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Expert
Posts: 1207
 
| I know I know, not horse related but just wanting opinions. I am of that "age" where I can take Medicare. Anyone dealt with this? Like did you take out any other supplemental insurance on top of the Medicare? If so who with? |
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 Paint Horse Lover
Posts: 1427
Location: oklahoma | I would stick with the traditioanl Medicare , LTC, SNF's , Hospital stays are very costly .
Traditional Medicare covers Parts A and B, and you pay standard rates for services, regardless of where you live. You can go to any doctor, hospital or other provider that accepts Medicare patients anywhere in the country. You can add Part D coverage by enrolling in a private "stand-alone" drug plan for an additional premium. You can buy separate medigap insurance to cover some or most of the out-of-pocket costs of Parts A and B. - The traditional program directly from the federal government
- Includes Part A (hospital) and Part B (medical) coverage if you enroll in both
- You pay a deductible and/or coinsurance when you get health care (usually 20 percent of the Medicare - approved cost for outpatient care)
- Most people pay a monthly premium for Part B. There’s no Part A premium if you have at least 10 years of U.S. work history.
- You can go to any doctor or hospital in the country that accepts Medicare (most do)
- No referrals needed to see specialists; no prior authorization for services
- You can buy a Medigap plan as supplemental coverage
Differences between
Original Medicare and
Medicare Advantage Plans
Some Medicare Advantage plans charge higher co-payments for big-ticket items such as hospitalization, or for critical services such as chemotherapy. Or they might not pay for the first 20 days in a skilled-nursing facility (which traditional Medicare covers). In addition, a plan may provide limited coverage if you travel out of state. - Plans sold by private insurance companies that provide Medicare benefits
- Must cover the same Part A and Part B benefits as Original Medicare. Some also cover extra benefits such as vision and dental care.
- The most common types are HMOs (Health Maintenance Organizations), PPOs (Preferred Provider Organizations) and PFFS (Private-Fee-for-Service) plans
- Private plan that typically has different costs and restrictions.
- You pay a deductible and/or copay for services (usually a fixed copay, like $35 per office visit)
- You still pay Medicare premiums, and your plan may charge an extra premium
- You must usually use doctors and hospitals in the plan’s network
- You may have to choose a Primary Care Physician, get referrals to see specialists, and/or get prior authorization for certain services
- You can’t buy Medigap supplemental insurance to help pay your out-of-pocket costs
- Plans must have yearly limits on your out-of-pocket health care costs (an out-of-pocket maximum), after which you pay nothing for the rest of the year
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 The Vaccinator
Posts: 3810
 
Location: Slipping down the slope of old age. Boo hoo. | Medicare does not cover everything - you will need a supplemental policy. |
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I'm a Cry Baby
Posts: 3781
Location: n.c. | You will need a supplemental policy. I got a policy for my hubby thru AARP. Plan F2 I believe. It's about $133.00 a month but if he has to go to the hospital, there is nothing out of pocket.
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 I Prefer to Live in Fantasy Land
Posts: 64864
Location: In the Hills of Texas | I joined the old ranks in January. We both have traditional Medicare then added a United Healthcare Supplement and a Blue/Cross Blue/Shield RX policy.
We bought the policies with the most coverage so we don't have to worry about paying anything out of pocket. For both of us we are paying a little over $625.00 for both of us and the premiums do go up. He has an increase on his supplement in Sept. |
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I Prefer to Live in Fantasy Land
Posts: 64864
Location: In the Hills of Texas | Go to:
www.medicare.gov/
Edited by Nevertooold 2015-07-17 9:16 PM
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 Take a Picture
Posts: 12841
| I just turned 65. Up till now I have had Aetna, Texas Teacher Retirement Insurance. That became my supplement and my prescription plan when I filed for Medicare. I did get the Medicare parts A and B. I have to pay for part B. I filed on line. Since I do not get Social Security, I have to pay for my Medicare part B out of my checking account. I just sent them a check for $534 for 5 months of Medicare. I also, just printed out the form to have the Medicare payment automatically withdrawn from my checking account so I do not have to pay for 5 months at a time. I am sure that your Medicare premium will be taken out of your Social Security. The premium for the Aetna is taken out of my Teacher Retirement check each month. I still have a few kinks with Aetna but that should be fixed shortly. You really need to get part B so that you do not have out of pocket expenses. You also need to have some type of prescription plan because some of the medicines can get expensive. You need to file ASAP because the longer you wait, the higher your premiums will be on the part B.
Please do not try to explain how I can get Social Security etc because I have researched it and if I could get 50 cents out of the government I would. If you get teacher retirement you are screwed. Yes this is true. I have been trying since I was 62 to get my husband's Social Security hasn't happened yet. |
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Expert
Posts: 1207
| Thanks everyone. Yes I have signed up for the Medicare Part B. Just didn't know what else I would need. I am a member of AARP so will look towards that maybe also. As of right now I carry BCBS. I am not on any medications so just don't know what else I would need. I thought getting older would be easier, guess not. There are so many twists and turns and you are ****ed if you do and ****ed if you don't.   |
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I Prefer to Live in Fantasy Land
Posts: 64864
Location: In the Hills of Texas |
Our supplements are through AARP. I'm not a real fan of AARP but my husband had to go with it, long story, and when he had to use it they paid for everything. Mutual of Omaha was cheaper and that is who I was going to go with but he wanted me to make it simple and have us on the same plan. The plans all have the same coverage.
As far as drugs...when you go to Medicare.gov/. There is a deal where you put in all of your meds, if you are on any, and they will come up with what company covers your meds the best. With BCBS we found the best plan for my husband and with using CVS, he pays very little co-pay. If we go to Walgreens his copay doubled.
Once you get it figured out, you'll take a sigh of relief..our at least I did..LOL
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Extreme Veteran
Posts: 555
Location: Puky midwest | Hope you signed up for Part A also, there can be a penalty for that also, if you don't sign up when you are first eligible. I work for a contractor for Medicare.
And, as for Advantage plans, the doctors, supplies, and hospital can leave the plan at any time. And then you are stuck until an open enrollment period Oct 15 to Dec 7 each year.
You will be better off with the original Medicare and a supplement.
If any claims do get denied, don't get discouraged, or frustrated. 90% of the time its the way the doctors, hospitals, and suppliers turn the claims into Medicare. Medicare is based on Medical Necessity, and the doctors determine that. So make sure you mention that when you get services. Ambulance services are famous for not turning it in as a Medical Necessity.
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Miracle in the Making
Posts: 4013
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i am on ssdi i am on medicare be sure and sign up drug program evn though u don/t use it i did not and i pay fine everymonth |
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Expert
Posts: 1207
| Yes I am signed up for Part A also. The way I read it was that when you signed up for Part B you are automatically signed up for Part A. That is what is stated on my card that I just got anyway. |
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 To the Left
Posts: 1865
Location: Florida | I had my mother sign up for AARP supplement and it is great. She has paid nothing for two serious illness. I wish I was eligible instead of the $2,250 deductible plan I have now. |
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 Over Informed
Posts: 5372
Location: West Tennessee | So what is part D? Or am I making that term up?
Im about to tackle my moms coverages. She's paying a bloody fortune monthly for medicine. I picked up her 30 days of Namenda and that alone was 155.00 |
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I Prefer to Live in Fantasy Land
Posts: 64864
Location: In the Hills of Texas | dme0324 - 2015-07-19 4:08 PM So what is part D? Or am I making that term up?
Im about to tackle my moms coverages. She's paying a bloody fortune monthly for medicine. I picked up her 30 days of Namenda and that alone was 155.00 That is the prescription Drug Plan.
This explains the drug plan and how to find the best plan for the drugs your mom is on.
Drug coverage (Part D) | Medicare.govhttps://www. medicare.gov/part-d/ Part D ( Medicare Prescription Drug Coverage) helps cover the cost of prescription drugs and may help lower your drug costs and help protect against ...
Edited by Nevertooold 2015-07-19 7:20 PM
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Over Informed
Posts: 5372
Location: West Tennessee | Thank you, NTO |
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Expert
Posts: 1207
| Thank you everybody. I still don't know what to do on supplemental. If I should or shouldn't. I don't take any prescription medication, I don't go to the doctor that much. I generally use just the dentist and eye doctor. Just don't know. I have been on BCBS now for the last 4 years and paying for it out of my own pocket, then they cancelled my plan last year so had to get something else and the last time I was in to see a doctor was 2012. So for basically 4 years I have paid $300 plus monthly and even when I did go to see the doctor my plan wouldn't pay for hardly anything. |
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I'm a Cry Baby
Posts: 3781
Location: n.c. | I would really be diligent about the supplemental policy. You just never know. My husband doesn't have a drug plan
at this time and we are not being penalized for that. So, until he has to go to the Dr., we will keep things the way they
are. Good luck. It's a humongous headache. |
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Folks on-line