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Old 09-02-2017, 06:07 AM   #1
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Tell me about Medicare - turning 65

Not exactly an RV topic, but I thought I might find a senior or two who has gone before me.
I am turning 65 this year, and a little intimidated and confused by all the plans and offerings.

If I am healthy, do I "need" a supplemental plan in addition to A&B?

I have small policies for vision and dental, and a prescription drug plan.

What's the story? Thanks.
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Old 09-02-2017, 06:14 AM   #2
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I have had a supplement for 2 years & I am as health as a horse. One thing I would suggest with a supplement is find out who accepts it. You will find some of the supplements that are free or very low cost are not accepted nation wide. My policy is accepted by any medical facility that accepts Medicare. Just remember you never no when you will need it.
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Old 09-02-2017, 06:48 AM   #3
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If you don't get a supplement, you are responsible for 20% of the costs. Medicare pays 80%, so with a $5000 bill, you pay 20% = $1000.

I don't think places accepting Medicare can charge more then Medicare pays.

Knowing that, you could put away a pile of money to self insure.
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Old 09-02-2017, 07:22 AM   #4
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You need A and B when you get the card. Do not skip B or when you realize you do need it, you WILL back pay for it from then till you turned 65. Don't ask how I know. Also you do need some type of your own Ins. Medicare only pays so much and your ins covers the rest. A is hospital and B is for Doctors.
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Old 09-02-2017, 07:38 AM   #5
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MY DW and I have Medicare Advantage that has no monthly charge. The out of pocket is quite high, but that is no worse than the steady monthly charges that you are guaranteed to pay with a supplemental plan. So far, I am well ahead of the game despite a number of serious medical charges.

Go to Medicare.GOV and run the numbers, and they do hide the Advantage plans rather well.
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Old 09-02-2017, 07:50 AM   #6
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The supplements can be VERY helpful! Debbie had extensive spinal cord surgery in late March, and I mean EXTENSIVE and EXPENSIVE. Medicare paid 80% of the $160,000 bill, her Humana supplement paid the other 20% (over $30,000) which will pay for the supplement for over 10 years! The supplements aren't cheap but given the potential OOP costs, self insurance just didn't make sense for us.

I'm still covered by my corporate retiree plan for another year and a half and then I'll have to shift over to Medicare also.
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Old 09-02-2017, 08:24 AM   #7
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MY DW and I have Medicare Advantage that has no monthly charge. The out of pocket is quite high, but that is no worse than the steady monthly charges that you are guaranteed to pay with a supplemental plan. So far, I am well ahead of the game despite a number of serious medical charges.

Go to Medicare.GOV and run the numbers, and they do hide the Advantage plans rather well.
We also have a Medicare Advantage plan. To help understand further as I didn't know how it worked at the beginning - Medicare pays the insurance company that has your Advantage plan a monthly fee to take care of you. So, the responsibility goes to the insurance company (Humana in our case).

Our plan is NOT a HMO and has nationwide coverage. Since we live in a senior citizen mecca, we have no problem with local doctors/hospitals taking our Humana Advantage. We've never needed a doctor while traveling, so can't personally speak to the effectiveness of it. I think it's like any other insurance plan. You need to find a place that will take your insurance.

Yes, there are no monthly premiums and yes, there are out-of-pocket costs each time you go to the doctor, etc. There is a schedule of costs for each visit/procedure you have with an annual cap. DH had gall bladder surgery in 2016, and we're still ahead of the game by not paying monthly premiums.

I'll agree with others. You definitely need something, whether a Medicare supplemental plan to augment your Medicare or a Medicare Advantage plan. You might be healthy now, as are we, but that could change
in a heartbeat. One serious illness/surgery and relying solely on Medicare could be catastrophic.
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Old 09-02-2017, 08:33 AM   #8
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Medicare

Quote:
Originally Posted by Acheron2010 View Post
Not exactly an RV topic, but I thought I might find a senior or two who has gone before me.
I am turning 65 this year, and a little intimidated and confused by all the plans and offerings.

If I am healthy, do I "need" a supplemental plan in addition to A&B?

I have small policies for vision and dental, and a prescription drug plan.

What's the story? Thanks.
I was an insurance agent selling Medicare Supl for 28 years. My best advice is to go to Medicare.gov and look for the comparisons of plans. Be sure to sign up for at least a prescription plan right away. If you do not you may incur a penalty later if you sign up.

I sold both Supplements and Advantage Plans. The difference is that the Supplement's generally cost more and less out of pocket, kind of pay me now and not later if I am sick. The Advantage plans have a much cheaper premium but have co-pays when you use it.

You have an open enrollment period every year from about Oct 15th to Dec 7th to change plans.

The Advantage plan has a prescription plan included normally and the Supplement does not. You have to buy a stand alone prescription plan with it.

I am turning 65 also in Nov.
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Old 09-02-2017, 08:34 AM   #9
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As with other insurance I'd suggest going through an independent agent. It costs you no more, they do the paperwork for you, and know the best plans to suggest. We have Mutual of Omaha as medicare supplement. The supplements make no coverage decisions at all. If medicare covers something and pays its 80%, then the supplement pays the other 20%. As the $160,000 example above illustrates, you never know but need the supplement just in case.
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Old 09-02-2017, 09:14 AM   #10
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If you don't get a supplement, you are responsible for 20% of the costs. Medicare pays 80%, so with a $5000 bill, you pay 20% = $1000.

I don't think places accepting Medicare can charge more then Medicare pays.

Knowing that, you could put away a pile of money to self insure.
Close, but not quite right. You can only be charged a max of 15% over what medicare approves. They might approve 1000. They will pay 800 (80%) you are responsible for 20% even though medicare approved 1000 as a acceptable charge. You might also be charged a max of an additional 150 (15%). A medicare supplement would have paid the 20% you owe of approved charges Some will also pay the excess charge of 150 some will not.

When I sold medicare supplements you were also responsible for a deductible hospital charge based on the rate for a room for a day. That may have changed, but used to be that the hosp deductible could be charged every 60 days if the hosp was for a different cause each time.

A supplement would pay most or all of your share in the above examples. Like all insurance it is nice to have when you need it, but seems like a waste of $$ when you don't. It all depends on how much risk you can tolerate and afford to take.
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Old 09-02-2017, 10:07 AM   #11
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I recommend the government Medicare program, not the "Advantage" program as offered by AARP and many others.

Along with that I would get the Plan "G" supplement. This pays everything that Medicare doesn't, after a yearly deductible. We had the Plan F supplement for many years which paid everything with no deductible, but found that the Plan G saved us about $400 per year even after paying the deductible! It doesn't matter where you buy the supplement as all companies provide the same coverage, as long as it's a highly-rated company that won't go belly-up when you need them! Agents that sell supplements can go online and shop for the best price for you.

My wife has had a total of 10 neck and back surgeries in the last few years, plus numerous nerve blocks, amounting to several hundred thousand dollars, and we have never paid a cent out of pocket!

Good luck, happy trails, and God bless!
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Old 09-02-2017, 10:36 AM   #12
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Originally Posted by MSHappyCampers View Post
I recommend the government Medicare program, not the "Advantage" program as offered by AARP and many others.

Along with that I would get the Plan "G" supplement. This pays everything that Medicare doesn't, after a yearly deductible. We had the Plan F supplement for many years which paid everything with no deductible, but found that the Plan G saved us about $400 per year even after paying the deductible! It doesn't matter where you buy the supplement as all companies provide the same coverage, as long as it's a highly-rated company that won't go belly-up when you need them! Agents that sell supplements can go online and shop for the best price for you.

My wife has had a total of 10 neck and back surgeries in the last few years, plus numerous nerve blocks, amounting to several hundred thousand dollars, and we have never paid a cent out of pocket!

Good luck, happy trails, and God bless!
I totally agree Joe. When I took the dive off of the ladder and had traumatic brain injury, broken jaw, fractured rib,etc,etc. The bill was paid in full by insurance. Like the Fram commercial from years back, "you can pay now or pay later".
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Old 09-02-2017, 10:49 AM   #13
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Close, but not quite right. You can only be charged a max of 15% over what medicare approves. They might approve 1000. They will pay 800 (80%) you are responsible for 20% even though medicare approved 1000 as a acceptable charge. You might also be charged a max of an additional 150 (15%). A medicare supplement would have paid the 20% you owe of approved charges Some will also pay the excess charge of 150 some will not.

When I sold medicare supplements you were also responsible for a deductible hospital charge based on the rate for a room for a day. That may have changed, but used to be that the hosp deductible could be charged every 60 days if the hosp was for a different cause each time.

A supplement would pay most or all of your share in the above examples. Like all insurance it is nice to have when you need it, but seems like a waste of $$ when you don't. It all depends on how much risk you can tolerate and afford to take.
I misread twinboat's post he is correct that facilities that accept medicare cannot charge the 15% excess charge my example included. You are, however, still usually liable for the 20% which medicare approves but does not pay as medicare approved and actual amount it pays usually differ by 20%. Sorry for the confusion.

As others have stated, if you need an expensive treatment you will wish you had a supplement. Be sure to take part B. Also usually if you do not take medicare part B when you are first eligible you will be charged a penalty if you decide to take it later.
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Old 09-02-2017, 11:00 AM   #14
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We used an independent agent/broker to shop the best deal for our needs. DW has rheumatoid arthritis and was treated for breast cancer, I had bladder cancer before I retired so we needed good coverage. We have a plan F (medigap) thru Cigna and it has been accepted everywhere we've been. Plan D (Rx drug plan) thru AARP/United Health. We do have copays on our meds but DW had spinal fusion and we paid nothing.

No it is not cheap but not as expensive as we would have expected.
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