How Much Do You think You Need to Retire/What Age Will You/Spouse Retire: General Retirement Issues (Part 2)

Oh my on listening to anyone on the Medicare Advantage plans and any give back.

Absolutely read everything official on SSA/Medicare web sites and “Medicare and You 2022” publication. Then see what the Medigap policies are - and check with your health care providers insurance/billing to ask for details. Some people can have a Medicare Advantage plan that works for them BUT first see what is there that is comparable to the coverage you may enjoy now - THEN research how the Medicare Advantage compares to the best Medigap policy fit for you.

You have to be so careful on your initial selection of your health care coverage supplement (Medigap/Medicare B, or Medicare Advantage/Medicare C) - because later switching during open enrollment will result in premiums based on your medical status versus the initial purchase price during Medicare initial enrollment.

Also understand “Medicare Advantage plans are offered by Medicare-approved private companies”.

Tread CAREFULLY!

I also saw where there is a youtube feature detailing Medicare A/B/C/D - I don’t think CC will allow me to post the link but there are 15 different video clips starting with “0:00 / 12:13 Medicare Basics: Parts A, B, C & D”

Be aware - this is by UnitedHealth Care providing this information at least on this first one.

So do the homework and don’t jump to a Medicare Advantage plan w/o understanding what it can and cannot do in your specific case. Talk to some of the free brokers and ask around to your friends. On my NextDoor there were a lot of details about local brokers - several got into it because they learned about Medicare due to their parents getting on Medicare and needing help with the decisions.

We used the software to decide on our drug plan, Medicare D. DH and I have different plans based on different drug needs. My plan went up in cost for the next calendar year but I have stuck to it - and will see how it comes out. DH got on a new medication that had him go to deductible immediately and then he has a ‘cost sharing’ of $42/month. We suspect after a procedure he will be off this medication - but we will see how the year goes and re-evaluate. My meds have not changed - I have two nasal sprays for allergies that keep me paying more for the drug plan but I also benefit from the limited costs of these two nasal sprays.

Yes.

btw: State Medicaid programs do assist with Part B premiums for those who are eligible (low income, low asset).

Well, yeah, and Medigap plant (Supplemental Plans for Parts B & D) are also offered by Medicare-approved private companies.

But there is a DIFFERENCE - the Medicare B you show your Medicare card and your supplement card. The Medicare Advantage is totally with your MA plan and you only use that card.

MDs and providers that accept Medicare but may not be on that MA plan for example - is a HUGE difference. What is in network and out of network. The providers you can get with that specific MA plan - and it may be a area network versus the states/coverage when you are traveling.

I’m already retired and have original Medicare and a Blue Cross Blue Shield supplement along with a BCBS prescription plan that has a deductible. It’s worked well for me. I have no interest in a Medicare Advantage plan. During open enrollment I got all kinds of email/snail mail for the Advantage plans. I had never heard the term “give back” before. I’m still wondering what it means in terms of Medicare plans. Just curious, not interested in changing my current coverage.

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Traditional Medicare also has a “network” – the set of providers who accept traditional Medicare. It is, however, a very large network, with 71% of primary care physicians willing to take new Medicare patients, and 93% if including continuing patients.

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Softball question: Each person signs up for Medicare on their own, right? Dh and I will turn 65 within two weeks of each other, but there’s not an option to sign up together, correct?

For Medicare, everyone is on their own.

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Each will have their own Medicare card, and in DH and my case, we each have a Blue Cross Medicare B ‘Medigap’ card - in our case it is BCBS of AL C Plus; we each have our own drug plan with our own drug plan card.

What is great is that you can both sign up at the same time - and you sign up for Medicare A and B during your initial enrollment period for Medicare (which begins 3 months before your birth month).

If turning 65 anytime soon - get very familiar - and get your reading and research done. Can find out the best fit drug plan for each of you using the computer information. I also called and talked to the pharmacist (that particular pharmacy at the time was 24/7 with only 1/2 hour lunch break during the night/unavailable – so it was good to bounce info off the pharmacist during non-busy time for him).

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It’s important to remember that plans vary by State. The cost of Supplements are determined by how each State prices them (and will also vary by the insurance company offering them) eg, a State with ‘community pricing’ means everyone with that plan pays the same price regardless of age etc. Other States determine price by age so plans may be very competitively priced for a 65 year old but perhaps out of reach financially for most in their ‘80’s. Also, some states allow annual switching between Supplements and Advantage plans whereas others allow companies to require underwriting for those who don’t initially sign up for a Supplement. Confused yet?
I think it’s a mistake to write off Advantage plans - typically they’re HMO’s and PPO’s which lots of people are familiar with through employer plans already. For many people they’re the only financially viable option - a Supplement could cost an extra $200/month or more vs $0 for an Advantage plan (that’s in addition to the $170/month for Medicare Part B). In some ways it’s either pay up front every month for a Supplement or pay as you go with copays and deductibles with an Advantage plan. Oh, and if you choose the Supplement there’s also a Part D drug plan to chose and pay for.
The devil is in the details with all the Medicare stuff. If you choose an Advantage Plan, it’s critical first to confirm that it’s accepted by the physicians you want to see. It’s complicated … not something to leave till the last minute.

Yes, I understand the difference, but still, both Medicare Advantage (MA) and Medicare Supplement plans are offered by PRIVATE insurers. Both can have networks. The easiest way to think about them is that a MA plan works much like an HMO. OTOH, some private insurers are starting to offer a Medicare Advantage PPO. (I haven’t looked into those.)

Medicare Supplements are registered/approved by individual states so they too, can have travel restrictions, which is important for the Snow Birds to consider.

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This is what I have. It’s a MA PPO.

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Maybe this makes it clearer: Medicare Part B Giveback Benefit | Humana. The giveback is only available with (some) Advantage plans; it’s not available with Supplement plans. The article touches on how the giveback works in terms of who can get it & how it’s “given” (reduction in premium). This article touches on the fact that the giveback is confusing even when you investigate it: https://www.forbes.com/sites/dianeomdahl/2020/11/24/got-questions-about-the-medicare-giveback-benefit-here-are-some-answers/amp/. My take on it is that you never get anything for free, so there must be a trade off in some area (copays, deductibles, OOP). I am blown away by how confusing things related to older folks seems to be … choosing a Medicare plan, enrolling in Medicare, RMDs, etc. I feel like the older people get, the easier things should be. One CC poster shared that her mom hadn’t enrolled in some part of Medicare when she should have, and it resulted in a financial loss due to penalties. Sad.

@kelsmom
Yep…as clear as mud.

DH turns 65 this summer, I am going to Zoom with an associate in CA who is expert in this stuff, she cannot sell me a plan in my state, but she is smart enough to review it all with me and make sure I know the questions to ask. I think I still have a couple of months to do the research before choosing.

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There are brokers who specialize in Medicare…and they are at no charge to you. We had several friends who used a broker when they were trying to tease out which Medicare plan would be the best choice for them.

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you can also get some free, unbiased advice from your State SHIP.

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In some cases I think there could be employer shared benefits to cover retiree/spouse together supplemental expenses(?).

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I agree about for some/many the affordability of Advantage plans for some is what is affordable. HOWEVER I do believe there are a fair number of people who don’t study the details and do get confused with the barrage of information that they don’t study or ask enough guidance from the right people. The underwriting if you switch plans under your state’s regulations (meaning you have your medical situation evaluated for the pricing of the new insurance you want making a change during a future open enrollment period).

So true about who your medical providers are, and also if you plan to travel and perhaps then have the risk of out of network for some of the Advantage Plans or other Medigap (Medicare B) providers.

Very important to follow all you need to follow for Medicare enrollment. The initial enrollment is VERY IMPORTANT with also having the right Medigap figured out (Medicare B plus Supplement) or if you indeed feel you can choose a Medicare Advantage (Medicare C) plan. You need to sign up for a Drug Plan (Medicare D) if the MA (Medicare Advantage) doesn’t include. Medigap supplements do not include drugs - the drug plans are priced separately. You can choose a drug plan with that particular Medigap supplement, but you may find better pricing/fit for you based on the drugs you take now. The drug plans are very easy to change during open enrollment period - you research what your current regular drugs are and see if another plan fits you better (DH is on new meds this year, so we will evaluate at the end of the year during open enrollment if he should change plans or keep in same plan). Every year we get what the pricing change is on the Medicare D drug plan we are on, so one can decide to take advantage of the open enrollment period of time.

There is a national 800# for Medicare and your local office for SSA/Medicare has an 800 #. Some enrollment can be done on-line, but it is important to also check on what you are doing. DH’s electronic Medicare/SSA file got internally messed up and it has been a nightmare. It was not complicated but due to SSA/Medicare clerk errors, misinformation by them, etc. - the automation on the system was not working correctly on DH’s file and his Medicare B finally got processed, back dated as months went with their internal system saying ‘being processed’ but it was not being worked on AT ALL. We still haven’t gotten billed for his Medicare B (which began Sept 1 2021, was ‘processed’ Dec 29th where we could get his Medicare B card printed online), so I guess we have to inquire about that if we don’t get a bill by the end of first quarter 2022 (DH would almost choose to have a root canal than call SSA/Medicare office again).

If you find you want the medical providers you have with your private coverage but ‘cannot afford’ the coverage under the Medicare plans that best fit your needs/wants - maybe it is not time to retire yet. Some people do not realize what good health care coverage costs out of pocket until they no longer have their company supplemented policy. One cannot assume you are low enough income or in a financial position to have a state sponsored lower cost option, or qualify for federal help unless you do the research.

DH’s uncle was a union electrician, and he was able to put extra money into a fund so he could retire before 65 and had medical coverage with his wife prior to them both being 65 - I imagine they have company/union provided supplement with Medicare B and drug plan).

Some companies have terrific insurance coverage for retirees. Government employees that had their time in for government retirement.

Most of us can pay COBRA or find something on the open market if that is affordable in our situation to retire before age 65. When DH retired 11 months earlier than planned, my employer health coverage got enabled - which was similar in cost and benefits to DH’s - and saved us about $1,000/month over COBRA costs; saved us a whole lot more than what open market was for our level of insurance coverage. My company had no dental plan and we paid COBRA for DH’s family dental coverage (DH and myself) which was a reasonable cost.

I work too hard, and have saved too much, been thoughtful on saving and investing, to have the signing up for health care at 65 and after getting screwed up. One needs to learn and be properly guided to make the best decisions.

Social Security is more straightforward.

FIRST thing to do if one has not done so is go onto SSA.gov and obtain a log on for self, and if married spouse to also obtain a log on. SSA gave us our original log in ID I believe back in 2014, and we changed our password after log in. We each also have our own email address.

Later one can go on Medicare.gov and set up log in and password for self, and if applicable, spouse to do as well.

Medicare uses SSA.gov for any financial transmission of info - so they have a verification system (double verification) with use of SSA.gov signing in.

It all goes to how the government designed and uses the level of automation and the rules/regs.

One system operates 24/7 and the other shuts down some hours during the night. One has some on-line ‘chat’ support, the other doesn’t.

When talking with SSA/MC office, they have access to stuff you do not see - and they see stuff processed before you may see stuff online.

The amount of information with what comes with the drug plans (listening to long scripts and saying ‘yes’) is all part of the control SSA/MC has on the private companies.

Private companies do what they do - with annoying soliciting phone calls, and lots of mail.

Caveat Emptor - buyer beware.

These programs are great to help find very affordable options - however, again one who wants more and can afford more may find better sources of information.

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Great plan - getting expert advice from someone knowledgeable, who you trust, and who is helping you with insight on your specific situation.

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