|
Post by spike on Mar 15, 2021 23:12:13 GMT -5
Lord have mercy! I turn 65 in November and I need to choose "Medicare" of some sort? Part A, Part B and other parts geez and then so many different companies. How the heck do you choose? My little brain hurts. Any advice is greatly appreciated!!
|
|
|
Post by brownrexx on Mar 16, 2021 7:39:34 GMT -5
It is VERY confusing and you will now start getting TONS of mail trying to sell you policies. Here are some basics that I have learned. It's not quite as bad as it seems at first. You will understand it eventually and you can change once a year if you don't like what you chose. It's not forever.
Medicare part A covers hospital expenses if you are admitted. There is no premium for part A. Everyone gets this but the deductibles can be higher than expected when using Original Medicare although the Medicare supplement may help pay for this. I am not sure because I do not have Original Medicare and a supplement.
Part B covers most of the stuff you will use. Doctor's visits, lab tests, diagnostic tests like MRI, X-rays, EKG, etc.
Part C is a Medicare Advantage plan which is private insurance offered by tons of companies like Humana, Blue Cross, United Health care, etc
Part D is coverage for prescription drugs and is offered through private insurance companies.
Original Medicare includes parts A & B and you must buy part D separately. Original Medicare pays 80% of covered expenses so must people with Original Medicare buy a Medicare Supplement to cover the rest. These are companies like AARP.
Medicare Advantage plans are called Part C and many include parts A, B & D for one premium. No supplement is needed with these and it is what DH and I have. We are very happy with it.
Some Medicare Advantage plans advertise zero dollar premiums BUT they have much bigger co-pays. I recently had an MRI and it cost me only $22. If I had one of those cheap premium plans like Humana, the co-pay would have been $350.
Last but not least - you can have any premiums deducted from your social security payment if you wish or you can pay separately. Everyone who has Part B will pay a set premium and I think that it's $148 this year. You will pay this whether you take Original or an Advantage plan and it will be automatically deducted from your social security payment.
|
|
|
Post by paulf on Mar 16, 2021 8:20:06 GMT -5
Very good Brownrexx. We have had original plus a supplement. For us it is cheaper per month than the advantage. In eight years we have not paid a cent more than the premium. We do not have prescription coverage since the premium is higher in cost than the cost of our medications. You still have to do the math to figure out the best route, but once figured out it all makes sense
|
|
|
Post by spike on Mar 16, 2021 9:02:59 GMT -5
brownrexx, HUGE HUG! I know I need A and B but we are military so scripts are covered. So understand that now. How did you choose a company? There are so many! Between AARP and all the medicare stuff I actually get mail that isn't bills!
|
|
|
Post by september on Mar 16, 2021 10:18:25 GMT -5
spike , many insurance companies have tiers of coverage for doctors and clinics in their state. So their preferred doctors may have full coverage, but you may have co-pays for the ones out of their system, which can get expensive. If you have a family physician or clinic you want to continue with, you may want to pick a plan that has them as a preferred provider. You can find this out on the individual insurance company websites, or in the material they send you when you request their information packets. It likely isn't as much a problem in more heavily populated areas, but living where I do with limited choices (realistically only one, unless I want to drive 200 miles) I keep getting mailings from companies that don't even cover my local clinic.
|
|
|
Post by brownrexx on Mar 16, 2021 13:15:19 GMT -5
How did you choose a company? There are so many! It was an easy choice for me because I retired from a large company, Johnson and Johnson, which offers a Medicare Advantage plan to it's retirees and they subsidize part of the premium. Our plan is through United Health Care and they have been really good. We can go to any doctor who accepts Medicate and our co-pay is 10% of the Medicare set price for the service. Like I said previously I paid $22 for an MRI and $12 for a visit to a specialist recently. I do have a $150 deductible. DH is 4 years older than me so I could not put him on my company's plan until I also qualified for Medicare. He had Humana's Medicare Advantage plan for 4 years and the monthly premium was very low but the co-pays were a lot higher than we pay now. The think that I really didn't like about Humana was the customer service. The customer service reps all had heavy accents to the point that I could barely understand some of them and every time I asked a question, they would put me on hold. I would spend 30-40 minutes on the phone any time I had a simple question and I hated that. Medicare Advantage plans do not require you to take Part D. Some plans have it and some don't. You need to look at things like the monthly premium, annual deductible, co-pays for services, and whether you have network and out of network prices. Some plans offer eye care and dental and some do not. I do not have eye care but my recent cataract surgery was covered as a medical expense and I think that I paid $110 for everything including the doctor and the surgery. Pick a couple of services that you may use such as mammograms or an MRI and compare the price among companies. This may help you make a decision. I also think that you must apply for your Medicare card 3 months before your birthday but that may have changed since I did it. You can Google this. Several months before your birthday you will receive a booklet from Medicare called Medicare and You. It will tell you about Original Medicare as well as give you a list of which Medicare companies are in your zip code. This will help you to make comparisons.
|
|
|
Post by spike on Mar 16, 2021 14:56:28 GMT -5
you must apply for your Medicare card 3 months before your birthday That is what I was told. I still have some time so I was checking things out in advance so I don't do the stupid thing. Thank you so much!!
|
|
|
Post by brownrexx on Mar 16, 2021 18:03:16 GMT -5
spike , I was also going crazy trying to figure it out in the beginning but after the Medicare and You booklet arrived it became easier and more clear to me. It also gives you current pricing so you will be able to compare plans offered by different insurance companies and all of the information will be in one place. Getting some opinions and seeing what other people think is not such a bad idea either and gives you a head start. Just don't panic. It's not as complicated as it seems now. Applying for the Medicare card does not cost anything and does not obligate you to any plan BUT my friend who recently went on Medicare said that she could not be accepted by an Advantage plan until she had her Medicare part A card so she had to wait to get that.
|
|
|
Post by pondgardener on Mar 18, 2021 8:29:36 GMT -5
spike, linked below are a couple of websites that I looked at and I did get a lot of help from both of them. Medicare is a tangled web, and you can get turned around pretty easily. The decisions you make early on may affect your ability to change your mind later. I elected to go with having a supplemental policy, as my wife has leukemia as well as some other issues and the agent at Boomer Benefits found a plan that didn't ask any health questions that would have disqualified her from enrollment. Generally the advantage plans are the cheapest way to go, and you need to do a thorough investigation. But if you currently have health concerns or feel that you may have some serious health problems, you may want to listen to the supplemental pitch. And if you initially go with an advantage plan, you may not be able to switch to a supplemental plan very easily. And if you decide on a supplemental plan and need Part D for drugs, and don't feel you take many prescriptions to justify the cost, still sign up for the very cheapest one. Medicare has penalties that would go into effect if you try to sign on to a Part D drug plan after the initial enrollment period, if you do need expensive drugs later in life. Good luck in your quest. Medicare informationBoomer Benefits
|
|
|
Post by spike on Mar 18, 2021 9:05:32 GMT -5
pondgardener, Thank you! I am responding before I check out those links cause I am gonna dive into them. We are military and have TriCare which can be confusing at it is. We don't need to worry about a drug plan as all our meds will come from the military. Fortunately we are currently basically healthy, thank God! This is just all so very confusing for me. Never had to worry about coverage before.
|
|
|
Post by brownrexx on Mar 18, 2021 9:20:28 GMT -5
spike, I know nothing about military plans but does Tricare have it's own Advantage or Supplement plan? Maybe you should check that out first. I am sure that they have representatives who can explain it to you over the phone.
|
|
|
Post by pondgardener on Mar 18, 2021 9:28:06 GMT -5
spike, I forgot you were military retired. Here's another link... Tri-care
|
|