MJ! Start with a specialist. I got calls and letters from multiple people, but each one represented one plan. That is why I turned to a real insurance agent, who would benefit from my business no matter which plan I chose.
I’m not a fan of HMOs. In my line of work, the co-fee is $45 a session. When I have patients track all their co-fees, it always amounts to more than if they had chosen a PPO. If someone rarely sees an MD, PhD or NP, maybe the HMO would work. However, when you add in annual meetings with GYN, IM, Derm, etc, the costs run up.
I thought about the easy insurances of my patients. One plan considered very good, meant that I had to send in a letter, the Medicare EOB, copy of bill. Most docs won’t do this. They have the patient pay the co- fee upfront, and leave it to the patient to write to the secondary to collect payment. I wanted to go with a plan that has automatic X-over to the secondary.
I will be signing up for medicare in February when I turn 65. Up to now, I still don’t know enough about it. When my father was alive, doing this stuff and wanting my advice, I just ignored it as I didn’t want to think about it. I guess now it’s time.
I am currently collecting SS. I was told by former coworkers (who are over 65) that I should receive my Medicare card in the mail about three months before my birthday. The payments will be deducted from my SS check for the basic Medicare package.
Is that correct?
Then I need to present my Medicare card to the medigap folks here with the state teachers retirement board, and they will sign me up for that…and deduct that premium from my teachers retirement pension.
I need to sign up for,the medigap…but my understanding was the basic Medicare card would be sent to me…because I’m already collecting SS. At least this is what happened with all of my former coworkers!
I’ll ask again.
Then once I receive the Medicare card, I then apply for the medigap policy though teachers retirement.
My husband is on Medicare and has the highest supplemental coverage - F (chosen because he has a lot of health problems). So far, at 73, he hasn’t had any coverage problems. He has been an MD Anderson patient/survivor since 2011 & certainly has had no problem there. I would say his coverage is better than my private coverage that costs considerably more (2 years 9 months and counting). I would say the supplemental plan is what makes the difference.
Medicare D prescription coverage is a whole other story. His prescriptions cost us a fortune.
I am not on Medicare yet, but of my friends who are, they rave about the AARP Medicare Supplemental Insurance. One friend buys the kind that has no copays because she did a calculation of her copays in years past and decided that one plan is worth it to her. She is somewhat healthy at age 81 but she seems to relish going to the doctors. It’s a social outing to a lot of seniors.
MommaJ, I manage a medical practice whose demographic is about 50% Medicare. We cannot afford to exclude ourselves from Medicare even though their reimbursement is 25-30% less than commercial insurance companies. To their credit, Medicare pays in a much more timely and fair mAnner when compared to Cigna, Aetna, Humana and United healthcare. I also prefer Medicare to Medicare Advantage plans and try at all costs to avoid contracting with those because of all the hoops they make their patients and physician offices jump through. Find a good quality plan F supplemental plan (it doesn’t have to be BCBS) and you will be set. N our area this type of plan costs about $200 per month per person.
I think my husband’s is AARP. We are actually locked in to whoever it is because the oil company he retired from pays a portion of it and will only pay for one particular company.
We have 60 physicians. The problem isn’t joining the MA plan; it’s making sure you know what you’re getting. For example, is it an HMO with a limited network. Does it have a $2000 deductible? Does it require your doc to get the dreaded “prior authorization” for every little service?
No, it’s not free. Medicare A (hospital only) is free if you or spouse paid into Medicare. Medicare B starts at around $104 a month but goes up if your income is high. Medicare supplemental varies depending on level you choose (are needed if you have much in the way of medical problems - I think my husband’s F plan is around $200 a month). Medicare D prescription premium varies by plan - if you have a lot of prescriptions your out of pocket can get very very high.
The enrollees pay about 100/month currently, so most people pay $1200 yearly. Annual medicare expenditures are $8000 per enrollee (I think, although that may be “net” expenditures after taking into account the enrollee premiums).
So as a group, s medicare enrollee is get $8000 of medical value for $1000 out-of-pocket.
I went from no insurance to Medicare Advantage and I am thrilled. My doctor takes it and I have no complaints about referrals. It includes medications, with a $250 annual deductible and costs exactly the same as regular Medicare–$104 out of my monthly social security check. $20 deductible to see a primary care provider, $50 to see a specialist.
The Medicare website has ratings of various plans, derived from complaints from patients and providers.
“…29.If you choose to file and suspend in order to enable your spouse to collect a spousal benefit on your earnings record while you delay taking your benefit in order to collect a higher one later, make sure you pay your Medicare Part B premiums out of your own pocket (i.e., you need to send Social Security a check each month). If you don’t, Social Security will pay it for you and treat you as waving (i.e., not suspending) your benefit apart from the premium and, get this, you won’t get the Delayed Retirement Credit applied to your benefit…”
"…31.When inflation is low, like it is now, there is a disadvantage to delaying until, say 70, collecting one’s retirement benefit. The disadvantage arises with respect to Medicare Part B premiums. If you collecting benefits (actually were collecting them last year), the increase in the Medicare premium this year will be limited to the increase in your Social Security check.
The written material was as incomprehensible as on the Medicare site but when I called, it was wonderful. Really smart people. The guy who helped me was a retired insurance executive who volunteers with them. I believe that they will try to match you with a volunteer in your area.