after medicare

[livingalmostlarge]

I had a question after reading the ERE thread. Those who like on $7k/year on ERE what happens after 65 when medicare happens? I know that to get on medicare you have to pay like $170/month which can easily ruin a budget for a couple. But then you can't turn down medicare and stay on ACA? And do you not buy supplemental?

[Teacher Terry]

Yes your Medicare costs are going to increase. Some people take a advantage plan which is often free.

[jim584672]

Usually Social Security becomes possible so that would help if needed. In CT and NY the QMB program pays for Part B and any out of pocket costs making a Medigap policy unneeded. It also would qualify you for Social Security Extra Help which pays for drug costs. CT QMB is under 200% FPL, NY is under 138% FPL starting in 2023.

[RetireBy90]

My understanding after enrolling DW and myself on Medicare, you only HAVE to get part A, the hospital coverage and that is without a cost to you. Part B the Doctor coverage is $170 per person or $4K/Year for a couple. I'm sure there is some help if you can't afford it as above post stated. I've also read about medicade coverage after 65 but don't know the details.

[jim584672]

Quote:

Originally Posted by RetireBy90 My understanding after enrolling DW and myself on Medicare, you only HAVE to get part A, the hospital coverage and that is without a cost to you. Part B the Doctor coverage is $170 per person or $4K/Year for a couple. I'm sure there is some help if you can't afford it as above post stated. I've also read about medicade coverage after 65 but don't know the details.

Post 64 Medicaid has a strict asset test in all but 1 state, so not helpful for FIRE types.

[athena53]

Quote:

Originally Posted by RetireBy90 My understanding after enrolling DW and myself on Medicare, you only HAVE to get part A, the hospital coverage and that is without a cost to you. Part B the Doctor coverage is $170 per person or $4K/Year for a couple. I'm sure there is some help if you can't afford it as above post stated. I've also read about Medicaid coverage after 65 but don't know the details.

The Part B premium paid to Medicare covers only 80% of the cost of doctor visits. You really need a supplement as well.

In addition to the Extra Help programs, which is what I believe they call Medicare/Medicaid, you CAN get Medicare Advantage plans at no cost but please do your research. Plenty of threads on that here. They have their limitations.

[ivinsfan]

I guess they get jobs so they can pay medicare or they realize their 7k figures is and was unrealistic. I'm not feeling the pressure to give them free or more subsidized Medicare.

ASA Medicare Advantage offering some plans that might have zero net cost. Your potential out of pocket could add up quickly.

[Aerides]

Quote:

Originally Posted by livingalmostlarge I had a question after reading the ERE thread. Those who like on $7k/year on ERE what happens after 65 when medicare happens? I know that to get on medicare you have to pay like $170/month which can easily ruin a budget for a couple. But then you can't turn down medicare and stay on ACA? And do you not buy supplemental?

I don't know any couple who live on 7k a year at 65+. It's one thing for a couple of 35 yo's deciding to do van life and eat ramen, but entirely another at 65+

Social security alone for a couple well exceeds $7k (or even $14k) per person. Planning for reasonable medical expenses, regardless of age, I believe is a responsibility for whatever kind of retirement one chooses, be it early, extreme, or regular, or any combination.

[harllee]

I don't know of anyone over age 65 that lives on $7000 per year but I know many people that live solely on their Social Security payments and many times that is only $1200 per month.

[athena53]

Quote:

Originally Posted by harllee I don't know of anyone over age 65 that lives on $7000 per year but I know many people that live solely on their Social Security payments and many times that is only $1200 per month.

My friend whose job is answering questions from Medicare beneficiaries talks to people trying to exist on $600 or $700/month SS. The average SS check now for a single is about $1,400/month, though.

Some of them wait to buy Part B or a prescription plan "till they need it" and are very unhappy to find that they now incur surcharges as long as they live.

Some don't buy a supplement and then freak out at their 20% co-pay when they have a major health event.

Some get a "free" Medicare Advantage plan like Joe Willie told them about on TV (my friend hated Joe Willie even back when he was playing football) and are very unhappy to find the limitations.

And some muddle through with the Medicare/Medicaid combination.

[Irishgirlyc58]

If I’ve done my math correctly $7,000/year is approximately $583 a month.
If someone’s social security is that low they would receive the difference in SSI-supplemental security insurance. The federal rate is $841/month. In California the monthly amount is $1041. Of course there is a $2,000 asset limit-home not included.

If someone has assets that they just don’t want to part with then I have a hard time drumming up any sympathy.

[GenXguy]

Quote:

Originally Posted by harllee I don't know of anyone over age 65 that lives on $7000 per year but I know many people that live solely on their Social Security payments and many times that is only $1200 per month.

I know people 65+ that don't (and won't) get ANY SS and NO free Medicare part A because they didn't work at least 40 quarters for credits to get minimum eligibility. So, to buy Medicare Part A with no credits, instead of free Part A, it's $499/mo and will probably jump to at least $549/mo in about 6 months. And you still have to pay for Part B, Part D, supplmental/medigap, and all of the co-pay / out of pocket expenses. And as someone mentioned earlier, the Medicaid asset limit for people 65+ is very strict and makes people ineligible for that as well.

[GenXguy]

Quote:

Originally Posted by Irishgirlyc58 If someone has assets that they just don’t want to part with then I have a hard time drumming up any sympathy.

I have no problem drumming up sympathy because those assets can be long time family businesses that provide their only (low) income. So, if they give it up, then they have no income at all. I believe these asset limits should be removed completely, just as they were for ACA Medicaid expansion and ACA marketplace subsidies, as well California's Medicaid program. Young millionaires are taking advantage of ACA subsidies and Medicaid Expansion, but they have extra strict rules for Medicaid for poor seniors who shouldn't be expected to work full time jobs in the golden years.

[Irishgirlyc58]

Quote:

Originally Posted by GenXguy I have no problem drumming up sympathy because those assets can be long time family businesses that provide their only (low) income. So, if they give it up, then they have no income at all. I believe these asset limits should be removed completely, just as they were for ACA Medicaid expansion and ACA marketplace subsidies, as well California's Medicaid program. Young millionaires are taking advantage of ACA subsidies and Medicaid Expansion, but they have extra strict rules for Medicaid for poor seniors who shouldn't be expected to work full time jobs in the golden years.

Oh I absolutely agree that the asset rule for Medicaid should be eliminated.
California increased the asset limit to $130,000 for 65+ Medi-Cal ( CA Medicaid program) effective 7-1-22.

I do have some ethical hesitations with people who have significant funds and manipulate the system so they don’t pay anything-regarding ACA etc.
IMHO this type of behavior just hurts people who are truly in need.

[jim584672]

Starting in 2023 NY made it so someone on ACA Medicaid can transition to Medicare plus QMB at age 65 wth the same 138% income. This gives about the same coverage. QMB in NY has no asset test, but does require someone to pursue potentially available income, like Social Security or pension before it can kick in.

[ivinsfan]

Quote:

Originally Posted by Irishgirlyc58 Oh I absolutely agree that the asset rule for Medicaid should be eliminated. California increased the asset limit to $130,000 for 65+ Medi-Cal ( CA Medicaid program) effective 7-1-22. I do have some ethical hesitations with people who have significant funds and manipulate the system so they don’t pay anything-regarding ACA etc. IMHO this type of behavior just hurts people who are truly in need.

My "take" on that is there should be some asset tests for ACA subsidies.

[jim584672]

Obviously don't agree, but porky will appear soon if this continues.

[ivinsfan]

Quote:

Originally Posted by jim584672 Obviously don't agree, but porky will appear soon if this continues.

Maybe but this on topic for this thread and something that keeps coming up for discussion which is the fact that for some people going from ACA to Medicare can result in BIG price increases.



There would be several ways to remedy this issue and I think respectful discussion about it is OK.

[jim584672]

Quote:

Originally Posted by ivinsfan Maybe but this on topic for this thread and something that keeps coming up for discussion which is the fact that for some people going from ACA to Medicare can result in BIG price increases. There would be several ways to remedy this issue and I think respectful discussion about it is OK.

Discussing current law is one thing, discussing what you think the law should be is politics and porky bait.

[ivinsfan]

Quote:

Originally Posted by jim584672 Discussing current law is one thing, discussing what you think the law should be is politics and porky bait.

I think HI ACA and SS have moved past the stage of being called politics. There seems to be universal agreement that basic heath care should be available to everybody.



For me the biggest thing is that Medicare costs and ACA costs are not in alignment. I understand that Part A is free ( as in pre payed by your SS payroll tax)...part B is rising fairly quickly and Part D can leave you paying a huge drug bill out of pocket. And we haven't even gotten to supplement or Medicare Advantage coverage. For people with private pay HI going to Medicare almost always meant saving money. Now the opposite can be true.


Say a person mentioned by the OP lives on a very low budget and spends 15K a year and gets 15K a year in ACA for very little cost. In theory they are spending 30K a year. Take that person to Medicare and instead of adding 15 plus 15 you are subtracting Medicare costs from the 15. That's a huge imbalance. And yes I know you could signup for SS if hard pressed for money.



I don't really see anything political in asking how this can be smoothed out for the public.