There are plenty of insurance brokers who have been blowing up my phone since the beginning of the year, but quite frankly, I trust the advice of the people on this board above some stranger out for profit.
I will be eligible for Medicare in December but understand I can apply in September. The health issues I have are issues I have to live with: fibromyalgia, high blood pressure, arthritis and stress from caring for bedridden hubby I see my PCP once a year, have a few cursory blood tests and that’s it. I haven’t been in the hospital for 6 years and that was elective surgery. Been 9-1-1-ed once, 10 years ago. I take a total of 2 meds that cost me $6.00, granted that’s with drug coverage.
For years and years I’ve dutifully written out checks for ridiculous amounts of money for health insurance I never use. We are in a terrific money crunch now. I added up hubby’s supplemental and drug costs and it’s over $200 a month. Plus we still pay a good buck for what Part D doesn’t cover.
Medicare Advantage holds a real appeal for me right now. People have said it’s great until you want to use it and then you pay through the nose with co-pays. But, I don’t use it! If I go for my yearly physical, what I’d have to pay would still be less than what the monthly fees for Medicare +Supplemental would be. To me, it’s like flushing money down the toilet. Money we need to use for other things...like food. I had a regular plan with CareSource a few years ago and wound up paying 1/2 the costs of my physical, x-rays, and blood tests anyway. Can’t be worse than that!
Help, help! Counting on you guys! Thanks!
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"Basic Medicare" is the plan you will have if you don't opt for Medigap or Medicare Advantage with an insurance company. You would submit claims to Medicare and deal directly with them. The coverage would be very basic, and you would still have to purchase dental and/or prescription coverage from a company. Insurance companies buffer you from having to deal directly, and take care of all the paperwork, etc. What people may not realize is that Medicare is paying those insurance companies for your basic coverage (at least with Advantage plans. I'm not as familiar with Medigap programs)... You are paying a premium to the insurance company which adds some benefits to the basic Medicare coverage, and is also more convenient. However, you will still hear the constant refrain of coverage “within Medicare guidelines”.
Medigap and Medicare Advantage are very different, and you cannot by law have both at the same time! Make sure which coverage you want, because otherwise you might not be able to change without penalty or at all. (If I remember correctly, Medigap insurance can be purchased when you first become eligible for Medicare, with no restrictions. But if you wait a certain period of time, it changes to whether they want to cover you – whether you meet certain standards/qualifications – and you can be denied coverage.
Next, all Medicare Advantage plans are not the same... Some offer low to zero premiums every month - and you think you're in heaven... That is, until you need coverage, and then you pay - and pay - and pay! Read the fine print of the policy! There are also hidden issues. Example: The first year I was eligible I chose a company MODA (don't know whether they're available generally or only in my area?) Their monthly premiums were higher than some other companies/options, but the coverage was better. Ever since I started dealing with my Mom's ongoing issues I've seen a counselor, until recently every week. My co-pay with MODA was $30 for mental health visits... AARP/United Health was constantly advertising and being touted as best, so the second year I switched to them. "0" copay for primary doc, $25 for Specialists... and, also I quickly found out - $45 copay for mental health visits (which certainly wasn't prominently disclosed). I ended up paying $60/month more for my counseling with AARP/United Healthcare. Besides that, they were much harder to deal with in general, and their pharmacy plan wasn't as good. I've switched back to MODA and am much happier.
Dental insurance is another issue... You can opt to add dental coverage to your Advantage plan... (MODA uses Delta Dental, which has been a really good plan) AARP's plan was different, and was actually a "rider" of sorts... With dental insurance, the kicker is that you HAVE TO KEEP IT CONTINUOUSLY - even when switching companies - or you are severely penalized for a long period, during which they won't cover most major issues. (Again, I had trouble with AARP because they couldn't/wouldn't give me proof of dental coverage to pass along when I went back to MODA. It took me 3 months, and a threat to go to the Insurance Commission, to get the needed proof from them.)
Bottom line: shop around, read the fine print, READ the Medicare booklet (pain in the fanny, but...), ask questions, and don't let some insurance salesman steer you into a plan you don't understand, need, or want. If you talk with Insurance company salesmen, understand they are pushing specific plans they offer, and get a commission for. Purchase Prescription coverage (Part D) right away, don't wait until later!
In my research, I’ve not heard anything from anyone whose said “I am really satisfied with my Advantage Plan.” Just the opposite! That worries me. I’ve always been fairly healthy, but this caregiving thing is wearing on me. I can completely understand how 40% of caregivers die before the people they care for.
Thank you you again for sharing you experiences and advice!
Your good historic medical care needs is not an indication of future needs. Especially, if you are unable to get needed care due to caregiving responsibility.
Every state has SHIP counselors (state health insurance plan). They provide (for free) assistance in choosing appropriate coverage. And they explain the choices available to you. I'd suggest you contact them to assist you in understanding all of your options.
I received a letter not long ago from an Insurance Counselor who says his services are free. I wouldn’t even presume to try to make this decision on my own.
I nave heard enough bad things about the Advantage programs that I will definitely research them before I make any decisions that might be irreversible.
Thanks again!
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When I turned 65, I decided it was worth it to have the kind of coverage they had. I figure I'll probably be too frail some day, as were my parents, and my caregiver(s) would have one less headache without having to worry about Medicare. I also figured I might end up with a chronic condition (who knows what the future holds?) that requires multiple hospitalizations -and I don't want to be fretting about whether to get needed medical attention because of money worries.
So I opted for Original Medicare, parts A & B, and a supplemental (Medigap) plan. I chose supplemental (Medigap) Plan F (which is just like Medigap Plan G - only G has a small deductible and F has no co-pay or deductible). I chose United Healthcare as the underwriter - through AARP - for my Plan F supplement. Every healthcare provider I've been to immediately recognizes my coverage (Plan F is the most popular medigap plan) and knows the bill will be paid for. They never ask for copay S or deductibles (or full payment) upfront.
I opted against Medicare Advantage plans because their networks, copay, deductibles, etc, change too frequently.
For Part D prescription coverage, I kept my retiree benefit plan, as it's certified under Medicare. I still pay co-pays for several drugs. Without that retiree coverage, I'd probably have to evaluate Part D plans every year to find the least expensive in terms of the particular drugs I take.
Always plan with the future in mind, knowing health issues tend to get worse as we age. A more inexpensive plan now may not work in the future and the "open window" to get the best insurance for future needs will be closed by then.
Just my thoughts. Good luck!
I do not want to be insurance poor, but also do not want to have a surprise emergency that takes a chunk out of my savings, either.
Like I wrote before, it’s the proverbial crapshoot. I’m sure not planning on “going down”, but with the stresses of caregiving, who knows.
Thanks fir taking the the time !to reply
$800 a month!!!