At age 60, and after 3 decades in NYC/Boston, I returned home to England, mainly to have access to the NHS. I am eternally grateful I did as I was found to be diabetic and have had a couple other health problems. All have been covered 100% by the NHS and I also have no prescription charges. i do feel for people trying to navigate healthcare in the US.
I did a quick estimate to compare supplement plan G vs the Advantage plan. For Plan G, if I get united health throught AAA plus the Prescription plan, I will have to pay about $184/month, but if I were to pick the Advantage from Blue Cross and Blue Shield, and assuming I pick the most expensive plan which would be $96/month with a maximum Out of Pocket of $6700. Therefore, assuming I am healthy (for about 6 years), it will be much cheaper to purchase the Advantage Plan. The only downside for the Advantage Plan is that it is HMO instead of PPO. Is it all that I need to look at ? The Advantage Plan also covers dental and vision.
In addition, I received a letter from SS that they will deduct certain amount from my SS check, but as my income was higher than a certain amount, I will have to pay extra. Does anyone know whether they will adjust the amount for 2019 if my income for 2017 was lower? TIA.
So far, every year around Nov/Dec, H gets a notice from Medicare as to what his premium for the coming year will be, adjusted based on our more recent year(s) of income taxes. We have never contested or asked for an adjustment.
My husband is still working so we pay an IRMA alsoā¦that is the extra cost for my Medicare and my RX plan. Honestly, I have no isssue with that.
Yes, it will be adjusted when your income reduces if you go below the income threshold.
I have an Anthem BC/BS Medicare Advantage Planā¦but itās a PPO with a max out of pocket cost of $2000. I donāt think Iād go with an HMO unless you are absolutely positive your providers are in the plan AND you donāt plan to be out of the coverage area for any extended periods of time.
We are PPO and I have been PPO my whole life. I like being able to choose the MDs and other providers I wantāin our city and throughout the US. It has worked well for our family.
My brother has been very pleased with his HMO.
If youāre pretty healthy and you rarely see providers, I suspect it doesnāt matter so much. If you have chronic health issues, it may matter much more.
Obviously, you want to check to see if your current proividers are in the Advantage Plan if you want to continue to see them. But it you donāt mind changing docs, then perhaps ok.
Also, donāt forget, that if you want to change back to Original Medicare (Plan G or any other one) in the future, you may have to pass medical underwriting at that time.
Premiums are based on tax returns two years ago. From what I understand, there are several reasons to appeal ā see Life Changing Events.
https://www.hhs.gov/about/agencies/omha/the-appeals-process/part-b-premium-appeals/index.html
Hereās info about Medicare medical underwriting:
^^thank you. It really helps.
For me, I think I should get Plan G if the difference in premium about 1200/yr.
After husband applied for Medicare and received the letter regarding the additional cost for IRRMA , we went to SS with a letter from his employer showing his reduced salary for that year. After completing the paperwork for a ālife changing eventā he no longer had to pay IRRMA.
For anyone considering California Anthem Medicare Supplement, after entering some basic info:here are rates:
https://www.anthem.com/ca/medicare/medicare-supplement-plans/california/
If its true in every state (not sure) the rates vary by zip code.
Well, I signed up for Medicare this morning. 
I found it strange that the online form didnāt seem to have a place to specify start date. I signed up at the earliest possible opportunity for a January 1st start date ā¦ but given that there is legally a longer time window, how does Social Security know what month the applicant wants to start?
There are new prescription drug plans for California for 2019 - including some that are a lot cheaper ā as low as $12.90 a month. I assume that is the same for other states. The low end plans make sense for someone like me who does not take any regular prescription meds ā I mean, for me the most likely outcome is that a the end of the year Iāve spent $155 for something Iāve never used. Obviously the equation is different for anyone using regular prescription meds-- the cheaper drug plans have deductibles & generally donāt have the donut hole coverage. The $12.90 plan is with Envision RX Plus.
Here is info that came to me a couple of days ago in an e-newsletter, reporting on nationwide Part D plans & premiums for 2019:
Iād call Medicare to talk about the effective date of your enrollment. We had to mail in our horn and then follow up by walking in to our local SS office when we never received confirmation of enrollment.
The guy we saw at SS insisted we didnāt complete the forms correctly and Hs fed them all back to us. H returned the next day to SS, saw a different SS employee and it was processed on the spot to start the 1st if the next month, just avoiding the penalty for late enrollment.
It was an exercise in frustration and confusion for sure. The employee who rejected Hās forms couldnāt articulate what was wrong with them, he just kept saying it was done incorrectly.
I did not realize there is a big difference based on the zip code. I tried AARP united Health. For Plan G, I will have to pay $142 based on my current zip code, but if I were to use Orlando, FL, I will have to pay $180/month.
Thanks for that advice, @Himom ā Iāll give it a little time to process online, as right now the Social Security site just shows it as at the first step in the process (submitted & transmitted, but nothing else yet). But itās good to know from your experience that I canāt just sit on my hands an assume that everything will take care of itself.
There was a spot on the form where you can enter more information or notes, and I did write in there that I want to start January 1st. For me, there is no concern about late enrollmentā¦ I literally signed on to the site about 5 minutes after it opened for apps this morning. But if I donāt have the Medicare in place on Jan 1, Iāll have no insurance at all ā¦ as I sure as heck have no intention of renewing my ACA exchange policy. So I definitely canāt be leaving anything to chance, either.
Iāve got an agent lined up so someone else who can help me with troubleshooting as well-- although the agent is for the Medigap & Part D, not for the initial signup for Medicare. But at least someone I can call who has experience with these things.
calmom, per a book I have on medicare, it says that any October applications are enrolled in Dec 1, or the month that you turn 65, if Jan 2 or later.
fwiw: I also applied today. Check the status of my app and it says that it was sent to the Richmond office for processing. (Rather strange that an electronic app gets sent to a retail office since that office is 400 miles away from me.)
My husband applied for Medicareā¦part A only as he is still employed with excellent benefits. He did his application online about July 15. He got a response almost immediately. He is U.S. citizen but was born abroad. Thy needed to see his birth certificate in person from the foreign countryā¦plus the certificate of a citizen born abroad. They told him exactly which SS Office to go to (nearest our home). So off he went. They looked at it, entered into their system, and two weeks later, he had his card in the mail.
His starts October 1. But itās only Part Aā¦and I think while he is working that is actually his secondary hospital insurance.
But he has itā¦and when he is ready for the restā¦Part Bā¦andā¦it wonāt be a huge song and dance.
@bluebayou - mine has gone to the Richmond office, too ā but Iād assume that they would do initial processing from more centralized locations ā and then if they need more info they can forward it onto local offices as needed. My agent told me it generally takes 7-10 days to get the confirmation letter with start dates and ID #.
H was still working until he turned 70 but I got him to get part A after he turned 65. Because he didnāt get both A&B at the same time, he had to mail or come in person for B.
While he was working with employer-provided insurance, his insurance was primary. Once he retired and came back as a contract worker with no benefits, his Medicare was primary and insurance secondary.
@HImom I thought you said you and your husband continue to have his wonderful insurance from when he was working?