It's Time For Medicare (whether I want it or not)

[KennyG]

This is an extremely helpful discussion. The information is not easy to understand and the Advantage advertising is very misleading. I was just lucky to avoid it. I retired at 67 and looked at the options. I found that Advantage plans did not cover overseas travel which is something I planned to do and my employer provided a $50/mo contribution to Supplement (Medigap) plans but not Advantage plans. I now realize the Benefits Office felt they couldn't badmouth Advantage plans but want to steer people to Medigap. I feel lucky to have chosen correctly even though I didn't understand some of the disadvantages of "Advantage".

 

[ultrarunner]

It must be popular because we see more with plan provided transportation to and from surgery

 

[ljjhouser]

The sole enrolling agent for MC Part A and Part B is SS and only SS. And they, alone can verify employment for MC.

Cobra is included in the booklet link as possible if your employment goes out of business. Also, for a person who is on Cobra and becomes eligible for MC, he should enroll in MC in his/her IEP and stop paying for Cobra. There is NO SEP for ending of Cobra if you continue on Cobra and DO NOT enroll in MC during your IEP.

The "working aged" (working over age 65) was discussed in post 45 above. Anyone working over the age of 65 (even 80) will have an SEP when they either leave their job OR the employment insurance ends.

Then the person who had not contributed to MC has no entitlement for MC. The can have part A and B, but they must pay for the premium. As mentioned before, the Part A premium in this case is substantial.

If they have never worked in the US and never contributed to MC and come here for a procedure, good for them. They have no claim with MC. No issue there.

Not sure what directive you are referring to.

I see that you are also from "outside the US." All of the training with MC is always presumed to be US citizens within the US. That is why Advantage plans do not cover anything out of US. Only some Medigap plans have foreign Benefit of $50K emergency expense. Because of this, you may have more information that I am not aware of relating to that situation.

 

[ultrarunner]

California born and raised…

Many of the seniors I know have an ever shrinking pool of trusted information and many times a surviving spouse is not the one up on finances…

When I think of the elderly neighbors I’ve had over the years missing a deadline or not understanding fits many…

The biggest complaint I hear is being directed to a website… most don’t own a cell phone let alone a smart phone… some gov offices are still limited adding to the burden.

I think the future ranks of technology peasants will continue grow…

My own grandparents were well read and kept meticulous farm records but had no use for computers, faxes and such… or TV

 

[ljjhouser]

The Advantage plans are popular. They are not bad insurance. But they have been miss represented. Many of those tv ads promise things that are only available to people who are DUAL ELIGILE - On Medicare and Medicaid.
My only concern about Advantage is that they change every year and the Max out of pocket continues to rise. If the network of the Advantage plan fits you doctors, then it may be a good choice. They are somewhat lower cost insurance for staying within their network.

I would also mention - Just because it is a ppo may not mean you want to go out of network (and some do have networks on PPO). Copays Out of network, even in some PPOs have been as high as 45%. Not good for a hospital copay.

I also like Original Medicare. If a person spends time out of town or has a vacation home, they are covered anywhere. But in an Advantage, the only MAY be the ER. Some will permit Urgent care. Some companies (I am referring to employment insurance in this case) - Aetna, for example (who is the same as CVS) does not pay for Urgent care unless it is truly Urgent. Their first treatment option is CVS Minute Clinic.

Well, think I am moving into other areas. Don't really want to do that. I have had tooooo much input about this. I need to back out and read what others have to say. Very interesting though.

Any insurance that helps is good. But in MC, there are choices to be made. Some can be changed, some cannot. Best Wishes. Another side note. 30% of MC beneficiaries are not over the age of 65.

 

[k0ua]

One other thing to consider if your are taking trips overseas is to take out a temporary travel insurance plan for the duration of your trip to cover the possibility of medical needs (accident or sudden severe illness). In many ways this is preferable to any overseas travel your normal plan might cover, BUT getting the payments coordinated and the overseas providers payed can be more trouble than it is worth. It is much easer to take out these temporary policies for a few 10's of dollars per individual and be done with it.

Again, this is "off the wall" and not really relevant to the original questions, but something to keep in the back of your mind if you do overseas travel.

I guess the biggest thing that really torques me off about the advantage plan commercials is this "give back benefit" and the way it is so misleading. Not many of us are going to qualify for this BS "give back benefit" because we won't qualify as "dual eligible" in other words qualified for Medicare and Medicaid. Very few reading these words are going to qualify for Medicaid. As someone pointed out, they may not exactly be liars, but they certainly skate very close on very thin ice.

 

[Jstpssng]

A lot of good info in this thread. Thank you to the OP for starting it and to everybody who has contributed. I will be eligible to sign up in two more years although I expect to work until I am 70. Health insurance is holding me to one job but qualifying for Medicare (?) might allow me the freedom of seasonal, part time, or self employment.

 

[Pixguy]

One other thing to consider if your are taking trips overseas is to take out a temporary travel insurance plan for the duration of your trip to cover the possibility of medical needs (accident or sudden severe illness). In many ways this is preferable to any overseas travel your normal plan might cover, BUT getting the payments coordinated and the overseas providers payed can be more trouble than it is worth. It is much easer to take out these temporary policies for a few 10's of dollars per individual and be done with it.

Again, this is "off the wall" and not really relevant to the original questions, but something to keep in the back of your mind if you do overseas travel.

I guess the biggest thing that really torques me off about the advantage plan commercials is this "give back benefit" and the way it is so misleading. Not many of us are going to qualify for this BS "give back benefit" because we won't qualify as "dual eligible" in other words qualified for Medicare and Medicaid. Very few reading these words are going to qualify for Medicaid. As someone pointed out, they may not exactly be liars, but they certainly skate very close on very thin ice.

and as JJ Walker says....... IT'S FREEEEEEE! BS

 

[ljjhouser]

and as JJ Walker says....... IT'S FREEEEEEE! BS

Or as George Foreman says.....IT'S FreeeEEE!' Wow, we must be starving for entertainment.

 

[Diggin It]

I've been contacted by someone from the medical insurance company I've been with for a few years. Though it was a cold call, he knows enough about the situation that I don't doubt his legitimacy. He says they've been having enough complaints about people calling in to the 800 numbers and getting in touch with knowledgeable people that can answer questions, that they've started to assign account reps. He knows my issue about being put on Medicare and says they already have enough information to assign me to one of their higher level Advantage plans that offers all sorts of extra benefits the others don't. The kicker is that he says this plan will somehow override the Part B deduction ... some sort of dual eligibility thing. I'm still not convinced of that and I'm sort of putting him though the ringer trying to get verification. I'm hoping I don't tick him off.


I mentioned a $500 per year Flex card in an earlier post ... this plan has a $1,500 per year Flex card. I mentioned a monthly allowance for Over the Counter items of something like $75, I don't recall the exact number now. This plan is something like $425 per quarter, either in store (CVS I think), or from a website and shipped to home. Most Prescriptions are covered too so Part D is taken care of. No monthly premium either.

How the heck are they going to offset Part B in full and give me all that 'cash' in credits and allowances each month?

I've verified everything he's been telling me by reviewing documents on their website.

I'm pretty well lost and not sure I believe him, but if it all pans out, it will be a far better plan over all.


There has to be a catch.