Looking ahead to Medicare

raee_gw zone 5b-6a Ohio

and at all of the associated supplemental plans, including Advantage plans.


I thought it might be useful to hear from those of you who are there already! Did you choose a supplement or Advantage? How did you sort through all the available plans/vendors (What did you think about, and what factors led you to choose the one that you did, or none but straight original Medicare?

How about part D?


Any experiences pro or con a particular company? Are you planning to change?

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morz8

Where you live, which county in your state - can make a difference in what's available to you. I went to an insurance broker and told him approx what I wanted. (complete freedom of physicians, no referrals necessary, and no restrictions on hospitals) He presented me with choices available to me at my address ;0)

My mother has a Kaiser Senior Advantage. It's affordable and works well for her in her larger city - I've had no complaints at all about her care or treatments and I've kept every appointment with her the last several years. I wouldn't want an HMO type plan for myself though, and couldn't if I wanted to residing in this coastal county.

My sister has more plans available to her in King County (Seattle) in this state. Her supplement is less expensive than mine. I have a Premera Blue Cross supplement and have been happy with it, I have no plans to make any changes. DH and I both have Premera supplements and have paid nothing over our premium, no co pays, no balances presented. We both have Humana for our part D. We don't take anything expensive but have had no complaints so far. I just wish Humana billed differently than a coupon book sent beginning of the year where one has to remember the payment. I paid for the year with 11 coupons in February, just to be able to put the coupons to rest for several months ;0)

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maifleur01

One thing that some are not aware of if they are still working is to check with their employer to see what changes if any turning 65 will have on your employee insurance if your company offers it. While you must enroll for medicare and pay the premium if still working some employee insurance can act like a supplement or advantage plan. Some employers just drop the employee from the company health plan if the employee was enroll. Others will allow the employee to keep their employee health insurance. Where my husband worked if he had not retired early at 65 employees were dropped but given $200 a month to pay toward Medicare and any supplemental insurance. Not enough to pay for both.

Some do this strange thing if you have employee health insurance in that who pays first the employee insurance company or Medicare. Mine the employee insurance was considered Primary and what they did not pay when I was still working Medicare A&B paid. The day after I retired that reversed. Some doctor's billing offices were aware of this others were not and I kept getting bills stating the charge was rejected and I had to pay.

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watchmelol

I don't understand why Maifleur01 had part B while still covered as an employee or spouse of an employee.

DH worked until age 72. We both went on Medicare part A as we respectively reached age 65 but declined part B until his actual retirement. I suppose I as the non employed spouse could have gone on Part B sooner but we were happy with the plan his employer offered.

He retired in April. His employer covered insurance plan covered us for the remainder of the month. In order to take one of the retirement plans offered by his employer we had to be on Part B. So we called Social Security and asked to have Part B commence on May 1st.

I read all the fine print and choose to go with a supplemental plan rather than an Advantage plan. We do pay more up front but have zero co-pays unless we go out of network and that would be pretty hard to do in out area and the doctors we use. I spoke to friends and several who are in the medical industry. All confirmed that my choice BlueShield Supplemental was wisest. Prescription cover is included with the standard tiered co pay. Our plan is pretty much the same as when he was employed except we no more copays for doctors visits.

The employer has a formula they follow regarding their contribution. DH was "grandfathered" into having his 17 years there counted as a full 25 which is the cap. We pay our own Part B premiums and our insurance runs us under 500 a month for the two of us. Friend have mentioned they pay far less but they don't consider the co pays and how fast they can add up when one becomes ill or develops a chronic condition requiring medical visits over and beyond the yearly check up and a handful of visits or less per year. For example a friend has Medicare Advantage through Kaiser. She only pays 90 dollars a month or something like that. However she recently had to go once a week for a problem with her blood pressure. At a 30.00 per visit co pay she came pretty close to my premium. That was just for having her BP monitored. Had she become ill at that time she would be paying more for the month than I do without the flexibility of choices.

Also if you are in an Advantage Program you will not be able to switch to a Supplement Plan later if you have a pre-existing condition.

DH is currently in the hospital. When he gets out he will be visiting his specialists. If we had Medicare Advantage I would more than be dipping into savings to pay out of pocket costs.

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PRO
Anglophilia

I am eligible for TriCareforLife as my late husband spent 20 years in the Navy (active and reserves). It's free and it's wonderful!

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ravencajun Zone 8b TX

Great timing for this. We are going through the same process right now. We are very similar situation to watchme. My husband had great insurance through work so we stayed with them. Now that I am of age we are going have to pick a plan. He is retired so we will be starting this together. We have been with blue cross for years and I definitely want to consider their options. We also want full choice of physician and hospital etc. I would prefer not having co-pays. We do have medication so definitely need a good medication plan.

So please keep adding your information and experiences!

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functionthenlook

We are both retired, but only my husband is over 65. I get to keep my employee health, eye and dental insurance after retirement for me and my husband till we are both dead. For my husband Medicare B is primary and my heath insurance is a supplement. With the combo he never pays any deductibles or copay and we have nation wide coverage. My husband has several health problems and it pays to have both.

I remember having to go through the advantage plans for my MIL. What a confusing mess.


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laceyvail 6A, WV

I'm on regular Medicare, a supplemental and drug benefit. Before you even consider Medicare advantage, I advise you to look at all the info on

https://justcareusa.org/category/your-coverage-options/medicare-your-coverage-options/

You'll learn a lot that will surprise you and that you won't find elsewhere.

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salonva

We have an Advantage plan. DH did most of the research and for sure, location (county) was a real critical determinant. I suspect that there is not a universal answer to this as in addition to location, the health/rx needs are quite variable. We have both been pleased ( I have hardly any health issues or rx, and DH makes up for me). We did check as to our preferred doctors/groups being in the specific plans we evaluated.

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OklaMoni

I needed to get A and B, to keep tricareforlife. Make sure to get hooked up early, as in before age 65, or you can loose tricare temporary. They truly expect you to have A and B, on your birthday, to keep tricareforlife!

I had to sign up for social security in order to get medicare. I get both through my ex, as I never worked, cause he didn't want me to. I could not do this online, as it wasn't in my name/social security number.

All this wasn't fun, and very time consuming. It was totally crazy to get an appointment with SS.

But the end story was, tricare did re-instate me.

Moni

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sushipup1

Here are a few things we learned:

AARP's association with United Health Care usually has best prices for supplemental plans. All supplemental plans (lettered plans) are standardized (ie, "F" is always the same) but prices will vary a lot.

You have to review Medicare Part D every year. It depends on the meds you take routinely, and drug companies and pharmacies will change every single year. Never assume that your meds/pharmacy will be covered the same each year.

If you don't sign up for a supplemental plan when you enroll in Medicare (there's a grace period), you probably will not be able to get it, due to per-existing conditions.

A Medicare G plan is usually cheaper than an all-inclusive F plan, and you will only pay the Part B deductible.

If you travel or have plans to move, be wary of Advantage plans tied to local doctors/hospitals.


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Mystical Manns

I had Tricare before turning 65, and the transition to Tricare for Life was easy-peasy.

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Elmer J Fudd

As a matter of clarification, I don't think AARP has an "association" with United Healthcare or has any involvement with the insurance. Instead, I think UHC just pays a royalty for the use of the name.

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maddielee

First thing we did was ask our doctors (who we like) what plans they accept.

Then it was easy. Luckily we are pretty healthy so we got a plan that has a high (to some people) deductible and $50.00 co-pay for specialists. Our plan cost is zero (this year, bound to go up next year). UHC - AARP (Florida)

Be aware that plans change every year. Last year UHC-AARP cancelled the plan we had been using for the last few years. I panicked, but soon learned that another plan was offered. The only difference was that the co-pay went up 15.00 and our monthly cost went from 75.00 to zero. Generic drugs are no cost, mail ordered.

It’s all more complicated then it needs to be.

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SaltiDawg

"I had to sign up for social security in order to get medicare." (OklaMoni)

I didn't... if you mean by "sign up" to commence drawing a SS pension.

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ravencajun Zone 8b TX

I didn't either. I decided to go ahead and do it while I was there since I had waited 5 hours to get my Medicare set up. I didn't want to go back next year for the social security and wait again.

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sushipup1

AARP is "associated" with UHC by means of selling the rights to use their name. Is that clear enough for you, Elmer?

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Lars

I got Medicare before I got SS, and I was still working. My employer recommended an agent, and that turned out to be a very bad idea for me, and he got me on blue cross, which doubled its price as soon as I had to make the first payment, and I was locked in for one year at double what I had agreed to pay, which was substantial.

My doctor recommended that I switch to SCAN, as they are affiliated with UCLA Medical, and so is my doctor. SCAN is somewhat like HMO, and so I have to get approvals to see doctors, and they pretty much have to be in the UCLA group, but this is a huge group and they have some of the best doctors in Los Angeles. It's very inexpensive (I think it is $35/mo compared to $200+ for Blue Cross, not to mention co-pays) and I have no co-pays - and that includes almost all drugs. It included a membership to Silver Sneakers, meaning I can go to a fitness club for free, but I don't take advantage of that. They also will provide free Lyft rides to and from my doctors' offices, when I request them, but I have to make the request 24 hours in advance. Usually I just drive myself, but there are time when I prefer to be driven.

I've gotten excellent care from UCLA Medical Center - the only problem is that I have to take the 405 freeway to get to Westwood for many of my appointments. Many of them are in Santa Monica, however, which is somewhat easier to get to, but parking is more expensive. Of course if I use the free Lyft service, I avoid parking costs. Parking at UCLA Medical Center is generally $14, and it can be $20 in Santa Monica, depending on how long the visit takes. At my main doctor's office in Pacific Palisades, I can park for free in front of a beautiful park overlooking a ravine. One of the reasons I go to that doctor is the scenic drive along the ocean on PCH and through Temescal Canyon. The 405 is pretty much always bad at some part, and I try to avoid having appointments that will require me to drive during rush hour in the morning, which can be brutal.

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morz8

DH enrolled for Medicare and a supplement without beginning to draw his SS benefits too. He was still working, but there were no employer benefits, we were the employer ;0) The cost of his insurance premiums since we had been self insured dropped by $1000 a month that year, but he postponed drawing on his SS benefits until he was ready and the appropriate age for full retirement.

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morz8

Lars, seems different states have different issues. We have Premera Blue Cross supplements and premiums have increased less than $10/month.

Before retirement age, we had Lifewise - being self employed. Also a division of Blue Cross. I'd come to expect rate increases of approx $90/month each year, or almost $200 for both of us. And then, there was the policy I was buying for our tech ;0(

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maifleur01

Watchme I did not state that I had part B when I was working. My husband was 5 years older than I was and he had part B but was covered under my insurance. When a claim was submitted for him before I retired my insurance was considered Primary for him and Medicare was secondary. When I retired it switched.

Having both Part B and regular insurance we seldom had anything to pay with his many health problems. Without both there would have been several things that we would have been deeply out of pocket for his care.

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Elmer J Fudd

sushipup, "associated" and "association" have more than general meanings in the business world and with that in mind, the two companies are not "associated" in the health insurance business at all, as I understand it. AARP has NO involvement, financial interest or participation of any kind in the insurance operations of policies bearing its name sold by UHC. You don't even need to be a member of AARP to buy one of those policies.

It's a name licensing agreement and nothing more. With this particular licensing, it gives an impression many misunderstand (as your "association suggestion demonstrates) and that's one of the reasons why it's of interest to UHC.

AARP licenses the use of its name (and that's what it is, straight licensing, not endorsements, associations or participations) to many different companies and that provides a large percentage of its income.

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PRO
Anglophilia

Be very diligent about your prescription plan. Most have a "donut hole" - a period during which they do not pay for prescriptions until a minimum is met. For those taking a lot of medicines on a regular basis, this can be a cost of $1000's of dollars. Interestingly, they use the full "list price" of the meds to calculate when one get into the donut hole, but the "price" for the amount one must spend before the prescription plan once again kicks in. Pretty tricky, huh?


Thank goodness TriCareforLife has no donut hole!

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catticusmockingbird

morz8

Was there a charge to consult with the insurance broker?

---------------------------------------------------------

maifleur01

Watchme I did not state that I had part B when I was working


Thanks for the clarification. I also misunderstood.

We have Medicare, but only part A. Dh is still working, so we have good health insurance. He says he'll retire at the end of the year so we need to start looking for supplemental options. I'm happy to see this thread.

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maddielee

FYI...on his retirement my husband’s company suggested contacting VIA Benefits (formerly One Exchange) in helping find the right plan for us. There is no cost to you, no pressure from them. They were and still are a big help in finding the correct plan.

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morz8

Catticus, no, no fee for consulting with an insurance broker. You can gather all the information you want and are not bound to commit to anything they show you.

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maifleur01

It may be different in other parts of the country but when I was looking some of the so called brokers were captive agents of one company. One gave me quotes supposedly from three different companies. However all were sub companies from a single parent.

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cooper8828

You can contact the SHIP counselor in your state. They can give you a completely unbiased opinion and it is a free service. If you take any medications, be sure to have them handy as they can help find the best Part D plan, if you go that route.


As for the brokers, some are wonderful. Some are more motivated by their commission and not your best interest. Again, it is free to speak with them but be wary if they are hard-selling a plan.


I get "volunteered" to assist the SHIP program during open enrollment each year. Many people just come in for a check-up, but I hear crazy stories about what they have been told sometimes.


Also, be aware that plans offered not only vary by state, but by zip code. You can also do your own searches on Medicare.gov.


Good luck!

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raee_gw zone 5b-6a Ohio

I think my employer also has an arrangement with a company (may be a broker) to help with this. I didn't remember that until maddielee mentioned her experience - thanks, maddielee!

I went to a short presentation at the AAoA for our county and was astounded (and felt a little overwhelmed at the thought of sifting through them all) at how many companies offer supplemental plans in our area.

A couple of you have mentioned that Advantage plans didn't make economic sense for you - could you explain a little more?

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sushipup1

Advantage plans leave you captive to one 'system' and doctors/offices who are in the system at one time may decide to drop it another time. To assure that you don't have that issue, have free choice of doctors and no need for referrals, you need a supplement plan. In big cities like where we are now, there are a number of Advantage plans. Where we were in Monterey, at the time we left (may have changed since) there was no decent HMO-type Advantage system. Yes, they may be cheaper for a lot of people, but there are limitations to them.

And if you travel a lot, or spend part of the year in another area, you may have hoops to jump thru.

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catticusmockingbird

Morz, thanks. A broker came to the house last year a few months before I was Medicare eligible. Have a feeling he wouldn't be the one to contact. ;)


Cooper, I'm sure SHIP services vary. We consulted with our local service last year and were not impressed.


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morz8

catticus, this particular broker is very laid back, not pushy. I don't have my home or car insured through him and he's never asked why. (why is just because I choose to stay with my long time agent who I've known prior to meeting him ;0)

When we sold my mothers home 5 years ago and I called to cancel her homeowners in another city, I inquired about a renters policy for her independent living apartment contents. Her agent quoted me almost $500/yr. That seemed really high to me so I called above broker and asked if he could provide a policy - when her new address put her into Oregon from Washington. He could, same coverage as I was quoted and identical terms. $100 a year.

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maifleur01

morz there is also the thing that rates are set by the state insurance departments. If you did not tell the agent her address the agent may not have known she was in a different state. He/she may have just been lazy. Be glad the second one was better than the first.

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chisue

We were spoiled with excellent and free health insurance through my DH's employer. After he retired, the company ceased handling health insurance in-house and employed Via. They are helpful; I don't know if the general public can access them.

A social worker at our local senior center can help guide people through the maze of plans and terminology for Medicare/Medicare Advantage, Supplemental Insurance, and Part D plans. You can also compare plans specific to your state online at Medicare.gov You will need to compare plans every darn year.

We have stayed with traditional Medicare plus a Supplemental. Our Supplemental for several years has been Plan F High Deductible from Blue Cross Blue Shield. It's good nationwide.

Beware Supplementals that "pay everything not covered by Medicare". You are very likely to pay premiums that cost you ten times more than what you will owe providers out of pocket. Why? Because Medicare covers so much!

Medicare has an 'approved cost' that every provider who accepts Medicare insurance must agree to accept. Never mind the United HealthCare commercials! They want you to think you will pay 20% of *unreduced* medical bills. Actually, your out-of-pocket is 20% is of the *drastically reduced* amount Medicare approves.

My DH and I pay under $100/mo. for our Plan F High Deductible from BCBS -- less than $1200/year each. My (healthy) DH has never paid more than a $400 out-of-pocket for his share of medical expenses. That was my case, too, until I developed a blood cancer a year ago and had to pay the deductible before my Supplemental picked up. Last year I was out $1200 in premiums and $2400 in deductible -- a total less than some people pay for just a 'pay everything' Supplemental *premium*. Chemo, MRIs, PET scans, CTs, etc. are all very expensive. Yet, I was only out that $3600 (premium + deductible) for the year.

Medicare requires you to buy Part D (prescription drug) insurance. Now HERE is where the money goes in my case! There are no reduced Medicare approved prices for drugs, and I take one that costs nearly $500/mo. retail. If you don't require expensive prescription meds, take the cheapest premium policy you can find. If things change and you do require expensive meds, you can change your Part D plan next year.

If you receive Social Security benefits, you can elect to have Medicare, Supplemental and Part premiums deducted from your benefit, or you can elect to have direct withdrawal from your bank. Some plans have the coupons mentioned above. I doubt any plan accepts payment by CC unless they charge you a fee to do so.

It's a burden Americans have to shoulder, but you can figure this out!


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ravencajun Zone 8b TX

With just about the whole alphabet used now in plan options which is the best option for you? I am seeing a lot of people with plan F. It's difficult to find a good place to view them side by side to understand the difference between them.

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morz8

Raven, that's why I visited a broker. He did lay things out side by side so I could make easy comparisons.

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sushipup1

It's difficult to find a good place to view them side by side to understand the difference between them.

Here you go. Very easy.

https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies

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C Marlin

I found the above gov website very helpful, easy to compare plans. I also wanted SilverSneakers so I only considered plans that included it. Since I am healthy I found plan F HD to be the best for me as I'm guaranteed lower premiums, if I stay healthy I've saved mooney, if not I fulfill my deductible and spend the same as regular plan F.

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C Marlin

I see chisue said about the same thing regarding plan F HD.

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maifleur01

My friends who are not using Advantage plans because they do travel have selected F because they do travel to other countries on vacation and they felt better protected. I do have one friend who chose the F simply because it paid the yearly Medicare deductible.

All policies can vary from year to year so you do need to look at what is covered for the next period to see if it is still what you need. I also suggest looking at the maximum amount of out of pocket that you will be required to pay. Some plans once you reach that amount there is no additional charges that you need to pay.

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catticusmockingbird

Morz, we spoke to a neighbor yesterday and today I contacted the broker he used. I'm preparing info the broker requested so he can do some comparisons before we see him in a few weeks. Thanks again for the suggestion.

I don't know if I mentioned, but we visited the local Council on Aging last year. Was less than impressed with their assistance.


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catticusmockingbird

chisue, if you don't mind me asking what state do you live in? In my phone conversation today the broker tossed out a figure for BCBS at $196 per person. I don't know what plan that was for or what the deductible would be. We're still in the preliminary stages of figuring this all out.

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maddielee

VIA is open to everyone. They are not a broker.

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chisue

catticus -- I'm ChiSue because we live not far from Chicago -- well, 30 miles north. This year I pay $87/month for Plan F High Deductible from BSCS. DH is 2.5 years older; his is $89/month. There's been discussion that they will stop offering this HD plan, but we've been able to keep ours, this year anyway.

You should be able to see what's available to you on the Medicare website that sushipup linked.


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sushipup1

The F plan, at least the regular one, not sure about the HD plan, is supposed to be phased out in the near future, and no more enrollees allowed. Which means that you can keep the plan, but the prices will rise faster because no more people are coming into the plan. The G plan is next best, only difference being that G does not cover the Part B deducible.

PLEASE ---- yes I am shouting ---- know that you cannot in the future move up to a plan with greater coverage after the initial enrollment period without medical underwriting, i.e. preexisting conditions. Start high.

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ldstarr

I have an Advantage Plan and so far, it works well for me. I did choose one with a limited network, but all my providers are in-network. To me, one of the most important things is the "Maximum Out-of-Pocket" for a plan. I'll gladly pay co-pays and deductibles in exchange for a low "max out of pocket" and low monthly premium.

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Kathsgrdn

I've only read a few of the posts, was going to read the rest but it's making my head spin. I really need to go through the retirement seminar at work again. It's all so confusing.

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raee_gw zone 5b-6a Ohio

Thank you everyone who is contributing. Some good information and discussion here.

We were told in that class that plan F was ending, but it seems not until next year and then it is just no new enrollees -- if I got it this year, I could keep it. Looks like plan C is going the same way.

The Medicare Access and CHIP Reauthorization Act (MACRA) is a law that will change Medicare Supplement plans in all states, which becomes effective January 1, 2020. MACRA is a federal law that will change who can buy Medigap Plans F, High F, and C. As of 2020 only beneficiaries that are not newly eligibles will be able to keep Plan F, High F and C.

If I understand correctly, it is because Congress passed a law that bars the plans from covering Part B deductibles.

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chisue

raee -- Isn't THAT a ridiculous excuse! They could just stop covering Part B -- which is a *nit* in the overall cost of medical care anyway. The Current Occupant is obsessed with undoing anything Obama accomplished and with rewarding big business (insurance companies in this case).

SaltiDawg -- It's pretty mean of you to sneer at your neighbors to the south, but we deserve it. American voters are evidently too lazy to vote in a government that will reform health care costs and raise our national ratings for the care itself.

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raee_gw zone 5b-6a Ohio

Chisue, it is soooo tempting to blame the Trump administration, but in fact this change was passed in 2015 in order to "relieve the strain on the Medicare Trust Fund". The large bill that this change was part of was passed with only 8 votes against in the Senate, and signed by Pres. Obama.

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SaltiDawg

Chisue,

" ...sneer at your neighbors to the south,..."

Huh?Have you confused me with a canook, eh?

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jemdandy

One thing to watch for is how wide is the geographical coverage; That is, what are the locations where the plan is accepted. In our state, there was a well known company that offered its plan only in 10 counties. When presented, no mention was made of any restriction leading one to think it was good in many locations, but had a restricted sales territory and no offices outside the 10 county area. Deeper digging revealed that it was good only in that 10 county area. The plan was not accepted anywhere else. It was not safe to travel beyond the borders of those 10 counties.

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salonva

Jemdandy's point is a very good one. Last summer, turned 65 AND I retired AND we moved to a different state. While DH was researching the various plans, it was made clear to us that yes it absolutely varied by county within the state. Some plans seemed wonderful at first glance either were not available to residents of county X or if they were available, the participating doctors in that region were more limited.

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raee_gw zone 5b-6a Ohio

Thanks Jemdandy and salonva, another point to look at.

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chisue

raee -- I stand corrected about when the Part B exclusion was enacted.

I would like to halt the current system of 'bought and paid for' legislators. Since the Supreme Court refused to limit campaign contributions, I'd limit campaigns to just a few months prior to elections. Candidates could run for office without Big Contributions from Big Insurance and Big Pharma -- or party funding. Seems it would open the way for more people to run.

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chisue

SaltiDawg -- OK, at least I guessed! Are you going to enlighten us? (Please include the extent of your coverage -- what's excluded, for instance.)

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SaltiDawg

I'm waiting to see if you do eventually hijack this thread with your political views,

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maifleur01

For those with regular insurance where you may have several plans to choose that are looking at this for perhaps parents and others jemdandy's comment about certain plans not being available in all areas of a state can also be true for them. For years my husband and I have been on a plan that only covers certain counties. When I was thinking about moving him to a new home I discovered that the nearest hospital was in a different country and would not be covered.

Seeing this thread was a good reminder for me to start looking at various supplemental plans as I am planning on traveling. While most health insurance both regular and Medicare plans will cover emergency treatment they may not cover more than just making you safe enough to travel. Transportation via ambulance either ground or air if you would need it is very expensive.

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Elmer J Fudd

"my husband and I have been on a plan that only covers certain counties. "

If you're talking about true insurance and not a combo insurance/provider like Kaiser that does have geographical limits (depending on where it has facilities), and also then unless you're talking about the odd situation as where different parts of Kansas City are in two different states and maybe with different regulations or obstacles making it difficult for one company to offer coverage in both, I think maybe that rather than having geographical limits, some insurance companies simply don't have contracts will all providers. For whatever reason. Hospital A has a contract and is in network and Hospital B (wherever located) doesn't and is out of network. A [policy holder can get services from an out of network provider but the cost can be much higher.

My employer sponsored plan integrated with Medicare recently changed and what had been more comprehensive coverage abroad is now limited to emergency services and repatriation. For foreign travel, there's an insurance broker that specializes in such coverage and if you check the website and then call, you can get what you need and not more for a modest cost. We've used them a few times for foreign travel, most recently a few months ago, and have purchased policies with top companies that had everything we wanted and nothing unnecessary. The people I've dealt with on the phone were very helpful, knowledgeable and very nice.


http://www.insuremytrip.com


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maifleur01

You may also be able to obtain health travel insurance if you take any trip. When I went to Hawaii the travel agent offered it and I accepted for the just in case. It was not the health insurance portion but the transportation feature if I became ill or died that made me decide to accept it. I think it was an additional $58.00 but having seen a bill for health transportation just 200 miles that small amount was worth it. The cost also included other stuff that I discounted as not needed.

Those travel accident plans that I used to receive all kinds of mailing on sound good but if you read the information most only cover you if you are a "common carrier". Common carrier means bus, plane, etc. not your own car.

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chisue

Salti Dawg -- It's not 'political' to want good health care for all. I wouldn't care what 'party' agreed it's something the US lacks, different from all the other first world nations. I don't think it's 'political' to try to limit the ability to buy legislators.

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SaltiDawg

Moronic. The post is seeking help for what to do NOW... your biggest disappointment is the wrong Congress and President caused part of the problem and your politics got in the way.

By again inserting inflamatory rhetoric reflecting your bias such as, " I don't think it's 'political' to try to limit the ability to buy legislators." you totally troll this thread away from providing the help being asked for!

Oh yeah, only two exclusions to my coverage and they are the only things my Medicare does cover... so no exclusions.

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C Marlin

Deciding on Medicare plans isn't as complicated as it sounds when reading through all these posts.

First decide do you want plans A and B, then decide do you want original medicare with a medigap plan or an advantage plan. Some of this is determined by your zip code, you may not like your options on one type of coverage. You personal current medical needs or finances may also dictate your choices.

As mentioned, your available plans are shown on the medicare.gov website. You can then determine your best prescription plan.

I've never gone to a SS office or a seminar to learn what plans are available for me, they are all listed online with a link to sign up.

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jane__ny

We have Medicare with AARP (UHC) supplemental. I would recommend it as everyone takes it no matter where you are or what doctors or specialists you have.

My hubby is 86 and has had multiple health problems over the years. He retired while we lived in NYC, then we moved to Florida. I am 70 and decided to get the same thing he has because we never had to pay anything to any doctor or hospital.


Our kids live up North and we visit frequently. Everything is covered no matter who we go to. Our daughter is in Ct. and a few times we had to seek medical help there and we were covered.


It is more expensive than the Advantage Plans, but I have seen terrible results with friends who have Advantage Plans. A friend of mine fell while walking her dog (dog went after a rabbit) and she broke her wrist. I rushed her to the closest ER as her arm was so swollen. When we got there, we waited so long and then she was told the Ortho on call was not on her policy nor the hospital and recommended I drive her to another hospital, which I did.


Anyway, long story, her wrist was never fixed, her fingers were involved because the broken wrist required surgery, and involved a tendon to her fingers, etc. etc. She never got the surgery because she would have had to pay more than she could afford for the surgery.


None of this would have happened with straight Medicare with supplemental. I would never, ever recommend Advantage Plans to anyone.

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womanofsteel twotones

I thank you all for this thread. I never paid much attention to health insurance as I rarely use it and DH and I are under his Federal BC/BS. I am turning 65 this year, and he is younger and still working. As I understand it, I have to sign up for part A at 65? Is there a cost to that?

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womanofsteel twotones

Yes.

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chisue

jane -- It's convenient to have everything paid. You can ignore bills. You don't spend time figuring out if you've been billed correctly because you know you aren't liable. However, you will pay large premiums for that 'everything covered' policy, whether you need it or not. Many people do not have out-fo-pocket anywhere near the cost of the premiums.

My DH would have paid at least $2000 a year in premiums for that coverage, but it would have 'protected' him against only between $200 - $400 that he actually owed.

Medicare pays 80% of *its approved cost* for any procedure. DH pays the remaining 20% of that, not 20% of the inflated provider bills. That's what the providers have agreed to accept under Medicare rules.

DH's Plan F HD protects against large expenses for under $1000/year in premiums. He can afford to risk the $2400 deductible and is protected against anything more than that. He's saved about $5000 in premiums over the last five years with the Plan F HD supplemental.


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maifleur01

Womanofsteel you should sign up for both Part A & B. Just something for you and your husband to be aware of when he retires is that his insurance will switch from being primary and become secondary to Part B. If you do have any medical bills at that time you may have to provide the provider several times which is which. Hopefully you have been on his medical insurance for the required 5 years for you to be covered after his retirement.

Another thing that you should do is go to OPM.gov and read about the various benefits both for employees and their spouses. Doing so can prevent surprises when he retires and when either of passes away.

For Jane and others. Depends on the state the plan is written in but most insurance plans will cover the cost to stabilize an injury or disease so that a person can travel back to the area in which they are covered. If you have any questions about this look at your plan.

Insurance is there to cover the "what ifs" while hoping those "what ifs" never happen. It is not to just reimburse you for your current expenses.

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functionthenlook

Also if you are on A & B with BC BS FEP they reimburse you $600 every year per person on BC BS FEP. The holder of the BC BS FEP can hold off taking part B as long as they are still working without penalty. My husband is the dependent and has part A & B. He has several medical conditions. BC BS pays for whatever medicare doesn't cover. Since he turned 65 he hasn't payed any medical bills. It is all covered 100 %.

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Grace

As I understand it, I have to sign up for part A at 65? Is there a cost to that?

Yes and no.


We have BCBS under my husband's employer. We're in the process of evaluating supplemental plans so when he finally retires we'll be ready to sign up for Part B and enroll in whatever supplemental plan we end up choosing.



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functionthenlook

No cost for part A.

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watchmelol

If have you have a SS # you will automatically be enrolled in part A upon reaching age 65. They will send you a card. You have to accept or decline Part B at the time depending on your circumstances.

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raee_gw zone 5b-6a Ohio

Automatic enrollment in Medicare at age 65 is ONLY if you are currently receiving Social Security payments. Otherwise, you do have to enroll, either on line, by phone or in person. My full retirement age is 66, so I have to apply/enroll for Medicare parts A & B since I won't be taking SS now.

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Kathsgrdn

I was hoping to keep my Blue Cross Blue Shield when I retired but you all are saying Medicare is mandatory?


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maifleur01

Kathgrdn depends on your age when you retire. It is mandatory to sign up for A at 65 and if you do not sign up for B there is a penalty that can be added. There is nothing that states you can not keep your BCBS. You would need some type of supplementary insurance to cover what Medicare A & B does not. The question you should be researching now is what happens with your insurance once you reach Medicare age and sign up. If it is through an employer some will allow you to keep it and it acts like a supplement/advantage plan. Others will simply drop you from the insurance but may or may not provide an amount toward purchase of other insurance.

Edited to add that you can find the information on types of care that each of the parts cover by looking on line. What you may not be able to find is what your insurance plan does when you sign up for Medicare.

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SaltiDawg

"If have you have a SS # you will automatically be enrolled in part A upon
reaching age 65. They will send you a card. You have to accept or
decline Part B at the time depending on your circumstances."

NOPE.

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ravencajun Zone 8b TX

You must enroll for part A and B. I went to the SS office and enrolled because I had questions and preferred speaking to an agent in person. Part A has no charge to you. Part B does have a charge which you can have taken directly out of your SS check.

I chose to have a Medicare agent broker come to our house to help us with the process and decision for what to go with. That was very helpful and it's free. She explained everything well. She did not try to sway us to a specific choice but did advise us about the history of the various companies and plans. I decided that for my needs and medical history I would prefer to go with a supplement plan f and a separate plan d for drugs. I picked the AARP United health care Medicare plan f. Let me clarify this for everyone! You must have a membership in AARP to enroll in any plan by United health care. If you don't you will have to enroll in AARP right then and pay the $16 fee for one year to enroll in the United health care Medicare insurance. You absolutely must have the AARP active membership! I had to pay for one year live on the phone with my credit card and get my AARP member number. Then proceed with the process of enrollment in the United health care Medicare plan. I do not have to continue my AARP membership after the one year if I don't want to. It will not affect my plan or cost. I probably won't be continuing the AARP membership unless I find it provides me with benefits in some way.

I really like the idea of having an agent that will continue to work with me and help me with any questions or concerns I have in the future. She was very helpful. I am so glad to have that part done. For the part D drug plan the best choice for the medication I take was mutual of Omaha. I have some very expensive medications which knocked me out of a lot of companies. The person at Medicare that I had spoken to had also told me that mutual of Omaha would be the best choice so I happy to see she found the same answer from her research for me. It's a big scary process, I am glad it's done for this year!

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watchmelol

DH was working full time with health insurance when he reached age 65. A medicare card came in the mail without any signing up etc. when he turned 65. He declined Part B. When I turned 65 four years later my card came in the mail. The only issue I had was when they messed up my declining part B at the time because I didn't need it. Unless you are very poor Part B is automatically deducted from your Social Security check. You don't ask for it. However some people with special circumstances like having Railroad Retirement can pay it themselves. I have a friend who does that. When DH retired a few months ago (April 9th) at age 72 we were given information on the medical plans offered to retirees by his employer. Took me about five minute to eliminate 2/3 of the options and another 30 minutes to choose the best plan for us including doing the math of what we would paying out of pocket for our share of the premiums. In order to make the change to the retiree plan we had to first be on Part B. So I downloaded the form online, made a quick call to make sure it was the correct one, we filled out one for each of us with the date we wished it to take effect and DH dropped it off at our nearest Social Security office while he was out running errands. Other than a few crossover visits to doctors some billed old coverage instead of new and having to update our records with our health care providers it wasn't as hard as so many are making it out to be. It was quite easy actually. I would say the whole process took about an hour of my time minus the time spent on hold with Social Security around 15 minutes and the drive to drop off the paperwork.

DH landed in the ER a few weeks ago and ended up being admitted and later having surgery. He was hospitalized for one week and in a nursing care center for one week of our choosing. Haven't been billed for one thing except by one doctor who was called in and a quick phone call updating giving him our info fixed that. No co-pays charged, no deductible for all the care surgery etc. Had we only used the emergency room our co pay would have been 100.00. Not sure if it would have been applied to the deductible which is 1000.00 each but most everything we would normally expect in our health care is covered without a deductible kicking in. I am so glad I choose a supplemental option.

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chisue

Watchme -- Sorry for your DH's medical problems and hope he's recovering well. Medicare pays all but 'small change' for ER and 'In Hospital'. Do you know what your supplemental paid for his care? Was it more than he paid in premiums for the coverage? Our experience has been that each of us could pay $2500 a year in premiums to cover out-of-pocket costs only come to a couple hundred dollars a year -- because Medicare pays so much, and because the Medicare-adjusted costs make our 20% copay so small.

My DH's share of medical expenses *after Medicare* has been $200 - $400 a year. He is 80. In his case, our high deductible supplemental plans have protected against major financial damage (beyond a $2400 deductible in 2019), while we each pay $1K a year in premiums for the coverage.

I have had to pay the deductible last year and this one, since my diagnosis of multiple myeloma last May. Still, Medicare pays so much -- and adjusts costs downwards so much -- that I would have owed 'only' 1% on provider billings that started at more than $500,000.

Of course we all pay for Part B Medicare -- $1626 in 2019. What a bargain, though, over supplemental premiums and Part D premiums and drug costs!

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Elmer J Fudd

"You must have a membership in AARP to enroll in any plan by United health care. If you don't you will have to enroll in AARP right then and pay the $16 fee for one year to enroll in the United health care Medicare insurance. You absolutely must have the AARP active membership! "


Sure, it's a way for AARP to gain financially from United Healthcare's insurance sales using its name. But as I said before, I believe AARP has no involvement at all in the insurance coverage or insurance operations of UHC concerning policies using the AARP name under license. It's misrepresentation by inference and misleading marketing that you would think such entities would avoid. The fact that so many think there's some connection is proof enough that people misunderstand what's going on.

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SaltiDawg

Yeah, I use Consumer Cellular for my Phone and Data plan... 5% discounted if a member of AARP.

This is the only reason I belong to AARP as I have much better Medical and Retirement benefits then they offer.

Certainly AARP does not have any involvement in my phone and data service... just a symbiotic financial arrangement.

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maifleur01

What some people do not seem to understand that there are time limits for what Medicare pays 100% for a hospital stay. They will the first 100 days with a deductible that varies each year. after that what they cover goes down. At one time, 2014 when my husband was admitted to the hospital, they only covered 60 days and their coverage reduced to 50%. Then to 25% then 0. While most would be transferred to a nursing home before then or die you do not want to be reaching to the end of whatever the time period and not be covered by some other coverage. Once you use the 60 reserve days the cost is all on you.

I attempted to look but they have a frustrating sign up pop-up that made it hard.

In case you do not know if you are in the hospital for 72 hours Medicare will start paying for skilled nursing home coverage if medically necessary. Any time period less than that nursing home costs are all on you.

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chisue

You also must be *admitted* to the hospital to have Medicare coverage. Being there 'under observation' isn't going to qualify.

Just wondering what Seniors are hospitalized for very long these days... Hospitals have so few beds -- everything is out patient.

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maifleur01

Stroke victims can also stay longer especially those with cranial bleeds that either will not stop or have additional bleeds. Not all strokes are from blood clots and cholesterol deposits moving to the brain.

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maddielee

"You must have a membership in AARP to enroll in any plan by United health care. If you don't you will have to enroll in AARP right then and pay the $16 fee for one year to enroll in the United health care Medicare insurance. You absolutely must have the AARP active membership! "


No. This is not true. I do NOT have AARP membership but do have AARP United Health Care. Have had it for 4 years.

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sushipup1

I had to have the AARP membership ONLY at the time I started my medigap policy, but it has since lapsed and I have not renewed. Maddielee, did you have AARP at the time you first got your insurance?

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maddielee

No. And I found this... on the UHC website (disclaimer).

“AARP® MedicareComplete® Plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. ... You do not need to be an AARP member to enroll. AARP and its affiliates are not insurers.Jun 26, 2019”

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girlnamedgalez8a

Like maddielee, we are not members of AARP. We do have United health care but still get emails from AARP trying to get us to join.

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ravencajun Zone 8b TX

I had no choice. I had to sign up for one year of AARP. I did not want it but I had to have a membership number to proceed with the enrollment process. I was not doing it myself I was with a broker who was filling out the paperwork. She said that she had to call and they could enroll me over the phone with AARP. Which is what we did. Maybe things have changed but as of yesterday that's what was required. As I said I only have to keep it one year after that I can drop it or keep it. I do not have an advantage plan, I have supplement plan F.

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ravencajun Zone 8b TX

Directly from the AARP UnitedHealth care site

https://www.aarpmedicaresupplement.com/find-a-plan.html

I don't know what the requirements are for the advantage plans. But for the Medicare supplements you do need a year of AARP to get started.

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sushipup1

And you apparently do not need to keep up the membership after it has lapsed.

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ravencajun Zone 8b TX

No you don't, just that original first year. I think the difference is that for the medigap supplement plans you do have to be a AARP member but for the Advantage plans you don't have to be an AARP member.

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girlnamedgalez8a

That would explain the difference, I believe that I have an Advantage plan.

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phoggie

I have a BC/BS supplemental plan...not cheap, but I have not had to pay a penny for and service or surgery that Medicare pays toward.

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SaltiDawg

My Plan covers 100% of everything with only a minuscule co-pay for drugs. - the plan is provided "free" by previous employer. I am prohibited from using Medicare... lol.

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Angela Id

She specifically asked for advice on Medicare! Why reply if you don't have any? And why bring it back up? *shaking head*

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Elmer J Fudd

"I am prohibited from using Medicare"

Maybe it's not what you have, salti, but many subsidized or provided retiree medical plans are Medicare Advantage plans and indeed have an unseen substantial Medicare paid-for component to cover provider charges.

A Medicare Advantage plan is one where the private medical insurance administers Medicare benefits on behalf of Medicare itself and sends them the bill for payments to doctors, hospitals, and other providers. Medicare Advantage plans can be far more generous than straight Medicare or Medicare plus one of the standard supplements and other than which system pays what portion of a charge (Medicare or the private insurance) invisibly in the background, the covered individual would never know they have anything other than coverage from the insurance company they deal with.

I have an employer provided Medicare Advantage plan and I too am "prohibited" from using Medicare directly. But it's there all the same and invisible to me but for one provision - I am required to go to providers that accept Medicare. But there's no in-network/out of network benefit difference for any health related service or goods. Not actually prohibited but I can be on the hook for some charges. For some non-Medicare accepting providers, I pay a deductible/co-pay and the provider gets what would have been the Medicare reimbursement if they accepted that in full

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ritaweeda

If cost won't be an issue when you retire, from what we've gathered a supplement is the way to go. It's costlier but you have more freedom with it, especially if you are one to do a lot of traveling or are away from your primary home for a good part of the year. Also it's my understanding that if you don't opt for a supplement the first time, then if you change your mind later and decide you don't like the Advantage plans, the supplements don't have to accept you. You will be forever stuck with the Advantage plans. We opted for Advantage plans due to the cost savings and the fact that we don't travel. If we do go out of the area and get sick or injured, we can go to the ER or an urgent care center but if there has to be a follow up with a specialist or tests or whatever we would be forced to go back home and follow through with the care we would require. And yes, it's correct that you do not have to be a member of AARP to buy United Health Insurance.

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Elmer J Fudd

Travel medical policies to provide comprehensive health coverage when travelling abroad, even including those policies with a generous allowance for evacuation/return to the US when necessary, are quite inexpensive. Having or not having that coverage shouldn't be a factor for deciding on medical policies, even for people who travel a lot.

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maifleur01

An extension of Elmer's comment but something some of us think about. The travel medical policy that my travel agent suggested earlier this year also covered the costs associated if I would have died on my trip. Probably not all plans cover that so it is something to ask about.

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Elmer J Fudd

mailfleur, in my experience most travel agents BARELY know much about choosing and booking travel, much less about travel insurance. I recommend you do it on your own.

There's a terrific agency that specializes in various types of medical and travel insurance and its website is

insuremytrip.com

I've dealt with them several times, usually doing some scanning first on the site and then by telephone. I've experienced an attitude from them each time about putting the customer's interests first that's shocking for an insurance agency. They'll ask questions to tailor the policy choice, answer questions about how they work, and in the end I've found they recommend options based on reasonableness of both price and insurance company dealings from among their past customers.

They handle policies from all the major US and international companies.


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maifleur01

Normally I did my own planning and will for most trips in the future except for my going to Chelsea Flower Show next year as I am unable to obtain tickets on my own other than going through a lottery as a member. I am still debating on using a tour agency for a trip to Japan. I bookmarked the site to use later, so thanks many thousands.

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SaltiDawg

Elmer "Maybe it's not what you have, salti, but many subsidized or provided retiree medical plans are Medicare Advantage plans..."

Nope. No restriction on using providers that accept medicare. No Co-pays for Hospital, emerg room, doctor's visit, MRIs/X-rays, etc, no nothing except a tiny ($7) Co-pay on 90 Day supplies of meds(. (And that was only recently added.)

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Elmer J Fudd

Sure, that was why I said "maybe".

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SaltiDawg

Sure, and that's why I clarified and pointed out that it was wrong.

Just trying to help. Don't get your panties in a wad.

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Elmer J Fudd

Ditto to you. I suggested a possibility and described it as such. It's correct to be mentioned to be a possibility, you're simply saying that's not what you have. I forgot to consult a crystal ball.

Several folks I know have made comments similar to what you said only to learn later that what they were saying related to their procedure (deal only with the insurance company, not Medicare), not their underlying insurer in whole or in part. These folks had Advantage plans and, indeed, invisible to them, underlying costs were being borne by Medicare.

Medical policy provisions are whatever decisions are made for them to be. Either for retail or participant cost control, or for sponsor cost control, or indeed to provide benefits or other allowances as are desired by the sponsors or designers. There are no limitations other than cost considerations and anyone's imagination. There are hundreds and probably thousands of permutations.

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