Medicare

Know nothing about. We do have very good insurance. Just wondering if Medicare is worth looking into.

Medicare with a good supplemental insurance plan is fairly reasonable. Advantage plans are a bit more tricky as I understand it.

I'm sure there are some insurance gurus here that will chime in soon enough.

It's a bargain, and good primary coverage. You do need a supplemental plan ensure you don't pay much out of pocket. I pay under $400 monthly for both; the Medicare comes out of my SocSec, the supplemental out of my pension, with the supplemental slightly more expensive than the Medicare.

If your insurance is through work, they may require you to enroll in Medicare, and they will coordinate with Medicare for an Advantage plan.
I am retired, and have Medicare Advantage through Kaiser. With Advantage plans, Medicare pays part of the premium. Then, you use your Insurance card instead of your Medicare card. My retirement plan pays for part of the premium. I pay for the balance.

73,
Rick

Worth looking into?
If you're approaching 65 you will need to at least look. Part A is automatic as you have paid for Part A through payroll deduction.
Are you federal? Can you keep your current insurance after age 65?

Unless you're covered by the an employer policy because you're still working, Medicare is the best plan in terms of coverage and cost.

If you're eligible for Medicare, not getting it is a bad idea. If you later decide you want it, your premiums will be higher than if you'd bought it when you were first eligible.

I have United Healthcare AARP Medical Advantage Choice Plan 2, that's what it says on my insurance card.

I use to have to pay a $15 copay for doc visits, and about 1/4 of what my prescriptions cost. After I turned 65 I've not paid a dime for anything...doc visits, scripts, lab work, and CAT and MRI's.

I think it's around $120 a month.

Medicare is for folks over 65, and if you're turning 65 there's no choice -- you get it. The supplemental coverage you choose.

The sad truth is that when this scam was created, the Government said that all of our "Tax Deductions" would pay for all of this....
Leaving it there before I get "dinged...

Medicare is not optional for those over 65. Automatically taken out of your social security benefits, and if you haven't claimed social security yet you will be required to pay the premiums.

Basic Medicare coverage includes hospitalization and doctors, subject to a schedule of benefits. Some medical providers accept Medicare, some will not accept new Medicare patients; either way, you can still be responsible for billings exceeding the schedule of benefits for the treatments provided.

Various Medicare options are offered at additional cost to provide some coverage for prescription medications, eye care, and other extended benefits. Varies from state to state so a knowledgeable advisor can help you decide which is best (and which you might be able to afford).

My primary coverage is through VA as a disabled veteran with honorable discharge. Medicare continues to be collected from my monthly social security benefit, but I have never used the plan.

Wife carries Medicare plus a private supplemental plan that covers most needs with some co-payments, also making her more acceptable as a patient to some providers.

From everything I've seen and heard just about all of the Medicare plan advertisements are insurance agents hustling for commissions. Be careful who you rely on for advice, ask around among your friends and social contacts for referrals.

What is best for one person might be less than ideal for every person.

Medicare only pays 80% of your medical bills. That's where the supplemental coverages come in.

Back in 2021 I spent 3 days in the Hanover (PA) Hospital. As a pensioner I would not have wanted to pay even the 20% of that total bill.

Yes Indeed

Kanewpadle said:

Know nothing about. We do have very good insurance. Just wondering if Medicare is worth looking into.

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Medicare is very worthwhile.
Sight up for that, and tale a look at an Aetna Med advantage supplement.
I have had this program for several years, and find it very beneficial, with many generous benefits.
Best,
Gary

LoboGunLeather said:

Medicare is not optional for those over 65. Automatically taken out of your social security benefits, and if you haven't claimed social security yet you will be required to pay the premiums.

Basic Medicare coverage includes hospitalization and doctors, subject to a schedule of benefits. Some medical providers accept Medicare, some will not accept new Medicare patients; either way, you can still be responsible for billings exceeding the schedule of benefits for the treatments provided.

Various Medicare options are offered at additional cost to provide some coverage for prescription medications, eye care, and other extended benefits. Varies from state to state so a knowledgeable advisor can help you decide which is best (and which you might be able to afford)....

What is best for one person might be less than ideal for every person.

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This is excellent advice. Medicare and health care at 65 and older is a serious decision, which the federal government sadly does not fully inform you of, and also is very confusing to sort through.

I went to a free seminar at my local library which explained how Medicare works, including the Parts A, B, C and D. Was very helpful. As pointed out, even after paying the Medicare monthly premium of $171 and up (based on income), you will have large co-pays and co-insurance without a supplemental plan.

When I have to make a decision later next year - turning 65 - I will be meeting with a local independent consultant ahead of time. Usually, you pay nothing for their advice, as they are paid by whatever advantage or supplemental plan you ultimately select. Everyone's situation is different and professional advice is worth getting.

Pisgah said:

Medicare is for folks over 65, and if you're turning 65 there's no choice -- you get it. The supplemental coverage you choose.

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Mostly but not entirely true. I just turned 65 last year, and fully investigated all my options because I DID NOT want Medicare as my insurance carrier. As it turns out, if you are still working full time and your employer offers health care benefits, you are allowed to keep your current insurance, and postpone going on Medicare until you quit your job or lose your benefits. I own my own business so I wanted to stay on my own plan. Turns out the business has to have at least 100 employees to allow them to stay with a commercial plan instead of enrolling in Medicare. I didn't have that many employees, so I had no choice.

Why do I NOT want Medicare coverage you ask? It's nearly impossible where I live to find a doctor who will accept new Medicare patients. Every doctor who decides to take a new Medicare patient knows he/she is losing money every time you walk through the door. Medicare reimbursement doesn't even come close to covering the expense of running a medical office.
I run my own medical practice, so I know. Since I started in 1986 my Medicare reimbursement rates have been cut by more than 50%. A thousand tiny little cuts. During that same 40 year period expenses have more than quadrupled. People will tell you that "Medicare pays 80% of your bill". Here is how it really works. You see your doctor and he sends a bill to Medicare for $76. Medicare does not pay 80% of $76. Check your Explanation of Benefits carefully. Medicare pays 80% of what they say is allowable. So Medicare allows $18 for your doctor visit. They pay 80% of $18, or $14.40. Great for you because you only have to pay the extra $3.60. Not so great for your doctor trying to pay his employees, pay his school loans, and run an office.

Anyone who thinks that Medicare is fantastic because you hardly have to pay a dime for your medical care, just know that it's not because Medicare is flush with cash. It's because the pay-out rate has been cut every year for the last 40+ years. It's what happens when you put government in charge of anything. Price goes up, quality goes down. Won't be too terribly long now before no doctors will accept any new Medicare patients. Don't worry though, you will now get to be seen in offices staffed with nurse practitioners and physician's assistants. We're almost there.

End of rant...

P.S. If you're employed and covered by a qualified plan, avoid going on Medicare if you can. Then while you still have good insurance, get yourself established as a patient with a good doctor who isn't going to retire on you and leave you high and dry once you must go on Medicare. If you're not covered you have no choice. Good luck. I hope you can find good medical care where you live.

P.P.S. I'm not in any way dissing PAs or NPs. There are good ones that I work with. Just don't be fooled into thinking their education is the same, or even comes close to what you get doing 4 years of college, 4 years of medical school, and 4-7 years of residency training. It's not.

Pisgah said:

Medicare is for folks over 65, and if you're turning 65 there's no choice -- you get it. The supplemental coverage you choose.

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I was forced into retirement at 50. I think I had to wait 2 years to get Medicare.

You can decline Medicare Part B at 65, but it is a serious mistake for many.

Well worth reading: Why You Shouldn't Wait to Sign Up for Medicare Part B - The New York Times

Politics aside we have UnitedHealth care F plan which is no longer available, pay about $300 a month and have not paid a cent to any provider. One has to be Very Careful as some supplemental plans are sort of slow to pay and providers will send you a bill. Actually they are required by Law to Accept what medicare and the supplemental pays. Always check your statements from your supplement and medicare each month.

Greyman50 said:

...Actually they are required by Law to Accept what medicare and the supplemental pays. Always check your statements from your supplement and medicare each month.

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This is true^ Once Medicare has paid and any supplemental insurance you might have, there is no billing of the patient allowed.

I've had Medicare since I started dialysis; it is diagnosis, not age, based. We get the supplemental coverage through my wife's eligibility as a State retiree, and then there are actually State consultants here that help you pick the prescription coverage and not get screwed.

Total for both of us is about $1300/month, and somewhere under $400 of that is for me. I have had a bypass (7 days in), a nasty GI bleed (9 days in), and daily home dialysis, and the out of pocket is trivial for all of that.

Don't forget part 'D', the drug plan. If You go without and later decide You want it You will be charged a penalty for not having it from the onset.