DH - 1 year to Medicare!

[Scuba]

DH recently turned 64. We already know we want to sign him up for traditional Medicare with a supplemental policy, How far in advance should we research specific policies? Anyone have a broker they recommend, or a recommended process if we don’t use a broker?

 

[Telly]

Going for Original Medicare, with a Medigap plan, the only Plan sort of thing to research is whether to choose Plan G, Plan N, or the HD-version of plans, like Plan G-HD.
Whichever plan type you choose, ALL providers of that plan type must toe the CMS line on how it works. There is no variation.

So after selecting one, then to choose how to implement it. Like using an online broker, if so, which one. If I had to do it all over again, I would have tried SeniorSavingsNetwork, Chris Westfall, in SC, instead of the broker I used, who is touted very often here. I've mentioned why, quite a few times here. The premiums of the same-type plans can be greatly different among insurance companies, but the actual coverage is the same. Don't buy a weasel, even if someone says it's what you need. Buyer beware.

Then there's the Part D drug plan to line up. There, you can go to the Medicare website and look at what is available in your county. For me and some others here, I use a low-premium company, as a placeholder. I am not on any continuing prescription medication. If your DH IS, then need to look through the formularies to see what may be best. The brokers get paid about zilch for helping to select Part D plans, as the premiums are low. I just review mine every open-season, to see if they have made any major changes, like jacking up premiums or whatever. For the last few years I've been with Wellcare, their Value Script Plan. I switched to it from another plan of theirs, that they went up-premium with. I've had a run of antibiotics for surgery this year, those were generic, and no charge to me. An antibiotic ointment was $1.88.

Since we can change Part D drug plans during open enrollment every Oct. 15 - Dec. 7th (I think that's the closing date) for the year starting Jan. 1, if I should suddenly need some really heavy-duty drug help, I'd re-evaluate and switch then. So the period of risk is not too bad.

 

[EastWest Gal]

Thanks for the question and the reply. DH turns 65 next January, me about 8 months after that.

Is there any education available for the differences between plans? We too will be going for original Medicare.

 

[audreyh1]

I’m about a year and a half out. But we already went through this with DH, so I know what and when. Will sign up online Medicare about 3 months ahead, then sign up for same Medigap and Part D as DH.

 

[MBSC]

DH recently turned 64. We already know we want to sign him up for traditional Medicare with a supplemental policy, How far in advance should we research specific policies?

As Telly stated above, most people quickly narrow their Medicare supplement (Medigap) choices to Plans G, N or HD-G. Your profile indicates you live in California. CA has a 'Birthday Rule' where you can switch to the lowest premium plan of equal or lessor benefits each year without medical underwriting. This usually means USAA or State Farm for Plans G or N.

CA Dept. of Insurance Medigap Rates (UHC/AARP is group): https://interactive.web.insurance.ca.gov/apex_extprd/f?p=111:31:::NO:SESSION

CA Birthday Rule: https://cahealthadvocates.org/medigaps-birthday-rule-is-extended-to-60-days/

Each state has a Senior Health Insurance Program (SHIP) with counselors that provide unbiased information on Medicare plans. https://www.shiphelp.org/

Is there any education available for the differences between plans? We too will be going for original Medicare.

CMS Guide to Choosing a Medigap Policy: https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf

CMS Guide to Part D Drug Coverage: https://www.medicare.gov/publications/11109-Medicare-Drug-Coverage-Guide.pdf

2023 Medicare & You Handbook: https://www.medicare.gov/publications/10050-Medicare-and-You.pdf

 

[marko]

DW is 97 days away (not that I'm counting) from dropping her $1400 a month BCBS coverage and hopping on to Medicare!!

She's going to take the same coverage as I have. Massachusetts has more limited options for supplement coverage, (only two IIRC) so it's fairly easy.

 

[qwerty3656]

I had not heard of HD-G plan. So it's cheaper, but you cannot switch back to the low deductible plan w/o getting a health screening. Is that right?

 

[teej1985]

I had not heard of HD-G plan. So it's cheaper, but you cannot switch back to the low deductible plan w/o getting a health screening. Is that right?

That's correct.

 

[omni550]

Is there any education available for the differences between plans? We too will be going for original Medicare.

As Telly mentioned Chris Westfall with https://seniorsavingsnetwork.org is worth checking out.

He has a TON of informative youtube videos and often posts new ones if there's some legislation or plan changes with retirees of major employers (Example: General Electric a while ago).

When I was doing my research. I called and set up an appointment with Chris a few months before my 65th birthday. He patiently walked me though my options (by age, gender, and zip code) and suggested some higher-rated insurers and better-priced plans for my needs. (He willlingly gave me a quote for my sister who lives in another state, too.)

Every year, someone in his office calls me in late summer to set up an appointment to review my current supplemental plan (Plan N, at the moment) plus any scheduled premium increases for the next year, and decide if there are better options or if I should stay on my current plan. I have both switched my plan and stayed on my existing plan based on these discussions.

Chris Westfall and his office get REALLY busy during the fall when existing Medicare subscribers are looking to resubscribe or switch plans. So I'd suggest calling between Jan - Aug/Sept to get the specific individualized attention and information you are seeking.

IIRC, you can sign up for Medicare 3 months before your 65th birthday. Of course, earlier is better than later as the policy can go into effect on your birthday, and you might miss some days of coverage if you file too late. I don't know if they cover retroactively.

omni

 

[Healthy Lifestyle]

A question that always comes up when talking to my peers is:

How does the price of the Medigap Plan (or supplement) compare to the Medicare Advantage plan for a 65+ year old in good health?

 

[qwerty3656]

A question that always comes up when talking to my peers is:

How does the price of the Medigap Plan (or supplement) compare to the Medicare Advantage plan for a 65+ year old in good health?

"In good health" - the problem is if your health deteriorates, you may not be able to switch.

 

[CardsFan]

"In good health" - the problem is if your health deteriorates, you may not be able to switch.

Not IF, but WHEN your health deteriorates. We are over 65 if on Medicare. News flash: your health is not going to get substantially better. If you are lucky, it stays the same for a while. At some point it WILL get worse.

Plan accordingly.

 

[ratface]

If you don't already have an account with Social security you can do so ahead of time as depending on your circumstances can be quite tedious.

 

[DrRoy]

I'm 14 1/2 months out. Been wondering about it.

 

[marko]

"In good health" - the problem is if your health deteriorates, you may not be able to switch.

"May not be able to switch" from which option? From an Advantage to regular Medicare or from Medicare to Advantage? Either way is news to me.

 

[MRG]

I did it 13 months ago, and it was a non-event.

 

[Scuba]

As Telly stated above, most people quickly narrow their Medicare supplement (Medigap) choices to Plans G, N or HD-G. Your profile indicates you live in California. CA has a 'Birthday Rule' where you can switch to the lowest premium plan of equal or lessor benefits each year without medical underwriting. This usually means USAA or State Farm for Plans G or N.

CA Dept. of Insurance Medigap Rates (UHC/AARP is group): https://interactive.web.insurance.ca.gov/apex_extprd/f?p=111:31:::NO:SESSION

CA Birthday Rule: https://cahealthadvocates.org/medigaps-birthday-rule-is-extended-to-60-days/

Each state has a Senior Health Insurance Program (SHIP) with counselors that provide unbiased information on Medicare plans. https://www.shiphelp.org/


CMS Guide to Choosing a Medigap Policy: https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf

CMS Guide to Part D Drug Coverage: https://www.medicare.gov/publications/11109-Medicare-Drug-Coverage-Guide.pdf

2023 Medicare & You Handbook: https://www.medicare.gov/publications/10050-Medicare-and-You.pdf

Wow! Thank you so much for all of these links. Sounds like we can wait several months before digging in, but happy to have these responses and especially all of these links.

 

[Scuba]

As Telly mentioned Chris Westfall with https://seniorsavingsnetwork.org is worth checking out.

He has a TON of informative youtube videos and often posts new ones if there's some legislation or plan changes with retirees of major employers (Example: General Electric a while ago).

When I was doing my research. I called and set up an appointment with Chris a few months before my 65th birthday. He patiently walked me though my options (by age, gender, and zip code) and suggested some higher-rated insurers and better-priced plans for my needs. (He willlingly gave me a quote for my sister who lives in another state, too.)

Every year, someone in his office calls me in late summer to set up an appointment to review my current supplemental plan (Plan N, at the moment) plus any scheduled premium increases for the next year, and decide if there are better options or if I should stay on my current plan. I have both switched my plan and stayed on my existing plan based on these discussions.

Chris Westfall and his office get REALLY busy during the fall when existing Medicare subscribers are looking to resubscribe or switch plans. So I'd suggest calling between Jan - Aug/Sept to get the specific individualized attention and information you are seeking.

IIRC, you can sign up for Medicare 3 months before your 65th birthday. Of course, earlier is better than later as the policy can go into effect on your birthday, and you might miss some days of coverage if you file too late. I don't know if they cover retroactively.

omni

Very helpful information, thanks!

 

[Scuba]

A question that always comes up when talking to my peers is:

How does the price of the Medigap Plan (or supplement) compare to the Medicare Advantage plan for a 65+ year old in good health?

We have already decided that regardless of cost, we prefer more choice so we’ll go with traditional Medicare. We’ve been paying big bucks for a PPO plan with excellent coverage all these years. It’s really nice not to ever have a doctor we want to use tell us he or she doesn’t accept our plan.

 

[Scuba]

Going for Original Medicare, with a Medigap plan, the only Plan sort of thing to research is whether to choose Plan G, Plan N, or the HD-version of plans, like Plan G-HD.
Whichever plan type you choose, ALL providers of that plan type must toe the CMS line on how it works. There is no variation.

So after selecting one, then to choose how to implement it. Like using an online broker, if so, which one. If I had to do it all over again, I would have tried SeniorSavingsNetwork, Chris Westfall, in SC, instead of the broker I used, who is touted very often here. I've mentioned why, quite a few times here. The premiums of the same-type plans can be greatly different among insurance companies, but the actual coverage is the same. Don't buy a weasel, even if someone says it's what you need. Buyer beware.

Then there's the Part D drug plan to line up. There, you can go to the Medicare website and look at what is available in your county. For me and some others here, I use a low-premium company, as a placeholder. I am not on any continuing prescription medication. If your DH IS, then need to look through the formularies to see what may be best. The brokers get paid about zilch for helping to select Part D plans, as the premiums are low. I just review mine every open-season, to see if they have made any major changes, like jacking up premiums or whatever. For the last few years I've been with Wellcare, their Value Script Plan. I switched to it from another plan of theirs, that they went up-premium with. I've had a run of antibiotics for surgery this year, those were generic, and no charge to me. An antibiotic ointment was $1.88.

Since we can change Part D drug plans during open enrollment every Oct. 15 - Dec. 7th (I think that's the closing date) for the year starting Jan. 1, if I should suddenly need some really heavy-duty drug help, I'd re-evaluate and switch then. So the period of risk is not too bad.

Great, this may be simpler than I realized. It seems overwhelming but maybe the most overwhelming part is choosing between traditional Medicare and Medicare Advantage. Appreciate the information.

 

[audreyh1]

By the time DH was getting close age wise I had already read so many Medicare threads here that we already had a pretty good idea of the timing, the options we likely preferred, and best ways to go about signing up.

 

[Texas Proud]

I had not heard of HD-G plan. So it's cheaper, but you cannot switch back to the low deductible plan w/o getting a health screening. Is that right?

IMO do not go cheap now on a plan that might cost you dearly later in life...

 

[Texas Proud]

BTW, I did not like either of the sales groups that have been mentioned to help you... now, witching the videos was good for learning but...


The senior saving network did not offer the AARP plan when I talked to them... when I did get a quote online for that plan I called them back to see why I did not as it was cheaper than the plan they were pushing and with a well established company using ratings that I liked (not individual rating)... they finally did give me a bid but it was like $10 or $20 more per month than my online bid... the comment I got from them was 'we do not want you if you do not see the value in our service'... really? You are getting paid very well from the insurance company, why should I pay more?


The other network (baby boomer or something) would not even give me a quote on a plan D without signing up for the medigap plan.. they also pushed a plan that was with a new company that I was not interested in and I do not remember them giving me an AARP quote either...


Go with either if you do not feel comfortable doing it on your own, but in the end it was really easy for me to sign up for medigap and D on my own....

 

[NW-Bound]

IMO do not go cheap now on a plan that might cost you dearly later in life...

We do not need a lot of health care right now, but knowing that there's no free lunch in life, we went with a traditional plan to pay now and pay less later.

I wonder if people who go with an Advantage plan put the money they save on the premium aside, in order to use it later when they need it.

What I have seen with some relatives is that they say they cannot afford the premium for a traditional plan anyway, so it is a moot point.

PS. We got bombarded with ads for Advantage plans and not any traditional plan. That alone made me extremely suspicious. Are these businessmen spending a lot of money on advertisement because they are so saintly and want to help people save money?

 

[qwerty3656]

"May not be able to switch" from which option? From an Advantage to regular Medicare or from Medicare to Advantage? Either way is news to me.

My understanding is that if you switch from an Advantage plan to Medicare, there is a health screening for the Medigap plans (i.e. medicare is guaranteed, but not the medigap plans if you don't take them initially)