It is certainly possible to have only Parts A & B and D, and no supplement. You will get billed whatever the doctor wants to bill you for the excess. Some people get no additional bills, others get nickeled and dimed.

Is it wise? No one can answer that for you.

i'm curious as to how much you would have to pay with no supplement. don't be too quick to say 20% because all those commercials say you MAY be responsible for that 20% that part B doesn't cover... not that you WILL be!?!

my supplemental plan if thru United Healthcare/AARP and frankly chosen almost like throwing darts at dart board. for the most part i think they all even out in the end. I don't have a "Cadillac" plan but it seems OK?? spent 5 days in hospital end of October last year (3 in ICU). NEVER got a bill, per se. got thick packet of stuff all about what i MAY have had to pay.... total was over $25,000. have gotten NO bills to speak of. wouldn't matter if I did... as they say, you can't get blood from a stone.

I have only Medicare A&B coverage - no supplemental and no prescription coverage. It makes sense for me, as I am a basically a very healthy person with minimal requirements - to date - for any sort of medical care. And I take no prescription drugs.

Will I continue to operate without any supplemental coverage? Hard to know but I suspect at sometime in the future it will become necessary, however I cannot afford to pay for what I do not need or use so will hold off until that time comes. I will gladly pay out of pocket for flu and pneumonia injections each year, as they are nothing compared to teh supplemental monthly premiums that might cover them.

I think everyone needs to evaluate the benefit to them based on their lifestyle and current health to decide if supplementals are necessary or not.....no one else can really make that decision for you.

It all depends on the provider. I had an elderly friend who had a minor procedure done in the doctor's office. She was billed $1100 until her daughter explained that she has no money (but too much income from SS to qualify for Medicaid by less that $200. She went to the ER by ambulance several times and got billed for the excess by the city emergency services. They didn't let her off the hook without filing a packet of forms. Same person's diabetes doctor billed her the excess of $40 for every visit.

I know all this because I helped her pay bills every month.

If you do not get supplemental insurance when you first sign up for Medicare, you may not be able to ever buy it. Pre-existing conditions and the requirement to get a physical may mean that you will shut out. And you can't move up to a more comprehensive plan later without those requirements, as well. Call someone like AARP and ask, there will be no obligation.

But it's an offer that you get when you first sign up and will not get again.

My mom's supplement with United Healthcare's Golden Rule has been a financial blessing this past year. Without it, she would have paid $9k out of pocket. Considering that her health was excellent up to...when it wasn't, I'm surprised she had purchased a supplemental policy.

Would the providers have billed my Mom the 20% if she didn't have the supplement? It's hard to say definitively but I tend to think they would have given it a go. Walking away from possible money doesn't fit most provider's MO.

I'm not at a low income level and anyway have insurance via my employer so I haven't faced this question personally. But I have a healthy in-law with very modest income (monthly expenses are covered by kids, including us) whose first dollar every quarter would be spent on the supplemental policy if that were the choice and funds were more limited. Meaning, everything else is of lesser priority to this person. We're talking about a person in very good health who just doesn't want to take a chance.

I don't know what the circumstance might be when going without available health insurance one can afford is a prudent decision. If it's a question of money and affordability, then you're saying you don't have a choice.

Good luck with whatever route you decide. If you can afford the coverage, I hope you don't make a decision that may prove to be penny-wise but pound-foolish.

Being without a supplemental insurance would not be an option for me but then I have to use Medicare a lot and live only on SS. I have BC/BS and never had to pay a penny out of pocket. .. and for 4 joint replacements and 2 major back surgeries, it would have been probably close to $300,000 plus all of the tests/MRI/labs that I have to do.

Personally, I have become aware that I would prefer the insurance pay me rather than the doctor. I think this structure would rapidly cure this insurance problem. I know I am right because both the insurance people and doctors I know hate the idea of it.

As for Medicare Part D policies -- if you do not sign up for a Medicare Part D policy as soon as you are eligible, and then sign up for one at a later point in time, you will pay an additional late-signup penalty fee every month. The only way you would avoid it would be if you had coverage past the age of 65 with your employer or your spouse's employer. There are a lot of Part D plans to choose from, so if you don't think you need prescription drug coverage, sign up for the cheapest one as soon as you are eligible. You can always change to a better plan in a subsequent open-enrollment period.

I cannot imagine going without supplemental health insurance unless I were so poor I was eligible, and had no other choice other than to be on MediCal or MediCaid or so very very wealthy I could afford a catastrophic illness that might impact me for the rest of my life. I don't care how healthy one is. You could slip in the shower, you could be in an automobile accident. Cancer can strike anyone. Athletes at the peak of fitness have been known to have heart attacks.

DH and I are both of Medicare age. At the time we don't need to worry about supplement parts because we still have insurance though his employer. We choose to pay for a more expensive plan. than others offered. Health care is a priority in our family over a new vehicle every couple of years or the latest greatest household trend. A major priority.

I wouldn't take the chance on going without supplemental insurance. I thought I was a healthy person too until I got a diagnosis of breast cancer My two surgeries, chemotherapy and radiation treatments didn't cost me a penny. I have BC BS bronze plan which is less than $100 a month and a Humana rx plan for $17 a month. If you ask me Medicare and the supplemental insurance plans are the biggest bargain on the planet.

A very big thank you for sharing your knowledge and advice with me. I am retired and have medicare and supplemental insurance with prescriptions through my employer. I definitely learned a lot from you. Lindsey, you are so knowledgeable.

My question pertains to my MIL who is quite elderly and BTW until recently has not taken any over the counter or prescribed meds. She has recently relocated to an assisted living residence in our state.

She has managed medicare and BCBS with meds coverage. BCBS will cover her until spring and might be available in my state then, but is not currently. So I am scouting out the choices for supplemental in my state.

How should I go about researching the plans available to her? I called my SHIP (state health insurance program) office for information, but they must be swamped and under staffed. I left a message weeks ago and have not had a call back yet. Thanks to you my most basic question is answered.

A friend recommended having a Medicare Advantage plan. Is anyone familiar with these?

It sounds like that's what she already has, if she has a managed care plan with drug coverage. (Medicare C, so to speak, but no one calls it that.) She can transfer into a non-Advantage plan, but you are picking up all the various parts separately. I'd start with the assisted living staff and ask them what doctors that their patients use. For convenience, I'd lean towards selecting the doctors first and see what they accept.

Perhaps a Christian Scientist would be OK never buying a Plan D. Maybe you'll be OK when the government starts controlling the cost of prescription meds -- or legislates that the makers can't advertise prescription meds.

DH didn't sign up for a Plan D because he took no prescription meds. Now, though, he has three 'maintenance' meds. Each year he pays a *penalty*, based on how many years he failed to buy Part D coverage. (It's not huge, but it's more than he saved over the years he didn't pay Plan D premiums.) If you currently have no expensive meds, get the cheapest Plan D you can find. Someday you will need a plan to help you cut the incredible retail costs of meds..

The omnipresent AARP United HealthCare TV commercial is deliberately misleading. The current one shows a pie that they say represents the medical provider's bill for services. It shows Medicare paying 80% of the pie and says you will pay for the 20% 'slice'. This is NOT TRUE.

To go along with their 'pie' example, the pie would have to represent the charges AFTER Medicare has reduced them to its approved rate -- much, much lower than the Big Gulp. My 20% of such bills has fallen hundreds of dollars short of what I would have paid to 'protect' myself with one of their supplemental policies.

Unless you choose a provider who doesn't accept Medicare negotiated rates, you will never pay one of those ridiculous bills. If you do choose such a provider, you may pay the ENTIRE inflated bill.

DH and I have High Deductible Plan F supplemental policies. Plan F covers virtually *everything* for less than $100/month. Our 'risk' is a $2500 deductible. Only once have I paid that much out of pocket -- while being protected against any amount beyond that. Most years I have spent under $200 out of pocket.

I highly recommend the book Medicare Demystified: A Physician Helps Save You Time, Money, and Frustration by Ronald Kahan. The author is a physician. This is what Amazon says in the "About the Author" section:

~*~*~*~

Ronald Kahan, MD, a sought-after health care lecturer and consultant, is an associate clinical professor at Yale Medical School and has practiced medicine for more than thirty years. He obtained his bachelor’s degree from Yale University and his MD from Weill-Cornell Medical College, and went on to conduct his residency at Harvard combined hospitals, specializing in dermatology.

Born in 1945, Dr. Kahan is one of the millions of Americans now covered by Medicare. He has tackled Medicare issues in both his personal and professional life, which brings an incredibly rich, practical perspective to his writing.

Uniquely combining his professional expertise with his own personal insights and recommendations, Dr. Kahan authored Medicare Demystified to provide senior citizens, and/or the loved ones overseeing their care, with unbiased, invaluable information on understanding Medicare, getting the most out of coverage, and accessing care effectively and with ease.

~*~*~*~

Amazon has the Kindle version for $6.99 and the paperback for $12.95. I bought the Kindle version in 2015, but the prices I just wrote are for the updated 2017 version. The book is extremely well written and informative.

I had also purchased two other "understanding Medicare" books from Amazon when I got Dr, Kahan's book, and read them all. One was written by an insurance agent who sells Medicare supplement policies, so his slant was biased towards the policies that bring him the largest commissions. The third book was written by a guy who has a blog about Medicare and Medigap, etc., but is totally unclear about what his qualifications are.

Dr. Kahan's book is by far the best, most accurate, and easiest for anyone to understand.

Happy2b - every state has a SHIP program, often contacted through your local senior center, which has trained volunteers who help guide seniors through the medicare/supplemental insurance process. They do not sell insurance but give help and information. They are quite knowledgeable and able to give good advice. See if you can contact their local office for help in determining what your MIL might need.

One might not be able to "afford" insurance, but these days NO ONE can afford to NOT have it! I take medications that would cost me $1350 a MONTH, plus another med every other month that would be an additional $890. In June, I had a bronchoscopy and Medicare and Tricare covered the entire negotiated cost. Out of pocket, it would have been $35,000 for an outpatient procedure that took less than 30 minutes! Who had that kind of money!

One buys health insurance when one is healthy and can get it. When one loses ones health, one will never be able to buy a supplementary policy to Medicare, let alone private health insurance if under 65. Insurance must be a priority.

I want to get MIL the same coverage as she has had. She needs coverage for hospital, doctors, prescription. Her insurance covers dental and vision also.

I definitely will check with the assisted living. They work with one medical group. MIL could have a different physician but since the physicians have a good reputation in my area, she will see them. They also come to the residence. I believe that they accept BC/BS along with Medicare, so she has coverage for now. As I shop for policies, I will contact the physician office. It would be great if I could speak with their insurance specialist.

It is a great relief that BC/BS extended the grace period until spring from 60 days. This gives me time to educate myself, research policies, and read Dr. Kahan's book.

When the volunteer from SHIP calls, I will be ready to ask questions.

lindsey, it sounds like you have an excellent understanding of this topic and can provide good resources for others.

Do note that the words as you quoted from a typical Amazon "About the Author" segment aren't prepared by Amazon but are typically provided by the author him or herself, the author's agent, or the author's publisher's marketing department. It's the response to the request from from Amazon, "Please provide us a backgrounder about you to put on the Author's Page or the About the Author section we'll set up". So it's, "What would you like to say about yourself?"

lol like amazon is human, has a care.

Elmer, neither of my parents lived long enough to be covered by Medicare. My mother was 53 and my father was 56 when they died 33 days apart in 1970. My husbands parents both had died before we met very early in 1981 (his mother in 1969 and his father in 1980). I really had no one to talk to about it who had personal experience with it (I am more than a year older than my husband).

I have had plenty of experience being given information by others (people who are paid to know the facts) that I then relied on, only to find out too late that they were wrong and didn't know what they were talking about. Some of these errors in trust ended up costing me financially.

Therefore, when it came time to think about signing up for Medicare, I didn't want to trust anyone else for the information. I wanted to read and learn for myself, to have a full understanding of how things really work when it comes to Medicare.

I've said plenty of times before, and I'll say it again now, that I know my husband and I are incredibly lucky to be State of California retirees. There are many health insurance plans from which to choose when you are an active employee, and when you retire, you keep the same plan unless you choose to change to a different plan. (And you can change every year during Open Enrollment, if you so desire.) You can retire from State service at the age of 55 (earlier if you are disabled), but when you turn 65 you must sign up for Medicare unless you are covered by your still-employed spouse's health care plan. In my case, my husband was still actively employed when I turned 65, so I was exempted from the Medicare requirement. However, knowing now what I didn't know then, I should have chosen to switch to Medicare immediately because the State's monthly contribution to health insurance more than covers the monthly premium for Medicare and our Medicare Supplement policy, but didn't fully cover the monthly premium for our PERSCare Anthem Blue Cross PPO policy. We were paying $527.74 out of pocket (well, a payroll deduction from my husband's monthly pay), which was over and above the $1,125 the State contributed each month, as well as having a yearly deductible (which is waived for preventative care), and a $20 copay for office visits. Now, we pay NOTHING. (Well, that's not quite correct -- we do have to pay the IRMAA fee for the prescription drug coverage [which is part of our Supplement policy], but that's because our income is over the threshold amount for paying just the regular premium. Although the State reimburses us for the monthly IRMAA for Medicare Part B, the law doesn't allow for reimbursement of the IRMAA for Part D. But the Part D IRMAA is less than $30 for the two of us.)

My husband retired a year and a half after I did, but he didn't turn 65 for another year. But, as soon as he retired, I had to sign up for Medicare because I lost the "coverage by a still-employed spouse" exemption.

Our PERSCare Anthem Blue Cross PPO policy became our Medicare Supplement policy when we started coverage with Medicare.

One thing that is admittedly odd is that the State pays more towards retiree health benefits than it does for active employee health benefits. But, since we're retired, that's ok by me. :-) The State contributes $1,349 each month. Our PERSCare Anthem Blue Cross PPO Medicare Supplement Policy is $779.52 for the two of us, leaving $345.48 extra. Out of that extra, the State reimburses us for our Medicare Part B premiums and the Medicare Part B IRMAA fees. There is still some $ left over, but the State keeps that. Our Supplement policy covers the deductibles for Medicare Part A and Part B, and it pays the 20% of the allowed fees that Medicare doesn't pay. We do not pay a copay for office visits. Since I have been on Medicare, the ONLY thing medically related for which I have had to pay anything at all has been prescription medicine - and that's a minimal amount because of our Supplement plan. (One generic med that I used to pay $5 for now costs me $0.58.)

ANYWAY, folks need to know the truth about how Medicare works and what doctors can and can't charge you (over and above what Medicare pays), so they can make an intelligent, informed choice about (1) whether or not to get a Supplement plan and (2), if so, which plan to choose. Dr. Kahan's book has a great full-page chart showing the various supplemental plans and what they do and don't cover.

By the way, Medicare Supplement plans (which are also called Medigap plans) all have to meet specific criteria and they are standardized, Different insurance companies may charge different premiums, but all "Plan A" plans have to cover the same stuff at the same rate, all "Plan K" plans have to cover the same stuff at the same rate, etc. "Plan F" plans are considered to be the "Cadillac" (or in my case, the "Lexus") plans because they cover virtually everything. That's what our PERSCare plan is.

Oh, that limiting fee that I mentioned in an earlier post -- the fee over and above what Medicare pays to a nonparticipating provider -- is covered by our Supplement policy.

The reason a procedure costs $35,000 is to scare people into more premiums. We've been nothing but a business since birth and when we die, we'll provide a living for some funeral broker selling $25,000 caskets.

lindsey, if my quick math is right, you lost your parents very early in your life. How sad, I'm sorry for you and sorry they died so young.

Thank you, Elmer. My parents didn't meet and marry until they were in their 30s. When my mother was pregnant with me, her due date was her birthday. I came one day early. All my life we had celebrated our birthdays together, which I loved. When my mother died, it was 11 days before my birthday (12 days before her birthday). That was the year that I turned 21. What should have been a very important, exciting birthday was very depressing for me. My father was such a wonderful man, and he did everything in his power to make the birthday special for me even though his heart was totally broken in two. Then, 23 days later my father died.

My parents were a few months shy of their 24th anniversary. It is so very odd for me to think about the facts that I am older than either of my parents ever were, and that my husband and I have been married over 31 years. It doesn't seem fair.

But, my parents were the best parents a person could have. I consider myself to be very lucky, indeed.