Question if you're on Medicare please

[Gotadimple]

OP. You can try and estimate based on today's costs, but, really the comparison should be compared to your current plan and its expenses. You should see a monthly reduction of 30-50% in premiums based on my experience. My employer plan was more expensive in premiums and had more out of pocket expenses than what I have today through Medicare, a Medicare Advantage Plan, and Dental insurance. (Assuming your AGI is below IRMAA thresholds).

You are trying to estimate. But there is no promise that the detailed costs you work up will increase with inflation as you project out to your switch over to Medicare plans. Because Medigap and Medicare Advantage plans are private insurance, their rates can change dramatically when compared to Part B premiums. But generally these private plans price to the competition. Medigap/Advantage plans can vary widely in out of pocket costs so price should not be the only consideration.

- Rita

[TrvlBug]

Quote:

Originally Posted by CRLLS Don't ignore that any Roth conversions count in that AGI. Really not fair IMO. But it is what it is.

Tax free interest income is also added to the AGI to calculate IRMAA.

[Teacher Terry]

It also depends on where you live. My sister pays 600/month for herself in Chicago.

[John Galt III]

Quote:

Originally Posted by MichealKnight Hello, I am tinkering with future plans, i.e retirement. My question is.... *today*....if you are on Medicare....can you please say what your total "out of pocket" expenses are for health care? Be it by month, or for a whole year? Thank you in advance....

I am on a Medicare Advantage plan, and all I pay is $145 per month for PArt B. I have used it once so far, for a 'new to medicare' exam. No charge for that. My blood tests are supposed to cost only $5, if the test is 'medically necessary'. ANd I always call my ins to make sure they are 'medically necessary'. Some large copays, for example, MRI is $300 copay. X-ray is $50 copay. I had been on the Affordable Care Act before Medicare, and the ACA was much cheaper for me , since I kept my income low for the means testing. My monthly premium cost was sometimes zero, and and high as $28. And $5 and $10 copays for everything. Those were the days, my friend. We thought they'd never end. Cue Mary Hopkin.

[Sue J]

I just started Medicare Feb 1st and DH started April 1st.

Part B 144.60 x 2 = 289.20
Medicare supplement Plan G for both (combined bill) = 219.46
Part D drug plan 14.20 x 2 = 28.40

Total cost for both of us = $537.06

DH has an HRA (Health Reimbursement Arrangement) from his pension plan of $337.50 - 2.33 admin fees = $335.17. I have it set up to automatically reimburse DH's portion of of the supplement $115.56 + one of our Part B costs of $144.60 + both of the Part D's $28.40. So every month we are automatically reimbursed $288.56. The balance in the HRA is used for dentist, vision, OTC etc.

Or it can be used for our Part B deductible of $198 each. We both had televisits with our doctors in April. I thought these would be part of our deductibles but our supplement paid it! I was very surprised. Seems it was one of the "perks" included in the current pandemic programs. Nice!

[Tom57]

Quote:

Originally Posted by MichealKnight Hello, I am tinkering with future plans, i.e retirement. My question is.... *today*....if you are on Medicare....can you please say what your total "out of pocket" expenses are for health care? Be it by month, or for a whole year? Thank you in advance....

I will give you my numbers but first you need to assess if you are/will be a light, moderate or heavy user of medical (Doctor, Hospital, Durable Medical Equipment- DME like CPAP, Constant Glucose Monitoring (CGM), etc. Then you also need to assess if you are/will be a light, moderate or heavy user of prescription drugs. These assessments will tell you how much insurance you need to buy.
My current monthly costs for 2 people are $946.61 per month for Medicare Part B, a Medicare Advantage plan with an annual $600 per person out of pocket (OOP) limit, a great prescription drug plan, dental and vision.
My copays (up to the $600 per year OOP limit) are: PCP doc $5, specialist doc $10, Hospital ER $65, Hospital in-patient $100, ambulance $50, DME $20, labs $0, and radiology tests $20. I have hit my $600 OOP limit for the last 4 years, including 2020 by June.
Prescription drugs copays: Generic - the lower of $10 or actual cost for each 90 day supply and Name brand - $40 for each 90 day supply.
I take 4 maintenance Name brand drugs each with an annual cost over $6,000, with an annual OOP of $160 each. I also take 7 Generic maintenance drugs with an annual OOP of $200 and other Generics at an annual cost of $65.

My savings/break even is simple for me and DW: annual insurance cost $11,359.32 ($946.61 x 12), $600 OOP limit for me, $300 OOP for DW, and $1,425 copays for DW and me for prescription drugs for an annual total of $13,684.32. My 4 Brand name drugs would cost $24,000 per year alone, not counting the tens of thousands annual cost for doctors and hospitals. That should help in understanding why $946.61 in monthly insurance premiums are a very good deal for DW and me.
Good luck with your research!

[spncity]

Just under $300 mo. for Part B, Carefirst Medigap G, and low-cost prescription plan. There is a $198 annual deductible.

Spouse still on HDHP for $630 per mo. with a $6,550 annual deductible.