket is $8,000.
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Old 08-23-2020, 06:03 AM   #54
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We aren't fully retired yet. When we are, we'll be too young for medicare and will have too much money coming in to qualify for subsidies.

ACA premiums/deductibles/copays will be around 35% of our annual budget.
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Old 08-23-2020, 06:44 AM   #55
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HC premiums are 1.7% of expenses with significant ACA subsidy. I have no deductible and my max OOP is $1200. I have not used my HI at all this year. If I reached my max OOP then my HC costs would be 7.7% of my expected expenses and 10.3% of my expected income.
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Old 08-23-2020, 08:03 AM   #56
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Medical costs are about 20% of essential expenses and about 10% of total standard of living cost. Age 62 with partially subsidized retired employee benefits.
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Old 08-23-2020, 06:18 PM   #57
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We retired last year and signed up for an ACA Silver Level plan with significant credit. For our family of 2, plan annual premium is 2.5% of our budget. Deductibles are 5%, and max OoP for family is 10% of our budget. Dental costs are not included.

Fortunately, we have used it only once for annual checkup. All doctor visit and lab costs are covered in the plan.
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Old 08-25-2020, 09:30 AM   #58
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We have been on Medicare For six years. It costs us $250/month each for Medicare + a high deductible MediGap F + the cheapest Part D Drug plan. No copays, deductible (never reached) for MediGap & Part D is ~ $2600. Generics drugs & a couple of annual office visits are not tracked.

So, the max would probably be less than $500/month if we hit the deductible.

Of more concern is that the aggregate Medicare premiums have risen 33% in six years.
I think we're going to really miss the cheap ACA plans when we hit Medicare, considering that we're only paying $68/mo. for two with a $1k deductible on a max subsisdy ACA plan.
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Old 08-26-2020, 04:20 AM   #59
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Here it is 12% of our expenses annually. We each pay for an individual insurance policy, as required by law.

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Old 08-26-2020, 07:26 AM   #60
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I pay 20% of my annual budget for healthcare premium (12k on 60k expense budget). Too much :-(

I decided to stay with mega-corp health plan, hence the cost. If I go with ACA, it may be lower, however, it is not guarantee to be around in the future.
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