Is Medicare Free?

[2retireearly]

My parents are on Medicare (of course) and they have a supplemental policy (that isn't cheap but very necessary). They are constantly at the doctors, have had numerous hospital visits in last few years, and they have not paid 1 penny out of pocket. So Medicare covers some very basics, but you need a supplemental policy..a few hundred a month per person. And my Dad has recently gone into the 'doughnut hole' for medicine, so now he is paying for his medicine. (My company will pay my supplemental insurance when i go onto medicare...but they stopped doing that for anyone hired after me)

 

[meierlde]

After being on Medicare for 8 years now, there are two things that you MUST do before meeting with a doctor or going for a test:

1. ASK (verify) the provider if they accept Medicare. If not, move on.

2. Once they say they accept it, CALL Medicare and ASK them if the visit/procedure/test will be covered by them.

Other than that, pray for no coding mistakes, of which, YOU will have to get resolved. (ask me how I know)

For the coding issue you might also ask how many medicare patients they have, the more the less likley they are to make the mistake.

 

[Koolau]

My various doctors always want me to come back for a "follow up." When I've complied in the past, they never seem to know what I'm there for. I've even had to say "follow up" (blank stare) "you know, for the blah, blah blah last time" (shuffle papers). Listen to heart and ask if blah blah blah (unrelated to heart, usually) is better or worse or gone. End of visit.

So these days, If the original issue has resolved I cancel the follow up. That's about 90% of the time. Don't know if this saves MC any money or my supplement insurance, but I'm sure it saves me the three hours I usually lose to the process. YMMV

 

[John Galt III]

I am in the ACA paradise for low income people currently, at age 62. When I go on Medicare, my costs will go way up. Higher deductibles, higher premiums, higher copays. Contemplating going for supplement as opposed to an advantage plan.

 

[John Clemore]

CA Medicare for All!

I have a good pension but since my kids are still under 26 I have all of them on my health care. I pay 400 for Cigna for entire family but when i retire it will be between 2000=4500 a month in health cost. I have decided to wait and see if Ca goes to medicare for all system. The legislation has passed the senate and it has great support in CA. It will cost 300 billion to insure everybody with no copays and 2 dollar meds. CA gets 250 billion from the feds for medical and the other 50 billion will be from employers but will be cheaper then what they are paying right now for each employee. Cigna, Kaiser etc will have to leave CA because there would be no need for them. Costs will come way down and have a much healthier population. If it doesn't pass I am starting to look for a job with benefits, i hear Costco gives you 100 medical for you and you family for zero. I have high tech skills and have put out my resume but me being 55 I realize that they will hire a much younger guy if they have the chance. Thank You!

 

[kcowan]

Thanks, I needed a good laugh today.

Seriously, it has always been a mystery to me why most other developed countries have figured out how to control healthcare costs, but we haven't. Maybe someday.

Hearsay answer: doctors have to carry extra insurance to cover malpractice and that erodes their earning power. From a couple of Canadian doctors who went there to practice and then came back because they were not netting enough extra income after costs.

 

[meierlde]

Hearsay answer: doctors have to carry extra insurance to cover malpractice and that erodes their earning power. From a couple of Canadian doctors who went there to practice and then came back because they were not netting enough extra income after costs.

In Japan there is an annual conference among various parties involved to set rates, all rates are the same. Whereas we have decided the Hotel/Airline model of pricing is best where no two folks pay the same for the same services. but lawyers make a killing negotiating the various agreements.

 

[Blue Collar Guy]

I have a good pension but since my kids are still under 26 I have all of them on my health care. I pay 400 for Cigna for entire family but when i retire it will be between 2000=4500 a month in health cost. I have decided to wait and see if Ca goes to medicare for all system. The legislation has passed the senate and it has great support in CA. It will cost 300 billion to insure everybody with no copays and 2 dollar meds. CA gets 250 billion from the feds for medical and the other 50 billion will be from employers but will be cheaper then what they are paying right now for each employee. Cigna, Kaiser etc will have to leave CA because there would be no need for them. Costs will come way down and have a much healthier population. If it doesn't pass I am starting to look for a job with benefits, i hear Costco gives you 100 medical for you and you family for zero. I have high tech skills and have put out my resume but me being 55 I realize that they will hire a much younger guy if they have the chance. Thank You!

I think you better fill out the Costco application, i dont see Cali getting 250 Billion.

 

[Diver]

My parents have a Medigap policy and pay about $300/each for that and Part D and have no costs, bills, co-pays or deductibles owed for hospital admissions, surgeries, etc. When my in-laws were thinking of dropping their same Medigap policy to significantly lower their premiums and get an "Advantage" Plan, they were (thankfully) warned against it by a senior center Medicare counselor who explained they would lose their "guaranteed issue" rights if they ever wanted or needed to return to a Medigap Plan. They could be charged much more based on their age and health when they wanted to return, and could even be denied coverage in a Medigap Plan in the future based on preexisting conditions. In other words, if you drop Medigap in favor of some lower priced Advantage Plan and later want to return, you will have the same community rating issue for preexisting conditions and age as the old pre-ACA insurance days. I had no idea about this until I looked it up myself after also talking to that same senior center counselor in a conference call.

Be very careful if you are thinking about switching to one of the many "Advantage" plans (non-traditional Medicare Medigap policy). They may look lower cost up front, but come with a big gotcha along with those deductibles and co-pays. Also, if you sign up for an Advantage Plan at the start of Medicare, you can only switch to a Medigap policy at guaranteed issue in the first year of Medicare eligibility. After that, no guaranteed issue rights to make the switch. Shocking to me that more is not out there on this. Annual sign-up is so confusing and the sales brochures mailed to seniors and nonstop commercials for different policies does make it very complicated for people to figure out what is best for them.

Quick synopsis here in a Money article, or you can google about Medigap loss of guaranteed issue rights to read actual Medicare training material and pamphlets.
Open Enrollment: Medicare & Medigap Policy Mistakes | Money

 

[John Galt III]

My GF had a Medicare Advantage plan and had numerous $40 copays for office visits, plus the 20% coinsurance for certain procedures. SHe was in the hospital often in the last year and had out of pocket costs of just over $6,000. The deductible was $6,400, I think. One of the case managers at the hospital highly recommended the non-Advantage plans (she called it a medicare supplement plan) over the Advantage plans because it covers everything with fewer hassles. But it is more expensive.

 

[Johanson]

(My company will pay my supplemental insurance when i go onto medicare...but they stopped doing that for anyone hired after me)

When I started at Megacorp, we had a DBP that paid retiree medical until 65 and supplemental after that. In 1999, they offered a CBP to existing employees and mandatory for all new employees. Around April of 2009, they announced that the only way to get the retiree medical was to retire before the end of September. In 2013, they dropped the CBP for all new employees. In November 2015, they announced that for those in the DBP, their wages were frozen at 2015 levels for pension calculation purposes. Now the only way it goes up for those still in the old plan is the years of service multiplier.

I'm just pointing out that nothing is set in stone regarding retiree plans.