Medicare Plans

[ncbill]

I like Belk's videos but IIRC he has ignored the possibility (and financial consequences) of a long hospital stay w/o a Medigap plan.

COVID-19 has resulted in a lot of people with very long hospital stays.

 

[kevink]

No, Belk addresses the hospital cost issue at the beginning of his presentation:




“ Medicare Part A: How Much Will a Hospitalization Cost You?

Let’s say you’re hospitalized and all you have is Medicare Part A. How much do you owe the hospital?
If the hospitalization lasts 60 days or less, the answer is $1,484; nothing more. This is an important point: For any hospitalization lasting 60 days or less, you will only owe the hospital $1,484 even if your hospital bill exceeds one million dollars! The doctor (or doctors) who see you in the hospital will bill you separately, but those bills are covered by your Part B benefits (discussed later).

Should you expect to ever be hospitalized for more than 60 days? No!
The average hospital stay in the US is 5-6 days and that number has been going down each year for more than a decade. Even people who need major surgery like a liver transplant or open heart surgery are usually home in about 7 days. I can’t say that 60-day hospitalizations never occur in the U.S., but they’re about as rare as jackpot lottery winners.

Also, if you have Medicare Part A, there’s no limit to the number of times you can be hospitalized for up to 60 days as long as you go home for two months after each hospitalization. Now, the average senior can expect to be hospitalized about 4 times while on Medicare, and that’s over a 20-30 year period of time. Do the math. How much will that really cost you when compared to the cost of your Medicare supplemental premiums?”

 

[ncbill]

His presentations are pre-COVID.

Unfortunately, pre-vaccine at least, plenty of those affected by the above have had continuous hospital stays for much longer than 60 days.

IIRC, Medigap plans do offer coverage for longer continuous stays, but not Part A & B by themselves.

 

[user5027]

I just checked for my wife's Aetna Plan G since 9/2019 thru 8/2021.
Premiums paid: $3,420.56
Plan paid: $3,205.22

 

[kevink]

His presentations are pre-COVID.

Unfortunately, pre-vaccine at least, plenty of those affected by the above have had continuous hospital stays for much longer than 60 days.

IIRC, Medigap plans do offer coverage for longer continuous stays, but not Part A & B by themselves.

The YouTube video presentations by Dr. Belk I provided the link to are from June 2020, so not pre-covid at all.

 

[kevink]

I just checked for my wife's Aetna Plan G since 9/2019 thru 8/2021.
Premiums paid: $3,420.56
Plan paid: $3,205.22

That's certainly valid as one couple's experience for a very short period of time. As for Part D plans, it's a YMMV situation where you really have to compare plans every year and see what makes sense. In many cases paying cash is cheaper, but in others the right Part D plan makes sense. What doesn't make sense is buying Part D automatically or thinking that paying in is going to guarantee access to a new high-priced brand-name drug when/if you need it. Formularies vary widely and change every year, and as Dr. Galt makes clear the insurers who provide the Part D coverage are themselves major drivers of the high cost of such drugs. That's why I referred to it as a "racket," though Greaney calls it a cesspool.

John Greaney has a great short piece on this as a follow-up to his recent post on Medigap plans:

https://retireearlyhomepage.com/medicare_partD_2021.html

 

[Calico]

Since I turn 65 in December I've been "down the rabbit hole" with looking into various Medigap plans for some months now, including reading everything on these boards I could find. <snip>

Anyway, thanks to many positive recommendations here and elsewhere I've tentatively set things in motion with Boomer Benefits to go with a high deductible Part G plan for $48.57 a month as well as a cheap Part D plan (I live in Arizona, FWIW). But after reading what Belk has to say and watching a slew of his videos as well as reading about the rate increases and needs to re-shop plans every year I'm wondering why more people don't just go with Medicare A and B and pay for everything else out of pocket. Don't want to post more links but Belk's video on Part D and the fear-mongering used to sell it as well as what the insurance companies make out of it is well worth watching.

I had cancer back in 2018. I was covered by gold-plated employer insurance at the time, and my share of treatment costs still ran to several thousand dollars.

There is no way on earth I would consider going without a Medicare supplement plan now, and rolling the dice on what "everything else" might cost me. The cancer could come back (not likely, fortunately) or a thousand other unexpected health issues could arise. Plan G is worth every penny I pay for it, and if I end up "wasting" my money on it, and never needing the coverage, I will still be one happy camper.

 

[user5027]

That's certainly valid as one couple's experience for a very short period of time. As for Part D plans, it's a YMMV situation where you really have to compare plans every year and see what makes sense. In many cases paying cash is cheaper, but in others the right Part D plan makes sense. What doesn't make sense is buying Part D automatically or thinking that paying in is going to guarantee access to a new high-priced brand-name drug when/if you need it.

Part D was an easier choice for her. Before going on medicare, we paid $500/month for one of her medications. Since going on medicare we never paid over $130, sometimes only $45. She recently added another medication that retails over $600. Her Part D premium was never over $30/month.

 

[teej1985]

The YouTube video presentations by Dr. Belk I provided the link to are from June 2020, so not pre-covid at all.

That may have been when they were uploaded, doesn't mean that's when they were recorded.

 

[Ian S]

“ Medicare Part A: How Much Will a Hospitalization Cost You?

Let’s say you’re hospitalized and all you have is Medicare Part A. How much do you owe the hospital?
If the hospitalization lasts 60 days or less, the answer is $1,484; nothing more. This is an important point: For any hospitalization lasting 60 days or less, you will only owe the hospital $1,484 even if your hospital bill exceeds one million dollars! The doctor (or doctors) who see you in the hospital will bill you separately, but those bills are covered by your Part B benefits (discussed later).

Should you expect to ever be hospitalized for more than 60 days? No!
The average hospital stay in the US is 5-6 days and that number has been going down each year for more than a decade. Even people who need major surgery like a liver transplant or open heart surgery are usually home in about 7 days. I can’t say that 60-day hospitalizations never occur in the U.S., but they’re about as rare as jackpot lottery winners.

Also, if you have Medicare Part A, there’s no limit to the number of times you can be hospitalized for up to 60 days as long as you go home for two months after each hospitalization. Now, the average senior can expect to be hospitalized about 4 times while on Medicare, and that’s over a 20-30 year period of time. Do the math. How much will that really cost you when compared to the cost of your Medicare supplemental premiums?”

I've noticed that increasingly, many procedures are done on an outpatient basis so Medicare part A doesn't come into play. For example, I had rotator cuff surgery on both shoulders at different times. Both were done on an out patient basis at a hospital. A 20% hit would have been a hefty chunk of change. Maybe some people could save a few bucks by going without Medigap (or heaven forbid Part B) coverage but I for one am not willing to do so.

 

[kevink]

Thanks to the OP and everyone else who's contributed to this thread. As someone just getting ready to go on Medicare it's invaluable to hear other people's decision-making process and even more so to hear from those who've already been on it a few years and had to deal with illness and/or premium increases. I'm also grateful for the numerous recommendations of Boomer's Benefits. They're great to deal with and are saving me from heaven knows how many call-back from insurance agents!

Like most others in this thread I've come around to agreeing that a Medigap plan and Part D are my best options. Perhaps at some point the annual premium increases for Medigap will become so onerous I'd think about doing without but I don't see that happening anytime soon.