|
|
07-31-2021, 05:20 AM
|
#21
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 38,139
|
Quote:
Originally Posted by pb4uski
Just received DW's Medigap claim summary for 1/6/21 to 4/8/21.... providers billed $14,724... we only paid $203.
|
Quote:
Originally Posted by teej1985
Who cares what they billed? What did the Medigap actually pay?
If you were billed 14,274, I'm guessing it was a lot less.
|
Yeah, the initial bill is meaningless. It’s always outrageous. Then there is what Medicare says is the cost.
You paid your deductible for the year. Your plans paid the rest.
__________________
Retired since summer 1999.
|
|
|
|
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!
Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!
You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!
|
07-31-2021, 05:32 AM
|
#22
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 38,139
|
That whole insulin racket was outrageous. Probably still is even with the price negotiated down to what it used to be for Medicare patients.
It’s even possible to reduce US insulin demand. A lot of type 2 diabetics are able to reduce or even stop their insulin use via diet. But it’s still not a common treatment. The UK is having more obvious success with this approach.
Type 1 diabetics however, are always going to need some.
https://www.businessinsider.com/insu...ndustry-2019-1
__________________
Retired since summer 1999.
|
|
|
07-31-2021, 05:55 AM
|
#23
|
Thinks s/he gets paid by the post
Join Date: Aug 2014
Location: Chicago West Burbs
Posts: 3,014
|
Quote:
Originally Posted by Bamaman
Which plan to choose often correlates to how healthy we are. And what's your future estimates of your cost of healthcare.
My wife and I have been on Plan F with AARP/United Healthcare. My wife's had 7 major surgical procedures done in 3 years, and our payouts have been minimal.
I'm diabetic, and my very expensive insulin pump was up for replacement under Plan B. Supplies run just over $2K a year, and insulin vials were costing $2500 a quarter. I was paying 20%.
We knew my wife was having foot surgery, and Medicare was going to pay $2500 for an electric wheel chair.
We switched from Plan G to Plan F because there are no deductibles on Plan B. Then Trump negotiated with the insulin companies to put insulin vials on Plan D for $105 max. per quarter--a big savings over $505.
My wife fainted Wednesday, and we took her to the emergency room. They've done every heart related test known to man, and it ended up being an arrhythmia issue. And we'll never pay a deductible or even see a bill. There's no telling how much the visit cost.
So you can see in our case, Plan F is the one for us.
|
It is not quite as easy as figuring out what your medical needs are now, in most cases one must bet on on what your medical needs will be in the future. In the name of blow that dough, this seems to me to be a poor place to be gambling on Medigap plans. Go for the best you can afford. Your Plan F was that plan when you entered.
Quote:
Originally Posted by grasshopper
Between medigap F an G if the cost per year for F is more than the $203(2021) deductible then G is the better deal.
Every year it's a little iffy.
|
A couple years back, we switched from F-HD under BCBS to G under AARP-UHC. Yes, we had to go thru medical underwriting. Last year I had my gallbladder removed at a rack rate of over $70k. I also had Back problems and 4 months of PT. Boy am I glad that I was on Plan G. Between Medicare's reduced price per procedure and the AARP-UHC I paid the Medicare deductible of $198 and that was it.
One thing to consider is, unlike a traditional insurance we got thru our employer, under Medicare, the deductibles are per person, not per family. When we got our F-HD plan we planned on each of us meeting our deductibles every other year. assuming deductible of ~2k per person per year, the upcharge from F-HD to F in premiums exceeded that amount so it was budgeted into our plans. When Medicare closed Plan F to new applicants, the writing was on the wall. No fresh blood into the plan means much higher annual increases in the future, so we switched while our health was still fairly good.
Repeat, Plan F is no longer open to new applicants. Plan G is today's "Gold Standard" plan.
|
|
|
07-31-2021, 05:58 AM
|
#24
|
Thinks s/he gets paid by the post
Join Date: Aug 2012
Posts: 1,829
|
Quote:
Originally Posted by grasshopper
Between medigap F an G if the cost per year for F is more than the $203(2021) deductible then G is the better deal.
Every year it's a little iffy.
|
If you're new to medicare after Jan1 2020, such as DW who turned 65 in Nov 2020, you aren't even eligible for Plan F.
|
|
|
07-31-2021, 08:10 AM
|
#25
|
Thinks s/he gets paid by the post
Join Date: Oct 2010
Posts: 2,471
|
Quote:
Originally Posted by finnski1
If you're new to medicare after Jan1 2020, such as DW who turned 65 in Nov 2020, you aren't even eligible for Plan F.
|
My comment was for a comment that there is no deductible with F. True but I am sure the deductible is just built into the higher price of the F policy premium.
I switched from F to G 3 years back, when BCBS said they would switch me with no underwriting.
__________________
For me experiences are not good or bad, just different
|
|
|
07-31-2021, 08:13 AM
|
#26
|
Thinks s/he gets paid by the post
Join Date: Jun 2017
Location: Western NC
Posts: 4,633
|
Isn't Plan F (& F HD) closed to new enrollees?
|
|
|
07-31-2021, 09:49 AM
|
#27
|
Full time employment: Posting here.
Join Date: Nov 2015
Posts: 705
|
Quote:
Originally Posted by CRLLS
It is not quite as easy as figuring out what your medical needs are now, in most cases one must bet on on what your medical needs will be in the future. In the name of blow that dough, this seems to me to be a poor place to be gambling on Medigap plans. Go for the best you can afford. Your Plan F was that plan when you entered.
A couple years back, we switched from F-HD under BCBS to G under AARP-UHC. Yes, we had to go thru medical underwriting. Last year I had my gallbladder removed at a rack rate of over $70k. I also had Back problems and 4 months of PT. Boy am I glad that I was on Plan G. Between Medicare's reduced price per procedure and the AARP-UHC I paid the Medicare deductible of $198 and that was it.
One thing to consider is, unlike a traditional insurance we got thru our employer, under Medicare, the deductibles are per person, not per family. When we got our F-HD plan we planned on each of us meeting our deductibles every other year. assuming deductible of ~2k per person per year, the upcharge from F-HD to F in premiums exceeded that amount so it was budgeted into our plans. When Medicare closed Plan F to new applicants, the writing was on the wall. No fresh blood into the plan means much higher annual increases in the future, so we switched while our health was still fairly good.
Repeat, Plan F is no longer open to new applicants. Plan G is today's "Gold Standard" plan.
|
Why didn't you go to G HD? Most employer insurance has an individual deductible and a family deductible.
|
|
|
07-31-2021, 10:34 AM
|
#28
|
Thinks s/he gets paid by the post
Join Date: Aug 2014
Location: Chicago West Burbs
Posts: 3,014
|
Quote:
Originally Posted by teej1985
Why didn't you go to G HD? Most employer insurance has an individual deductible and a family deductible.
|
At the time we started our application for change, for year 2020, G-HD was not even an official Plan yet. They were still working out the kinks. In fact at the time, there was no official mention at all about F-HD being closed or open to new entrants after Jan 2020, just speculation. We also wanted to switch companies at the same time for the future rate protection as we age that AARP/UHC offered, i.e. community rates vs attained age. In addition, I was tired of tracking every transaction between Medicare, the Drs, Supplemental and the back and forth of corrected billing etc all year long. Now with Plan G, I only have to do that until we meet the annual deductibles. After that it is not my problem. Our decision to change at all was also in part, a blow-that-dough decision. I have no regrets in our change at all. And I think we will be well ahead in the coming years as our health invariably will decline. We learned as we went.
Yes, employers typically offer individual and family and some offer spousal plans/deductibles. I was trying to keep the focus on married couples. Few understand that Medicare is an individual coverage regardless of marital status and it is a surprise later on.
|
|
|
07-31-2021, 11:14 AM
|
#29
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 38,139
|
Quote:
Originally Posted by teej1985
Why didn't you go to G HD? Most employer insurance has an individual deductible and a family deductible.
|
Ok I can tell you why we didn’t. All these years on ACA, I’m tired of dealing with deductibles. Especially those paid up front. With Medicare this is usually dealt with billing afterwards intead of up front, so it’s a little better. But you still have track and pay all these bills. I’m capable of doing that today, but I really don’t want to deal with it 20 years from now. As a gift to our older selves we decided to “splurge”.
__________________
Retired since summer 1999.
|
|
|
08-01-2021, 08:42 AM
|
#30
|
Moderator
Join Date: Oct 2010
Posts: 10,723
|
Medicare was a topic like when to take SS, that I ignored on this board for years. Now DW is going to turn 65 and I really appreciate all of these well reasoned posts, even if the solution differs for each. It reminds me of the Roth conversion decision because to do it "right" you need to consider all years, until the plan "sunset", and during that time, there are unknowable variables (tax law and length of the plan in the case of Roth, and rate increases and length of plan in the case of Medigap).
One of the most interesting ideas to me was to get into a plan with the healthiest cohort with the idea that they'll need less care, and so have fewer and smaller rate increases. But I'm not sure that the insurance companies even keep those buckets separate (HD plan vs non).
The other idea I find appealing is the minimal paperwork and tracking with the small deductible; it's not "hard", but it's annoying to do. I'm bad at something like this, but if one knows what the deductible is, I could keep paying without tracking, and just quit paying when the deductible was achieved. Provider A might get too much and provider B might get shorted, and it would be my problem, though.
Given we use almost no services, though, we'd come out way ahead with the HD plan. Of course things could quickly change. If that happened, the 2K would be the least of my worries.
I'm thinking the "advantage" class plans are continuing the headache of what I've been experiencing on the ACA plans. They've got you roped into a network, so if you get a recommendation for a good specialist, they might not accept your plan. That's happened a few times...we take BCBS NC, but not your flavor of BCBS NC. So it creates the top tier of options off the table.
I'm not sure how accurate my understanding is...I haven't done anything but read threads on this board. But I've come to trust what the real people say here more than most sources.
What I'll probably end up with is G HD with a company that's got a reasonable reputation for not jacking up the rates too bad. I bet Consumer Reports has some advice (that I skipped reading), so maybe that's my next assignment.
|
|
|
08-01-2021, 08:59 AM
|
#31
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Apr 2012
Posts: 6,173
|
Quote:
Originally Posted by sengsational
Medicare was a topic like when to take SS, that I ignored on this board for years. Now DW is going to turn 65 and I really appreciate all of these well reasoned posts, even if the solution differs for each.
|
+1
Our Megacorp retiree health insurance expires at 65. DW will be eligible to apply in about a year, and me in early 2023. Threads like these are useful from an education/experience perspective. I also have questions about various tools/calculators/planning resources available beyond Medicare.gov. A couple were entered on this thread, If I cannot find an existing thread with that info consolidated I might create one.
__________________
FIREd date: June 26, 2018 - "This Happy Feeling, Going Round and Round!" (GQ)
|
|
|
08-01-2021, 09:13 AM
|
#32
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 38,139
|
Quote:
Originally Posted by sengsational
The other idea I find appealing is the minimal paperwork and tracking with the small deductible; it's not "hard", but it's annoying to do. I'm bad at something like this, but if one knows what the deductible is, I could keep paying without tracking, and just quit paying when the deductible was achieved. Provider A might get too much and provider B might get shorted, and it would be my problem, though.
|
No, it’s actually a bit simpler than that. You’ll get billed by a provider only after it’s been through the Medicare review and adjustment, and then your Medigap insurer, and Medicare has determined that you have not yet met your deductible. You don’t have to track or worry about who to pay.
__________________
Retired since summer 1999.
|
|
|
08-01-2021, 09:23 AM
|
#33
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jun 2002
Location: Texas: No Country for Old Men
Posts: 50,021
|
Quote:
Originally Posted by audreyh1
No, it’s actually a bit simpler than that. You’ll get billed by a provider only after it’s been through the Medicare review and adjustment, and then your Medigap insurer, and Medicare has determined that you have not yet met your deductible. You don’t have to track or worry about who to pay.
|
^ This.
DW and I have been on Medicare/Medigap for almost 10 years. The dozen or so providers we have used do not send us bills until both Medicare and our Medigap insurer have processed our claims. Very straightforward, at least in our experience.
__________________
Numbers is hard
|
|
|
08-02-2021, 11:51 AM
|
#34
|
Thinks s/he gets paid by the post
Join Date: Dec 2017
Posts: 1,616
|
Quote:
Originally Posted by Telly
Some of the brokers say that they will help you with problems such as billing problems. BB says they do, though the only problem I have had in using Medicare I went after myself... Dermatologist has a third-party billing company which seems to be run as a distributed collection of loosely-coupled incompetents. I read them over the phone what Medicare had already paid them, same with what AARP/UHC had paid them. After me hounding the billing company every two weeks over the phone, they finally relented and went with my numbers, which were correct.
Another internet broker is Chris Westfall's Senior Savings Network in South Carolina.
|
Although I can do it myself, I would rather not. After I understood that the biller's main recourse was a threat to credit ratings I took a little more relaxed approach to my mothers bills. A potential negative mark on a credit rating isn't really going to affect an 89 year old. I had problems with 3 entities out of 15-20. I have noticed that with MIL there have been no issues of this type for her MA account. They do however re-bill rejected charges with a 10 day payment deadline. I have learned to let thing clear insurer's before paying.
|
|
|
08-02-2021, 12:44 PM
|
#35
|
Thinks s/he gets paid by the post
Join Date: Apr 2007
Posts: 1,322
|
Thank you all for the very informative posts and suggestions.
This month is my Medicare three months before month, so let the fun begin.
My first hurdle is signing up for part A and part B with the government.
After that I am pretty well settled on getting a Medigap Plan G and from the comments am leaning toward ARP/UHC. I took a quick look on their site and got a rough estimate that seems more or less in the range I was expecting.
I am not sure, but suspect that it would be best to be signed up for medicare A and B before I try to sign up for the Medigap. Does the Medigap payer need to have my medicaid number etc?
I will have to get on the stick and get a few more price quotes on the Medigap policies.
August came a lot sooner than I expected. It seemed like I had forever to get ready for the sign-up process.
I guess I will have to also get moving on picking a Part D plan as well.
Thanks gain for all the help on this.
|
|
|
08-02-2021, 12:57 PM
|
#36
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Oct 2017
Location: Chapel Hill, NC
Posts: 5,316
|
joe, when I signed up a few years ago I had to do the Medicare part first and get a Medicare number before I could sign up for the supplement and Part D. The easiest way to do the Part D is on the Medicare.give site, you enter your prescriptions and pharmacy and the website gives you your options. I take no prescription drugs so I always do the cheapest Part D.
|
|
|
08-02-2021, 01:02 PM
|
#37
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 38,139
|
Quote:
Originally Posted by joesxm3
Thank you all for the very informative posts and suggestions.
This month is my Medicare three months before month, so let the fun begin.
My first hurdle is signing up for part A and part B with the government.
After that I am pretty well settled on getting a Medigap Plan G and from the comments am leaning toward ARP/UHC. I took a quick look on their site and got a rough estimate that seems more or less in the range I was expecting.
I am not sure, but suspect that it would be best to be signed up for medicare A and B before I try to sign up for the Medigap. Does the Medigap payer need to have my medicaid number etc?
I will have to get on the stick and get a few more price quotes on the Medigap policies.
August came a lot sooner than I expected. It seemed like I had forever to get ready for the sign-up process.
I guess I will have to also get moving on picking a Part D plan as well.
Thanks gain for all the help on this.
|
That’s correct. You need your Medicare number before you can proceed with the other parts.
DH signed up online at Medicare.gov for part A and B (but not SS) and got a Medicare number in a few days that he could see in his Medicare account. He then got signed up for Medigap and part D using that number. We got the Medicare card in the mail a week or so later.
We went through Boomer benefits to sign up for those, but we had already made our choices (UHC was one of them). They will quote other insurers to you, but sign up who you want.
__________________
Retired since summer 1999.
|
|
|
08-02-2021, 09:02 PM
|
#38
|
Full time employment: Posting here.
Join Date: Nov 2015
Posts: 705
|
Quote:
Originally Posted by joesxm3
Thank you all for the very informative posts and suggestions.
This month is my Medicare three months before month, so let the fun begin.
My first hurdle is signing up for part A and part B with the government.
After that I am pretty well settled on getting a Medigap Plan G and from the comments am leaning toward ARP/UHC. I took a quick look on their site and got a rough estimate that seems more or less in the range I was expecting.
I am not sure, but suspect that it would be best to be signed up for medicare A and B before I try to sign up for the Medigap. Does the Medigap payer need to have my medicaid number etc?
I will have to get on the stick and get a few more price quotes on the Medigap policies.
August came a lot sooner than I expected. It seemed like I had forever to get ready for the sign-up process.
I guess I will have to also get moving on picking a Part D plan as well.
Thanks gain for all the help on this.
|
You might want to pick UHC if you're in a state that has a one time irrevocable choice, but if you live somewhere like California or Oregon, some others, that lets you change to a different insurer annuially, you should just pick the cheapest plan G you can find.
|
|
|
08-03-2021, 06:00 AM
|
#39
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Nov 2010
Location: Sarasota, FL & Vermont
Posts: 36,358
|
Quote:
Originally Posted by audreyh1
No, it’s actually a bit simpler than that. You’ll get billed by a provider only after it’s been through the Medicare review and adjustment, and then your Medigap insurer, and Medicare has determined that you have not yet met your deductible. You don’t have to track or worry about who to pay.
|
I sometimes wonder about the Part B deductible for $203.... why bother for such a small amount? Why not just get rid of it and simplify things?
Add $5-15 to the monthly Part B premium if you must to offset the cost.
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.
Retired Jan 2012 at age 56
|
|
|
08-03-2021, 06:22 AM
|
#40
|
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 38,139
|
Because it was important to Congress that Medicare recipients “have some skin in the game”.
I guess the thinking was that if you had to pay even just a little up front, it might make you stop and think about whether that doctor visit was really necessary.
__________________
Retired since summer 1999.
|
|
|
|
|
Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
|
|
Thread Tools |
|
Display Modes |
Linear Mode
|
Posting Rules
|
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts
HTML code is Off
|
|
|
|
» Recent Threads
|
|
|
|
|
|
|
|
|
|
|
|
|
» Quick Links
|
|
|