Time to signup for Medicare,,,,,, maybe

[Wrknrvr]

  First of all this not political.

 

 This is what I may see in the near future. It will soon be time to sign up for Medicare. We have paid healthcare premiums since 1885 , except for about 18 months of coverage from an employer.

 

 So I was looking if the government shutdown would affect me signing up for Medicare . At my appropriate time. It is not this month but soon. So I am not posting a link to it because of being political.

 

 So now my health insurance premium is paid automatically. Now with some looking into things about two months ago it seemed perty easy to sign up and all things would fall into place.

 

  Now if you have a prexisting condition and your insurance ends on its appropriate day. What happens if Medicare does not start for you at the appropriate time.

 

 It has happened before. 

 

  I really hope if anyone on this forum is or may experience this subject could help those that may have this question explained.

 

  I have tried to help many people on this forum. If anyone has experience on this question, I hope you will provide help.

 

 

 I may need help for my situation when the time comes. But if there is one person here is having this problem we need to help them.

 

  Thanks in advance,.   Vern

[Barbaraok]

You can sign up now - actually you should sign up for Medicare about 3 months before you turn 65.    One of the nice things about taking SS early was that we didn't have to do anything when we turned 65,  our "welcome packet" and cards arrived about 2 months before our birthdays without us having to do a thing.   SS/Medicare are not affected by the shutdown because they are in a different funding stream.

[whj469]

Sign up for Medicare is a time to celebrate! Now you don't have to pay for health care unless you choose to add a supplement policy? I couldn't retire until I was 65, Medicare age, because of the cost. Good Luck

[Wrknrvr]

  For a better understanding of this situation I did some more thinking about it while I was out working. I stoped back to the office for more reading and decided to post a link to what I was reading earlier this am.

 

 http://www.crfb.org/papers/qa-everything-you-should-know-about-government-shutdowns#What services are affected in a shutdown and how?

 

  So I hope this is nothing to worry about. And I hope this can help others that are possibly in the same situation.

 

 I have started the process and have waited along time for eligibility to do so. 

 

 But I am concerned about the possibility of a problem occurring if the insurance stops and Medicare has a problem for coverage. You need to read the article I posted for a good understanding of this situation. I need to go to work again so I will do more reading tonight.

 

  Thanks,    Vern

 This may not be a problem if you do not have a health issue. But if you do or if one happens during that unknown time. Could it not be covered.

[Barbaraok]

Remember this is only a partial Shutdown.  HHS, which is the parent agency for CMS (Medicare) has its full 2019 funding. 

[Kirk W]

I strongly suggest that you start by reading the information Medicare provides as it is the most accurate source. If you will turn 65 in the next 90 days, visit Getting Started with Medicare now and start the process. It is very easy and should be done well ahead of your 65th birthday.

[Ray,IN]

3 hours ago, whj469 said:

Sign up for Medicare is a time to celebrate! Now you don't have to pay for health care unless you choose to add a supplement policy? I couldn't retire until I was 65, Medicare age, because of the cost. Good Luck

Well, yes; Medicare part B is not free.I think the premium is about $58/month now.

[docj]

6 minutes ago, Ray,IN said:

Well, yes; Medicare part B is not free.I think the premium is about $58/month now.

Try $135.50 per month for 2019

[richfaa]

Yes it is 135.50. We have been on Medicare for several years and it does pay for 80% of allowable expenses.Wife is also on Medicare. We both have other insurance as a supplement. I can not recall ever having to pay a bill since I have been on Medicare.Wife had some very expensive surgery a couple of years ago and had to pay up @ 3K of a @ 70K bil.l

[Wrknrvr]

  My wife is on Medicare and she is the one that deals with most of that kind of stuff.

 

 But since this government shutdown, there may be a problem for new enrollment. If you follow my original post and read the section on posible problems that has ocurd before.

 

 Just asking ,.      I hope this is not a problem for people in Februarys new enrollment .

 

 Just thinking.    Vern

[kb0zke]

As Kirk said, you should sign up for Medicare before you turn 65. I don't know how automated the process is in the Medicare office, but since they have their funding they should be functioning normally. I'm guessing that if you sign up online there is little human interaction that would affect you. The packets are mostly preassembled, so the only human work would be putting your card into your packet and then the day's basket of new packets goes to the post office.

You DO have some decisions to make, though. Original Medicare only pays 80% of the allowable cost, leaving you to cover the rest of the allowable cost. Most people buy a supplemental policy to cover that part, and those policies vary in what they pick up and what they cost. The policies are standard, in that a Plan G policy from ABC Insurance will cover the same things as a Plan G policy from XYZ Insurance. You can also get Advantage policies, which more or less replace the original Medicare and may have the drug coverage built in. They are network policies, though, so they may not be of much use if you travel a great deal.

There are lots of options available to you, so start doing your homework. Just like buying an RV, pick the one that fits your needs, not what your neighbor got. Remember that you can change anything during the open enrollment time in late fall.

[Barbaraok]

In addition to adding a supplemental, remember that you must join a Part D (drug) plan within a short period of time of when you start Medicare or you will pay a penalty when you do need it.  Shop around for the Part D plan - if you don't take much in the way of medicine, then go with the cheapest you can find.  You can shop each year, just make sure you keep coverage of some type, because even though you might not need it now,  an office visit for a nagging problem can change your life and you go from $1.50/90 pills to $600/pill without insurance!

[Sehc]

I found the AARP policy to well received by Doctors. I got tired of the little bills and deductions to figure in my budget. Now I have Plan F.

I can not complain. I have had lots of unexpected medical this past year, and am glad I have  Plan F. I don't have very much good to say about Part D, but it is necessary to maintain coverage to avoid increased premiums.

[whj469]

I don't know what Plan F is but we have an Advantage Plan and are very happy with it and a drug plan is included. The $1335.50 per month for part B is taken out of our SS before we get it. We remember paying over $900 per month for just my BH for the same type of plan as our Advantage Plan.

[docj]

43 minutes ago, whj469 said:

I don't know what Plan F is but we have an Advantage Plan

As has been mentioned previously, there are two "branches" of Medicare supplements.  One consists of the traditional Medigap supplements and the other are the Medicare Advantage plans.  The Advantage plans are all variants of "managed care" whereas the Medigap plans are traditional "fee for service" plans.  The decision as to which is best for you is a personal one and can be different for each person.

In general, it's fair to say that under the Advantage plans you trade lower monthly premiums for somewhat higher out-of-pocket costs if you do need hospitalization.  In addition, with an Advantage plan you probably have office visit co-pays in contrast to Plans F and G which have no co-pays. 

How each type affects your "bottom line" depends on your health, both now and what you think it might be in the future.  For example, my spouse goes to MD Anderson once a year for a follow-up check.  It appears that Medicare pays Anderson ~$6k for each such visit including all the tests that she gets.  Under Plan F we pay nothing, but my examination of the available Advantage plans in SD seems to indicate that we probably would have to pay 10-20% of that cost each year.  Sure, after 5 years she could probably be Ok to discontinue those visits, but with the coverage we have we don't need to make that decision.  Each person's situation will be different.

[JRP]

23 hours ago, docj said:

Try $135.50 per month for 2019

Try $189.50 for the monthly premium if your previous years income was over $85,000. 

My usual retirement income is well under 85,000, but I made some significant withdraws from my 401K nestegg when I bought my live aboard sailboat and another seasonal home and those withdraws pushed last years taxable income over their new limit. I was aware of the tax hit but was just recently surprised that CMS had significantly lowered their definition of "high income" for Medicare premium purposes. I believe it used to be $160,000 for an individual.

[whj469]

Some of which you say is true? The question was Plan F? What is that? My Advantage plan has no monthly premiums. If you add Medicare supplement monthly premium times two times 12, as apposed to a $3,500 total out of pocket. Six daily meds my co-pay $150 for the full year. No charge for Plan D it is icluuded.

[Ray,IN]

On 1/22/2019 at 2:42 PM, docj said:

Try $135.50 per month for 2019

Wow! There went the COL raise -again. Thanks for updating me, and everyone else too.

[Dutch_12078]

18 minutes ago, Ray,IN said:

Wow! There went the COL raise -again. Thanks for updating me, and everyone else too.

The Part B premium for 2018 was $134. The deductible went from $183 to $185 for 2019.

https://www.usatoday.com/story/money/personalfinance/2018/10/12/medicare-premiums-going-up-what-expect-pay/1618044002/

[Barbaraok]

5 hours ago, whj469 said:

Some of which you say is true? The question was Plan F? What is that? My Advantage plan has no monthly premiums. If you add Medicare supplement monthly premium times two times 12, as apposed to a $3,500 total out of pocket. Six daily meds my co-pay $150 for the full year. No charge for Plan D it is icluuded.

Yes, for some people Advantage Plans work well.  But you are usually limited to specific groups of physicians, etc, usually have to a referral, etc.  if in one area all of the time, that works, if fulltiming, not as easy.  

[Dutch_12078]

6 hours ago, Barbaraok said:

Yes, for some people Advantage Plans work well.  But you are usually limited to specific groups of physicians, etc, usually have to a referral, etc.  if in one area all of the time, that works, if fulltiming, not as easy.  

Our United Healthcare Advantage Plan gives us coverage everywhere we travel using their "Passport" feature. No referrals needed either. We can use in-plan providers at our normal co-pays where we travel, and out of plan providers with a higher co-pay.

[whj469]

Yes my Advantage plan only has 450 Doctors and no referral is required. Drug plan included with very low co-pays. If you are out of service area you only get emergency care. But what ever you pay for supplement per month times two times 12 is what you don't pay.

Unless I missed it, has anyone explained what an F Plan is?

I spend 4 or 5 months in the UP of MI per year and some time in south Florida each year but I am not a full timer.

[Barbaraok]

IIRC,  Plan F is supplemental that covers everything that Medicare doesn’t.  Plan G is the same except doesn’t cover the yearly deductible.   

We are only in Texas maybe 10 days every other year or so.  So for any advantage plan we would always be out of area.  

[docj]

My inherent dislike for Advantage Plans is that they are all "managed care" which means your ability to get treatment depends on someone providing approval of the treatment and the specific provider.  If you are fortunate enough never to have a complex medical condition then maybe this approach will work for you.

But ~5 years ago my wife discovered she had an extremely rare form of cancer, so rare that there are only ~500 cases in the US each year. After some quick internet searching we learned that the nearby University of Texas MD Anderson Center in Houston is one of the centers that specializes in this rare disease.  Because we had Plan F she didn't need anyone's permission to go there. Within a couple of weeks she was setup for an appointment there and she's been their patient ever since.   The followup annual checkups at Anderson cost Medicare $6-7k each time but, as a result of having Plan F,  it cost us nothing.   

I contrast this with the bitterness that of one of my Corpus Christi acquaintances toward his Medicare Advantage provider that refused his wife permission to seek treatment of her cancer at Anderson because it wasn't "in network". By the time they granted permission it was too late to save her.  I don't know the details so I can't make any definitive statements or draw conclusions, but when anyone I care about is ill, I seek to find the best available care anywhere in the country.  I sure don't want some cost analyst telling me that sending my spouse to one of America's leading cancer centers is not approved because it's not in my network!     ☹️                  

[Randyretired]

3 hours ago, docj said:

My inherent dislike for Advantage Plans is that they are all "managed care" which means your ability to get treatment depends on someone providing approval of the treatment and the specific provider.  If you are fortunate enough never to have a complex medical condition then maybe this approach will work for you.

  ☹️                  

Most advantage plans work as you state but there are a few that allow full coverage at any place plan F is accepted.  We have such a plan, it is provided by my wife's former employer at no cost to us.  There is a small copayment to see a doc ($5) and everything else is 100% covered.  These special advantage plans may not be available on the open market.