5 Months I'll be 65 Medicare questions

Time2

Thinks s/he gets paid by the post
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Oct 3, 2019
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I'm starting to look seriously at Medicare options, and really don't have a clue yet. I'm in good health and my healthcare expenses have been low. Basically see the doc once a year for the physical and have my BP and cholesterol RXs renewed. But I also don't want to sign up for the least coverage and then find that I should have stepped up a bit.
Just looking for what others have run into. Male, btw.
 
A good book I have recommended before is: https://www.amazon.com/Get-Whats-Yours-Medicare-Maximize/dp/1501124005/ref=sr_1_1?crid=3EC2TVPNHT27G&keywords=get+whats+yours+for+medicare+book+by+philip+moeller&qid=1570252617&sprefix=get+whats+yours%2Caps%2C183&sr=8-1

It was ~$10 - 11 until recently, maybe they bump the price this time of year. Either way, it has a lot of digestible info, in an easy to read format (really!). Reading this first will give the background to help in understanding what can be read on the gigantic Medicare.gov website.
 
I'm 65 in November and have selected a supplemental G plan and Part D.

For me, the "discounts" on Supplemental plans made them difficult to compare by price. This will probably be different by state. My state does not allow attained age pricing, so we have application age or community rated prices. But for community rated pricing there is typically a discount for buying "early". In other words it costs less if you are younger. OK.

The discount is usually in the fine print, difficult to find, but it's on the order of 30%+ at age 65, so very significant. And the price comparison sites just give the discounted price without mentioning that it will be going up. Typically the discount decreases by 3% (of the full price) each year for 10 or 11 years. A built-in price increase.

And then there's the problems noted in other threads here about how the insurance companies will change plan features, costs, or enrollment, or create new insurance companies for the same reason. So it's really hard to make a decision about the value of any supplement plan. And if I want to switch plans in the future I will probably have to go through an underwriting process and pay at a higher new application age rate. Time will tell if I've made a decent choice.

Plan D didn't feel quite as bad. I'm on four prescriptions, all generic. I was able to check on plan costs at medicare.gov, though the cost presentation was confusing, particularly when looking at a partial year of coverage. And while you can compare costs for drugs you currently take or may take, there's no easy way to know if a plan's formulary is otherwise reasonably comprehensive or value priced if you need new drugs in the coming year.

Most plans have "preferred" pharmacies. You need to select the preferred pharmacy in order to get the lowest costs. So more searching for each particular plan's best prices, before comparisons to other pharmacies. There was only one drug plan that covered all my prescriptions within the first two pricing tiers.

In addition, I had to be a little careful to get my prices before the deductible was satisfied. If everything remains stable I won't be exceeding the deductible during a year, so co-pays are not necessarily important to me at this time. I was able to find a drug plan that promises to cost me less for drugs, at a nearby pharmacy, than I currently pay at Costco. And the premium price change for 2020 was nominal. That's nice, but formularies and tiers can change, along with prescriptions and premiums, so who knows if things will go as well as I hope?

The one good thing for drug plans is that there is no underwriting, so you can change plans yearly if you want. Seems like a lot of us will be doing that for 2020. A poor plan selection can be fixed the next year.
 
You are in "good health" now, but in all likelihood you eventually will not be - either temporarily or permanently. Either way the paperwork and bills can add up very quickly. In addition to that, as you age and your mental acuity declines dealing with insurance companies and their rules and billings will likely become much more difficult for you.

Those are the two primary reasons that I chose the best plans that I could afford which turned out to be traditional Medicare (NOT Medicare Advantage) plus a plan G supplement. As it turned out I had to use my coverage extensively very shortly after my coverage took effect. By the way, I had been very healthy up to that point.

Because I chose these plans pretty much all that my wife and I had to deal with was paying the approximately $185 or so annual deductible. Finding doctors, receiving treatment and reviewing and paying bills were all simple and straightforward. With regard to bills we mostly just watched it all happen as Medicare paid their share, handed the balance off to the supplement carrier and they took care of the rest (after the deductible was covered). As a result we were able concentrate on my treatment and healing which was plenty to deal with. Fast forward two years (although it actually seemed like slow motion) and I am now very healthy again. I thank my lucky stars that I made the decision I did with regard to my Medicare coverage and my wife has thanked me for it too.

That's my story. I hope it's useful to you.
 
Coming up for me next year. Planning to go with Kaiser Senior Advantage which will cost me a whole $18/mo.
 
DW started medicare last year and we went with Kaiser. We had our company provided health care with them for many years. Only pay $36 per month on top of the medicare cost. It is a PPO I believe as we have to get care from a Kaiser facility unless they refer us to outside provider and they pay them directly. No paperwork and $20 so see the Dr or $40 for specialist. Of course it depends on where you live as they only offer in certain states or areas. I'm on Tricare till I'm 65 and will go back to Kaiser then.
 
There have been many very good discussions here already, so I’d encourage you to do a search and read up. Here’s one I found helpful http://www.early-retirement.org/for...r-selection-a-medicare-newbys-path-94740.html.

My situation was exactly the same as you/OP and I also wanted good coverage even though I have zero medical issues yet, I’m just a few months older, started Medicare this past May. I researched until I was comfortable with all my choices * and then worked through Boomer Benefits (instead of a local broker). For many it boils down to three basic decisions - 1 Medicare Advantage vs Medigap, 2 if Medigap, which supplement plan, and 3 do you want Part D.

* Original Medicare A&B, Mutual of Omaha Plan G, Aetna Part D. I also have a dental-vision-hearing plan, but I’ll prob all drop that and self insure.
 
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