Help with choosing a medicare part b plan--AARP?

[JimMIA]

I strongly second the Medicare ADVANTAGE suggestions! I pay $0,00 per month for FULL coverage at Miami's very best hospitals. I have free gym membership, no copays for most doctors, no copays for most meds, and a max out of pocket of $3,400 per year. My only cost is the Part B deduction others have mentioned.

All Medicare plans are EXTREMELY marrket-specific, so compare the details carefully -- especially in-network hospitals and specialists.

 

[georgina]

‘Anyone know what a general amount is that is deducted? We are in our 50’s now so we are starting to think about and plan more carefully for retirement now.

It is also income dependent. We had a spike in income in 2018 and DH's 2020 premiums for both part B and part D went up. I expect they will go back down next year when they will be based on 2019 income!

 

[Miffy]

OP, a few things.

(1) Re the comments about about Medigap Plan F, please transfer those comments over to Plan G, because F is no longer available. People who have it got it before it was discontinued and they're grandfathered in.

(2) The biggest decision is between Medigap (those lettered plans) and Medicare Advantage. Advantage is an HMO. Whether or not it would work for your mother is 100% dependent on where she lives and who and what are available on that plan. In the area where I live, Advantage plans are all but useless since many participating specialists are far far away. But that isn't true everywhere. You have to do your reserarch.

(3) Many organizations offer free seminars about Medicare and the various supplemental plans. If these are still happening (might not be due to covid), this is a good place to start. But never totally trust any of these seminars since they're often run by representatives of a particular plan they're trying to sell.

(4) My cynical belief is that they purposely made the entire Medicare procedure confusing and convoluted. It could've been simple--just put everyone in the same pool and spread out the charges. Instead they have a zillion different plans and--warning--many of these supplemental plans have huge deductibles. That's why Plan G is best, and also can be kind of expensive--again, depending on your location. The plan prices are governed by zip code.

(5) Everyone I know with a Medicare supplement plan got theirs through AARP because it had the best prices. That may or may not be true where you live.

(6) Part D--Rx coverage--is also available in many different forms. If you know the medications your mom is regularly on, that would be very helpful as you can find out which Rx plan covers what drugs. Of course this isn't helpful if your mom ends up needing a drug you didn't anticipate and it isn't covered on her plan. Yeah, another very annoying aspect of Medicare.

Hope you're not screaming for help now! Because it is extremely complex, but others have figured it out--even I have--and so will you. Good luck!

 

[MrsCobraBubbles]

OP, is this a one time decision for your mother or does she have to pick something every year?

The reason I ask is once I hit 65 (over a year ago) my school insurance I've been on since I was retired at 61 now became my supplemental as I was now on Medicare as my main plan. I do remember having to pick the right "letters" when getting on Medicare, tho.

I don't honestly know? I assumed that one you chose it would roll over for the following years unless you switched during some sort of open enrollment period?

 

[tvguy]

I don't honestly know? I assumed that one you chose it would roll over for the following years unless you switched during some sort of open enrollment period?

You have open enrollment every year, so you can change plans once a year.

 

[ctinct]

Honestly, I don’t know how a lot of people figure this out. I’ll be 65 in April, and I’ve spent hours researching this stuff, and I’m still a bit confused.

I’ll second ( or third) the suggestion of the state help agency. Every state has one, anD their advice is free. I’ve also seen Boomer Benefits recommended, but have yet to check them out. I also have heard there are some good tutorials on YouTube.

I’m going by my notes here, so if my information is incorrect, I hope someone will correct me. Important points I have noted: there is a 6 month window for signing up for medigap after you get part b. You may have to undergo underwriting if you wait longer than that. You can also switch advantage plans later if you choose that route, but again, may be subject to underwriting. Advantage plans seem to be much cheaper, but their networks may be limited. Only some advantage plans cover drugs, vision, dental, etc.
If your mom plans on traveling, be aware that I think advantage plans only cover true emergencies in EDs when traveling.

You said your mom is not retired yet. Is she planning on retiring, or does she want to work for a while longer? The reason I ask is, in certain cases you can stay on your employers plan after 65. I think they have to have more than 20 employees. My employer, which is a city education department, mailed me several months ago wanting to know my plans. Uhhh, I’ll let you know later. It turns out that for me, it will be cheaper to stay on my employers plan while I am still working, but it will continue to cost my employer a lot, which is why I’m sure they are gently nudging me toward Medicare. Also, I can continue to contribute to my HSA until 6 months before I take part A. I believe HSA funds can be used to pay for part B if I don’t take social security, but I don’t see that in my notes at the moment, so don’t hold me to that.

Oh, Medigap plans also guaranteed without penalty /underwriting if you don’t get coverage until you stop working.

Part D: drugs. If you have an advantage plan that covers drugs, you may not need this. They run about $40 a month, but varies. If you do buy plan D, make sure drugs currently being taken are on the plans formulary. Also, if you don’t enroll when first eligible, you will have to pay a penalty as long as you have it, UNLESS you have been on a creditable (check with your hr dept. ) prescription plan.

As I said, I’ve been doing hours of research. I’m just beginning to feel like I have a handle on this stuff. It’s so complicated! Good luck.

Oh, one last thing I just thought of. Medigap plans are sometimes referred to as Medicare supplement plans, just to confuse us more

 

[Mom2Stitch]

Oh my! Hubby is turning 65 in March-this is going to be a wild, not fun ride I have a feeling. Thanks to all for the input.

 

[debknight]

"The Medicare trustees forecasted in April that the standard 2021 Part B premium would rise to $153.30 in 2021 from $144.60 this year ($8.70 more monthly, or a 6% increase).Sep 29, 2020"

 

[tvguy]

Only some advantage plans cover drugs, vision, dental, etc.
If your mom plans on traveling, be aware that I think advantage plans only cover true emergencies in EDs when traveling.

I know my mom's Advantage plan's Dental coverage was set up so that you didn't make an appointment to see the Dentist, the Dentist's office called you a few days in advance of when they had an open slot and offered it to you. For most retired folks that isn't an issue to go to the Dentist on a few days notice.
Good point about traveling, most people don't know what if any coverage they have if they travel, especially internationally. Check and confirm with your insurer. I know my mom's plan did cover international travel. The agent said there was a very practical reason for that. The costs of medical services in many countries outside the U.S. are much lower, so it actually saves the insurance company money for treatments done outside the U.S.

 

[luvnwdwgal]

I assume she is just turning 65. If she is still working and has health insurance she might be able to continue with that.
You asked about the part b plan. Part A pays hospital bills. Part B is what pays 80 % of doctors, tests , shots and other things. It is deducted from her SS checks each month if she is on SS.
The alphabet plans cover the expenses not covered in Part B. The plans are exactly the same no matter who you purchase from. However the premiums can vary.
Part D is for prescription drugs and is separate from the other parts.

The other choice is advantage plans Often called Advantage plans which cover everything. They are HMOs and are usually less expensive. Kaiser Permanentee is the most famous.

Call AARP for advice. Also the HR at her work may have some info. You can call SS also.

If she is in good health the plan G high deductible is a good choice. The premiums are a lot less than the regular G.
The difference in premiums each month adds up to about the same as the deductible. The good part is if she has less than about $10000 In bills ( not hospital) she will come out ahead. We have had the for 9 years and we have each come out ahead every year except 1. I usually am over $1000 ahead and DH is usually a little under $ 1000 ahead.

My husband turned 65 in August. He is still employed and has health coverage through his employer. We thought he had to apply for Medicare or he would be penalized but when we talked to Social Security they told him that the signup deadline is waived as long as you are still working. They told him to try to call 2 months out when he knows his retirement date which probably won’t be for another 2-3 years.

 

[MrsCobraBubbles]

OP, a few things.

(1) Re the comments about about Medigap Plan F, please transfer those comments over to Plan G, because F is no longer available. People who have it got it before it was discontinued and they're grandfathered in.

(2) The biggest decision is between Medigap (those lettered plans) and Medicare Advantage. Advantage is an HMO. Whether or not it would work for your mother is 100% dependent on where she lives and who and what are available on that plan. In the area where I live, Advantage plans are all but useless since many participating specialists are far far away. But that isn't true everywhere. You have to do your reserarch.

(3) Many organizations offer free seminars about Medicare and the various supplemental plans. If these are still happening (might not be due to covid), this is a good place to start. But never totally trust any of these seminars since they're often run by representatives of a particular plan they're trying to sell.

(4) My cynical belief is that they purposely made the entire Medicare procedure confusing and convoluted. It could've been simple--just put everyone in the same pool and spread out the charges. Instead they have a zillion different plans and--warning--many of these supplemental plans have huge deductibles. That's why Plan G is best, and also can be kind of expensive--again, depending on your location. The plan prices are governed by zip code.

(5) Everyone I know with a Medicare supplement plan got theirs through AARP because it had the best prices. That may or may not be true where you live.

(6) Part D--Rx coverage--is also available in many different forms. If you know the medications your mom is regularly on, that would be very helpful as you can find out which Rx plan covers what drugs. Of course this isn't helpful if your mom ends up needing a drug you didn't anticipate and it isn't covered on her plan. Yeah, another very annoying aspect of Medicare.

Hope you're not screaming for help now! Because it is extremely complex, but others have figured it out--even I have--and so will you. Good luck!

Honestly, I don’t know how a lot of people figure this out. I’ll be 65 in April, and I’ve spent hours researching this stuff, and I’m still a bit confused.

I’ll second ( or third) the suggestion of the state help agency. Every state has one, anD their advice is free. I’ve also seen Boomer Benefits recommended, but have yet to check them out. I also have heard there are some good tutorials on YouTube.

I’m going by my notes here, so if my information is incorrect, I hope someone will correct me. Important points I have noted: there is a 6 month window for signing up for medigap after you get part b. You may have to undergo underwriting if you wait longer than that. You can also switch advantage plans later if you choose that route, but again, may be subject to underwriting. Advantage plans seem to be much cheaper, but their networks may be limited. Only some advantage plans cover drugs, vision, dental, etc.
If your mom plans on traveling, be aware that I think advantage plans only cover true emergencies in EDs when traveling.

You said your mom is not retired yet. Is she planning on retiring, or does she want to work for a while longer? The reason I ask is, in certain cases you can stay on your employers plan after 65. I think they have to have more than 20 employees. My employer, which is a city education department, mailed me several months ago wanting to know my plans. Uhhh, I’ll let you know later. It turns out that for me, it will be cheaper to stay on my employers plan while I am still working, but it will continue to cost my employer a lot, which is why I’m sure they are gently nudging me toward Medicare. Also, I can continue to contribute to my HSA until 6 months before I take part A. I believe HSA funds can be used to pay for part B if I don’t take social security, but I don’t see that in my notes at the moment, so don’t hold me to that.

Oh, Medigap plans also guaranteed without penalty /underwriting if you don’t get coverage until you stop working.

Part D: drugs. If you have an advantage plan that covers drugs, you may not need this. They run about $40 a month, but varies. If you do buy plan D, make sure drugs currently being taken are on the plans formulary. Also, if you don’t enroll when first eligible, you will have to pay a penalty as long as you have it, UNLESS you have been on a creditable (check with your hr dept. ) prescription plan.

As I said, I’ve been doing hours of research. I’m just beginning to feel like I have a handle on this stuff. It’s so complicated! Good luck.

Oh, one last thing I just thought of. Medigap plans are sometimes referred to as Medicare supplement plans, just to confuse us more

I wish you luck too

I don't know whether she will retire or not, I think she wants to but she isn't eligible until 66 or 67 maybe? I'm not sure about her retirement age I just know she isn't eligible for full social security at 65. Yeah, I'm realizing how involved and confusing this whole thing is, no wonder my mom threw up her hands and gave up. It looks like PA's free help service is called APPRISE so I'm going to contact them on her behalf.

https://www.aging.pa.gov/aging-services/medicare-counseling/Pages/default.aspx

 

[marybet]

We have Humana, Part C or the Advantage as some call it, it is a PPO. Still pay the Part B to Social Security, the premium for Humana can be as low as $0, depends on where you live. You can go to Humana.com and put in your zip and see all the plans. The best thing about a PPO is drugs are included, so if you mom takes any this is the way to go. Just remember you have to chose a prescription plan if you don't go with a PPO, there is a penalty if you wait a year or two to choose one. There is open enrollment, it's Oct. 15 to Dec. 7. When you first become eligible for Medicare you can't be turned down but during open enrollment I think you can. I usually look at what's out there, I've stayed with Humana but have changed plans, ours includes dental and vision.

 

[RaySharpton]

Also, keep this in mind regarding plan F......

Starting January 1, 2020, Medigap plans can no longer cover the Part B deductible. This means Plan C, Plan F, and Plan F-high deductible aren't available if you:

• Turned 65 on or after January 1, 2020
• Are under 65, and your Medicare Part A starts on or after January 1, 2020

If you turned 65 before January 1, 2020, or if you’re under 65 and your Part A started before January 1, 2020, you may be able to buy these plans if they’re offered in your state. If you already have one of these plans, you can keep it.

I found out about that last year. I signed up for Medicare Megagap Plan F and Medicare Plan D for Rx.

But I will still compare Medicare plans every year for Medicare Megagap Plans and Medicare Plan D plans for Rx, and Medicare Medicare Medicare plans.

I want to see what plan additions and plan deletions and plans price changes were made each year.

This year my Medicare Plan D plans for Rx doubled in cost, etc.

I didn't sign up for Medicare Part B until I retired in 1969.

I received an email yesterday reminding me their website will be ready to accept 2021 changes.

Medicare <mymedicare@subscriptions.cms.hhs.gov>
Thu 10/8/2020 12:33 PM
To: You

Medicare Open Enrollment starts October 15 — find out what's new!​

​

​

Ray,

Mark your calendars — Medicare Open Enrollment starts October 15, 2020! It's your chance to review your coverage and see if you can save money next year. Plan premiums are at historic lows — they've dropped an average of 34% over the last 3 years, and in some states up to 60%! So you may be able find a less expensive plan that meets your needs.

Wondering what's new this Open Enrollment? Starting in 2021, some plans may offer a month's supply of insulin for as low as $35.

Preview Plans link

​

Visit Medicare.gov to preview plans ahead of Open Enrollment! When comparing plans, look at the estimated "Yearly Drug & Premium Cost." A plan with the lowest premium may not always provide the lowest total cost to you.​

Sincerely, The Medicare Team​

Part D: drugs. If you have an advantage plan that covers drugs, you may not need this. They run about $40 a month, but varies. If you do buy plan D, make sure drugs currently being taken are on the plans formulary. Also, if you don’t enroll when first eligible, you will have to pay a penalty as long as you have it. Oh, one last thing I just thought of. Medigap plans are sometimes referred to as Medicare supplement plans...

I agree.

I need some help. I'm trying to assist my mother with choosing a medicare part b plan because it's time for her to enroll, she is not really able to help choose for herself so it is falling to me and I am really out of my league! Wow is this confusing! I did some looking and there are 6 plans available to her through AARP/United Healthcare based on where we live. Anyone have one of these plans? Are they any good?

If the United Healthcare plans are no good, do you have anything you can recommend? We live in PA. My mother is not elligible for any low income plans, she has not retired yet. Is there some agency I can contact for advice?

Hi, MrsCobraBubbles.

I hope you receive a lot more comments that may help you.

I asked similar questions last year in the link below.

https://www.disboards.com/threads/w...om-october-15th-to-december-7th-2019.3776346/
At that time I was getting very sick and I was wanting to know the other options that I might need as I get older.

It seems like I will need to check for changes every year.

Cost is important, but so are things that your mother needed over the years. Maybe could check her previous bills or talk with her primary physician.

Are her medications covered or do you have to pay cash?
Does she need to see her regular long time physician or see whoever is covered?
Is her specialist covered or see whoever is covered?
Is her hospital covered or see whoever is covered?
Then compare coverage deductibles, coverage limits, gap limits.

And check it every year to see if her insurance has stopped covering the things she needs like medications.

Try and Google your state's Council of Aging.

My state has Medicare GeorgiaCares Program: State Health Insurance Assistance Program (SHIP).

 

[jerseygal]

but who? All the ads for supplement insurance seemed kind of shady and I'm not retirement age yet so I don't really know anyone who has medicare.

We are not of age yet for Medicare, but I seem to recall that there are free Medicare reps through AARP..Maybe you can check into that..Good Luck, I hear it is a wealth of info to digest!

 

[antmaril]

Deleted.

 

[NannyBeBe]

My husband just had surgery and was in the hospital for one night. We got the bill yesterday. The total bill was over $96,000.00. After our insurance paid, we owed $245.00. That's pretty good insurance.

 

[lanejudy]

My husband turned 65 in August. He is still employed and has health coverage through his employer. We thought he had to apply for Medicare or he would be penalized but when we talked to Social Security they told him that the signup deadline is waived as long as you are still working. They told him to try to call 2 months out when he knows his retirement date which probably won’t be for another 2-3 years.

I don't know whether she will retire or not, I think she wants to but she isn't eligible until 66 or 67 maybe?

@MrsCobraBubbles does she have health benefits through her employer? As @luvnwdwgal mentions - she can stay on an employer-sponsored plan as long as she (or the employee-subscriber) is actively employed. No penalty as long as she later applies within the designated time after that “active employment” status ends (i think it’s 6 months but may be less).

 

[longboard55]

We went through this a year ago. Medicare hires people to meet with you and explain it. I would check at your local senior center or city.

 

[MrsPete]

How on earth do people choose wisely if they aren't feeling well or have help?

Add to that, people who don't read well /people who are on the low end of the educational spectrum. Do they have any hope of making the best choices for themselves?

We went through this a year ago. Medicare hires people to meet with you and explain it. I would check at your local senior center or city.

Yes, my Social Worker daughter is studying to become an expert in Medicare-Maedicaid -- her intention is to work in a hospital helping people navigate these confusing waters. It's sad that programs intended to help people are so incredibly complicated that experts are necessary.

 

[Dan Murphy]

It's sad that programs intended to help people are so incredibly complicated that experts are necessary.

And it used to be worse. Back about 35 years ago, the Medicare supplement policies, for Part A and B, were similar to the Part D policies today. Every insurance carrier put out what they thought was a good, saleable bucket of benefits, priced at whatever price. Then, about 35 years ago, Congress standardized the benefits from company to company, leaving only the pricing different. Hopefully, some day, they will do the same with Part D.