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Does anyone have a true understanding of Medicare?
#13220252
07/20/19 02:46 PM
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Joined: Nov 2006
Posts: 1,904
Dan_n_Texas
OP
Extreme Angler
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OP
Extreme Angler
Joined: Nov 2006
Posts: 1,904 |
Turning 65 soon and trying to figure out about Medicare.
I am on Medicare Disability now and have a secondary insurance through my employer (I'm retired). If I keep my secondary insurance, do I need a supplemental when I turn 65? If I decide at a future date to cancel my secondary insurance, can I get a supplemental insurance then?
Under my current circumstances, do I need to do anything when I turn 65?
On average, your heart beats 100,000 times a day. One day, one of those heartbeats will be your last. Then what?
The answer is found in Jesus Christ who said "I am come that they might have life, and that they might have it more abundantly." John 10:10 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
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Re: Does anyone have a true understanding of Medicare?
[Re: Dan_n_Texas]
#13220255
07/20/19 02:54 PM
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Joined: Sep 2008
Posts: 5,190
fishslime
TFF Celebrity
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TFF Celebrity
Joined: Sep 2008
Posts: 5,190 |
If your secondary insurance is paid for by your employer after you retire, I would think it wise to keep that. However, if not then it might be more cost efficient to look at other supplemental options. I have retired teacher friends who have retained Aetna secondary coverage and pay much more for it than necessary, but for some reason they don't want to give it up. Am sure you will get more educated responses than mine, though, on your particular situation.
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Re: Does anyone have a true understanding of Medicare?
[Re: Dan_n_Texas]
#13220257
07/20/19 02:58 PM
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Joined: Jun 2016
Posts: 10,372
Nickbyrd
TFF Guru
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TFF Guru
Joined: Jun 2016
Posts: 10,372 |
One does not simply understand Medicare.
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Re: Does anyone have a true understanding of Medicare?
[Re: fishslime]
#13220261
07/20/19 03:01 PM
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Joined: Nov 2006
Posts: 1,904
Dan_n_Texas
OP
Extreme Angler
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OP
Extreme Angler
Joined: Nov 2006
Posts: 1,904 |
If your secondary insurance is paid for by your employer after you retire, I would think it wise to keep that. However, if not then it might be more cost efficient to look at other supplemental options. I have retired teacher friends who have retained Aetna secondary coverage and pay much more for it than necessary, but for some reason they don't want to give it up. Am sure you will get more educated responses than mine, though, on your particular situation. I have to keep my secondary insurance for at least 9 months to be able to keep my wife on the same insurance. After she turns 65, we'll be able to "shop" for a different insurance.
On average, your heart beats 100,000 times a day. One day, one of those heartbeats will be your last. Then what?
The answer is found in Jesus Christ who said "I am come that they might have life, and that they might have it more abundantly." John 10:10 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
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Re: Does anyone have a true understanding of Medicare?
[Re: Dan_n_Texas]
#13220272
07/20/19 03:08 PM
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Joined: Feb 2006
Posts: 5,092
BillS2006
TFF Celebrity
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TFF Celebrity
Joined: Feb 2006
Posts: 5,092 |
You will need a supplemental policy. If your current company policy is not real expensive, it's probably best to stay with it. Does it include prescription drugs? If not you will need Medicare Part D which is based on what scripts you take. About your company policy.Some policy's switch to Medicare Advantage at 65. If it does, you will experience the most confusing thing you have ever been through. Under a Medicare advantage policy, you will still pay the $135 a month for medicare, but medicare will no longer pay any benefits and you still pay a monthly fee to your company policy. And your medicare advantage plan will pay what medicare would have paid and leave you part of the expense.
There is an open enrollment period every October that if you want to change plans you can. Best advice is to find an insurance agent that specializes in senior medical insurance. He can take your current policy and prescription plan and advise you on the best move.
Transgenders: God made them, the devil changed their minds.
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Re: Does anyone have a true understanding of Medicare?
[Re: Dan_n_Texas]
#13220282
07/20/19 03:23 PM
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Joined: May 2002
Posts: 82,953
Bob Davis
Bunkeroid Bob
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Bunkeroid Bob
Joined: May 2002
Posts: 82,953 |
If your secondary insurance is paid for by your employer after you retire, I would think it wise to keep that. However, if not then it might be more cost efficient to look at other supplemental options. I have retired teacher friends who have retained Aetna secondary coverage and pay much more for it than necessary, but for some reason they don't want to give it up. Am sure you will get more educated responses than mine, though, on your particular situation. I have to keep my secondary insurance for at least 9 months to be able to keep my wife on the same insurance. After she turns 65, we'll be able to "shop" for a different insurance.You almost need to be a lawyer to understand all of the Medicare stuff. It varies by situation. It sounds like you are already in the system. My understanding, having just gone through this in February is that 6 months or less prior to turning 65, everyone needs to "sign up" for Medicare. Even if I continued my employment and having BCBS with my company. Medicare becomes the "secondary insurance" in that case. But I retired the day after my 65th birthday. So I lost my BCBS with my company and then Medicare Part A (hospitalization) and Medicare Part B (doctors and other expenses) became my primary insurance. You are also required to acquire Medicare Part D approved (prescription drug coverage). Or you will pay a fine. (thank you ACA). Medicare Part A insurance is free. Medicare Part B, YOU will have to pay for this. The least amount is $135/mo. If you had a high income for whatever reason 2 years prior on your IRS 1040 AGI, you may have to pay MORE for your Part B and your Part D (IRMMA, thank you ACA). Medicare Part A and Part B have deductibles associated. If you don't want to be liable for those deductibles or holes in that coverage you can: 1. Buy a MEDIGAP supplemental insurance plan (BCBS for example is $165 mo.) to help cover Medical problems AND you will have to buy the Part D approved PRESCRIPTION plan. (relatively cheap Wellcare for example is $11 mo.) OR: 2. Buy a MEDICARE ADVANTAGE plan to cover both PART B supplemental and PART D supplemental. Some people like the Advantage plans but you are restricted as to where you can go, which doctors etc. Kind of like an HMO plan. But this is good if you don't have any serious issues. So in essence, The Government makes YOU pay for the MEDICARE insurance that you paid into All of your working life. My company did not offer me any Medical insurance plan coverage after I retired. But IF I buy my MEDIGAP or ADVANTAGE supplements through their 3rd party, I was able to get a reimbursement for some of my costs and able to get a subsidized rate for my wifes health insurance (she is not 65 until 2 years). So for me, I have to pay Medicare Premiums for Part B and D, and my Medigap supplemental insurance and my wifes insurance. It is painfull expensive. Disclaimer: This is all just my own understanding of the system for MY situation. All situations are different. No responsibility is assumed for any of this. Good luck and may God be with you on your medical insurance journey.
Foxtrot Juliet Bravo
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Re: Does anyone have a true understanding of Medicare?
[Re: Dan_n_Texas]
#13220293
07/20/19 03:37 PM
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Joined: May 2002
Posts: 82,953
Bob Davis
Bunkeroid Bob
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Bunkeroid Bob
Joined: May 2002
Posts: 82,953 |
Foxtrot Juliet Bravo
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Re: Does anyone have a true understanding of Medicare?
[Re: Dan_n_Texas]
#13220336
07/20/19 04:33 PM
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Joined: Jan 2014
Posts: 1,902
fmrmbmlm
Extreme Angler
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Extreme Angler
Joined: Jan 2014
Posts: 1,902 |
Keep the company ins. if affordable, you will need a supplement. In no way drop medicare for medicare advantage, you might be in for a big surprise. Some clinics, Dr.s, and hospitals do not accept medicare advantage, be sure you check with your facilities, if you think about changing. That might have changed now, but a few years ago some didn't, happened to some people around Taylor when a salesman came around and talked them into changing. Scott &White didn't take it and there were some unhappy people.
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Re: Does anyone have a true understanding of Medicare?
[Re: Dan_n_Texas]
#13220410
07/20/19 06:51 PM
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Joined: Feb 2005
Posts: 4,706
Big Possum
TFF Team Angler
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TFF Team Angler
Joined: Feb 2005
Posts: 4,706 |
I googled MedicareSolutions and filled info in their form.
Lady called as I looked over plans and she gave me some help. I told her I didn't understand anything about this crud. She is sending a e-mail with more info.
You might try filling out the form and see if someone calls.
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Re: Does anyone have a true understanding of Medicare?
[Re: Big Possum]
#13220411
07/20/19 06:56 PM
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Joined: Feb 2014
Posts: 669
Po Boy
Pro Angler
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Pro Angler
Joined: Feb 2014
Posts: 669 |
Bottom line! Medicare doesnt understand Medicare, so how can anyone else.
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Re: Does anyone have a true understanding of Medicare?
[Re: Dan_n_Texas]
#13220431
07/20/19 07:23 PM
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Joined: Sep 2008
Posts: 5,190
fishslime
TFF Celebrity
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TFF Celebrity
Joined: Sep 2008
Posts: 5,190 |
I have a Humana advantage plan (PPO). $87 per month. Pays for all my prescriptions (3 generics) and no reference from primary care dr. for referrals. One primary dr. visit per year is free for the required Medicare physical. Additional are $15. Specialist is $35. Any surgery (including cataract) is $375. Also has one eye exam and dentist exam/cleaning per year covered. Had to go to ER recently, and they did EKG, catscan, and blood work. My part was $126. Went to the dr. in the box this week and was charged nothing. In this area of the state, most drs. take these type of plans. I have never been denied so far. The surprises I have had have been the positive type as the ER visit for $126. I was expecting a lot more since I wasn't admitted to the hospital.
I have been very happy with this but have not had many medical issues so far - knock on wood. My wife goes to a lot of drs. and has switched to a plan that costs app. $115/mo. However after a general deductible is met, there are no copays for any dr.
This stuff is not that hard to figure out. Talking to a reputable representative is a good idea, and then decide on the best type plan for your situation. Just be sure they aren't trying to sell you something you don't need in order to increase their commission.
Like anything like this it is one's responsibility to attempt to educate yourself before making a decision. If not, and you get screwed, you have no body to blame but yourself.
Last edited by fishslime; 07/20/19 07:26 PM.
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Re: Does anyone have a true understanding of Medicare?
[Re: Dan_n_Texas]
#13220437
07/20/19 07:28 PM
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Joined: Jul 2012
Posts: 12,214
Cast
TFF Guru
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TFF Guru
Joined: Jul 2012
Posts: 12,214 |
It is not that hard you guys.
1. Medicare is as good as most employers health plans, and way, way cheaper. Get it when you can and drop the high priced employers insurance. Unless you have to keep dependents insured...
2. Talk with the boss about dropping his insurance and paying for your Medicare insurance. It makes financial sense for him. I hear most will do it.
3. You will not have dental, vision or prescription coverage with plain Medicare. You must move to a Medicare Advantage plan to get those. My Humana MA is free and provides some extra coverage like dental and vision. Have your MA provider add Medicare Part D to cover prescriptions. I think I pay $19 monthly on top of my $135 monthly for my script coverage. You will still have a small drug co-pay.
4. Yes, you may have to change doctors and dentists. I fought it but eventually figured out that I had several local new doc offices opening around here locally. I no longer have to drive into town to see a doc. Local doc handles my needs and is ten minutes away.
5. Do not fear Medicare Advantage plans. They simply administer and advocate your Medicare needs. They get a cut of your monthly fee for Medicare in return for arguing with Medicare for you. A whole lot easier that talking to gubment idiots.
6. Hospital coverage is way way better than anything you have had before.
It is a good thing.
Cast I have a short attention spa
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Re: Does anyone have a true understanding of Medicare?
[Re: Cast]
#13220446
07/20/19 07:41 PM
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Joined: Sep 2008
Posts: 5,190
fishslime
TFF Celebrity
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TFF Celebrity
Joined: Sep 2008
Posts: 5,190 |
It is not that hard you guys.
1. Medicare is as good as most employers health plans, and way, way cheaper. Get it when you can and drop the high priced employers insurance. Unless you have to keep dependents insured...
2. Talk with the boss about dropping his insurance and paying for your Medicare insurance. It makes financial sense for him. I hear most will do it.
3. You will not have dental, vision or prescription coverage with plain Medicare. You must move to a Medicare Advantage plan to get those. My Humana MA is free and provides some extra coverage like dental and vision. Have your MA provider add Medicare Part D to cover prescriptions. I think I pay $19 monthly on top of my $135 monthly for my script coverage. You will still have a small drug co-pay.
4. Yes, you may have to change doctors and dentists. I fought it but eventually figured out that I had several local new doc offices opening around here locally. I no longer have to drive into town to see a doc. Local doc handles my needs and is ten minutes away.
5. Do not fear Medicare Advantage plans. They simply administer and advocate your Medicare needs. They get a cut of your monthly fee for Medicare in return for arguing with Medicare for you. A whole lot easier that talking to gubment idiots.
6. Hospital coverage is way way better than anything you have had before.
It is a good thing. All true!!
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