Carpediem
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What are your thoughts on an annual budget expectation for healthcare costs (including prems) while on Medicare? Is $1500 per month too high?
Retirement planning for Medicare costs
- Thread starter Carpediem
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SumDay
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Having just spent ~2 hours with a trusted advisor last week (DH is Medicare eligible on 6/1) I think $1500 seems high, but I guess you're probably factoring in vision and dental?
His Part F & D premiums & Medicare B will be $350 a month, and from what I can see, there will be very little out of pocket, unless he gets some unworldly expensive medication prescribed for some new malady.
If we switch to Advantage next year, that cost will be a lot less.
His Part F & D premiums & Medicare B will be $350 a month, and from what I can see, there will be very little out of pocket, unless he gets some unworldly expensive medication prescribed for some new malady.
If we switch to Advantage next year, that cost will be a lot less.
Depending on a number of factors (overall health, life expectancy, etc.), it is estimated that for a 65 year old retired *couple*, total health care costs in retirement will run anywhere from $275K - $490K. Again, that is *per couple* aged 65.
I am not against a Medicare Advantage Plan- but cost are only one aspect of healthcare.. Remember that an Advantage Plan is a limited provider option and in certain situations the limited provider option can be a major disadvantage if outcome of a health issue is a concern. Just be careful. Some of these plans are great - but they all limit choice- which may or may not be important in health outcomes. Health outcomes certainly is not always linked to the most expensive path- just be aware of what you are choosing.
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REWahoo
Give me a museum and I'll fill it. (Picasso) Give
For us, your $1,500/mo number is substantially high but as has been stated, your actual number will depend on a number of factors, primarily your state of health.
As a couple, during our first five years on Medicare our total costs including premiums, out-of-pocket, drugs, dental and vision is averaging about $700/mo.
As a couple, during our first five years on Medicare our total costs including premiums, out-of-pocket, drugs, dental and vision is averaging about $700/mo.
aja8888
Moderator Emeritus
A couple of recent experience examples:
M.D. Anderson (renowned cancer treatment center) does not accept MA plans.
The surgeon who replaced my DW's heart valve does not accept MA plans.
The list is long as I can add more real life examples, but, then again, I am sure some doctor in an MA network will cover the above if needed.
Medicare B is $134 monthly, per person. Medicare D depends on your prescription lineup. IRMAA applies to both and drive that price up. Medicare supplemental high deductible F is often financially compelling option where available, and the $2240 deductible policy might cost less than that in annual premium.
The cost of dental care is the most uncertain and unpredictable component.
The cost of dental care is the most uncertain and unpredictable component.
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REWahoo
Give me a museum and I'll fill it. (Picasso) Give
Yes, highly unpredictable, variable and potentially financially painful.
If you count as "healthcare" costs a lot of items that may not be covered by Medicare it makes it hard to generalize. Some fairly expensive items can include vision correction, dental (I had a pretty expensive implant one year) and hearing aids.
As was referenced upthread, your income (including RMDs) can affect your Part B and Part D premiums via IRMAA surcharges.
Great article here:
https://www.kitces.com/blog/irmaa-m...-premium-surcharges-new-2018-magi-thresholds/
omni
Great article here:
https://www.kitces.com/blog/irmaa-m...-premium-surcharges-new-2018-magi-thresholds/
omni
Dtail
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
MissMolly
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They don't all limit choice. Our advantage plan is a PPO. No network. We can see any doctor we want. No difference in coverage. There is no in-network/out of network.
Moemg
Gone but not forgotten
My SO's medicare advantage is also a PPO . He has had heart surgery and two total knee replacements while on this plan and he paid very little out of pocket and had top doctors and great care .
Souschef
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One thing to factor is is the "donut hole" in drug coverage.
https://blog.medicare.gov/2010/08/09/what-is-the-donut hole/
I put off filling a prescription in December to wait for January which starts the new year as far as the donut hole is concerned.
https://blog.medicare.gov/2010/08/09/what-is-the-donut hole/
I put off filling a prescription in December to wait for January which starts the new year as far as the donut hole is concerned.
By Definitionreferred Provider Organization (PPO).. Therefore by definition the preferred providers limit (maybe by cost) availability..In smaller towns with not enough providers to form a panel- choice may not be limited because they can't get a panel-especially in sub-specialities(oncology, heart, etc... These plans are PPO by definition but not by how they are run because of necessity where they are provided as an option. The cost to the plan is expensive, but to the patient there maybe an advantage in care.
referred Provider Organization (PPO).. Therefore by definition the preferred providers limit (maybe by cost) availability..In smaller towns with not enough providers to form a panel- choice may not be limited because they can't get a panel-especially in sub-specialities(oncology, heart, etc... These plans are PPO by definition but not by how they are run because of necessity where they are provided as an option. The cost to the plan is expensive, but to the patient there maybe an advantage in care.A couple of recent experience examples:
M.D. Anderson (renowned cancer treatment center) does not accept MA plans.
The surgeon who replaced my DW's heart valve does not accept MA plans.
The list is long as I can add more real life examples, but, then again, I am sure some doctor in an MA network will cover the above if needed.
But do M.D. Anderson or other high-end specialists accept Medigap?
My reason for going with Advantage is I had heard from many that docs don't want to deal with Medigap and some will refuse to take it. Didn't think to check into M.D. Anderson, etc.--which is a significant consideration, just in case.
Here's M.D. Anderson's page on Medicare/Medigap:
https://www.mdanderson.org/patients...ling-financial-support/medicare-medicaid.html
omni
wmc1000
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DW has Medicare A & B + Plan G supplement + Plan D - total mo. cost including amortizing $183 plan G possible deductible over the year and adding in her mo. Rx copays = $261 per mo.
She has 7 medications but fortunately all are generic.
She has 7 medications but fortunately all are generic.
CRLLS
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I keep seeing statements that "so-and-so" doesn't accept this or that Medigap (aka Medicare Supplement) policy. This is what mdanderson states.
It is my understanding that if a medical provider accepts Medicare assignment, then they cannot deny you treatment based on your choice of Medigap policy/provider. You may not have Medigap coverage if your particular policy has a restricted medical provider list. But the doctor cannot refuse to see you based on the Medigap policy itself. In such cases, you will have to pay based on what Medicare deems fair an reasonable and would be your Medicare copay or Medicare deductible.
At least that's how I understand it.
DW and I have Medicare Part A ( no fee) + Medicare Part B (134/mo) + Medigap Plan FHD (~50 per mo) and Medicare Part D (~20/mo) for a total each of $204ish, or $408 for the two of us. Drug copays, Medicare deductible and copay, and Medigap deductible will vary from year to year depending on our health needs. Eye care and dental are additional.
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This is an important thing to keep in mind. Depending on finances, it may not matter, but virtually no Dr. will refuse to see you. They may not accept your insurance but that is a different (financial) matter. Certainly, finances matter for many, if not most, people, however, you insurance does not commit you to a specific course of action. Unfortunately, your finances may, but even there, you'd be surprised at how much a provider will discount a bill if insurance is not covering something. I'm thankful enough to have some good financial fortune and have not had a significant health situation but when a Dr. asks what insurance I have, I explain that I want what he/she thinks is best and I'll worry about whether or not the insurance will pay for it or not. Bottom line is that my choice of insurance does not dictate my medical care - only influences it financially.
As for Medicare Advantage plans, they are a buyer beware. Some are very well received while others are very restrictive. Personally, I think you're better off with original Medicare and adding on a supplemental plan. Maybe not the cheapest arrangement, but I think the one with the best coverage and good financial protection.
Yarnstormer
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I think I read on here that your medicare payment is determined by your income the year you are 63? So maybe plan a low income year for 63?
Yarnstormer
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wmc1000
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IRMAA is calculated based on the most recent filing year so for example, 2018 adjustments would be based on income reported on 2016 tax return. So, yes it is your age 63 filing year in most cases. IRMAA kicks in for married couples over 170K AGI and singles over 85K AGI -
It varies each year based on the prior filing years AGI. 2018 based onn 2016, 2019 based on 2017, etc.
It varies each year based on the prior filing years AGI. 2018 based onn 2016, 2019 based on 2017, etc.
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teejayevans
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Since it starts when you turn 65, 1st day of the month IIRC of your bday, if you’re bday is April or later, you could use previous year instead going back 2 years, or will they not accept your copy of tax return as proof and need IRS computers to give them information?
