Question about health insurance at the Medicare stage

[whitestick]

My mega corp Health Plan tells me that when I reach the age of 65 it will automatically convert to a supplement plan to work with Medicare. Is obtaining a supplement at Medicare age and beyond, easier to do, given pre-existing conditions, or is it just as difficult/relatively expensive as the discussions about health insurance that have been discussed here before?
Is there a corbra like extension when the mega corp policy reaches the 65 age conversion timeframe. To allow shopping for other, hopefully cheaper plans?
What would I expect in pricing for the current mega corp plan to change to, when the plan changes to the supplement at 65?

 

[mykidslovedogs]

When you turn 65 and go on Medicare part A, you will have hospitalization coverage. If you are currently on a group plan with a large group, your Medicare will become "primary" and your group coverage rates will go down, since that coverage will be "secondary". You might want to investigate obtaining Medicare Part B (office visit coverage) and then leaving the group and supplementing your Medicare Parts A and B coverage with a Medicare Supplement product (preferable plan F) and Medicare Part D prescription drug coverage. At age 65, the supplement (Plan F) will pick up most everything that Medicare does not cover except for a small deductible, and Part D will be your drug copay card. You can get a supplement for about $100.00/month with United World, and you should investigate which Part D plan will give you the best Rx coverage. You can plug in your prescriptions at:

www.medicare.gov

to find out which plans will have all of your prescriptions in their formulary using the "Formulary Finder". Part D plans range from about $25-$45/month depending on which plan design you choose.

 

[haha]

Definitely check the amounts quoted in the post above. It varies from state to state and even community to community, and in WA at least the cheapest Type F supplement plan is now about $145-mo.

 

[mykidslovedogs]

Definitely check the amounts quoted in the post above. It varies from state to state and even community to community, and in WA at least the cheapest Type F supplement plan is now about $145-mo.

"Tis true that the rates vary from state to state and carrier to carrier.

 

[whitestick]

Are these rates reflective of prior conditions, (bypass, high bp and diabetes), or does that have much affect on the supplement portion. I understand the rates vary, and I'm in Texas, which doesn't help a lot.
I thought a lot of the previous discussions around high risk pools, and other plans, all seemed to have really high monthly rates, and the high deductible plans didn't help much, since I usually use all of that high deductible every year anyway.
It sounds like you are saying that once I get to Medicare, my out of pocket should go down drastically for total health care, which doesn't "sound" right, from many of the previous posts. Or did I not understand them?

 

[haha]

Are these rates reflective of prior conditions, (bypass, high bp and diabetes), or does that have much affect on the supplement portion.

Don't know about TX, but in WA you do not even disclose your history during the initial sign-up window. No idea what the case might be after that, as it seemed to me that it was clearly a good idea to sign up pronto.

Just call a broker, or call Mutual of Omaha, which writes a lot of this business.

Ha

 

[mykidslovedogs]

After you get Medicare Part A AND Part B, you open up an open enrollment "window" to get a Medicare supplement with NO underwriting, and I believe that window is 6 months following the date that you get part B. That's why it's very important to get the supplement right away. Rates do not depend on health history..however, they are age banded, so the older you get the more expensive it gets. But, if you don't enroll during the open enrollment period, you will be subject to medical underwriting after that, and you could be declined for a supplement. I highly recommend getting your supplement within the open enrollment period. Medicare does not have an "out of pocket maximum", so if you get very ill, you could still be out a lot $$, even if you are on Medicare. The supplement takes care of that risk for you.

If you are currently on a group plan and you want to keep that coverage for a while, you won't have to have Medicare Part B. Your cost for the group coverage goes down quite significantly once Medicare becomes "primary". Once you leave the group, you will need to get part B, and that will open up the open enrollment window for you. You really should apply for a supplement during that time frame or else you could be declined if you have certain pre-existing conditions.

 

[whitestick]

Thanks MKLD for explaining that. It has been confusing for those of us, who haven't gone through that. Now for the $$ question. How does the rates for the Part A and Part B run given the conditions I have expressed. It sounds like I may be able to reduce my planned budget for total health care, by taking the supplement MegaCorp group price and the A&B prices and add those together. What would I expect to pay for each of those?

 

[mykidslovedogs]

Part A and Part B ARE Medicare, so I doubt they are very expensive. A is hospitalization coverage and B is office visit coverage. To tell you the truth, I have no idea how much the governent charges for part A and part B. I imagine it is fairly cheap.

I sell the supplemental products which you are allowed to buy after (or at the same time as) you obtain Medicare Part B. Supplemental products are private policies (not part of Medicare). They pay for what Medicare does not pay. I wish I could tell you how much Medicare part A and B cost, but I really have no clue. Maybe someone else on this board would know.

 

[haha]

What would I expect to pay for each of those?

Part A is hospitalization, and free. Part B this year is $93.50/month, up fom $88 in 06. There are also other possibilities- PPO plans and HMOs which wrap around Medicare. Often there is no additional premium at all in one of these plans. The HMO or plan administrator gets its revenue directly from Medicare.

Ha

 

[mykidslovedogs]

Part A is hospitalization, and free. Part B this year is $93.50/month, up fom $88 in 06. There are also other possibilities- PPO plans and HMOs which wrap around Medicare. Often there is no additional premium at all in one of these plans. The HMO or plan administrator gets its revenue directly from Medicare.

Ha

Correct - Those are called Medicare replacement plans. The only thing I don't like about them is that it is hard to find doctors that accept them. The networks are much more limited for Medicare Replacement plans than they are with Medicare and Medicare supplements.

 

[ziggy29]

Definitely check the amounts quoted in the post above. It varies from state to state and even community to community, and in WA at least the cheapest Type F supplement plan is now about $145-mo.

I would expect WA to be more expensive than most, because that state tends to protect consumers with pre-existing conditions more than most states.

 

[haha]

I would expect WA to be more expensive than most, because that state tends to protect consumers with pre-existing conditions more than most states.

Actually, Medicare Supplements are sold in a tightly federally mandated framework. If you act during the open enrollment period, you are good to go even if you have metastatic brain cancer.

This is not something to procrastinate over or to get overly clever about.

Ha

 

[whitestick]

Thanks to all. Makes my planning a bit more precise and realistic.

 

[ERguy]

I have another comment/question on this if anyone's still out there.

I think it was recently that Medicare trumpeted the fact that they're now covering annual physicals. This got my attention because I've had annual physicals for years and my Blue Cross employer policy covers them.

As I recall the medigap policies that go with Medicare only cover things that Medicare covers. Is this right? If so, then my annual physicals wouldn't have been covered, right?

Am I better off keeping my employee Blue Cross policy in retirement (since it seems to have broader coverage), instead of going with Medicare/medigap?

What about coverage when I'm traveling overseas? I know Medicare doesn't cover that. Do the medigap policies pick up the ball? My employee Blue Cross does cover overseas travel and people living overseas.

Again, my concern is whether giving up the employee health insurance in favor of the Medicare/medigap combination would result in a reduction in overall coverage.

 

[haha]

Your state insurance office will send you something telling what policies are available in your state, what they cost, and what they cover. Type F Medigap has some foreign coverage.

I can't stress enough, you need to do a little research. It isn't very hard, and then you will be informed about your state.

Ha

 

[ERguy]

Thanks for the advice, Ha. I will do that.