Friday, January 15, 2016

Medicare, Oh Medicare-The First Steps

 As often happens when I write, I learn things along the way, including things about the current article or post. So it has been the last couple of days.  I write about myself, not necessarily as a road map to others, and this article was about MY transition to Medicare. However, I do like to be as accurate and informative as possible. To this end, I have learned that as I read it, those of you in the market place need to resign your medical insurance and move to a Medigap or Advantage plan. Those people who have insurance from other sources outside the market (generally meaning through an employer can keep their current insurance as I have been doing, depending on your employer. While people who have employer based retiree insurance include federal or state employees, there are other corporations who meet that criteria.  Hopefully, this is a little more clear when it comes to the general population. As for me, my plans below remain fairly clear.

In September, I turned 64. No sooner did my birthday approach, than I began to receive slews and slews of Medicare information. So much information in fact, that I double checked my birthday and age. I mean, why were all these folks sending me all this stuff???

I now know that this is the norm. In one way it makes sense I guess, because you don't want to wait until the last minute to get your financial ducks in order, after all. Still, a year ahead did seem to be a bit "whack" to me, as the kids say. And of course, many those pieces of mail were medical advantage plans trying to "sign me up".

Even so, I've been doing my due diligence.  So far, while I can see how things could be confusing to some, it is nothing compared to the research my adult kids have had to do to get coverage through the state system (These kids are perfect examples of why health coverage should not be tied to employment. One is self employed and the student, and the other only offers care for people who work 40 full hours. My other kid is getting a grad degree in OT and works about 35 hours per week).

Anyway, the bottom line in all of this is that at this point, I will be signing up for parts A and B, ignoring parts C and D, and keeping my current health insurance rather than getting an advantage plan.  My current medical premiums will double from 120 to 240 dollars beginning in September.

Confused?  Me too. In fact those readers who are a bit older and I probably know much, much more about this process than I do. If so, feel free to share opinions and your experiences with medicare-please.

I used two primary reference sources as I began my journey.  First, I went to the federal government health and benefits website (as opposed to the medicare website).  As often happens, their information was concise and to the point.  I also referenced the NOLO book, Social Security and Government Pensions, a book I need to delve in more directly.

From my federal website I learned that my federal drug benefits are at least as good as those offered by Medicare Part D.  I have the option of dental, eyeglass coverage and the like through the Feds, so I probably will not need part C.  And finally, my former employer requires that all beneficiaries sign up for both Part A (Hospital) and Part B (medical).  The end result? By keeping my full coverage insurance and signing up for medicare A and B, I should be good for the future in Medicare.

I could have dropped my full coverage insurance and move to a Medicare Advantage Plan.  Right now, as I understand it the advantages of doing so have to do with drug coverage (which I have) and an out of pocket ceiling, which I will also have.  Medicare will pay first, my current insurance second, and my co-pays with my current insurance are $20, my deductible is $750 and my out of pocket max is $5000.

At the moment (knocking on wood), I feel fairly comfortable as to where I am going. That said, I need all the input I can get and will continue to research until that sign up day arrives.

What about you. Do you have an advantage plan?  Original Medicare?  Are you happy with what you have?  Do share!





15 comments:

  1. I am 68 and my husband is 69. We are in good health. I take no prescription drugs and my husband takes only 1 on a continuing basis. We have Medicare and a Medicare Advantage plan. We chose the Humana Gold Plus plan. I recently had to have surgery to repair a hernia. Since the surgeon and the hospital were on the plan, my out of pocket expense was less than $300.
    That said, health care in the U.S. whether you are on Medicare or not is an absolute carp shoot. You can plan based on your recent health care needs but there is no way to know what you will actually need. It's a gamble. Surely there is a better way. IMHO.

    ReplyDelete
  2. If you are eligible for medicare, it was my understanding that no other health insurance would cover you. The advantage plans will only cover what medicare will cover. Should you want a procedure that medicare doesn't cover, you have to pay for it yourself. For example, if you want a certain type of knee replacement that is not approved or covered by Medicare, no other insurance company, advantage or otherwise will pay for it. I'd double check to make sure you can continue your private insurance once you are 65 and on Medicare.

    ReplyDelete
    Replies
    1. Cindy that is not correct. Medicare will be the first payer however.I absolutely can keep my federal insurance after sixty five. For life, in fact.

      Delete
    2. The key word is 'federal'. You are most fortunate. Not so for us civilians.

      Delete
    3. Actually efter further research, marketplace policies 3xpire with medicare. However employer plans remain and can be used with medicare, federal or not. We don't get special dispensation just because we we federal.I am not sure why the marketplace is different.

      Delete
    4. This comment has been removed by the author.

      Delete
    5. After reading this, I checked on my insurance being compatible with Medicare since I will be 65 this October. I was told that my BXBS is compatible and that Medicare would be the primary with BXBS the secondary. Thank you for the heads up. I feel better knowing that this is set.

      Delete
  3. Thanks for mentioning the NOLO book. We also will be continuing our federal health insurance and adding Medicare when my husband retires in mid 2017. Then we will move across the country and need all new doctors and dentists. I need all the information possible to help us navigate all the decisions and maximize our financial returns!

    ReplyDelete
  4. $120 monthly medical insurance payment!! I didn't know those even existed now. My insurance went the other direction and halved when I went on Medicare five years ago. You must have a government sector plan, they are sweet...

    ReplyDelete
  5. My husband did a combination. He continued on the Tricare for Life, which is free for him. It covers anything normal he is not covered for through the VA. The VA is his secondary since he is disabled. Last is Medicare, which, in great humor, the VA and Tricare charge to if it is a coverable expense. He has to take the Medicare in order to keep the Tricare- so his health insurance is only the plan B of Medicare costs. Whew.
    Mine will be way simpler and more expensive. Tricare for Life has a charge and so will Medicare.
    Really, this is all so insane. I wish the congress had done what they had the mandate to do during Obama's first term- single payer health care. Come on Bernie!

    ReplyDelete
    Replies
    1. Have you ever explored your VA care? Your meds are "free" with VA is you have over a 50% rating….

      Delete
    2. I will check that out janette, but it would be under my service time which was not that great.

      Delete
  6. In Arizona there are many medicare advantage plans that seem to cover more than regular medicare does. We are 63 this summer, have a couple of years to go, but that is probably the route we will take.Till then we have a plan through the ACA exchange and don't pay an exorbitant amount. I believe we should go to a single payor system in American and really make sure all of us get the health care we need.

    ReplyDelete
  7. I began Medicare six months ago. Because I'm not taking Social Security yet my Medicare Premium Part A &B is $121 a month as it will be for everyone. I have Blue Cross for Medicare Part F (the complete one) which covers all in network deductibles and copays. And I have a separate Medicare Part D plan---for medications. It's $54 a month and I don't pay that much at all for meds but I would rather be prepared if something happens. It's still the least I have paid for insurance in over 20 years---I lived in NY a "no fault" state so everybody could get insurance but as I lived in Manhattan it was absurdly expensive. I realize now when I worked for the federal government they charged us more the rest of the country. Incredibly unfair---people assume that when you live in NY you make a lot of money. Not in human services---for the federal government, state, city or private. So yes---single payer for all! I love Medicare.
    ~pia
    http://courtingdestiny.com

    ReplyDelete
  8. This comment has been removed by a blog administrator.

    ReplyDelete

Things I'm Enjoying This Monday-And A Couple Things That Are Frustrating Me!!

One of the many reasons I don't do serious (other than visiting family) travel during the summer is the chance to stay at home. Warm w...