Educate me about Medicare?

3,625 Views | 27 Replies | Last: 3 yr ago by permabull
chris1515
How long do you want to ignore this user?
AG
A relative that is in their early 70s just lost their job, and the accompanying healthcare benefits. So they are now looking at Medicare options.

I've been reading up on it, but could use any helpful advice y'all might contribute.

They are most concerned at this point about the cost of a few prescriptions and how they will be covered. How can someone research this and know what this expense will look like under various coverage scenarios?
Brush Country Ag
How long do you want to ignore this user?
AG
There should be a Medicare advisor in their area. I would contact their pharmacy…they should be able to give them some folks to call to assist them.

permabull
How long do you want to ignore this user?
AG
I'd get a list of the medications and search them on goodrx.com to see if they are even that expensive w/o insurance.

After you get that baseline you need to try and find a medicare part d plan that covers that combo the best. The medicare.gov weboage let's you put in the medicine you take and helps you see how much you will be paying with the various plans
oklaunion
How long do you want to ignore this user?
How did they not get put on Medicare when they hit 65? I didn't think it was an option to opt out.
permabull
How long do you want to ignore this user?
AG
When you turn 65 most are forced into Medicare part A which covers hospital and surgeries but can delay enrolling in B, C or D if you are still working and have qualified coverage
chris1515
How long do you want to ignore this user?
AG
That's the case here.
90 bull
How long do you want to ignore this user?
AG
My wife went through this with her mother. An advisor was incredibly helpful. She used United Medicare advisors, and was really pleased.
woodyhayes
How long do you want to ignore this user?
Medicare currently takes $148 out of the social security check and I did a lot of reading, studying, and asking, and settled with Humana for scriphts, eye & dental, etc.
AgPT06
How long do you want to ignore this user?
AG
Ideally stick with traditional MC with a good supplement that covers the drugs. Yes there are some docs that opt out of MC but overwhelmingly for hospitalizations and other services MC gives the easiest options. If they go the MC advantage route do NOT go with the HMO plans unless just financially unable to afford anything else. You pay very little for these plans but getting everything referred and pre-authorized is a nightmare. Ideally find a rep/broker who will shop ALL options, not just a single company. Also know that initially you can get on a supplement without underwriting but if you want to change plans in Texas later you may be subject to underwriting and denied.
OldArmyCT
How long do you want to ignore this user?
AG
hypeiv said:

When you turn 65 most are forced into Medicare part A which covers hospital and surgeries but can delay enrolling in B, C or D if you are still working and have qualified coverage
No, when you turn 65 you ENROLL in the Medicare options you will be in later, that's all. They don't take $ until you participate. If you fail to enroll in that 6 month window you will be charged more when you do enroll. I enrolled at 65 but kept on my company plan until 68, and all I have ia A & B, I'm retired military so I'm eligible for Express Scripts and Tricare for Life, meaning I don't need a secondary. And I think what the OP is asking is info about a secondary. And frankly, choosing a secondary this late is going to cost, unless they choose one that is cheap but never pays anything.
schwack schwack
How long do you want to ignore this user?
AG
I'm just starting to research this for myself. 65 in December. Man - how do "old people" navigate thru this?!?!
Ark03
How long do you want to ignore this user?
AG
OldArmyCT said:

hypeiv said:

When you turn 65 most are forced into Medicare part A which covers hospital and surgeries but can delay enrolling in B, C or D if you are still working and have qualified coverage
No, when you turn 65 you ENROLL in the Medicare options you will be in later, that's all. They don't take $ until you participate. If you fail to enroll in that 6 month window you will be charged more when you do enroll. I enrolled at 65 but kept on my company plan until 68, and all I have ia A & B, I'm retired military so I'm eligible for Express Scripts and Tricare for Life, meaning I don't need a secondary. And I think what the OP is asking is info about a secondary. And frankly, choosing a secondary this late is going to cost, unless they choose one that is cheap but never pays anything.
Before you scare everyone who is still working past age 65, you actually can defer your Medicare enrollment if you are still working with creditable coverage and if your employer plan allows for it, without incurring a penalty.

Source is Medicare.gov.

When you do lose your employee coverage, you'll have your employer fill out the Request for Employment Information form from CMS, which Medicare uses to confirm you were eligible for the deferment without penalty.

In general, talk to Medicare and your employer about making these decisions, and not random sports forums.
Aggiewes
How long do you want to ignore this user?
AG
OP - where is the relative located? I would suggest you get into contact with a specialist in this area. The right specialist can help.

NOTE - I am not a specialist so I am not trying to make money on this.

Wes '87
chris1515
How long do you want to ignore this user?
AG
Are these specialist all working for insurance providers?
I see there are special requirements for Medicare advisors that limit their ability for shady sales tactics it appears.

As for part D coverages, how much difference is there in terms of what's covered/payouts between the different providers?
jamey
How long do you want to ignore this user?
AG
hypeiv said:

When you turn 65 most are forced into Medicare part A which covers hospital and surgeries but can delay enrolling in B, C or D if you are still working and have qualified coverage



What's the monthly cost for all the above assuming that's full Medicare coverage? Anyone have a roundabout number
ItsA&InotA&M
How long do you want to ignore this user?
When I was looking a few years ago, I spoke with Cheryl Barr. She specializes in the various options and explains the options, differences, pros and cons of each one.
Six 8 two two five 6 one six one six.
Aggiewes
How long do you want to ignore this user?
AG
chris1515 said:

Are these specialist all working for insurance providers?
I see there are special requirements for Medicare advisors that limit their ability for shady sales tactics it appears.

As for part D coverages, how much difference is there in terms of what's covered/payouts between the different providers?

Specialists sell supplemental policies. Some end up just being salesmen/women. Good ones are consultants and get you in the correct product and are Medicare experts. They are compensated via commission (no out of pocket for you). If you get a good one, they will make sure you have the right product.

Wes '87
OldArmyCT
How long do you want to ignore this user?
AG
Ark03 said:

OldArmyCT said:

hypeiv said:

  • When you turn 65 most are forced into Medicare part A which covers hospital and surgeries but can delay enrolling in B, C or D if you are still working and have qualified coverage
  • No, when you turn 65 you ENROLL in the Medicare options you will be in later, that's all. They don't take $ until you participate. If you fail to enroll in that 6 month window you will be charged more when you do enroll. I enrolled at 65 but kept on my company plan until 68, and all I have ia A & B, I'm retired military so I'm eligible for Express Scripts and Tricare for Life, meaning I don't need a secondary. And I think what the OP is asking is info about a secondary. And frankly, choosing a secondary this late is going to cost, unless they choose one that is cheap but never pays anything.


Before you scare everyone who is still working past age 65, you actually can defer your Medicare enrollment if you are still working with creditable coverage and if your employer plan allows for it, without incurring a penalty.

Source is Medicare.gov.

When you do lose your employee coverage, you'll have your employer fill out the Request for Employment Information form from CMS, which Medicare uses to confirm you were eligible for the deferment without penalty.

In general, talk to Medicare and your employer about making these decisions, and not random sports forums.
If you read my post I said I deferred and worked while on the company health plan past 65, but I enrolled at 65. Enrolling is not the same as being on medicare.
Ark03
How long do you want to ignore this user?
AG
OldArmyCT said:

Ark03 said:

OldArmyCT said:

hypeiv said:

  • When you turn 65 most are forced into Medicare part A which covers hospital and surgeries but can delay enrolling in B, C or D if you are still working and have qualified coverage
  • No, when you turn 65 you ENROLL in the Medicare options you will be in later, that's all. They don't take $ until you participate. If you fail to enroll in that 6 month window you will be charged more when you do enroll. I enrolled at 65 but kept on my company plan until 68, and all I have ia A & B, I'm retired military so I'm eligible for Express Scripts and Tricare for Life, meaning I don't need a secondary. And I think what the OP is asking is info about a secondary. And frankly, choosing a secondary this late is going to cost, unless they choose one that is cheap but never pays anything.


Before you scare everyone who is still working past age 65, you actually can defer your Medicare enrollment if you are still working with creditable coverage and if your employer plan allows for it, without incurring a penalty.

Source is Medicare.gov.

When you do lose your employee coverage, you'll have your employer fill out the Request for Employment Information form from CMS, which Medicare uses to confirm you were eligible for the deferment without penalty.

In general, talk to Medicare and your employer about making these decisions, and not random sports forums.
If you read my post I said I deferred and worked while on the company health plan past 65, but I enrolled at 65. Enrolling is not the same as being on medicare.
I can't speak to your specific situation, but for the benefit of others - I'd speak to Social Security/Medicare (not just a broker who sells Medicare supplement plans) to verify your information... BUT, you're creating pedantic distinctions that don't have any meaning. In the industry, "signing up" is analogous to "enrolling" in Medicare.

I'm not going to cite all the resources that show this because I don't want to further clutter the OP's post, but Medicare and You is a fantastic resource (linked here in PDF) that answers just about every question someone would have. For this specific question, see page 16 regarding enrolling in parts A and B at age 65, page 23 regarding paying the late enrollment penalty UNLESS you enroll in a Special Enrollment Period, and then flip back to pages 17-18 regarding Special Enrollment Periods, which include the 8-month period following coverage ending due to your employment ending (which would be the situation of someone covered past age 65 by their employer).

That's all I say here. I think it's probably enough for someone who comes along who may have been confused or concerned by this discussion.
txaggie79
How long do you want to ignore this user?
AG
It's 170.10 for 2022. It was 148.50 in 2021.
OldArmyCT
How long do you want to ignore this user?
AG
Ark03 said:

OldArmyCT said:

Ark03 said:

OldArmyCT said:

hypeiv said:

  • When you turn 65 most are forced into Medicare part A which covers hospital and surgeries but can delay enrolling in B, C or D if you are still working and have qualified coverage
  • No, when you turn 65 you ENROLL in the Medicare options you will be in later, that's all. They don't take $ until you participate. If you fail to enroll in that 6 month window you will be charged more when you do enroll. I enrolled at 65 but kept on my company plan until 68, and all I have ia A & B, I'm retired military so I'm eligible for Express Scripts and Tricare for Life, meaning I don't need a secondary. And I think what the OP is asking is info about a secondary. And frankly, choosing a secondary this late is going to cost, unless they choose one that is cheap but never pays anything.


Before you scare everyone who is still working past age 65, you actually can defer your Medicare enrollment if you are still working with creditable coverage and if your employer plan allows for it, without incurring a penalty.

Source is Medicare.gov.

When you do lose your employee coverage, you'll have your employer fill out the Request for Employment Information form from CMS, which Medicare uses to confirm you were eligible for the deferment without penalty.

In general, talk to Medicare and your employer about making these decisions, and not random sports forums.
If you read my post I said I deferred and worked while on the company health plan past 65, but I enrolled at 65. Enrolling is not the same as being on medicare.
I can't speak to your specific situation, but for the benefit of others - I'd speak to Social Security/Medicare (not just a broker who sells Medicare supplement plans) to verify your information... BUT, you're creating pedantic distinctions that don't have any meaning. In the industry, "signing up" is analogous to "enrolling" in Medicare.

I'm not going to cite all the resources that show this because I don't want to further clutter the OP's post, but Medicare and You is a fantastic resource (linked here in PDF) that answers just about every question someone would have. For this specific question, see page 16 regarding enrolling in parts A and B at age 65, page 23 regarding paying the late enrollment penalty UNLESS you enroll in a Special Enrollment Period, and then flip back to pages 17-18 regarding Special Enrollment Periods, which include the 8-month period following coverage ending due to your employment ending (which would be the situation of someone covered past age 65 by their employer).

That's all I say here. I think it's probably enough for someone who comes along who may have been confused or concerned by this discussion.
Thanks, I agree with everything you said, except signing up at 65 is easy compared to flip back to pages 17-18 regarding Special Enrollment Periods, which include the 8-month period following coverage ending due to your employment ending (which would be the situation of someone covered past age 65 by their employer).
frankm01
How long do you want to ignore this user?
I am already retired and will be turning 65 in September, so my situation is a little different than the OP's relative. The whole Medicare thing was confusing to me in terms of "Advantage" plans vs "Supplemental" plans. The few times I called the Medicare or SSA call center, I got several different answers to my questions.

However, I found this video to be very helpful. Obviously he is looking for your business, but the way he explained the differences between Advantage and Supplement plans made my decision making easier. Video is about 30 minutes.

https://www.medicareschool.com/get-the-workshop-now

Hope this helps.

Edit: I re-read the OP and it looks like he's concerned about estimating drug costs. If you go to Medicare.gov and look for a Part D plan, you can compare and even add the names of the drugs to see the estimated copays and deductibles.

LMCane
How long do you want to ignore this user?
is it possible to NOT pay medicare costs if I want?

I have a second passport and the Israeli health care is less expensive and covers more starting at age 60.

it may be cost effective to use their insurance and save the money on the US side if it's possible to NOT participate
Larry S Ross
How long do you want to ignore this user?
AG
Everyone on Medicare and a script plan should check yearly at renewal and rerun all their medications to see if they will still be covered in the coming year by that company. Companies change medicines they cover frequently and you can get caught needing your expensive medication and find out they don't cover it in the coming year or they are increasing the cost. It gives you the chance to check out other options.
Good Day.
YouBet
How long do you want to ignore this user?
AG
I have nothing to contribute other than I was witness to some older friends discussing this very thing yesterday. I was somehow not aware you are essentially forced into Medicare and really have no choice unless you want to be penalized. And they all said it was a nightmare to understand, navigate, and signup.
strbrst777
How long do you want to ignore this user?
Medicare Part B in 2022 for most does cost $170 per month deducted from the Social Security "government benefit." What some do not know that the premium may be as much as $578 per month. Premium is based on prior income per IRS. I call that means testing. Only gov could get away with such flagrant price discrimination. It to me would be like Kroger charging customers different prices for a loaf of bread...some $1, some $2 and others $3 depending on means tests. Gov follows the money. Keep Gov out of the bread biz (lol).
wcb
How long do you want to ignore this user?
AG
I'll put in a shameless plug for a buddy of mine here. He consults and sells services as well. Great guy and can hopefully point you in the right direction if necessary.

http://1836seniorbenefits.com/
permabull
How long do you want to ignore this user?
AG
You are only required to enroll into Medicare part A which is free if you have paid into medicare for 40 quarters (10 years). You only get extra money taken from social security if you sign up for part B, C or D.

So if you don't want to pay just don't sign up for b, c or d
Refresh
Page 1 of 1
 
×
subscribe Verify your student status
See Subscription Benefits
Trial only available to users who have never subscribed or participated in a previous trial.