Employer coverage ends at 65. What should I do for spouse?

[barkley]

As for yourself, start investigating Medicare supplement plans right now. It's not as straightforward as it could be, and Medicare by itself is insufficient.

good advice on researching in advance-and this goes for mediCARE in general for wherever you live. find out if your current provider accepts it AND if they will allow you to continue as a patient once you have it (some have long wait lists). explore plans to see which hospitals, labs and pharmacies in your area are covered. depending on your health needs an advantage plan can be an option as well.

 

[longboard55]

You can actually apply for cobra 3 months after leaving your work insurance so the trick is do nothing and if by chance something happens apply for cobra

 

[tvguy]

good advice on researching in advance-and this goes for mediCARE in general for wherever you live. find out if your current provider accepts it AND if they will allow you to continue as a patient once you have it (some have long wait lists). explore plans to see which hospitals, labs and pharmacies in your area are covered. depending on your health needs an advantage plan can be an option as well.

This is especially true for Medicare ADVANTAGE plans, if they are available in your area. I bought my insurance through a broker and they started by seeing how many options I had. Based on where I live, I qualified for 30 different plans. Entering my Primary care Doctor, the options dropped to 3 plans. Entering my specialists, it drop to none. So I would have to find new specialists.
Checked regular Medicare and a Medigap policy through a major insurance company. All my Doctors accepted them Last statistic I can find is 99% of all non-pediatric Doctors take regular Medicare.

 

[barkley]

Last statistic I can find is 99% of all non-pediatric Doctors take regular Medicare.

the issue is that even before the shortages we are seeing these days of primary care physicians many doctors/practices balance the number of mediCARE patients and traditional insurance patients in their mix of whom they serve. some primary care physicians will continue with a patient when they transition to mediCARE but others will be at their practice's chosen cap and the patient is left to find a new provider-and there can years long waiting lists (that's why some of the advantage programs are so popular-guranteed a doctor).

speaking to one's doctor a year in advance of mediCARE kicking in is advisable to learn if you can continue on with the doctor (or if they even plan to be with the practice that far down the line).

 

[Marrila]

This is especially true for Medicare ADVANTAGE plans, if they are available in your area. I bought my insurance through a broker and they started by seeing how many options I had. Based on where I live, I qualified for 30 different plans. Entering my Primary care Doctor, the options dropped to 3 plans. Entering my specialists, it drop to none. So I would have to find new specialists.
Checked regular Medicare and a Medigap policy through a major insurance company. All my Doctors accepted them Last statistic I can find is 99% of all non-pediatric Doctors take regular Medicare.

Yes, many Drs take Medicare. They don't have to accept new patients. And depending on where one lives this can be a huge problem. Some Drs cap their new Medicare patient load and when they hit it that's all until next year. Some hit their limit as early as Jan/Feb.

 

[tvguy]

the issue is that even before the shortages we are seeing these days of primary care physicians many doctors/practices balance the number of mediCARE patients and traditional insurance patients in their mix of whom they serve. some primary care physicians will continue with a patient when they transition to mediCARE but others will be at their practice's chosen cap and the patient is left to find a new provider-and there can years long waiting lists (that's why some of the advantage programs are so popular-guranteed a doctor).

speaking to one's doctor a year in advance of mediCARE kicking in is advisable to learn if you can continue on with the doctor (or if they even plan to be with the practice that far down the line).

Well, if currently only one percent of Doctors not taking Medicare it can't be a big problem. And to be clear I am speaking about traditional Medicare, the Federal Government program, not Medicare Advantage, which is the Medicare system paying a flat premium to a private health insurers to provide coverage. That has to be a much bigger issue for those with those private plans.
I have had issues with my private Vision, Hearing and Dental insurance. My eye Doctor's office correctly points out they don't have a contract with my insurer. Nobody does, they don't have contracts, they pay a fixed benefit for a service to everyone. The eye Doctor won't file a claim they expect me to pay the bill and file a claim on my own. My Dentist has no issue filing a claim

 

[Frwinkley]

OP here:

Thanks for all the great advice! The supplement part actually is easy--the state teacher's retirement organization has great options, with an incentive that gets added to my pension each month. Dental, vision and prescriptions are included.

 

[Frwinkley]

You can actually apply for cobra 3 months after leaving your work insurance so the trick is do nothing and if by chance something happens apply for cobra

I actually think this is what I may do. My DH takes some meds that we get through a mail order pharmacy for a 90 day supply. I'll just need to make sure he's got those while he waits for Medicare.

 

[lanejudy]

All my Doctors accepted them Last statistic I can find is 99% of all non-pediatric Doctors take regular Medicare.

Well, if currently only one percent of Doctors not taking Medicare it can't be a big problem.

They accept Medicare from current Medicare patients. As PPs noted, many are not accepting “new Medicare” patients. It is absolutely a big problem in many areas — particularly rural areas. The local dermatologist and endocrinologist just 5-7 minutes from my home are “full” so we have to go 20-30 miles away for those specialties. That’s a 35-45 minute drive vs 5-7 minutes. I work full time but have to drive my DH to his appointments so that can be a half-day lost from work.

 

[Lewisc]

Some medicare advantage plans, also called plan C, claim to offer out of network benefits. They claim you can see any doctor who accepts medicare. Your out of pocket costs are higher then in network providers. The fine print, the doctor also has to agree to accept those patients. Many, in some areas almost no, doctors accept out of network patients.

Medigap plans, also called medicare supplement plans cover some or all of your copay and deductibles. The AAARP plan is popular.

 

[tvguy]

They accept Medicare from current Medicare patients. As PPs noted, many are not accepting “new Medicare” patients. It is absolutely a big problem in many areas — particularly rural areas. The local dermatologist and endocrinologist just 5-7 minutes from my home are “full” so we have to go 20-30 miles away for those specialties. That’s a 35-45 minute drive vs 5-7 minutes. I work full time but have to drive my DH to his appointments so that can be a half-day lost from work.

Sounds like our friend who lives in a small town and has coverage through California's version of the Affordable Healthcare Act, "Covered California". She needs surgery that requires two Doctors, there is only one in her town who does this surgery. And NONE of the hospitals is set up for this type of surgery. So she will have to go to a hospital 150 miles away here in the town where I live. But there is a problem. California added a rule that you have to get treatment within 30 miles of where you live. Fortunately there is a process to get an exemption and be assigned a hospital. Five months in, still no decision on the appeal. Unfortunately, they have selected two possible hospitals to do the surgery. The one 150 miles away in the town we live in. And one 250 miles away. She has no say in which hospital she will be assigned to, or which Doctor.