Most Military Retirees Will See Medicare Costs Increase in 2024

[Chalkie]

I'm posting this here although it could have gone in the medical forum I guess. This article is from military.com.

Medicare Costs Increase in 2024

[Second Chance]

Thanks, Chalkie. I just read this on another platform as it applies to anyone on Medicare. Thank heaven for Tricare For Life!

Rob

[Chalkie]

45 minutes ago, Second Chance said:

Thank heaven for Tricare For Life!

Amen to that! I just had a "discussion" with my sister on how awful it was to have a Senior Advantage Medicare HMO plan because of this and that and how much the out-of-pocket expenses were. I told her that that Tricare for Life took care of all the expenses that were not covered. She did not understand how it was possible to have a supplement with an HMO plan. I told her I did not know and did not care as Tricare was processing all claims and it acts as my Part D coverage.

[lappir]

5 hours ago, Chalkie said:

Amen to that! I just had a "discussion" with my sister on how awful it was to have a Senior Advantage Medicare HMO plan because of this and that and how much the out-of-pocket expenses were. I told her that that Tricare for Life took care of all the expenses that were not covered. She did not understand how it was possible to have a supplement with an HMO plan. I told her I did not know and did not care as Tricare was processing all claims and it acts as my Part D coverage.

The key is to stay away from the "Advantage Plans". I my mind the only person getting any advantage is the salesperson who convinced you to give them your money. 

I'm not an expert on insurance at all, but I am a health care provider who is very disgusted with how Health Care has turned into a "Retail Business" and in many ways is no longer Care, but how much can be made from each patient. Pretty soon they will start taking away "Birth Control" methods and slipping in reproduction drugs to make sure everyone has as many babies as possible. 

Rude way to look at it, but it's not the 1970's anymore. I started as a Volunteer Fire Fighter, then Advanced First Aid, EMT, EMT-Level One, EMT-Paramedic and Finally an RN since 1989. Things were starting down hill then. The ER I worked at went from seeing true emergencies to a Social Gathering place every Friday, Saturday and Sunday. They all said their primary Dr. was the "ER Doctor". When I started in EMS in 1980 every patient I picked up in the Ambulance wanted their personal physician called to meet them at the ER (or they had already talked to the Dr. and were informed to call an ambulance. He or She would meet them there.)

Yes health care has made some great strides, we just have to remember it's patient care and not customer care. The Patient is not always right in their expectations and neither are some of the providers. 

Rod

 

[Chalkie]

18 hours ago, lappir said:

The key is to stay away from the "Advantage Plans". I my mind the only person getting any advantage is the salesperson who convinced you to give them your money. 

Not all advantage plans are created equal I think. In our case, we pay nothing for it and, in fact, get a rebate back to our Part B coverage costs. In turn, we deal with the provider, pretty much exclusively, for medical care and the plan covers many things that Medicare does not. My understanding is that because they act as a Medicare "aggregator" they are able to pass along the saving back to us as stipends for hearing aids, dental, vision, fitness programs and quarterly OTC medical purchases. 

We have no complaints about the quality and scope of our medical care.

[Kirk W]

20 hours ago, lappir said:

I my mind the only person getting any advantage is the salesperson who convinced you to give them your money. 

I feel quite safe in my opinion that insurance companies would not spend the vast amounts for advertising that they do if the policies that they are selling do not make them very handsome profits. I find many of the advertisements for Part C plans to be very offensive, implying that your are stupid or mentally deficient if you don't buy their Plan C. 

Edited November 16, 2023 by Kirk W
typo

[2gypsies]

2 hours ago, Kirk W said:

I feel quite safe in my opinion that insurance companies would not spend the vast amounts for advertising that they do if the policies that they are selling do not make them very handsome profits. I find many of the advertisements for Part C plans to be very offensive, implying that your are stupid or mentally deficient if you don't buy their Plan C. 

The brokers selling Advantage plans are making a good salary that's why they are being pushed so aggressively.

[RV_]

My problem was with Tricare For Life and Medicare and getting my prescriptions on base I paid zero co-pays so we ignored the Advantage plan offers. Here the VA counselor I used to get my Disability up from 30% to now 80% and soon to be 100% once they process my COPD active duty records that I have copies of and sent last month recommended Humana PPO. He also said I should talk to Beowolf (His name) about the Humana PPO made for TFL who is there at the counseling center Mondays from 10-2.

When dealing with military retirees we all have the same TFL and Medicare even if our disability percentages are different.

When I saw it was Humana I was interested enough to look and found that the old holdup was because of Medicare/TFL prescription benefit conflicts which have been resolved now.

I did not believe I would save money. But the first thing after we signed up that happened was our deduction from Social security for Medicare indeed did go down $75 each. That is $150 bucks a month we were leaving on the table and started saving in the last year.

They also have free memberships with Humana's Sliver sneakers to health and fitness exercise clubs like Planet Fitness the Y etc.  and there are several I am choosing from now. I get free Plant Fitness and several others and I believe the local Y all close to us.

Rather than read brochures I would suggest the military retirees sit down with a counselor like I finally did.

However, these new PPOs are just in the last couple of years or so. Check and you may be glad you did. I have no idea about Vets without military retirement benefits. My agent has a Concierge phone number so I don't have to call or navigate the Humana website or operators on the phone. They get me my info and stay with me to connect to the department I need with little to no waiting on hold.

Just my most recent experience with finding something that sounded too good to be true but was true! Of course YMMV. But until I sat down and ran the numbers with my agent Beowolf and found out I now have saved a bunch in the first year. Many may find that can offset the Medicare increases.

Humana knows Tricare for us military retirees.

https://seekingalpha.com/news/3920339-humana-to-remain-on-tricare-contract-in-2024-while-centene-loses-out

Edited December 20, 2023 by RV_

[Blues]

On 11/15/2023 at 9:48 AM, Chalkie said:

She did not understand how it was possible to have a supplement with an HMO plan. I told her I did not know and did not care as Tricare was processing all claims and it acts as my Part D coverage.

In the Medicare world, "supplement" is a term of art, describing plans that enrollees in traditional Medicare can buy to cover what Medicare doesn't pay (a lot of people don't realize that traditional Medicare pays only 80% of charges, for example; if you buy a supplement, it will pay your 20% share on your behalf).  That's the way your sister is using the term "supplement," and she's right--supplements are available to people enrolled in traditional Medicare and aren't available to people enrolled in an Advantage plan.  (BTW, supplements are also known as "medigap" policies, in case you see that term being thrown around--they're the same thing.)

Tricare isn't a supplement, but it acts as one for people who are enrolled in traditional Medicare--it covers people's out-of-pocket costs.  Tricare also provides prescription drug coverage, so people with Tricare who are enrolled in traditional Medicare don't have to buy a standalone Part D prescription drug plan.  There are no Medicare supplements that provide prescription drug coverage.  Tricare does, but it can do that because it's not a supplement.

What's also unique about Tricare is that it DOES cover the out-of-pocket costs of people who are enrolled in an Advantage plan.  As far as I know, there are no products available to the general public that cover out-of-pocket costs for Advantage plan members, similar to what supplements do for people with traditional Medicare.  And it's those out-of-pocket costs on an Advantage plan that can add up; regular people have no choice but to pay them themselves.

23 hours ago, Chalkie said:

My understanding is that because they act as a Medicare "aggregator" they are able to pass along the saving back to us as stipends for hearing aids, dental, vision, fitness programs and quarterly OTC medical purchases.

I don't know what you mean by "aggregator," but Advantage plans are paid a set amount by the government for every member they have (about $1,000/month for healthy people, and more if the Advantage plan can upcode them to sicker categories).  The Advantage plan then takes over all the member's healthcare.  Every dollar they don't spend on the member goes into their pocket.

So there's an incentive for the Advantage plan to control costs, and the most well-known methods are requiring members to see providers who are in that Advantage plan's network (traditional Medicare doesn't have networks), get referrals for specialists, and to require precertification for procedures.  This is managed care, and it differs from traditional Medicare in that respect.  Not being subject to the restrictions of an Advantage plan is always better than having to deal with the managed care elements of an Advantage plan, but it comes at a financial cost because premiums for supplements are higher than premiums for Advantage plans.

A huge benefit of Tricare is that you can get the equivalent of a supplement for traditional Meciare plus a prescription drug plan for free.  That's a hell of a deal, and takes out of the equation the only complaint about supplements--their cost.

[Chalkie]

30 minutes ago, Blues said:

A huge benefit of Tricare is that you can get the equivalent of a supplement for traditional Medicare plus a prescription drug plan for free.  That's a hell of a deal, and takes out of the equation the only complaint about supplements--their cost.

And this is what I said about the plan we have - it has $0 cost to us and, in fact, pays $50/month to our Part B which takes our Part B cost to $114.90/month in 2023. Yes, there are co-pays, however, this is where Tricare comes into play as it covers all those. As said previously, it also covers things that regular Medicare does not, such as hearing, vision, fitness, home meals after a hospital discharge, transportation to medical appointments, OTC allowance, etc. Even without Tricare it is a pretty good deal and Tricare makes it all great IMO. 

[Ray,IN]

Whatever insurance you have, TFL always pays last. Express-scripts co-pay is $14/3 mos supply, for generic brands eff Jan. 1 2024. DW is on Eliquis  for a blood clot in her heart; Express-scripts charges $54 for a 3-month supply,much much less than  civilian ins.

I cannot fathom any of the "advantage plans" being better than standard gov. Medicare and TFL. I spent a month in hospital and nursing home, with kidney dialysis 3X week. I never received a bill for any medical related expenses.

[Kirk W]

2024 VA health care copay rates          and also.......

VA priority groups     and      VA Healthcare Priority Groups Explained

 

Edited December 31, 2023 by Kirk W
added a link

[Chalkie]

9 hours ago, Ray,IN said:

I cannot fathom any of the "advantage plans" being better than standard gov. Medicare and TFL. 

The one we have covers hearing aids, dental, vision and fitness gyms, as well as providing transportation to/from doctor visits if needed. None of this is covered by Medicare. Also, one must realize that TFL only covers IF a treatment is covered by Medicare in the first place. 

[Ray,IN]

On 12/31/2023 at 10:51 AM, Chalkie said:

The one we have covers hearing aids, dental, vision and fitness gyms, as well as providing transportation to/from doctor visits if needed. None of this is covered by Medicare. Also, one must realize that TFL only covers IF a treatment is covered by Medicare in the first place. 

Humm, thanks for the information.  So I assume your private advantage plan works with TFL?

BTW, did you watch the Rose Bowl parade today? When the armed forces float went by they were playing Anchors aweigh, impressive.

Edited January 1 by Ray,IN

[Chalkie]

20 hours ago, Ray,IN said:

Humm, thanks for the information.  So I assume your private advantage plan works with TFL?

BTW, did you watch the Rose Bowl parade today? When the armed forces float went by they were playing Anchors aweigh, impressive.

The plan does indeed work with TFL. I/we visit a doctor or have lab work done and a couple of weeks later I get an email saying that Tricare has processed a claim. We also got the plan without Part D and use the TFL for medications. I forgot to mention that we also each get a card that allows us to spend $30 quarterly which can be used on OTC meds or vitamins or even a bandaids. It is not much, I agree, but every little bit helps. 

And no, we did not watch the parade this year, I'm sorry we missed it.

[Ray,IN]

Thank you Gary. I'll keep this information in mind for next open season.