Question if you're on Medicare please

[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....

 

[pb4uski]

DW just went on Medicare.

Part B... $145/mo, Part D (Rx)... $13/mo, Medigap... $124/mo.... Total... $282/mo

 

[MichealKnight]

Thanks - any other expenses to come?

Potentially - would there be things like co-pays, deductibles for hospital stays, etc....or does Medicare cover all of that.

 

[pb4uski]

Medigap covers that... there are some deductibles but they are negligible in the whole scheme of things.

 

[CardsFan]

DW just went on Medicare.

Part B... $145/mo, Part D (Rx)... $13/mo, Medigap... $124/mo.... Total... $282/mo

Pretty much the same here, though our Medigap's are a little higher. About $700/month, all in for 2 (including the $198/year deductible for each).

Now, if you get an Advantage plan, things change. Some fixed costs could go away (part D and Medigap), but more variable costs can be added (deductibles, co-pays, etc)

 

[TrvlBug]

DW just went on Medicare.

Part B... $145/mo, Part D (Rx)... $13/mo, Medigap... $124/mo.... Total... $282/mo

These costs are for base Medicare. Depending on income your costs could be much, much higher. Ours are triple these costs for Parts B and D.

Don't forget dental costs. Seems as if DH and I have each had an implant (DH 2 in the last 3 years.) Vision costs are relatively low.

 

[NoMoreJob]

DW just went on Medicare.

Part B... $145/mo, Part D (Rx)... $13/mo, Medigap... $124/mo.... Total... $282/mo

Mine is $297/mo for part B +D + Medigap plus the $198 part B annual deductible. I take no maintenance medications so that's about it.....total $3,762/yr for medical. Out of pocket dental and eye care adds around $500/yr so grand total of about $4,300/yr.

That's for me only. My wife is not yet on Medicare.

 

[meierlde]

These costs are for base Medicare. Depending on income your costs could be much, much higher. Ours are triple these costs for Parts B and D.

Don't forget dental costs. Seems as if DH and I have each had an implant (DH 2 in the last 3 years.) Vision costs are relatively low.

If your income exceeds certian amounts the premiums you pay for part b and d go up. Note that as of Jan 1 you can no longer get plan f for medigap but need part g which means that you can add the $198 or so part b deductable on to expenses. Dental plans tend to run about $35/month,and vision plans from $17 on up. Note that you do not want to get in an age rated medigap plan as then the premiums will go up and up as you get older. look for a community rated plan such as the AARP plans where the are discounted at 65 and rise until age 72 and only rise due to rising costs not due to getting yet older. If your income is above 85k per year single or 170k married you will pay the income related monthly adjustment amount, check the medicare.gov website for details.

 

[jpeter1093]

So, when you all say "Medigap", is that analogous to Medicare part N, for example? Or would I want Part N AND a Medigap plan?

 

[VanWinkle]

145.00 for part B and 29.00 for part C United Health Care Advantage. 174.00 per month. I have 4400.00 per year OOP max which I hope to never meet. I can afford the 4400.00 so I opt not to insure to the first dollar(medigap).

 

[Hermit]

I also have an Advantage plan. I think it is about $174/ mo. No copays. I haven't had major insurance problems but I do not travel much. I get negotiated rates for dental plus the cleaning and one filling or extraction that is covered by Medicare. I am restricted to plan doctors, but there is only one health facility in the area and they seem to be part of all plans.

 

[REWahoo]

So, when you all say "Medigap", is that analogous to Medicare part N, for example? Or would I want Part N AND a Medigap plan?

Medigap = Medicare supplemental insurance. Medigap policies are available in a variety of standardized plans (not parts) A, B, C, D, F, G, K, L, M, N described here: https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies

 

[REWahoo]

OP, the Boomer Benefits website has a great tutorial on Medicare.

Recommended viewing for someone new to Medicare trying to learn how it all works: New to Medicare

 

[Time2]

I'm paying $144.80 for Part A-Medicare.
$176.25 for Part B for a Plan G.
And $13.20 For part D my drug plan.
I'm supposed to have a $198 deductible,
but every time I go in for something, they say it has already been paid.
It has only been 3 months and I don't ever remember paying it.
Previously I had a $10k deductible, so I paid every time I went in.
With Medicare I'm paying $40 or $50 less than with my $10k deductible plan, but it's nice to have no additional bills.

 

[Happyras]

Don't ignore the IRMAA's on medicare! For us it is costing almost more to be on medicare than prior insurance.
Part A is free, big yippee...
Part B is $144.60 per person
IRMAA is $462.70 per person for part B
Part D is only $18.30
but IRMAA for part D is $70 per person
Part G is $169 per person plus $198 ded
The good news is the drugs we take, pretty generic, cost almost the same as over the counter pricing, the drug coverage is worthless currently....
I guess that puts us at $864.60 per person per month for medicare with plan G, we were paying $684 per person for what I thought was better coverage. At least the drugs were better covered, but the med deductible was $1000/yr. So we now pay about $1360 more per year after deductible per person. Thank you medicare! What a deal.....

 

[CardsFan]

Don't ignore the IRMAA's on medicare! For us it is costing almost more to be on medicare than prior insurance.
Part A is free, big yippee...
Part B is $144.60 per person
IRMAA is $462.70 per person for part B
Part D is only $18.30
but IRMAA for part D is $70 per person
Part G is $169 per person plus $198 ded
The good news is the drugs we take, pretty generic, cost almost the same as over the counter pricing, the drug coverage is worthless currently....
I guess that puts us at $864.60 per person per month for medicare with plan G, we were paying $684 per person for what I thought was better coverage. At least the drugs were better covered, but the med deductible was $1000/yr. So we now pay about $1360 more per year after deductible per person. Thank you medicare! What a deal.....

WADR, for you to hit the IRMAA limits bolded above, your AGI for MFJ is in excess of $326,000/year.

 

[Happyras]

WADR, for you to hit the IRMAA limits bolded above, your AGI for MFJ is in excess of $326,000/year.

Yeah, but my wife has several show horses so income just doesn't go that far

 

[CRLLS]

$145 for part B, $13 for part D and $110 for a Plan G supplement. If I amortize the obligatory Part B deductible of $198 per annum over each month and I'm all in at $280 per month. Should be no additional OOP costs for any Medicare approved services except for any drug co-pays. I'll be testing that out. This last month, I spent some time in the ER and then had outpatient surgery.

While Part B is the same base premium nationwide, Part D drug plans and Supplement costs vary widely based on the plan one chooses, the location one is in and ins company chosen. IRMAA can be a big multiplier for those with higher income. Delays in signing up will increase costs also as will changing supplement plans in some states.

 

[CRLLS]

WADR, for you to hit the IRMAA limits bolded above, your AGI for MFJ is in excess of $326,000/year.

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

 

[ivinsfan]

Don't ignore the IRMAA's on medicare! For us it is costing almost more to be on medicare than prior insurance.
Part A is free, big yippee...
Part B is $144.60 per person
IRMAA is $462.70 per person for part B
Part D is only $18.30
but IRMAA for part D is $70 per person
Part G is $169 per person plus $198 ded
The good news is the drugs we take, pretty generic, cost almost the same as over the counter pricing, the drug coverage is worthless currently....
I guess that puts us at $864.60 per person per month for medicare with plan G, we were paying $684 per person for what I thought was better coverage. At least the drugs were better covered, but the med deductible was $1000/yr. So we now pay about $1360 more per year after deductible per person. Thank you medicare! What a deal.....

Just like ACA a lot of the cost is income based and driven. Is it fair? Well I don't see that tying cost to income is anymore fair then tying insurance to your job. However it is the way it is.

It might be intuitive to think that going on Medicare will lower your costs but it's not always true by any means.

These comments by myself and other are not off-topic at all as income is a basic part of the cost for everyone.

 

[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]

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]

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!