Searched but Cannot Find (Medicare ?)

[Rianne]

I had a casual conversation with my DF yesterday. Her husband turns 65 this November. She won't turn 65 for @ 15 years, yes age difference.

We're 62 and and are not planning for that kind of medicare cost.


After investigating, she said her DH will be paying approx $1000/month in EDIT medical (medicare + her ACA). I was shocked. I've never read a cost like that on this forum.

My general question:
Cost for medicare:
1. High end, all the best benefits, most you pay.
2. Middle road, decent benefits, covers gap insurance and drugs.
3. Low end, least expensive route.


At this point in time, they are both on ACA, he's retired, she works part time with no medical benefits.

 

[folivier]

I just started Medicare last month. My total for plans A, B, D, G are: $305/month with a one time deductible for A of $185.00
Your friend may be in for a pleasant surprise. Unless he is on some very expensive Rx's.

 

[REWahoo]

Thread on the subject:
http://www.early-retirement.org/forums/f38/budgeting-for-medicare-costs-80693.html

 

[ShokWaveRider]

Medicare itself has fixed costs.

2019 Medicare Part A premium

Most people do not pay a premium for Medicare Part A in 2019. To qualify for premium-free Part A, you must have worked and payed Medicare taxes for 40 quarters (10 years).

If you paid Medicare taxes for only 30-39 quarters, your 2019 Part A premium will be $240 per month. If you paid Medicare taxes for fewer than 30 quarters, your premium will be $437 per month.

2019 Medicare Part B premium
The standard monthly Medicare Part B premium is $135.50 in 2019. While most people pay only the standard premium, higher income earners will be charged a higher premium.

I pay an additional for AARP Supplement Plan G of $166pm. from what I understand it is basically the best you can get.

Part D is an additional $13.50pm.

 

[Dtail]

Perhaps he will be paying an IRMAA premium due to very high Medicare MAGI.

 

[ivinsfan]

Except for the Part B cost, the rest of it is very location specific. For example I have very similar coverage to SWR and the cost is 245 a month. Drug coverage is extra.

We live in an area with abundant excellent medical care, but it comes at a cost. The heart center 45 minutes from our house literally saved my DH's life during a surgery gone wrong. It's top ranked nationally for excellent outcomes. I'm not sure my DH would have lived through the operation at another location. I don't like the higher cost for my area but would not trade the quality of care for a few dollars less.

 

[Rianne]

Except for the Part B cost, the rest of it is very location specific. For example I have very similar coverage to SWR and the cost is 245 a month. Drug coverage is extra.

We live in an area with abundant excellent medical care, but it comes at a cost. The heart center 45 minutes from our house literally saved my DH's life during a surgery gone wrong. It's top ranked nationally for excellent outcomes. I'm not sure my DH would have lived through the operation at another location. I don't like the higher cost for my area but would not trade the quality of care for a few dollars less.

Both worked at least 40 quarters.



So...
Part A - Free
Part B - $245 (very best care in area)
Supplement - $166
Part D - $13.50
Total - $424 Far cry from $1000 and he is keeping his MAGI below the threshold.

 

[REWahoo]

Medicare cost info, directly from the source...

https://www.medicare.gov/your-medicare-costs

 

[audreyh1]

Yeah, something not adding up right.

Did the number include her health insurance premiums?

 

[ShokWaveRider]

What is Part B VERY BEST. It is all the same where we are, places either take it or do not. I did not think there were levels.

 

[Rianne]

Yeah, something not adding up right.

Did the number include her health insurance premiums?

That's a good question. Right now, both on ACA, premiums @$250/month with subsidy.

Ahhhh...her income combined with his SS might put them over the cliff. They file jointly. They could somehow work around that. She could drop part time hours to a minimum, then figure out IRA WD to stay in clear. I think they need a FA.

 

[CRLLS]

Both worked at least 40 quarters.



So...

Part A - Free
Part B - $245 (very best care in area)
Supplement - $166
Part D - $13.50
Total - $424 Far cry from $1000 and he is keeping his MAGI below the threshold.

Her 40+ quarters of working history has nothing to do with his Medicare cost.
The "very best care in the area" has nothing to do with the Part B premium.

If IRMAA is considered, the 1st 2 steps in premiums are about 190 or 271. The 245 mentioned is neither. What am I missing?

Did you possibly mis-hear "medicare" costs when they said "medical" costs. I could easily see $1,000 including the 15 yr lounger spouse having a ACA plan. In fact, $1,000 may be on the low end.

 

[ivinsfan]

OP even your original question leaves lots of questions. When you say lowest cost, least expensive, are you talking premiums because some MA policies are actually free but can really nail you for extra costs when you have medical issues.

 

[Rianne]

Her 40+ quarters of working history has nothing to do with his Medicare cost.
The "very best care in the area" has nothing to do with the Part B premium.

If IRMAA is considered, the 1st 2 steps in premiums are about 190 or 271. The 245 mentioned is neither. What am I missing?

Did you possibly mis-hear "medicare" costs when they said "medical" costs. I could easily see $1,000 including the 15 yr lounger spouse having a ACA plan. In fact, $1,000 may be on the low end.

The $245 guesstimate came from Ivansfan great HC community, it was a guess for me.
If his medicare is $424 and her HI on ACA subsidy (they are filing jointly) is $250, that is getting up there.

Her income + his SS and whatever IRA WD they take could throw her over the edge and eliminate ACA subsidy. BUT if she took a HDHC plan, had an HSA...still need FA. Her goal is to stay under ACA cliff. They'd have to figure out a way to keep income low (as we all do).
Do I make sense?

 

[Rianne]

OP even your original question leaves lots of questions. When you say lowest cost, least expensive, are you talking premiums because some MA policies are actually free but can really nail you for extra costs when you have medical issues.

So we are in Illinois. The state you're in makes a difference.

 

[CRLLS]

The $245 guesstimate came from Ivansfan great HC community, it was a guess for me.
If his medicare is $424 and her HI on ACA subsidy (they are filing jointly) is $250, that is getting up there.

Her income + his SS and whatever IRA WD they take could throw her over the edge and eliminate ACA subsidy. BUT if she took a HDHC plan, had an HSA...still need FA. Her goal is to stay under ACA cliff. They'd have to figure out a way to keep income low (as we all do).
Do I make sense?

So we are talking about the $1,000 is their combined healthcare monthly cost.

When I was budgeting our HC costs, I included some deductibles and copays in the overall costs. Maybe that is making up the difference. Possibly?

FYI, DW went on Medicare shortly before I did. I was surprised that the ACA subsidized premium for me alone was within a few dollars of what it was for the two of us! I'm not sure if that works the same for everyone or just for our situation. There is no subsidy formula for married with one on Medicare. ACA is either single or Married coverage with no consideration for "other" medical premium costs being included.

 

[ivinsfan]

OP I think something got lost in translation between you and your friend. I see you edited your post to reflect that. Yes it's been posted many times here that when a couple on ACA goes to one on ACA and one on Medicare costs will rise.

 

[Rianne]

FYI, DW went on Medicare shortly before I did. I was surprised that the ACA subsidized premium for me alone was within a few dollars of what it was for the two of us! I'm not sure if that works the same for everyone or just for our situation. There is no subsidy formula for married with one on Medicare. ACA is either single or Married coverage with no consideration for "other" medical premium costs being included.

I believe this is what she was saying. Her ACA subsidy coverage would not change that much BUT they are on a plan that does not offer a HDHC plan. They could lower costs considerably if she chose that plan and got an HSA.

BTW between this discussion I called our insurance agent. She put me at ease and explained the confusion. Said if medicare stays similar to what it is now, when DH/me reach 65 our medicare costs would be approx $500 combined. She said this would be the high end medigap policy and drugs.
Thanks! I need to learn to search better.

 

[ivinsfan]

I believe this is what she was saying. Her ACA subsidy coverage would not change that much BUT they are on a plan that does not offer a HDHC plan. They could lower costs considerably if she chose that plan and got an HSA.

BTW between this discussion I called our insurance agent. She put me at ease and explained the confusion. Said if medicare stays similar to what it is now, when DH/me reach 65 our medicare costs would be approx $500 combined. She said this would be the high end medigap policy and drugs.
Thanks! I need to learn to search better.

If you can get that coverage for 500 bucks total that's great but that leaves only around 115 for each of you to get Medigap and drug coverage that seems a little low. I guess it depends on how much OOP expense you are comfortable paying.

 

[Rianne]

If you can get that coverage for 500 bucks total that's great but that leaves only around 115 for each of you to get Medigap and drug coverage that seems a little low. I guess it depends on how much OOP expense you are comfortable paying.

Probably, this was over the phone and a very quick estimate. I was freaked out by what my friend said, so even if it's a couple hundred more for the both of us, NBD.

 

[CRLLS]

Probably, this was over the phone and a very quick estimate. I was freaked out by what my friend said, so even if it's a couple hundred more for the both of us, NBD.

I'm glad you are now not "freaked out". Being on Medicare is great IMO. Having had ACA plans dropped every year and ACA provider going bust mid-year and having to find another, was a constant job for us. Stability in Medicare is finally here.

$408 / mo for the two of us now. That is for Part B, Plan F-HD and Part D (Humana/Walmart).

 

[Rianne]

I'm glad you are now not "freaked out". Being on Medicare is great IMO. Having had ACA plans dropped every year and ACA provider going bust mid-year and having to find another, was a constant job for us. Stability in Medicare is finally here.

$408 / mo for the two of us now. That is for Part B, Plan F-HD and Part D (Humana/Walmart).

Thank you for that. We're spoiled right now on ACA. On a HSA HDHP we're paying close to $9/month premiums. Our yearly blood tests and DR visits come to approx $2K/year, while we're healthy anyway. This is the best HC plan we could have asked for. That year of nail biting and worry before we went on ACA was awful.
Both of us have pre existing conditions that are manageable.

 

[audreyh1]

If someone has an ACA subsidy, then moving to Medicare could see prices increase, although you are no longer subject to high deductibles.

For those of us not subsidized on our ACA premiums, moving to Medicare is a big decrease in premiums as well a a huge drop in deductibles.

 

[Midpack]

At 65 I'm starting at $311/mo with very good coverage:

• Original Medicare A&B - $135.50/mo
• Supplement Plan G - $124.60/mo
• Part D - $17.10/mo
• Dental-Hearing-Vision - $34.17/mo

DW will be on COBRA for a while at $712/mo, then ACA until Medicare

So we're at just over $1000/mo for the next 18 months for excellent coverage - I'm thrilled with that, about half what I expected based on pre-65 open market coverage quotes I've seen.