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Medicare,
jake16
Reg. Apr 2006
Posted 2019-11-22 9:57 AM
Subject: Medicare,


Go Get Em!


Posts: 13502
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Location: OH. IO

can you tell me what you have as far as extra plans?I'm trying to learn more asap.thanks

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streakysox
Reg. Jul 2008
Posted 2019-11-22 10:19 AM
Subject: RE: Medicare,



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The main thing that I can tell you is DO NOTrepeat DO NOT get an advantage plan for your supplemental. I had to go to the emergency room. Bill was $16,000. I did not pay a cent. I never pay a copay at the doctor's office. There are some other disadvantages of an advantage plan but too much to type. Also for drugs I HAD part D Medicare. Just changed that and I am using GoodRX Gold. Had a $777 prescription and part D would not take any discounts. Through GoodRX it would have been $575. I shop around and ask a lot of questions. Looks like it is going to take an act of Congress to get off that part D!  
Medicare part B about $113

Supplement(Mutual of Omaha) $155

Goodrx$5.99 for individual, $9.99 for family and includes pets (like heart worm). Check pharmacy to make sure they accept it. Kroger does. 
I use Members Mark toilet paper!  Guess that covers it. Laughing

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Frodo
Reg. Jul 2004
Posted 2019-11-22 12:07 PM
Subject: RE: Medicare,


"Heck's Coming With Me"


Posts: 10794
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Location: Kansas

streakysox - 2019-11-22 10:19 AM


The main thing that I can tell you is DO NOTrepeat DO NOT get an advantage plan for your supplemental. I had to go to the emergency room. Bill was $16,000. I did not pay a cent. I never pay a copay at the doctor's office. There are some other disadvantages of an advantage plan but too much to type. Also for drugs I HAD part D Medicare. Just changed that and I am using GoodRX Gold. Had a $777 prescription and part D would not take any discounts. Through GoodRX it would have been $575. I shop around and ask a lot of questions. Looks like it is going to take an act of Congress to get off that part D!  
Medicare part B about $113


Supplement(Mutual of Omaha) $155


Goodrx$5.99 for individual, $9.99 for family and includes pets (like heart worm). Check pharmacy to make sure they accept it. Kroger does. 
I use Members Mark toilet paper!  Guess that covers it. Laughing


Good to know.  I'm still on our company's BC/BS primary plan but since Obamacare stomped on us, the deductibles are high and so are the premiums.  I'm past retirement age and need to start checking out Part B and a supplemental plan.  I think my Part B will be more like $140.00.

 

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streakysox
Reg. Jul 2008
Posted 2019-11-22 12:20 PM
Subject: RE: Medicare,



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By the way, I went to an insurance agency to get them to help me. Did not use any internet sites. Why would you part be cost so much. I thought everyone's was the same price?

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Frodo
Reg. Jul 2004
Posted 2019-11-22 12:41 PM
Subject: RE: Medicare,


"Heck's Coming With Me"


Posts: 10794
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Location: Kansas

streakysox - 2019-11-22 12:20 PM


By the way, I went to an insurance agency to get them to help me. Did not use any internet sites. Why would you part be cost so much. I thought everyone's was the same price?


My friends go through a gentleman who assesses your needs and picks a plan for you and have been very happy with him so I thought I'd give him a try.  I don't even know for sure what his job description is.

I was on Part B for a while and then it was $109, but because our BC/BS folks assured me I didn't need it with our primary plan I cancelled it.  The last time I spoke with SS they had jumped it to $140.  I took all the right steps when I cancelled because I know how they love to penalize you for life so I'm not sure how they came up with that amount.  Thought I'd take it up with them when I got ready to go back on it which will probably be in the next year.

 

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Frodo
Reg. Jul 2004
Posted 2019-11-22 12:45 PM
Subject: RE: Medicare,


"Heck's Coming With Me"


Posts: 10794
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Location: Kansas

Ironically I remember when Hillary was running for President, Bill Clinton standing up in front of a crowd and raising the roof about how wrong it was for people to have to work so hard, sometimes two jobs, just to be able to afford their premiums, then not even being to use their insurance because the deductibles were sky high.  He was spot on.

 

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Delta Cowgirl
Reg. Apr 2005
Posted 2019-11-22 1:23 PM
Subject: RE: Medicare,



The Vaccinator


Posts: 3810
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Location: Slipping down the slope of old age. Boo hoo.

There are web sites that allow you to input your information and location in order to compare Supplemental Plans.  Plans differ by location.  We are in southeast Arkansas and my husband has the best plan offered by Humana.  It has worked very well.  Part D for him is Express Scripts which has also worked well.  (You input you prescriptions, too, and it looks for the best fit for you for Part D.)  There are local insurance agents in most areas that will help you compare and find the best supplemental fit for your situation.  I advise finding one of these brokers to sit down with  -- take a list of your medication.  It's very complicated and it helps to have someone help you find the best fit for your needs.  I DO NOT advise an Advantage Plan -- it sounds great on TV!  However, a relative was talked into getting one and it was a nightmare.  The relative ended up having to hire an attorney to have an emergency hospital stay paid for.  It's very limited as to who you can see, where you can be hospitalized, etc... you must have pre-approval to die I think.   It was difficult to say the least.  The relative switched back to a Blue Cross supplemental.   Just be cautious and read - and understand - all the fine print!  With all that being said -- it is my understanding that in certain areas of the USA, Advantage Plans are wonderful -- just did not work out in our rural area. 

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Sandok
Reg. Jan 2011
Posted 2019-11-22 1:23 PM
Subject: RE: Medicare,


Expert


Posts: 1207
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So this is what I know.  I have Medicare and Aetna.  Not sure what my medicare costs as it comes out of my SS check.  I am thinking maybe only in the $80-$100.  Aetna has went up in cost since I started and am thinking it is around $104 or something like that.  I had an emergency that I had to go to the hospital for last year and I am thinking the cost was around $20,000 and I did not pay a cent.  Deductible on Medicare is low.  I go to a chiropractor about every 2 weeks and once my deductible is met which I think is about $80 or something like that and with my supplemental I pay nothing unless she puts me on a machine (stretching).  Once my deductibes are met I usually don't pay anything unless I need a prescription filled which I am (so far) not on any prescription meds and I am 69 years old.  Although I just now signed up for a prescription plan through Humara and not sure I am going to keep although it is supposed to only cost me $13.20 a month.

  Now my other half who is a Vietnam Veteran goes through the VA which he still has terrible service and we just got him on the Medicare Part B and he pays close to $300 for that as he did not sign up when he turned 65.  The longer you wait past retirement age the more you have to pay for Medicare.  He does not have a supplemental insurance outside of the VA.  My understanding is that he can go into any doctor but if they are not affilated with VA, Medicare only pays for 80% and he would have to pay the 20%.  They say that Veterans can now do this and go to any hospital or doctor's office and what Medicare doesn't pay that the VA would pick up, but that is not true.  

I went through an insurance agent and not through the internet.  I also heard not to get an advantage plan also.  Not sure why.

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jake16
Reg. Apr 2006
Posted 2019-11-22 1:55 PM
Subject: RE: Medicare,


Go Get Em!


Posts: 13502
5000500020001000500
Location: OH. IO

thank you all for your replies so far:),I appreciate the time you took to write it all out!

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Fun2Run
Reg. Jul 2005
Posted 2019-11-22 3:37 PM
Subject: RE: Medicare,



A Barrel Of Monkeys


Posts: 12972
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Location: Texas

I have United Health Care thru AARP - the advantage plan.  I've been very happy with it.  I just had hip replacement and the whole thing cost me $275.00.  So instead of the govt. getting the premium that they take out of your social security, it goes to AARP.  No extra charges. 

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Sandok
Reg. Jan 2011
Posted 2019-11-22 3:41 PM
Subject: RE: Medicare,


Expert


Posts: 1207
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Are you on Medicare?  Or just United Health Care?  My Medicare B is the only thing that comes out of my SS.

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hoofs_in_motion
Reg. Apr 2011
Posted 2019-11-22 7:14 PM
Subject: RE: Medicare,



Undercover Amish Mafia Member


Posts: 9991
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Location: Kansas

streakysox - 2019-11-22 10:19 AM


The main thing that I can tell you is DO NOTrepeat DO NOT get an advantage plan for your supplemental. I had to go to the emergency room. Bill was $16,000. I did not pay a cent. I never pay a copay at the doctor's office. There are some other disadvantages of an advantage plan but too much to type. Also for drugs I HAD part D Medicare. Just changed that and I am using GoodRX Gold. Had a $777 prescription and part D would not take any discounts. Through GoodRX it would have been $575. I shop around and ask a lot of questions. Looks like it is going to take an act of Congress to get off that part D!  
Medicare part B about $113


Supplement(Mutual of Omaha) $155


Goodrx$5.99 for individual, $9.99 for family and includes pets (like heart worm). Check pharmacy to make sure they accept it. Kroger does. 
I use Members Mark toilet paper!  Guess that covers it. Laughing


GoodRx can cover pet meds? Well I mean reduce the cost?

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slipperyslope
Reg. Nov 2008
Posted 2019-11-22 9:24 PM
Subject: RE: Medicare,





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Location: in the ozone

Frodo - 2019-11-22 11:41 AM


streakysox - 2019-11-22 12:20 PM


By the way, I went to an insurance agency to get them to help me. Did not use any internet sites. Why would you part be cost so much. I thought everyone's was the same price?



My friends go through a gentleman who assesses your needs and picks a plan for you and have been very happy with him so I thought I'd give him a try.  I don't even know for sure what his job description is.


I was on Part B for a while and then it was $109, but because our BC/BS folks assured me I didn't need it with our primary plan I cancelled it.  The last time I spoke with SS they had jumped it to $140.  I took all the right steps when I cancelled because I know how they love to penalize you for life so I'm not sure how they came up with that amount.  Thought I'd take it up with them when I got ready to go back on it which will probably be in the next year.


 


It has gone up for everyone.  When I originally signed up, it was $105/month & it jumped a bunch last year.  I imagine it will go up again this year too.

I also don't suggest the Advantage Plans.  From what I understand also, is that you can end up getting locked into them & not be able to every get a supplemental instead.  Our insurance agent told us we could have the Advantage for one year, but then either needed to get on a supplemental or stay on Advantage plan.

Also, the supplementals have different plans & each is different cost & coverage.  I can't remember for sure what one we have but we have a yearly deductible of like $185 on Part B.  Then everything is covered 100% between Medicare & supplement.

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streakysox
Reg. Jul 2008
Posted 2019-11-22 11:25 PM
Subject: RE: Medicare,



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Sandok - 2019-11-22 1:23 PM


So this is what I know.  I have Medicare and Aetna.  Not sure what my medicare costs as it comes out of my SS check.  I am thinking maybe only in the $80-$100.  Aetna has went up in cost since I started and am thinking it is around $104 or something like that.  I had an emergency that I had to go to the hospital for last year and I am thinking the cost was around $20,000 and I did not pay a cent.  Deductible on Medicare is low.  I go to a chiropractor about every 2 weeks and once my deductible is met which I think is about $80 or something like that and with my supplemental I pay nothing unless she puts me on a machine (stretching).  Once my deductibes are met I usually don't pay anything unless I need a prescription filled which I am (so far) not on any prescription meds and I am 69 years old.  Although I just now signed up for a prescription plan through Humara and not sure I am going to keep although it is supposed to only cost me $13.20 a month.


  Now my other half who is a Vietnam Veteran goes through the VA which he still has terrible service and we just got him on the Medicare Part B and he pays close to $300 for that as he did not sign up when he turned 65.  The longer you wait past retirement age the more you have to pay for Medicare.  He does not have a supplemental insurance outside of the VA.  My understanding is that he can go into any doctor but if they are not affilated with VA, Medicare only pays for 80% and he would have to pay the 20%.  They say that Veterans can now do this and go to any hospital or doctor's office and what Medicare doesn't pay that the VA would pick up, but that is not true.  


I went through an insurance agent and not through the internet.  I also heard not to get an advantage plan also.  Not sure why.


Yep if you don't sign up at 65 it is higher. What a rip!  Happened to the teacher across the hall from me. What the school did to her was criminal but too much to type. 

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Fun2Run
Reg. Jul 2005
Posted 2019-11-23 1:14 AM
Subject: RE: Medicare,



A Barrel Of Monkeys


Posts: 12972
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Location: Texas

Sandok - 2019-11-22 3:41 PM

Are you on Medicare?  Or just United Health Care?  My Medicare B is the only thing that comes out of my SS.

It's AARP Medicare Advantage. So instead of having Medicare, with their deductible and 80/20 plan, I have no deductible, 0 copay for my primary dr. and $35 copay for a specialist.  I've been happy with it, and I've had 3 surgeries over the past 3 years.  



Edited by Fun2Run 2019-11-23 1:17 AM
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jd&ez
Reg. Oct 2003
Posted 2019-11-23 7:36 AM
Subject: RE: Medicare,


Expert


Posts: 1956
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Location: Ky

jake16 - 2019-11-22 9:57 AM


can you tell me what you have as far as extra plans?I'm trying to learn more asap.thanks


Got a month for answers? 

 

A quick Medicare 101. Medicare A is your hospitaization and the first 20 days of nursing home confinement. The premium for Medicare A is very high. In the neigborhood of $400/mo. But, the vast majority of people do not have a premium for Medicare A. Last figure I saw was less than 1% have to pay. The Medicare A deductable for 2020 is about $1400. That's your cost for a hospital stay. It will be assessed for each hospital stay if the visits are separated by 60 days. There's more but it can get long and more confusing.

 

Medicare B is doctors visits and charges. Taking B is optional. The premium for Part B for 2020 is going to be just under $145/mo. Unless the person is a high earner, then it will be more. I'm trying to keep this short so I won't go into that detail. After you have paid your deductable of $198 for 2020 then Medicare pays 80% of all approved Medicare doctor's charges and you pay 20%.

 

That is pretty much the whole Medicare plan in a nut shell. You become eligible for Medicare on the 1st day of the month in which you turn 65. Unless your birthday is the 1st of the month. In that case you become eligible on the 1st of the previous month. You also become eligible for Medicare after 24 months of SSDI regardless of age. And even sooner for some serious illnesses, like end stage renal failure. 

 

Then there's "extra help" which is completely income and asset based. There's a wide range of extra help from apying all of your premiums and coinsurance and Rx plans to paying a small percentage. Whether you qualify for that is handled by a SS caseworker. This is a subjuct we could discuss for days. And you are subject to requalfy every year.

Now comes supplements and Medicare Advantage plans and Rx plans called PDP's. Supplements are also called Medigap plans.

They are not the same thing and we as agents are forbidden to call them the same thing. Although most consumers still call them the same. In trying to be short, a supplement is just that. It supplements Medicare coverage. You still use your medicare card for services and pay what I described above. Then the supplement kicks in and pays all, or most, of your coinsuance depending on which plan you chose to buy. Supplements do not include PDP. So you would need to buy a separate PDP is you want drug coverage. 

PDP plans vary widely in premium, co pays and formulary. With the formulary being the most important factor. They are administered by private comanies but have to follow Medicare rules. They are Part D of the Medicare program. 

Medicare Advantage plans are all inclusive plans. They do not supplement Medicare. They are part C of Medicare. They are only provided by private companies. They will provide Parts A&B of Medicare and usually also include Part D. When it includes Part D it's known as MAPD. There are many zero premium plans available. Most today are also PPO's or HMO's. If your doctor is not in the network you will need to change doctors or not chose that plan.

 

The choices for Advantage plans varies far too much to go into. The plans are not just state specific but also county specific. And there is not pat answer as to which is best, supplement or avantage plan. Each person's needs vary and als their wants.

This is where an agent comes in. Deal with an independent agent that can write them all. Also a local agent is better because they will know the area details of the networks if you are looking at advantage plans. People think they can get a better deal by bypassing an agent. They can't. The premiums will be the same if you sign up thru an agent or if go direct to the company. 

Right now we are in the Annual Enrollment Period, AEP. That only applies to Medicare Advantage and PDP's. Enrolling now for plans to start Jan 1. There are exceptions called SEP's where you can change those plans throughout the year but again, best handled with an agent versed in those situations. Medicare supplements can be changed anytime. There is no AEP for supplments.

And you don't have to do anything during each AEP. If you are satisfied with how things are working then you can stand pat. The company has to notify you every year if they are making changes to your plan. If you can live with the changes then do nothing. If you can't, then look at what's out there. It is daunting and Medicare has what seems to be their own language. 

Having a prficient agent to help you with this is priceless. But you have to do your due diligence on that too. Never get taken in by what's suppsedly Medicare calling you or Medicare reps coming to your house. That simply does not happen. Medicare will never call you. Medicare will never come to your house. Those are agents making those calls and visits and it is a serious violation to do that and pretend to be be from Medicare. Even though it's a serious violation it happens every day. They just haven't been caught yet. If someone does show up just tell them to hang on while you call Medicare to verify. Call !-800-Medicare and tell them you want to verify their representaves that are standing on your porch. All you will get is windburn from their leaving once you pick up that phone.

 

 

 

 

 

 

 

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vjls
Reg. Mar 2005
Posted 2019-11-23 7:43 AM
Subject: RE: Medicare,


Miracle in the Making


Posts: 4013
20002000

i am 68  i am also a spinal cord injury  i have united health its out of my ss check about 110 a month. that all i have,  i do have a co pay  my medical supplies for my wonderful injury is 126.00 ever 3 montyh  most of you will not need  that but the cost if i did not have it would be close to 2699.00 everytre 3 month  i have otipma x for prescrition del to me thru mail  i am on 2 drugs  cost 28.00 total 3 monthsd supply.

 

i just had a pacemaker put in again as my old died ****ed me off i don/t need the dam thing that was 99k of which i payed about 3k total .

 

i like what i have but i am very healthy. i just don/t get sick  i never have i  have never had a flue shhot andf not getting 1  have not had flue for 50 plus years

 

seriusly  io sayu just get rgular medicare don/t bother with all the other crap

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jake16
Reg. Apr 2006
Posted 2019-11-23 8:22 AM
Subject: RE: Medicare,


Go Get Em!


Posts: 13502
5000500020001000500
Location: OH. IO

THANK YOU ALL very much for taking the time to reply;)) You have definitely cleared some questions up!I really appreciate all of you

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streakysox
Reg. Jul 2008
Posted 2019-11-24 3:12 AM
Subject: RE: Medicare,



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Posts: 12838
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hoofs_in_motion - 2019-11-22 7:14 PM


streakysox - 2019-11-22 10:19 AM


The main thing that I can tell you is DO NOTrepeat DO NOT get an advantage plan for your supplemental. I had to go to the emergency room. Bill was $16,000. I did not pay a cent. I never pay a copay at the doctor's office. There are some other disadvantages of an advantage plan but too much to type. Also for drugs I HAD part D Medicare. Just changed that and I am using GoodRX Gold. Had a $777 prescription and part D would not take any discounts. Through GoodRX it would have been $575. I shop around and ask a lot of questions. Looks like it is going to take an act of Congress to get off that part D!  
Medicare part B about $113


Supplement(Mutual of Omaha) $155


Goodrx$5.99 for individual, $9.99 for family and includes pets (like heart worm). Check pharmacy to make sure they accept it. Kroger does. 
I use Members Mark toilet paper!  Guess that covers it. Laughing



GoodRx can cover pet meds? Well I mean reduce the cost?


Yes check out the Gold plan for the family. It is $9.99. I think you have to get the meds at the pharmacy. Hoping to get my EPM meds for my horse. Think that one will wash?

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streakysox
Reg. Jul 2008
Posted 2019-11-24 3:15 AM
Subject: RE: Medicare,



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Posts: 12838
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That freaking medicate part D has a $485 deductible on prescriptions. I don't have that many prescriptions all year. (Till that darn $777 one)

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jd&ez
Reg. Oct 2003
Posted 2019-11-24 7:44 AM
Subject: RE: Medicare,


Expert


Posts: 1956
10005001001001001002525
Location: Ky

streakysox - 2019-11-24 3:15 AM

That freaking medicate part D has a $485 deductible on prescriptions. I don't have that many prescriptions all year. (Till that darn $777 one)

There's a lot of Part D options. My area has 42 plans to chose from. If you look in the back of your Medicare and You booklet that you are supposed to receive every year it will have all the plans listed for your state. Many plans do not have a deductable. 

If you see the premium for that plan printed in blue ink that means that the person on 100% LIS, {Low Income Subsidy}, will not any premium for that plan. 

 

The formulary is really more important than the premium. Doesn't matter if it's a cheap premium if your meds are not in the formulary. On cost, the most important number is annual cost. You can enter all your meds and get an estimated annual cost for all plans. Or a qualified agent could help you with that. Also an agent could help with step therapy if your meds get changed during the year. 



Edited by jd&ez 2019-11-24 7:45 AM
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