Routine question about Medicare (for old timers)

@lookingforward – again, a medical advantage plan is different. – It works like regular insurance, and the companies can offer whatever benefits they want above and beyond standard (“original”) Medicare.

(I started a thread with a question about apples and everyone wants to talk about oranges ----- I wouldn’t mind except that there seems to be something of a sustained effort to contradict whatever I am figuring out tied to original Medicare by volunteering helpful facts about a totally different type of coverage that I don’t have.

@jym626 - I also have an HSA and you can continue to use previously accumulated HSA funds that to pay for out-of-pocket medical expenses - and also for Medicare Part B & D premiums, or Medicare Advantage premiums – but not for Medigap (supplement) premiums. However, you can use the funds to pay for long-term-care premiums. And of course for various medical expenses that aren’t covered by Medicare (such as dental).
See:
https://www.connectyourcare.com/blog/hsa-medicare-using-hsa-to-pay-for-medicare-premiums-and-more/
https://www.65incorporated.com/topics/out-pocket-medicare-costs/heath-savings-account-distributions-medicare-premiums/
http://money.com/money/4169422/hsa-account-medicare/

When it is time to choose a supplement, it can be worth shopping around – the basic benefits are the same for equivalent plans, but there can be some significant differences in premiums.

But it’s possible that things are more competitive for the supplements in California, because our state law allows us to change plans each year, so the companies can’t really lock us in. Although I’m not entirely clear on whether I would be able to keep my F plan if I swapped to a different carrier. I know I’m grandfathered in for the existing plan, but not sure how that works if I decide to change carriers.

Yes, different. But jym had asked and in your response to Himom, you mentioned Rx and that pysical therapy is limited. By Original Medicare, yes. By all MA plans, no.

That’s all. If we want to limit this to your plan, ok.

Agree, @lookingforward. Thread discussions always meander from the original question. Thats what makes them interesting and helpful, and is the benefit and beauty of the hive minds here. The wellness question has been asked and answered in the several weeks this thread has been open. And because related issues have been discussed, it may be a useful source of information when the time comes to look into choices and options for Medicare B.

When I start to collect SS and go on Medicare, if I pick B, I believe the premium will get paid from SS. So can I repay myself for the cost of the premium from the HSA?

@jym626 — that appears to be correct – you can withdraw money from the HSA to replace the amount deducted from SS for the part B premium:
https://www.kiplinger.com/article/insurance/T027-C001-S003-use-a-hsa-to-pay-medicare-premiums-tax-free.html

Private insurance companies do not want to insure patients eligible for Medicare. Why should they take on the whole burden instead of just supplementing Medicare? There are some insurances, such as the teacher’s on listed above, for various groups.

Just got H’s copy for 2020. So complicated, even if you are already using Medicare. Plus, not all companies have released their pricing- October 15 is the magic date to start, or make changes from this year. So many variations but it is logical. One size does not fit all and we as a nation cannot afford to take care of everything.

or, Pub 69:

https://www.irs.gov/publications/p969#en_US_2018_publink1000204086

(For the life of me, I do not understand why the feds start a description with a double negative: you can’t…unless…)

I think this comes up mostly in the context of employer-provided spousal or family coverage, not in the context of individual market coverage. So it isn’t that the insurance company has any particular desire to insure a medicare-eligible individual – it is that the insurance company does want to collect premium dollars to insure as many of company X’s employees as reasonably possible. And the average age of company X’s employees is going to be well below the age of Medicare-eligibility. In the employer context, premiums are usually uniform for all employees, regardless of age. That is, typically the company pays just as much to insure a 23-year-old employee as it pays for a 50-year-old. And the insurance company math is based on the combined totals – that is – total premiums collected vs. total payouts.

Huh? the above post. I was referring to the fact that isurance companies do not want to be the primary payer for Medicare eligible people. Obviously those of age who are still employed will be able to utilize company insurance benefits. Companies are willing to be secondary insurance payers for individuals, eg after Medicare. There is no reason to take up the entire burden. This in answer to the poster who wondered about non-Medicare insurance for those of us of Medicare age eligibility but don’t want Medicare.

By law, employer plans are primary for an employee still working who is enrolled in Medicare. And unless its a crappy employer plan, Medicare would then pay nothing most times as a secondary payor. (In such case, there’s no value in enrolling in and paying for Part B.)

Note that employers <20 employees have different rules than large employers in that small employers can require employees 65+ to enroll in Medicare but large employers cannot require it.

(or am I missing your point, wis?)

My point is that some people over age 65 retain private insurance rather than signing up for Part B or a Medicare Advantage plan, because they are covered by employer plans. They are not necessarily the covered employee – they could have a younger spouse who is not yet eligible for Medicare. Medicare can be the secondary rather then primary coverage in employer-coverage settings-- here’s a site that explains the difference: https://boomerbenefits.com/when-is-medicare-primary-and-when-is-medicare-secondary/

This does not apply to very small employers (fewer than 20 employees) and does not apply to people purchasing insurance on the individual market. But the system is structured to allow people to retain their employee coverage rather than Medicare, and insurance companies seem to be perfectly happy to provide primary coverage to Medicare-eligible members in those situations, I assume because they are looking at the entire group they insurer rather than individual cases. That is, in the employer coverage situation, the dollars collected for premiums for young healthy employees is enough to offset potential higher costs for a small number of older employees or employee-spouses.

That describes my situation. Am still on DH’s insurance. When he retires it goes on Cobra, I will sign up for B.
Didn’t know I could pay for LTC premiums write HSA money. That’s helpful.

Some of H’s former fed employee colleagues have opted to just keep their fed health insurance as retirees and not buy Medicare B. They are counting on it continuing to remain good policies in their retirement.

We are risk adverse and have H’s federal insurance as our family plan and also got H both Medicare A & B. We aren’t good at guessing the future and medical costs can certainly be high.

The insurance is secondary after Medicare for federal retirees who purchased Medicare and are retired. The insurance is just an extra layer of protection and caps the our of pocket expenses.