Medicare!!!!

[Tractorat]

Being on Medicare we pay just shy of $1k/month

You pay $1000 a month for Medicare ? Wow!!!! Our medicare plan that includes part d is not cost with $70 for the two of us for mediocre dental.

 

[CBari]

Working in the healthcare arena where most of my clients are Medicare age or turning that age I can give you some advice for you to use as you wish.

1) You worked, you payed in to the Medicare system use that benefit it is payed for. Medicare Part A is hospitalization and you get no questions asked. It has a deductible and a 20% copay.

2) Medicare Part B you can opt in or out of if you opt out and want in later you are penalized the monthly cost later will be more than it is now. It covers doctors visits, Durable Medical Equipment(oxygen, wheelchairs), Home health, and Hospice(hope you never need). It also has a yearly deductible and 20% copay.

3) Now one of the few things Congress got right was the law in where they created Medicare Supplement insurance plans. These plans you here them referred to as MEDi-PAK plans with names C-F the thing that congress got right on these is every company's plan F has the exact same coverage, you just have to look at the price. These also do not matter if your provider is in network or not with these companies. If they accept Medicare they have to accept what the Medi-Pak plan pays. The different plans C-F some cover your Medicare deductibles and your copay's, others only your copay's. Mutual of Omaha historically is one of the least expensive of these.

4) Medicare D plans These didn't exist 10 years ago and they all really and truly give you the same dollar benefit for what you pay in. What I mean by this is if you have one of the base plans that cost you $35 a month your copay's on your drugs will be somewhat higher. Look at your annual expense. 12 months of $35 plus 12 months of 3 drugs with $15 copay's cost you $960 a year. If you choose a premium plan you may pay $60 a month for the plan and you copay's $7 now for the $960 annually. Different companies make different brother-in-law deals with different drug manufactures, so you will find some drugs are not covered by certain companies just like some venues only carry Coke products and not Pepsi products. To figure which drug plan is best for you, I recommend you sit down with your Independent family Pharmacist, and use some of the tools that are available to them to plug in your medications and compare plans. If you are a snowbird make sure your plan works in both locations or that your Pharmacy can mail your medicine to you. Most of the plans want you to do 90 day supplies because it is easier for them to process 4 claims a year on you as to 12. If you are healthy and don't take any medicine you can gamble and not get a drug plan, you are penalized for this but it isn't very much at all.

5) Medicare Advantage Plans - The only one who gets an advantage here is the salesman who get the monthly commission check for selling you the plan. When you do an advantage plan you are selling your Medicare benefits to an insurance company now any provider you see must be in network with the plan you have chosen (This plans typically pay providers less than Medicare so you find few providers are in network with them) If you go to someone out of net work you have high deductible and higher copay usually or sometimes they don't pay out of network at all. If your provider is in network you will still have a 20% copay until you have reached an annual out of pocket max then the Advantage Plan will pay 100%. You can get Advantage plans that have drug coverage too, they tend not to be as good as the regular part D plans when you look at your annual expenses on the drug portion. Some advantage plans have vision and dental, but they don't cover near what an employee based insurance would. Short of getting a whole new set of implants or dentures or crowns annual dental maintenance isn't really that expensive compared to the cost of some of these plans.

In wrapping this long winded synopsis up if you can afford a Medi-Pak plan that is the way to go for your copay and deductible and use regular medicare as it accepted in all 50 states and territories.

 

[SnoKing]

Working in the healthcare arena where most of my clients are Medicare age or turning that age I can give you some advice for you to use as you wish.

1) You worked, you payed in to the Medicare system use that benefit it is payed for. Medicare Part A is hospitalization and you get no questions asked. It has a deductible and a 20% copay.

2) Medicare Part B you can opt in or out of if you opt out and want in later you are penalized the monthly cost later will be more than it is now. It covers doctors visits, Durable Medical Equipment(oxygen, wheelchairs), Home health, and Hospice(hope you never need). It also has a yearly deductible and 20% copay.

3) Now one of the few things Congress got right was the law in where they created Medicare Supplement insurance plans. These plans you here them referred to as MEDi-PAK plans with names C-F the thing that congress got right on these is every company's plan F has the exact same coverage, you just have to look at the price. These also do not matter if your provider is in network or not with these companies. If they accept Medicare they have to accept what the Medi-Pak plan pays. The different plans C-F some cover your Medicare deductibles and your copay's, others only your copay's. Mutual of Omaha historically is one of the least expensive of these.

4) Medicare D plans These didn't exist 10 years ago and they all really and truly give you the same dollar benefit for what you pay in. What I mean by this is if you have one of the base plans that cost you $35 a month your copay's on your drugs will be somewhat higher. Look at your annual expense. 12 months of $35 plus 12 months of 3 drugs with $15 copay's cost you $960 a year. If you choose a premium plan you may pay $60 a month for the plan and you copay's $7 now for the $960 annually. Different companies make different brother-in-law deals with different drug manufactures, so you will find some drugs are not covered by certain companies just like some venues only carry Coke products and not Pepsi products. To figure which drug plan is best for you, I recommend you sit down with your Independent family Pharmacist, and use some of the tools that are available to them to plug in your medications and compare plans. If you are a snowbird make sure your plan works in both locations or that your Pharmacy can mail your medicine to you. Most of the plans want you to do 90 day supplies because it is easier for them to process 4 claims a year on you as to 12. If you are healthy and don't take any medicine you can gamble and not get a drug plan, you are penalized for this but it isn't very much at all.

5) Medicare Advantage Plans - The only one who gets an advantage here is the salesman who get the monthly commission check for selling you the plan. When you do an advantage plan you are selling your Medicare benefits to an insurance company now any provider you see must be in network with the plan you have chosen (This plans typically pay providers less than Medicare so you find few providers are in network with them) If you go to someone out of net work you have high deductible and higher copay usually or sometimes they don't pay out of network at all. If your provider is in network you will still have a 20% copay until you have reached an annual out of pocket max then the Advantage Plan will pay 100%. You can get Advantage plans that have drug coverage too, they tend not to be as good as the regular part D plans when you look at your annual expenses on the drug portion. Some advantage plans have vision and dental, but they don't cover near what an employee based insurance would. Short of getting a whole new set of implants or dentures or crowns annual dental maintenance isn't really that expensive compared to the cost of some of these plans.

In wrapping this long winded synopsis up if you can afford a Medi-Pak plan that is the way to go for your copay and deductible and use regular medicare as it accepted in all 50 states and territories.

Thanks for your run down on these plans. We have been on a Seattle based Medicare Advantage Plan managed through BofA and will be cancelling that next year and will be switching medicare and a Medi-Pak. I have heard Mutual of Omaha was good. Will we have issues and mountains to climb switching back to Medicare and signing up for a Medi-Pak? Thanks Snoking

 

[Tractorat]

5) Medicare Advantage Plans - The only one who gets an advantage here is the salesman who get the monthly commission check for selling you the plan. When you do an advantage plan you are selling your Medicare benefits to an insurance company now any provider you see must be in network with the plan you have chosen (This plans typically pay providers less than Medicare so you find few providers are in network with them) If you go to someone out of net work you have high deductible and higher copay usually or sometimes they don't pay out of network at all. If your provider is in network you will still have a 20% copay until you have reached an annual out of pocket max then the Advantage Plan will pay 100%. You can get Advantage plans that have drug coverage too, they tend not to be as good as the regular part D plans when you look at your annual expenses on the drug portion. Some advantage plans have vision and dental, but they don't cover near what an employee based insurance would. Short of getting a whole new set of implants or dentures or crowns annual dental maintenance isn't really that expensive compared to the cost of some of these plans.

Our med advantage plan is hmo with drug coverage and no premium. Office calls are 0 copay. In network specialist $45 copay, Preventive care $0 copay, Inpatient care $450/day for day 1-4 then $0 copay for days 5-90, outpatient care at surgery center $400 copay, lab test from lab facility $0 copay, Pharm deductible $200, the $4/$15/$47/$100 copay. But I try to get my meds from the VA because it is better than medicare or an advan plan. I forget what actual medicare pays, but I think you pay 20% on everything, dont you ?

 

[RideSlow2004]

In wrapping this long winded synopsis up if you can afford a Medi-Pak plan that is the way to go for your copay and deductible and use regular medicare as it accepted in all 50 states and territories.

That right there is exactly the info I was looking for....Thanks much!!!

 

[SnoKing]

That right there is exactly the info I was looking for....Thanks much!!!

We were just talking to other snowbirds about this. They have F plan AARP and are very happy. That will be what we do next January. Chris

 

[SnoKing]

Dup post. Snoking

 

[Cooper_D]

I'm not taking sides but if you are not interested in AARP (liberal) you have another option in AMAC (conservative) also known as Association of Mature American Citizens.

Thanks to CBari for your informative post on Medicare we will be signing up in the next couple years

 

[RideSlow2004]

I'm not taking sides but if you are not interested in AARP (liberal) you have another option in AMAC (conservative) also known as Association of Mature American Citizens.

Thanks to CBari for your informative post on Medicare we will be signing up in the next couple years

AMAC just showed up in my mailbox! I am looking forward to what they have to say.

 

[jhenderson]

My wife has an advantage plan. She's quite happy with it. It's through Blue Cross so there's not much that's out of network and her scripts are included. They also chip in on her gym membership to keep her in shape for such wifely duties as shoveling snow and stacking firewood.

 

[SnoKing]

Question, when one goes to ER and the bill is 10k, and Medicare pays them 795 dollars, does the hospital write the difference off as a business lose on their taxes?

 

[Tractorat]

Ive seen or heard an answer to a similar question and I dont remember the answer exactly. It is very convoluted. It works something like this. They advertise very high prices, and some people even pay them. But they are actually able to consider anything that is not sold at list price as a loss and therefore deductable unlike any other business. It is a racket.