Welcome to the wonderful world of Medicare - long rant

[NameRedacted]

OP just out of curiosity, was there any world where you thought Medicare would cost you zero a month with a yearly OOP of 200 bucks..?

I think you are the classic case of not wanting to pay for something that you had been getting for free.

BTW ACA is regular health insurance with some or a large part of it paid for by the government....I think that's pretty simple to understand. Part A of Medicare is free but no one ever said that being completely covered by Medicare was free..

I didn't honestly know how much it cost. I assumed not much since so many people raved about it.

 

[NameRedacted]

After the "pleasure" of acquiring an incurable disease at age 69 I'm immensely grateful for having the wisdom (nah sheer luck) of sticking with regular Medicare and a plan G. Just my infusions add up to about $125,000 a year (not to count CT scans, and many, many other tests and multiple specialist visits). Just for the fun of it I checked some advantage plans in my area. It turns out they wouldn't cover my infusions at all. Yes, I would have saved the cost of my plan G - about $470 a quarter. Buyer beware.

I'm glad you made the right decision.


It makes me wonder why it is structured like this in the first place. A wrong decision can essentially bankrupt you. That just can't be right morally.

 

[CardsFan]

In most other Western countries the cost of healthcare is essentially free. The rest of the world is laughing at us. You may be tired of people whining about the cost but I'm equally tired of privileged people not giving a damn about how unaffordable it is for the average person as long as they can afford it.

See bold:

FREE? Seriously? No one gets paid? The doctors and nurses work for nothing?

It may be "free" to the user, but it MUST be paid for. By somebody. Maybe a taxpayer?

 

[CRLLS]

Comparing ACA, Medicare and corporate health plans is not possible with any real meaning. The ACA Subsidy does not reflect the real cost of service. Nor does employee contributions reflect the real cost of medical coverage. Medicare does not reflect the real cost either. They are all hiding the full costs differently. At least ACA is clear as the real cost of the coverage is clearly stated before subsidies along with what is covered . With Original Medicare, it doesn't cover everything that many ACA plans and corporate plans cover such as drugs. Corporate plans generally do not disclose the corporate's share of premiums, although Cobra costs are generally close to the full cost. It is hard to make any comparable comparisons. When you are no longer working, you either go to Cobra, ACA or Medicare. Once you qualify for Medicare, you no longer can be on ACA. You can't change the system (individually). You just have to go with what you qualify for.

 

[NameRedacted]

Most of us, however, live in states without community pricing. For me, Medicare is a far better deal than the ACA was, though I'm very thankful the ACA existed when I wanted to retire. The last full year I was on the ACA, 2018, the full retail cost of my bronze PPO plan through the ACA was $1,386/month. I got a subsidy of nearly 50% of that amount. IIRC, there was a $6,550 annual deductible. So complain all you want about Medicare, but for me and for a lot of people, it's a much better deal. My combined Medicare premiums, Plan G premiums, & Part D premiums are a fraction of what I was paying on the ACA. My only out-of-pocket expenses since I started Medicare have been the small annual plan G deductible.

Just out of interest - what State are you in?. The most expensive Platinum plan was I think about $800-$900 where I live. People complain about New York State for lots of reasons but when it comes to healthcare we seem to be ahead of the curve.

 

[NameRedacted]

See bold:

FREE? Seriously? No one gets paid? The doctors and nurses work for nothing?

It may be "free" to the user, but it MUST be paid for. By somebody. Maybe a taxpayer?

Yep, I agree with you, the taxpayer should pay for it. It's just like insurance with a much larger pool of participants with the profit motive removed so it's much cheaper. And far better than the current system that penalizes people in poor health.


Also, all the nonsensical complexity - just like that ... it's gone.

 

[Happyras]

Medicare is a mandatory tax on those who retire with continued income from their hard labor and thrifty standard of living. It is unjust, regressive, and poor coverage for the cost of IRMAA and premiums, need for supplemental G plans, and drug costs. It forces those of us who have worked and now have to draw upon our invested hard work and retirement savings, to pay for everyone elses coverage. We pay so much more than Cobra coverage from our prior labor income companies, and the coverage is so sub par, we can't even go in for an annual physical without it not being covered. OH, WELCOME TO MEDICARE, what a deal they do not even cover standard blood work on the one and only physical they cover. Can you tell I am a little pissed? We not only do not get the wonderful relief checks, we now get to pay even more in taxes and fees. OH, and thank you for the NIIT taxes on our hard earned capital gain and rental income. The drug addicts that took over our rentals and do not have to pay rent also thank you for the free money to buy more drugs. Why pay rent when you can get high and trash your landlords house. OH, and repairing the trashed roof, what a deal we can depreciate it after we are dead, but can't expense it now, but we get to go to jail if we do not fix it. The leaks would put out the flames on their joints and the gov can't stand for that! This world is upside down and is forcing a separation of classes. Why work hard if the gov is going to simply give it to others. Medicare, not real choice, just penalties if you do not apply and pay and pay and pay......

 

[Happyras]

The preceding was an unpaid, non-politcal rant...

 

[momoftwo]

I have inexpensive retiree health insurance, turning 65 this year.
Not looking forward to learning new rules and processes.
Especially, figuring out how Medicare and the secondary retire coverage will work.
Very fortunate to have total premiums for DH and mysrlf less than $600/month.

 

[ivinsfan]

Yep, I agree with you, the taxpayer should pay for it. It's just like insurance with a much larger pool of participants with the profit motive removed so it's much cheaper. And far better than the current system that penalizes people in poor health.


Also, all the nonsensical complexity - just like that ... it's gone.

What do you mean penalizes people in poor health? What are you calling a penalty...?

 

[Telly]

Lest we forget, Medicare is not truly "mandatory". One can simply look over LBJ's shoulder:

On July 30, 1965, President Lyndon B. Johnson signed into law the bill that led to the Medicare and Medicaid. The original Medicare program included Part A (Hospital Insurance) and Part B (Medical Insurance). Today these 2 parts are called “Original Medicare.” Over the years, Congress has made changes to Medicare...

And decide "that's not for me", and proceed like most elderly people in America had to do before Medicare was enacted. The difference, of course, is they were overjoyed to have it when it was enacted! It lifted millions and millions out of health poverty and allowed so many to actually get health treatment.

Is it a perfect and easy to understand system? No. But it sure beats the alternative.

I've been on Original Medicare + Medigap Supplement + Part D drug plan for a few years now. The billing administration and paying for my part of services has been real smooth. The doctors offices seem to know how to submit bills to Medicare without problems, and it chunks through the system, and months later, if there is something I need to pay some $ for, I get billed by the Dr. office. I can look up online and see it work through the stages, and see the result. Would be pretty hard to cheat me. Can't say that for all the other health insurance I have had over the years.

I'm happy. I don't want to see it broken or screwed up. [Mod Edit] Political comment removed. [Mod Edit]

 

[Dtail]

OK. Here is MY Rant:

Frankly, I am tired of fairly well off folks whining about the cost of Medicare and supplements. The fact that you may have been getting close to a free ride on ACA has no bearing on the cost of Medicare or any other HI plan. Consider yourself lucky you were able to play the ACA card, but don't b*tch about about having to pay the going rate when you get Medicare.

I consider the less than $350/month each that we pay to be a bargain.

Agree that the ACA and Medicare costs are not comparable, even though I will be one who pays more for Medicare in 4 years. Just happy my cost is low now.

 

[target2019]

Wow, very good description, I am trying to figure out Medicare too, because I turn 65 in a few months. My state gives a webinar about Medicare plans but I missed half the zoom call so I have signed up again for the next one in February. But, a new confusion is at work they said that I don't have to initiate signing up for Medicare at 65 because of my coverage at work. The employer's plan is expensive but it also covers my kid who is in school. I have no idea if it would be cheaper to switch to Medicare and then pay for her to have ACA coverage except I think the subsidies in ACA only are for employed people?

At 65 I signed up for Medicare Part A (-0- cost), and continued on Spouse's plan from work for everything else.

At the end of this year we'll both transition to Medicare. BoomerBenefits videos were helpful. These threads are also very helpful, and I learn something useful in each one.

Can't help with the ACA aspect you mention.

 

[JoeWras]

FREE? Seriously? No one gets paid? The doctors and nurses work for nothing?

It may be "free" to the user, but it MUST be paid for. By somebody. Maybe a taxpayer?

In Germany, the payment for public health care is much like the USA social security. %7.3 percent by the employee matched by the employer.

It is not free.

 

[Winemaker]

After paying $1865/month for the past 6 years for non ACA HI for the both of us, I just started Medicare this month. Now, monthly costs are $148 for Part B, $335 for Medigap plan, and $900 for her. We're $482/month to the good, and even if we get hit with IRMAA, we're still good.

 

[jollystomper]

DW turns 65 towards the end of 2022, at which point she is no longer eligible for Megacorp retiree insurance, so this year I need to start looking at Medicare in detail.

My only real issue is the complexity. We pay less that $11,500 for the year for both of us for Medical/Dental/Vision, which is a far better deal than non-subsidized ACA. In my view, this is quite fair and affordable. Figuring out the best Medicare plan for us, along with the related Megacorp transition considerations, will take some time. My wish would be for Congress to simplify the plans and options. But, just like tax code, too many people make money or maintain power/control from the complexity, so that is a pipe dream .

Some seem to forget that ACA was never meant to replace Medicare, but to be a bridge to get one to Medicare, not a "pay free forever program". I would also guess that 95% of the folks who frequent this site could well afford non-subsidized ACA and it would not impact the quality of their FIRE life, given the amount of "how do I keep my income down?" discussions that occur.

 

[ivinsfan]

In Germany, the payment for public health care is much like the USA social security. %7.3 percent by the employee matched by the employer.

It is not free.

Isn't it strange somehow that if they take the money from you before you even see it, some people think stuff is cheaper or free?

 

[troutnut1]

What an awesome summary of the whole program. I’m going to copy it and give it to relatives and friends who are just starting that research. I know I spent dozens of hours coming to the same conclusions.

But once I figured it all out, we are very happy with the way it works. We supplement with plan n at $80 a month and our part D drug plan only adds $14 a month. I just switched my mom from a $95 AARP plan to a $14 Clear Springs plan that pays a lot better for way less monthly. So one must shop annually for this. Plan N is cheaper monthly, but you get to pay your own deductibles. But with the annual savings you should be able to pay your own deductibles in years you incur them. “Excess charges” is possible, but when you do the math on them they are very rare, and usually tiny if they occur. Mom prefers a higher supplement premium that pays deductibles for her but is built into her cost. To each his own.

I eliminated “advantage” plans from my thinking because the real reason we have these plans are to protect us from a worst case scenario. And “advantage” plans don’t work for that.

Thanks for a great summary of how things work. We are grateful to have such good coverage for such affordable premiums. Sure beats what I had working. I have had major surgery with it, and my wife had open heart surgery with it in our first couple of years. Aside from the expected reasonable deductibles, they paid everything,

 

[Venturer]

When I turned 65 I took the free medicare only and stayed on my employer's plan, because my DW was still working for 1 more yr. So it was cheaper for me to keep it and keep her on mine than it would have been for her to have to get ins. elsewhere. As it is now we pay less than $700. monthly for Medicare +supplement G + prescription D. We have $0 copay on all but 1 prescription and for that one I use GoodRX to get it cheaper than the plan. We each have the $7.53 a mo. plan. I realize that at some future point I may/will have to get one of the higher priced part D plans but for now I'm good. I had knee surgery in 2020 and my DW fell and had an ER visit. Between the 2 of us we would have had over 45k in DR.xray,surgery,ER,& all associated misc. bills and we had to pay less than $400.00 out of pocket. I'm happy because with with megacorp ins. my family deductible of $12k would have been met easily. I'll keep my medicare thank you.

 

[ncbill]

~$1,000/month currently for employees' share for employee & spouse, figure we'll pay roughly the same (in real terms) on Medicare, ~15 years from now.

My in-laws did complain mightily when they had to start paying Part B premiums, though.

F-I-L had retired early 50s with gold-plated, zero-premium retiree health coverage provided through his union.

 

[cathy63]

Just out of interest - what State are you in?. The most expensive Platinum plan was I think about $800-$900 where I live. People complain about New York State for lots of reasons but when it comes to healthcare we seem to be ahead of the curve.

Whether or not you think NY is ahead of the curve depends on what part of the curve you are on. Here's a price comparison between San Diego CA and Oneonta NY (picked because I have friends there and happen to know their zip code).

Unsubsidized monthly premium range for a 64 yr old on an ACA policy
NY -- $485.31 to $1673.02
CA -- $743.31 to $2020.12

Unsubsidized monthly premium range for a 30 yr old on an ACA policy
NY -- $485.31 to $1673.02
CA -- $304.81 to $764.28

While things in NY are looking great for the person about to go on Medicare, the 30 year old who's paying more to subsidize his elders might not feel the same way.

 

[orchid55]

We have had 2 big pluses switching my husband from unsubsidized ACA to Medicare. First is a substantial reduction in premiums - from $950 for an ACA Bronze policy to less than $300 for original Medicare and supplement and drug plans. The second plus is a much larger group of available doctors and hospitals. His ACA plan was a very narrow network HMO with coverage only in our county and no out of network coverage other than life threatening emergencies. I actually called the insurer to ask what would happen if we had Covid and the one hospital on our ACA plan was full. The answer was that we would be on the hook for the full bill. That wasn't the answer I wanted to hear and I hope it really wasn't true.

 

[NameRedacted]

What do you mean penalizes people in poor health? What are you calling a penalty...?

Medical Underwriting for one - that basically forces people to buy expensive supplemental insurance when they probably don't need it.

 

[NameRedacted]

Isn't it strange somehow that if they take the money from you before you even see it, some people think stuff is cheaper or free?

Yes but if you look at all the studies, other countries spend a much lower percentage of their GDP on health care and with much better outcomes.



Plus, it's so simple even I can understand it.

 

[NameRedacted]

Whether or not you think NY is ahead of the curve depends on what part of the curve you are on. Here's a price comparison between San Diego CA and Oneonta NY (picked because I have friends there and happen to know their zip code).

Unsubsidized monthly premium range for a 64 yr old on an ACA policy
NY -- $485.31 to $1673.02
CA -- $743.31 to $2020.12

Unsubsidized monthly premium range for a 30 yr old on an ACA policy
NY -- $485.31 to $1673.02
CA -- $304.81 to $764.28

While things in NY are looking great for the person about to go on Medicare, the 30 year old who's paying more to subsidize his elders might not feel the same way.

He'll change his mind when he gets older