Author Topic: 64 and 7 months-- Medicare time  (Read 2186 times)

BTDretire

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64 and 7 months-- Medicare time
« on: October 01, 2019, 04:45:58 PM »
I need to start thinking about signing up for medicare.
As is stands now, I have myself my wife and both kids on a grandfather* in BCBS policy. 
I will be the only one moving to a new policy.
Assume I have no knowledge of what my options are or what I should be looking at.
What's important? I have two prescriptions of $14 a month, although one is free, a benefit of the ACA, "I do suspect my premium went up more than the $3.42 that the prescription did cost me."

*grandfathered in= I had the policy before Obamacare and it was found good enough that it didn't need to be displaced. That doesn't mean the ACA didn't force new benefits on it causing the price to rise considerably.

MDM

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Re: 64 and 7 months-- Medicare time
« Reply #1 on: October 01, 2019, 05:39:39 PM »
Assume I have no knowledge of what my options are or what I should be looking at.
In that case, starting with Medicare.gov: the official U.S. government site for Medicare might be appropriate.

Cranky

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Re: 64 and 7 months-- Medicare time
« Reply #2 on: October 02, 2019, 06:00:44 AM »
You will soon be receiving approximately 1 bazillion pieces of mail from companies who want you to sign up for their plan. So, first you have to decide if you want traditional Medicare or a Medicare Advantage plan (which is like an HMO).

Be aware that you will have to create a social security account online in order to apply for Medicare, and the security questions are confusing. Find the names of all your mortgage lenders ever before you even start.

6-Saturdays

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Re: 64 and 7 months-- Medicare time
« Reply #3 on: October 02, 2019, 07:43:04 AM »
You will soon be receiving approximately 1 bazillion pieces of mail from companies who want you to sign up for their plan. So, first you have to decide if you want traditional Medicare or a Medicare Advantage plan (which is like an HMO).

Be aware that you will have to create a social security account online in order to apply for Medicare, and the security questions are confusing. Find the names of all your mortgage lenders ever before you even start.

DW and I had to help my parents with this, my advice is to run your free credit reports with the various credit agencies to get a list of what loans you have had in the past and what credit cards they have on file. They will ask you questions about credit cards you may have had 10 + years ago! My parents couldn't remember half the things that were being asked so the credit reports really helped fill in the blanks. 

Another Reader

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Re: 64 and 7 months-- Medicare time
« Reply #4 on: October 02, 2019, 08:19:18 AM »
Medicare has a lot of parts.  Part A is hospitalization.  Part B is doctors.  Part D is the drug plan.   With "traditional" Medicare, you will need to purchase a supplement, or "Medigap" plan.  There is also Medicare Advantage, an insurance company administered all in one plan.  Think of that option as a very restrictive HMO plan. 

It's best to understand all the Medicare options as it is very difficult to switch plans once you enroll.  You can shortcut the research project by dealing with one of the large, pro-consumer insurance agents.  The two biggest are Boomer Benefits and Senior Savings Network.  Unless your company offers a subsidy and uses an administrator such as Via Benefits, I would start with those people.
« Last Edit: October 02, 2019, 08:27:05 AM by Another Reader »

InSearchOfFire

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Re: 64 and 7 months-- Medicare time
« Reply #5 on: October 02, 2019, 05:14:21 PM »
Woof!  I just went through this.

First of all, my former employer offered Via Benefits, but I chose not to even talk to them.  They have a bunch of complaints online, which gave me pause.  And they had only two Medigap plans in my zipcode, while Medicare.gov had @25 plans, and I found less expensive plans online very easily.  YMMV.

Medicare.gov is useful for a bunch of info, but it doesn't try to tell you everything, so google is your friend.  Do read up at medicare.gov about the basics of how Medicare works, and how Medicare Advantage vs Medigap works.

Medicare.gov will give you a list of what plans are available in your zip code, for MedicareAdvanatge, Medigap, and Rx Drug Plans, and the list has links to those insurance companies.  It's then up to you to check out each of those plans on your own.

They seem to want you to choose MedicareAdvanatge.  If you click on the New to Medicare link on the medicare.gov website (I might have gotten that wording wrong), they only list MedicareAdvantage Plans and Rx Drug Plans.  If you want to see Medigap plans, look for a link labeled something like "Find health and drug plans."  And I see they have just revamped their website.  So my wording on links should be taken with a grain of salt.

First of all, whatever else you decide about talking to Via Benefits or other such firm, you must sign up for Medicare Parts A and B before signing up for anything else.  Part A is for hospitalization.  Part B is for doctor's visits.  If you delay signing up for this, you will pay a higher premium forever.  But if you sign up during your Initial Enrollment Period, you will pay the usual premium.

Your Initial Enrollment Period is a 7 month period, including the three months before the month you turn 65, the month you turn 65, and the three months after you turn 65.

Medicare.gov will tell you that in order to sign up for Medicare you must first create a mySocialSecurity account at ssa.gov.  Good luck with that; I was completely unable to do so.  Partly because I had a security freeze on my Equifax account (SSA uses Equifqax to verify your identity), and partly because SSA's website does not give a clue as to the format they require for things like your SSN (include dashes or not?) and your phone number (home phone or cell?  parens around the area code?).  Then they lock you out for 24 hours if you don't get it right in three tries.

Tip 1: Medicare.gov says that you must create a mySocialSecurity account, or at least try to.  So after becoming utterly frustrated, I called them.  It took a while waiting till they had a live person answer, then it took maybe 10 minutes to run through some questions they had, and then they scheduled me for a phone call to enroll in Medicare.  It might be a couple of months to get a phone appointment or an in-person appointment at your local SSA office, but I was lucky and got a phone appointment for 3 days after that first call.  Then on the appointment call (they call you at home at a scheduled time), it took about 10 minutes and that was it - I was enrolled in Medicare Parts A and B.

Tip 2: You don't actually have to have a mySocialSecurity account if you don't want it.  You can enroll in Medicare without it.

You don't actually have to wait till you're enrolled in Medicare to check out Medicare.gov and the plans in your area.  Start reading up now to get familiar with the jargon.  Look at the lists of insurance companies from Medicare.gov that sell medicare policies in your area, and check them out.

Along with Medicare Parts A and B, you will probably need either MedicareAdvanatage or a Medigap policy plus a Part D Rx Drug plan.  Some MedicareAdvanatge palsn include Rx drugs; some do not - in which case you will need a separate Rx plan.

MedicareAdvantage plans are sort of like HMOs; you usually have to see doctors in their network to get any benefits at all.  But there are Advantage plans that are HMOs, some that are blends of HMO with POS or PPO.  You will usually pay a lower premium for an Advantage plan than for a Medigap plan.

Medigap plans are secondary insurance plans, where Medicare is your primary insurer.  You do not have to see a doctor in your Medigap plan's network.  With Medigap, and Medicare, you can see any doctor you want, as long as they take Medicare.
Note: You do need to check if the doctor you want to see takes Medicare - not all of them do.  If they do, then they must also take your Medigap as well. 

There are a bunch of different Medigap plans, all approved by Medicare.  They are designated by letters from A to N, and a plan of any letter will be identical anywhere in the country in terms of what it must cover.  Medicare.gov has a table of all of the Medigap plans, showing exactly what each plan covers.  Check that table out, decide which letter plan works for you, and then you can focus on which companies offer that plan.

Medicare imposes requirements on the Medigap plans as to the max deductible.  A couple of the plans have a max OOP, but most do not.

Rx Drug Plans - Again, Medicare imposes requirements on the insurance companies as to the max deductible.  The trick is to figure out if the company covers the drugs you take, and if so, how much you will pay for them in copay or coinsurance.  The insurance companies can set up their own tiers of drug types, with different copay/coinsurance for each tier.  This can really affect how much you pay during the year.  The same drug can be in different tiers at different companies, making the cost you pay very different.  Also, different insurance companies will have different "preferred" vs "standard" pharmacies, with different copay/coinsurance depending on where you get your Rx filled.

Medicare.gov supposedly has a way you can check your Rxs to see which company would be more cost-effective for you.  Take that with a grain of salt.  Each insurance company will also estimate your costs, anonymously online, if you put in your drug info.

Ok, well, I hope you are not already exhausted just reading this.

Good luck!
IsoFIRE

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Re: 64 and 7 months-- Medicare time
« Reply #6 on: October 02, 2019, 06:09:31 PM »
ISOFire:

Does your company pay some or all of your Medigap and Part D?  If so, you likely have to go through VIA Benefits to get the subsidy.

My last employer pays for Part B at the lowest cost level (no IRMAA) and offers an annual amount to be used for the supplement, Part D, and unreimbursed medical expenses.  It was a substantial amount and it covered both the supplement and Part D.  Still have money for anything that's not covered.  For example, the doctor recommended checking blood pressure daily.  The money covered the cost of the monitor.

In your shoes, I would verify you are not missing out on a significant amount of money by not using VIA Benefits.  I would also verify what plans are actually offered through VIA Benefits for your employer.  The generic website may not include all the plans offered through your employer.

InSearchOfFire

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Re: 64 and 7 months-- Medicare time
« Reply #7 on: October 02, 2019, 06:19:10 PM »
AR:

Not to worry - of course I checked all that out.  I did check the specific webpage for what plans were offered at Via for my former employer, not the generic offerings.  I am not missing out on anything.


Your last employer is generous!

InSearchOfFire

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Re: 64 and 7 months-- Medicare time
« Reply #8 on: October 02, 2019, 08:34:27 PM »
OP,

One last thing.  The Fall Open Enrollment for Medicare and the various supplemental insurance policies starts Oct. 15th.  Medicare.gov and all the insurance companies will be very busy, so do your research and talk to whatever companies you want to while they are not yet swamped!


Another Reader

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Re: 64 and 7 months-- Medicare time
« Reply #9 on: October 02, 2019, 09:10:51 PM »
OP also needs to understand that "guaranteed issue" only applies during initial enrollment.  In most states, you have to go through medical underwriting if you want to change supplemental policies.  Since all medigap policies offer the same coverage for each plan type, price becomes the issue.  You should look at not only the initial premium, but the history of increases.  In addition, it's very difficult to get out of Medicare Advantage after you have the policy for 6 months.

Supplement plans are classified by letter.  For new enrollees, Plan G is the most comprehensive plan available.  Plan F is no longer available to new enrollees.  Other plans have varying copays and deductibles.  Understanding the differences and estimating your out of pocket costs under the various plans will help you make a good decision.

Again, if you do not have to go through VIA Benefits to get an employer subsidy, you can purchase your policy through one of the two major agents.  In addition to selling the policy, they have staff that will deal with issues with the insurance company and Medicare on your behalf.  Many people find that useful.

BTDretire

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Re: 64 and 7 months-- Medicare time
« Reply #10 on: October 03, 2019, 09:18:18 AM »
This is a second response, I have no clue why my first didn't show up.
 Anyway I said thanks to all who have given input and I'm taking it all in.

 I see some have said it is hard to change plans, I assumed every year
at your enrollment time you could pick a new plan,
is that incorrect?

Maybe some medical history is in order. I'm on two meds, blood pressure and cholesterol.
Neither are out of control, in fact I only take half my BP pill otherwise it goes to low. The cost is $14 mo, although one is now free, so $10. I see the doc once a year for a hardly visible physical, mostly just the usual blood tests. Ten years ago I herniated two disks in my lower back and early this year decided to see about getting surgery, I was sure I would, but the surgeon said, without actual nerve involvement, we don't know where to operate. I had nerve involvement, but that pretty much went away and I'm just left with low back pain, that he said he can't fix. So I doubt I will have anymore back related expenses unless something changes,
and over ten years it has got better not worse. Dad had heart problems, that I blame on a hard work life in some physically dirty industries. I'm 22 years beyond dad's first problems and show no signs of any heart problems.
 My expenses are fairly low, my family of four never hits my $10,000 deductible, if it even hits $2,000, and that the family, not just me.
 But, I'm only getting older, so who knows.

InSearchOfFire

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Re: 64 and 7 months-- Medicare time
« Reply #11 on: October 03, 2019, 12:02:33 PM »
Hi, BTD,

Every Fall, at Open Enrollment time, you can change your Rx Drug Plan, and I believe that you can switch from a MedicareAdvantage plan to a different MedicareAdvantage plan, and you can change to a MedicareAdvantage plan from a Medigap plan.

But if you have originally chosen a MedicarAdvanatage plan, it is not so easy to change *from* a MedicareAdvantage plan *to* a Medigap plan.  At that point, the insurance company will ask you a bunch of health questions, and they can reject you, or quote you a high premium if they do accept you. 

So you need to carefully consider your future possible needs as well as your current needs, when choosing your plan.

As for your medical history - You should ask your doctor any questions about future possible medical issues.  Nobody here can answer that for you.


BTW - You do understand that your Medicare and Medigap/MedicareAdvantage plans cover only *you*, right?  They do not and cannot cover your family.


One other thing (so many one other things with Medicare) - You can sign yourself up directly with whatever insurance company you choose.  You do not have to sign up for any plan through a company like Via Benefits or any other such company.  Via Benefits, and other such companies, is/are marketplaces; they will only advise you about the companies they have in their marketplace - and there are lots of reasons why an insurance company might choose not to join some other company's marketplace.

HTH!


BTDretire

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Re: 64 and 7 months-- Medicare time
« Reply #12 on: October 03, 2019, 12:49:20 PM »
Yes, I understand, I'm the only one going on Medicare at 65. :-)
I was just relating how low our expenses have been.
 I did a google search of VIA just to get an idea what it is about.
And then for comic relief or you never know what you will find,
in the VIA search I hit this, https://www.youtube.com/watch?v=oPw2E0nQFcc
While I appreciate her sexuality I'm not so keen on the way she gets there.
Don't watch if you are easily a offended, although you shouldn't be offended.
I didn't watch it all so I don't know how it ends :-)

Another Reader

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Re: 64 and 7 months-- Medicare time
« Reply #13 on: October 03, 2019, 01:37:21 PM »
I'm going to disagree here.  First, if your employer is giving you a health insurance subsidy as part of your retirement, you must use their broker to receive the subsidy.  Yes, that sucks, but there could be a substantial amount of money involved

Second, you can spend a lot of time on this and still not have enough information to make the best choice.  Going through a highly rated, unbiased broker such as Boomer Benefits will save you a lot of time and they can help you narrow down your choices to what best fits your circumstances.  There are a lot of nuances to Medicare.  For example, it's open enrollment season starting on October 15.  Humana is playing games with their customers by automatically enrolling them in a more expensive Part D drug plan unless they opt out.  A Medigap provider is raising rates by closing one company and pool of insured and opening another, driving up rates for the closed pool.  A broker that is on the ball will be aware of this and alert you to the issue, because you are an ongoing customer.

I think you would be well served by looking at some of the Medicare threads over at early-retirement.org.  There are two current threads on Part D renewals and a well written thread on researching Medigap plans from last year.  Lots of people over there are facing the same issues you are.

BTDretire

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Re: 64 and 7 months-- Medicare time
« Reply #14 on: October 03, 2019, 03:04:16 PM »
I was self employed I have no on going health insurance plan, just our BCBS coverage.
 I'll look over at early-retirement.org.