Medicare Costs?

[Dash man]

It depends what Medicare Advantage plan you have. Mayo Clinic in Rochester accepts both United Heathcare Advantage and Humana Medicare Advantage - the two largest Medicare Advantage programs in the country.

I believe it was the Mayo Clinics in Florida and Arizona. Don’t hold me to it.

 

[RetMD21]

It depends what Medicare Advantage plan you have. Mayo Clinic in Rochester accepts both United Heathcare Advantage and Humana Medicare Advantage - the two largest Medicare Advantage programs in the country.

Yeah the MA situation with Mayo is complicated.

https://www.medpagetoday.com/special-reports/exclusives/101320

According to the article United Health Care MA patients were getting notified that Mayo wouldn't schedule appointments for them. Apparently this was resolved.

Part of the issue is likely related to prior authorizations required MA plans. This can take a lot of staff time to manage. Mayo may have come to an agreement with some plans.

If you want maximal flexibility you want traditional Medicare

 

[Dtail]

My DGF has a PPO Medicare Advantage. Access to all doctors by us. Zero premiums but 25 to 35 copay typically.
I will go the Medicare/Medigap/Part D route for my brother and I, even though it will clearly be more than our ACA.
One potential disadvantage for MA is the unlimited costs not covered by Part B if one has long term cancer, etc.

 

[teej1985]

I thought Part G and Medigap were the same thing. You have them listed separately with different prices.

Also, you didn't list your Part B. Or maybe the Medigap was really Part B?

Look up the premium amount for Part B, and the answer should be rather obvious...

 

[Tom57]

I agree that company sponsored PPO plans are GREAT!

There is a difference between Medicare Advantage plans:
- HMO plans. Yes, very restrictive, agree to avoid, I would not want to be one.
- PPO plans. Flexible, you choose any doctors that accept medicare, want within the network, no pre-approvables for specialists necessary.
- Company sponsored PPO plans. Probably the best, as they are for a limited audience and may have additional benefits for that audience.

These distinctions I never see made in the "evils of Medicare Advantage" videos .

We are fortunate to be on the latter. We have better coverage under this plan than our pre-retiree health insurance, with lower premiums and deductibles.

I understand that most people may not have this option. But if one does, it might be good to look into it. I am glad I researched and compared these types of Medicare Advantage plans, as we would be paying a lot more with Medicare + Supplements.

MY DW and I have a company-sponsored PPO plan for Medicare Advantage that is great. Besides the $164.50 per month each for Medicare Plan B we also pay $700.28 a month total for drugs, dental, vision, etc. $600 out-of-pocket limit per person per year for Plan A and B non-covered costs. No preapprovals are needed. Specialists are only a $10 co-pay. The $ 700-a-month insurance premium might seem high but I alone have 5 prescriptions that cost more than $5,000 each a year for only an annual co-pay of $160 each. We more than cover the $700 monthly premium in prescription savings alone on 1.7 prescriptions. As Jolly Stomper said these plans are for a limited audience and that includes us. We do save lots of money each year compared to Medicare + B, C, D, F, G, etc.

 

[MissMolly]

My DGF has a PPO Medicare Advantage. Access to all doctors by us. Zero premiums but 25 to 35 copay typically.
I will go the Medicare/Medigap/Part D route for my brother and I, even though it will clearly be more than our ACA.
One potential disadvantage for MA is the unlimited costs not covered by Part B if one has long term cancer, etc.

Any Advantage Plan I've seen has a MOO. Mine is $1,200/yr. Where have seen one with no MOO?

 

[bada bing]

My wife just turned 65 and signed up for a 'G' Plan that costs $180 per month and another 8 dollars for prescription coverage (1 Generic Prescription) through Boomer Benefits. I can't recommend them enough...they did all the heavy lifting.

I turn 65 in Dec and I've been doing my Medicare set up. I went with Boomer Benefits as well and it's been a good experience. JMO, but using an agent for Medicare plans is a no-brainer because you can't save any money DIY. You'll get the same pricing whether you use an agent or not. Boomer Benefits says they will be available to help with any claim issues down the road - we'll see. The phone consultation to set up with them was very smooth and professional.

I currently have "free" retiree medical from former employer that is valued at $1200/month and covers pretty much anything, anywhere. At age 65, I transition to Medicare and former employer will pay my part B and plan D but won't pay for medigap. I'm going with UNH (AARP) plan G @ $130/month and Aetna plan D (I don't use any meds currently). My company also sponsors a PPO "C" plan, but after looking into it I decided on traditional Medicare. The company's PPO was better than the retail plans I looked at.


One confusing thing is the eligible expenses of the various plans/parts for RRA (Employer's Retiree Reimbursement) and for HSA. I haven't worked all that out yet.

 

[Dtail]

Any Advantage Plan I've seen has a MOO. Mine is $1,200/yr. Where have seen one with no MOO?

True, misspoke.

 

[GenXguy]

Look up the premium amount for Part B, and the answer should be rather obvious...

Sorry, I'm not going to look up pricing and search anything in response to pricing someone posted if they can simply clarify. Like I said, both Plan G and Medigap were both listed. I proposed a possible explanation since Part B was not listed. I was not asking you.

 

[braumeister]

Sorry, I'm not going to look up pricing and search anything in response to pricing someone posted if they can simply clarify. Like I said, both Plan G and Medigap were both listed. I proposed a possible explanation since Part B was not listed. I was not asking you.

Well, you could just look at the half dozen posts in this thread that provided the Part B cost and it should be obvious.

 

[Guamaniac]

Just one more bit of info from someone who is not a fan of Medicare Advantage plans. I'm not saying it's a bad choice for everyone but it's worth a read I think.

https://retireearlyhomepage.com/medicare2022.html

 

[GenXguy]

Well, you could just look at the half dozen posts in this thread that provided the Part B cost and it should be obvious.

OK, I'll do that, but I thought it was a fair question about Medigap and Part G.

 

[Gotadimple]

I thought Part G and Medigap were the same thing. You have them listed separately with different prices.

Also, you didn't list your Part B. Or maybe the Medigap was really Part B?

GenX
The Part G in the post refers to a Medigap Plan called Plan G. The federal government has approved several variations of Medigap plans, and each variation has a letter: G, N are most common. It doesn't matter which carrier you buy the plan from, the plans with the same letters all offer the exact same benefit.

HTH,
- Rita

 

[Midpack]

It's not as much of a bargain if you haven't worked 40 quarters. And if you have worked less than 30 quarters, Medicare Part A alone is over $500/mo!

Anyway, it all seems ridiculously expensive for me.

As it should be...

Are you suggesting someone who has worked (and paid into Medicare) less than 40 quarters, should pay the same premium as a senior who worked and paid in for 140 to 180 quarters - worked 35 to 45 years?

 

[orchid55]

If you don't qualify for Medicare you can stay on an ACA policy and probably still receive a subsidy. However, in my state you would only have a choice of narrow network HMOs on the ACA. Paying for Medicare might be a better option.

 

[Rianne]

Just one more bit of info from someone who is not a fan of Medicare Advantage plans. I'm not saying it's a bad choice for everyone but it's worth a read I think.

https://retireearlyhomepage.com/medicare2022.html

Interesting link. There are way too many commercials on TV, through snail mail, inbox, etc. trying to sell medicare advantage plans. Advertising is expensive. It must be worth it to spend all that $$ on medicare advantage plan advertising. I have not seen one advertisement for traditional Medicare policies.

 

[pb4uski]

I'm still five years from Medicare, but was watching some videos yesterday and was surprised by the related costs. $170 for part B, $200 for medigap G, $20 for drug coverage. That's almost $400 month, a lot more than I was expecting for Medicare.

I did some quick browsing on the medicare.gov site to see what plans were available. I guess I was expecting something like the ACA web site where I could compare plans and apply online. This seemed more like an advertised listing of insurance companies I would have to contact individually for quotes and to apply. At least two of the recommended insurers said they didn't offer plans in my area when I clicked through to their web site? I was also surprised that many of the insurers were places like State Farm or life insurance companies, and not health related companies.

Also, if I understand correctly all insurers are required to provide the same coverages, so why would I choose a more expensive plan over a cheaper one?

That's about right... a little heavy compared to our experience but only by $25 or so. But the thing to remember is that for the most part other than a $226 Medicare part B deductible and any Rx copays (which can be substantpending on what meds you are on). So using your numbers all in abut $5k a year/$417/month unless you have meds with really extreme Part D copayments.

But no significant 4 or 5-figure annual deductibles like most ACA plans.

Alternatively, you can go with Medicare Advantage, pay nothing but accept a significant deductible and managed care.

We chose Medigap (Plan G)

 

[pb4uski]

My friend paid nothing in premiums for his advantage plan but when he needed surgery 3 years in a row he paid 7k each year which was the maximum out of pocket for his plan.

Yeah, my BIL thinks I'm a fool for my $188/month Medigap plan. The way I figure it I'm just prepaying my deductible if I was on MA.

 

[RetiredHappy]

Our good friends who have alot of money but are too stingy to spend on themselves buy a $0 premium Medicare Advantage HMO plan. He had significant gallstones/gall bladder issues and had to wait 4 months to get surgery. By then, organs were in sepsis, and he had to wear a bag to drain the nasty stuff for 2 months before the infection was under control.

His wife needed shouder surgery and could not use her arm for almost a year before she got surgery. She could not see a rheumatologist for 6 months.

Yet, they refuse to switch to a Medicare Advantage PPO which would have given them more options. To them, free is the best.

 

[pb4uski]

^^^ There is a fine line between frugal and cheap that your friends obviously cannot see.

 

[trumpeting_angel]

I'm in the traditional Medicare, Part G crowd. I'm also a member of Physicians for a National Health Plan (though I'm a retired psychologist). The horror stories from the docs and others in this organization about the problems of Medicare Advantage patients should have shocked me, but I was practicing during the heyday of managed care - it's hard to shock me about the lengths insurance companies will go to preserve profits over the lives of insureds.

I am not in terrible heath, but I have various problems that have been hard to diagnose. There was no clarity on several of the symptoms until the most advanced testing was done. I know that not all the MA plans are problematic, but I am so glad I didn't have to hound my doctors to fill out forms and call the insurance company and be pestered by poorly-qualified "reviewers." And so happy I didn't have to wait for months to see if this or that test would be approved.

I have had good and bad experiences with doctors and hospitals. I am unwilling to accept poor care, and certainly unwilling to accept rationed care from a Medicare Advantage program.

 

[Gotadimple]

Interesting link. There are way too many commercials on TV, through snail mail, inbox, etc. trying to sell medicare advantage plans. Advertising is expensive. It must be worth it to spend all that $$ on medicare advantage plan advertising. I have not seen one advertisement for traditional Medicare policies.

Traditional Medicare is provided by the US Government and you will see "commercials" for it but they are public service announcements and so not very numerous. Annually you get info from Medicare before open enrollment, and you get a separate mailing regarding the upcoming change in premium for the new year.

Medigap policies - called supplements - do advertise as they are sold by insurance agents.

It really depends on which part of the country you live in. Live in an area with lots of retirees? You'll see lots of MA and Supplement advertising.

- Rita

 

[Dash man]

Traditional Medicare is provided by the US Government and you will see "commercials" for it but they are public service announcements and so not very numerous. Annually you get info from Medicare before open enrollment, and you get a separate mailing regarding the upcoming change in premium for the new year.



- Rita

There is no open enrollment for Medicare Supplements. Open enrollment is for Medicare Advantage and Part D prescription plans.
Medicare Supplement plans can be changed at any time as long as you can pass underwriting or are still within your Initial Enrollment Period.

 

[Teacher Terry]

Another friend of mine spent 8 months getting permission for a knee replacement as she had to have her cardiologist say her heart was fine for surgery, etc. She finally got it scheduled and her advantage plan has a dispute with the contracted hospital system and instead of honoring the contract for a year service is terminated immediately. So she couldn’t get the surgery and would have to start all over with whatever medical group her advantage plan contracted with. She often has to change doctors yearly because of these issues.

 

[GenXguy]

As it should be...

Are you suggesting someone who has worked (and paid into Medicare) less than 40 quarters, should pay the same premium as a senior who worked and paid in for 140 to 180 quarters - worked 35 to 45 years?

No, I'm suggesting a senior citizen shouldn't have to pay so much for Medicare while people through age 64 with much much more resources can get a free ride on ACA Medicaid Expansion, that 65+ are not eligible for. So, it's not fair, definitely NOT as it should be.