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Her traditional health care plan is Kaiser HMO which from what we learned this morning will not be carried under the Extend contract. I have encouraged her to check with various brokers but she has never been outside the HMO system so she dosen't know where to turn. I gave her the name of my broker as an option, and encouraged her to start with a visit to HIPPA (the people who explain senior health care) to educate herself. As a single senior, her subsidy is very important to her but all things that count, can't be counted. I hope she continues to explor her options and makes a wise choice.
You are right, I don't like so many palms getting greased resulting in expensive care for seniors. There is a reason their stock priced doubled, they serve the stockholders, so I worry about what this new system provides. That can also be said for many insurance companies so it is important to keep your eyes wide open and think.
Is the general concensus here that you should stick with original Medicare and get an F supplement? That's what I have gleaned from this thread that most of you have the original Medicare.
DH is eligible and his eyes immediately glazed over just five pages into the pamphlet. So it's on me to figure out.
Another thing that makes me suspect an Advantage plan is not the way to go is that on all of the Medigap provider websites here in NY, you can't find them on their website, they immediately present you with Advantage plans.
Is the general concensus here that you should stick with original Medicare and get an F supplement? That's what I have gleaned from this thread that most of you have the original Medicare.
DH is eligible and his eyes immediately glazed over just five pages into the pamphlet. So it's on me to figure out.
Another thing that makes me suspect an Advantage plan is not the way to go is that on all of the Medigap provider websites here in NY, you can't find them on their website, they immediately present you with Advantage plans.
I think that's the general consensus assuming you can afford it. In terms of specific companies - you might ask around locally and/or chat with an agent about which companies are best. Most people here have been pretty happy with AARP UHC Medigap policies. But different plans have different administrators - depending on where you're located - so MMV with regard to the best company(ies) in a particular place.
Also get a Part D plan. The best for you will depend on what drugs you take or might likely need in the future. Also where you shop for drugs (e.g., we've found that some generics cost us less than we'd pay in co-pays at Target if we pay for them out of pocket at Costco and don't use the Part D coverage). Medicare.gov will give you a pretty good idea in terms of comparing plans. Although there may be pricing glitches when it comes to particular drugs (e.g., one drug that costs us $5 for 90 days "rang up" erroneously on medicare.gov as costing $115 for 90 days). This year - we found that the cheapest UHC plan will cost us less overall than the medium plan (although there's a deductible - the premiums are lower - and the co-pays for Tier 3/4 drugs are lower too). Also - make sure that all but super cheap drugs are included in a particular plan's formulary.
Right now we are looking at an F high deductible plan. There is one up here that is only 52 dollars a month.
We're not looking at a whole lot of drugs in the near term. Medicare will finally allow DH to see a specialist regarding his hip. Painkillers will probably be involved.
We would like to try stem cell injections rather than a hip replacement. I doubt Medicare covers that, it would make too much sense to cover something inexpensive and less invasive.
Right now we are looking at an F high deductible plan. There is one up here that is only 52 dollars a month.
We're not looking at a whole lot of drugs in the near term. Medicare will finally allow DH to see a specialist regarding his hip. Painkillers will probably be involved.
We would like to try stem cell injections rather than a hip replacement. I doubt Medicare covers that, it would make too much sense to cover something inexpensive and less invasive.
Like I've said elsewhere - I try to be practical. And us women are the ones most likely to be practical IMO . Because we're the ones who basically wind up buying "health insurance". I've found that men tend to be more ideological than women - and/or they just have their heads in the sand.
If you can get plan F for $52 - even high deductible plan F - from a reputable insurance company - my first inclination would be grab it and run with it (that's the lowest price I've ever heard of anywhere). OTOH - look at the deductible versus your annual anticipated out of pocket (just looking at last year's costs). And compare the regular plan F with the high deductible plan F premiums. With the high deductible - best I can figure out - even if you go over the deductible - you'll pretty much break even. And if you have a low cost year one year - you might come out a bit ahead. I would have gone with a high deductible plan F if UHC offered one in my zip code - but it doesn't.
Another thing to keep in mind is what Medicare allows (which counts toward the deductibles). I've observed that Medicare allowable is about 25-30% of the list prices we used to see pre-Medicare.
Hard to see how you can go wrong at that price. But what are the deductibles/co-pays? And what's the price of a regular plan F policy? Also - what kind of Medigap policy is this in terms of pricing? Can the company keep raising its prices as you get older?
The best painkillers are generic and cost peanuts. It's harder to get a doctor to prescribe them for you than to pay for them. They're "mother's little helpers" for me and my husband dealing with various kinds of age/disease related pain.
I don't know much about hip stuff or what insurance (including Medicare) covers in that area. All I know is my right hip is deteriorating and painful at times. Perhaps I won't live long enough to think about my options in that department - or perhaps I will. Time will tell. Good luck to you in evaluating your options there - and what Medicare does/doesn't cover . Robyn
The two F plans are United and Humana, Humana is 79 a month. Max out of pocket is 6700 dollars a year. I'm sure prices will get higher as time goes on. Only time will tell. I've found cheaper plans in FL but they were Medicare Advantage plans and after some initial research I'm pretty sure we want him on original Medicare.
I have no idea what our out of pocket is going to be because neither of us has had health insurance since 2003.
Didn't need a doctor until February 2011 when he was in incredible pain. Dragged him to the chiropractor. Found out the hip was toast. We see the chiropractor and dentist regularly. I know the chiropractor is helping his hip because when we skipped it for a month he was in agony and it took biweekly visits to get him back to 'normal'.
We do have a wellness discount membership with Aetna that saves us TONS. It's 25 percent off on dental, vision and chiropractic. It's 12.95 a month per family. If noone has heard of it I urge you to get it, provided that your doctors and dentists accept it. It's a discount program, not insurance, which I found out about in an AARP magazine article.
My dentist does, she actually recommended it. My chiropractor does but I had to tell him it's A.S.H. then he recognized who to bill. They actually have English first language on the other end of the phone if you need to call them. I've had it for over two years.
We see the Chiro once a week, both of us. Cash price is 35 per person per visit, with the Aetna it's 25. So my 12.95 per month saves me 80 dollars a month at the chiropracor. His 1100 dollar dentures cost us 700 dollars with it. Priceless.
So, in March we will venture into the wild west known as Medicare. We will go to an orthopedic who specializes in sports injuries. We have seen him before when DH tore his rotator. Yes, they will say hip replacement is the only solution. DH will refuse. Hopefully they will agree on pain meds. Maybe down the road he will have it done. Better doctors in Florida.
Robyn you should seriously look into the stem stell therapies for your hip. I believe it's five injections. There was a gal on these boards who had it done in Mexico. Five shots, 700 dollars. A month later she was out riding her bike.
At least consider a chiropractor.
DH hates doctors but will take any supplement he thinks will help. Our current cocktail, twice a day:
Shark cartilage
Glucosamine with chondroitin and MSM
Sam-e
Greek Island Labs Natural Joint (best price on the web is 36 dollars a box free shipping no tax, I have the site saved on my personal PC, if anyone needs it PM me after six evenings)
Biotin
L-lysine
We know they help because if he goes off of them he's in more pain.
OTOH old Ellie up the road a bit is in her late eighties and has had both hips replaced with titaniums. She raves about it. 'You wake up in recovery and there is no more pain.' Her DH, Ben, still drives and turns 94 this year.
Thanks you for the well wishes. I believe your DH has MS? Blessings, DH's sister died of a heart attack due to hers at age 41. LeChaim.
I haven't seen any plan that doesn't have an increase each year based on age or claims and once you reach a certain age it seems to be a wash.
Are you able to switch from a high deductible Plan F to a regular Plan F if you want to in the future? Make sure you factor in if your state allows excess charges when you are comparing plans. Don't know if that matters in the high deductible plan though.
I'm pretty sure you can change plans every time open enrollment season starts.
It's going to depend on how close we are in our Florida move as well. He's eligible as of March 2014. If we're loading a moving van we will have to shop it all over again.
The two F plans are United and Humana, Humana is 79 a month. Max out of pocket is 6700 dollars a year. I'm sure prices will get higher as time goes on. Only time will tell. I've found cheaper plans in FL but they were Medicare Advantage plans and after some initial research I'm pretty sure we want him on original Medicare.
That's an ASTOUNDING max out of pocket for an hd-F. Around here, the hd-F deductible quoted is $2,110. Period. Plan pays 100% after that, including excess charges.
I am 71, and this year have the option of:
American Republic for $71.60/mo, includes $500 preventive not covered by Medicare, not subject to deductible; and
Physicians Mutual for $76.40/mo, includes unlimited preventive not covered by Medicare, not subject to deductible.
Both attained-age rated. Last year, when BCBS was in the market, deductible was $2,110, my rate at age 70 was $55/mo. I didn't enroll then.
This year BCBS has left the hd-F market, grandfathering the old plans, but they may be back. They've done this before.
That $6,700 sounds like an Advantage out of pocket, not any hd-F I've ever investigated here. Max oop on my current Advantage for 2014 is $4,950/yr.
States must really vary in that hd-F deductible. I always believed the $2,110 was standard everywhere. Who knew??
Frankly, with that high a deductible, I think I'd just enroll in a straight Medigap F or G. I can handle a few thousand a year. When it gets on to a $7,000 exposure, I'm not a happy camper.
Last edited by Ariadne22; 11-14-2013 at 04:16 PM..
All Medigap plans have to have the same exact features. No Plan F would have a deductible any different from any other.
The only differences can be in the price.
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. Because we're the ones who basically wind up buying "health insurance". I've found that men tend to be more ideological than women - and/or they just have their heads in the sand.
