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Medicare.gov will show various plans offered per zip code; however, they don't show all plans. I contacted several independent insurance agents and worked with them to discover all options open to me.
The advantage plan I chose offers a zero monthly premium plan but I did not want HMO and went with a PPO plan that is $20/month, no annual deductible and an average of $20/per visit copay, and it has prescription coverage.
It is a lot of information to take in and the agents can help clear up a lot of confusion. There is no fee using the services of an agent, they get paid by the insurance carrier when they sign up someone.
Medicare requests a person sign up three months prior to their 65th birthday; and until a person is on social security, an invoice will be issued for three month's premium at a time.
When I signed up for Medicare A & B, I made an appointment at the local Social Security office and the representative was extremely helpful in explaining the program.
I am a retired English teacher--I know how to do research and have a fairly good grasp of how to read a web page--
I just thought the site was poorly done--
I did not expect you to "gift wrap" it for me although I do appreciate your comments and williningness to help...
I just know that there are thousands of people who might be trying to find information via the Internet who have MUCH less confidence in searching for information or deciphering what they see on the page...so that negative was about the WEB SITE--not you--
You did not create it
I very much recommend that your friend find an excellent insurance agent who represents a lot of companies to help her in terms of finding the best Medigap and Part D plans for her (you said she had ruled out Medicare Advantage). Shouldn't be too hard in Dallas (she can interview 2 or 3 - find one who sounds knowledgeable). You can read everything on line until you're blind - but still not know all the in's and out's that the good agents do. And a good one will cut through all the plan differences - keeping in mind your friend's medical problems - in no time. Lay them out on her dining room table (yes - the agents make "house calls").
For example - as a cancer patient - maybe she wants access to MD Anderson in Texas if required. An agent will know what plans are accepted and pay for what at MD Anderson.
As another example - we use Mayo JAX. Which takes Medicare patients - but does not "accept Medicare". So it can charge us an extra 15% on top of Medicare reimbursement. Our agent picked a plan for my husband that paid that extra 15%.
I am not only a lawyer - but I know about insurance - and our Medigap agent saved us hundreds of hours in terms of picking a good plan for my husband (and using an agent won't cost you 10 cents extra). Robyn
Did I read correctly when you said your friend ruled out a Medicare Advantage Plan because her friends told her it wasn't a good idea? If that is the case, please have her check into it with an expert from a Medicare advisory agency.
Friends can be well-meaning but they are not always correct in their advice. She could fined information about Medicare Advantage that would pertain to her situation. In the SHIP booklet for example that my state publishes with Medicare information, there are side-by-side comparisons that show the differences between the two.
I just believe that people should thoroughly investigate all possibilities when it comes to health care.
Medicare requests a person sign up three months prior to their 65th birthday;
I was still working at age 65. Medicare automatically enrolled me in Part A. At that time, I had health insurance through my employer which was primary. It was not necessary to enroll in Part B until I no longer had employer coverage. There was no financial penalty for delayed enrollment in Part B or D as long as I had coverage through my employer.
Quote:
Originally Posted by katie45
and until a person is on social security, an invoice will be issued for three month's premium at a time.
I was still working at age 65. Medicare automatically enrolled me in Part A. At that time, I had health insurance through my employer which was primary. It was not necessary to enroll in Part B until I no longer had employer coverage. There was no financial penalty for delayed enrollment in Part B or D as long as I had coverage through my employer.
What three-month premium?
When you sign up for Part B (for which there is a monthly premium), and you are not collecting social security, you will receive an invoice to pay for the premium three months at a time. If you are collecting social security, the monthly premium is deducted from your social security check automatically.
Yes, you are correct, if you are covered by health insurance through your employer, you can delay signing up for Part B.
What I discovered is that the Advantage plan I have was just about equal to the monthly premium at work....however, there is no deductible and just a low copay with the Advantage plan. The insurance through work had a $500/annual deductible and was a 80/20 plan. So in the long run, it was more cost effective for me to have the Advantage plan vs. insurance through my employer. As a rule, it was rare I ever met the deductible and was paying out of pocket for the majority of medical visits.
Last edited by katie45; 05-05-2011 at 06:02 AM..
Reason: typo
What I discovered is that the Advantage plan I have was just about equal to the monthly premium at work....however, there is no deductible and just a low copay with the Advantage plan. The insurance through work had a $500/annual deductible and was a 80/20 plan. So in the long run, it was more cost effective for me to have the Advantage plan vs. insurance through my employer. As a rule, it was rare I ever met the deductible and was paying out of pocket for the majority of medical visits.
Similar experience here.
When I worked, I had high deductible employer coverage mainly because I wanted to stash $3,700 tax free into an HSA. Premium for employer coverage was $40/month. Only doctoring I did was out of network chiro. Thus remaining on low deductible employer plan didn't make sense, plus my goal was to minimize taxes because I was collecting SS and working for a couple of years. Saved a lot of money those years.
Was on employer retiree health insurance after I retired (laid off, actually), but dropped that in favor of a zero premium Advantage. Retiree plan still had $500 or $1,000 deductible (I forget), plus co-pays, co-insurance, and the Medicare carveout. They were paying NOTHING and I was paying them $1,000/year, plus had to pay Medicare Part B deductible. So I replaced it with an zero-premium Advantage, no Part B deductible, no other deductibles. I, too, don't doctor much. Advantage was much more cost effective for me, as well.
Try all that junk when you get cancer and want to go to Mayo or MD Anderson or similar. The low cost spread works fine - as long as you don't get really sick. But most people do eventually get really sick (and die - fingers crossed sooner than later). This is an area where you get what you pay for. Robyn
Try all that junk when you get cancer and want to go to Mayo or MD Anderson or similar. The low cost spread works fine - as long as you don't get really sick. But most people do eventually get really sick (and die - fingers crossed sooner than later). This is an area where you get what you pay for. Robyn
Oh, I agree with you. My medical expenses when I worked were minimal. Insurance cost was very low. Immediately on retirement (forced), health insurance cost quadrupled and my income reduced 70%. Employer pension a joke. They had cut it years back in favor of a defined contribution plan which effectively reduced the benefit 50-70%. One of the reasons I had planned to work into my 70s. But they had always got rid of their retiree age employees over the years. I was no exception, although I thought I might be because I looked and acted 15 years younger than I am. However, the economy was their excuse to eliminate a lot of people, including me. They weren't having financial problems, just capitalized on the opportunity.
While total premiums of $2,200/year (including Medicare Part B) is not a lot of money as far as health insurance goes, I was furious about the entire situation and the double whammy to my income from both sides of the ledger. Tolerated it for a year and then decided to take the risk and drop the employer plan in favor of Advantage.
I haven't given up the idea of another Medigap plan, and do know if I delay signing up it will be more expensive and that I could be subject to a health questionnaire. On the gene pool side, none of my closest relatives died of cancer or had heart trouble. Most lived to be about 90/91. Father's brother on his feet to the very end with just a very short time in the hospital - a few days. No cancer - just old age system failure. Very little doctoring during his lifetime. Never hospitalized ever that I can remember.
I have never smoked, do not drink at all, have low blood pressure and normal weight, take no medication because I almost died years ago because of medication, eat organically, take many supplements, get a lot of sleep, and don't believe I'll get anything terrible. So, we will see.
Down the road, as I said, I may sign up for something else. Health issues are roll of the dice. The older one is the poorer the odds, of course. As I said, never having had serious medical issues up to this point other than one that was medically induced. For that reason alone, I pretty much stay away from doctors with a couple exceptions.
My goal, along with everyone else, is to stay healthy and on my feet. However, I am not at all interested in medical treatments that require travel and all its attendant hassles and long recuperation times. Went through a terrible year in my 30s recovering from that medically induced illness at a clinic in Florida using naturopathic methods because traditional medicine was useless and the cause of my problem. (long story) Therefore, I don't have the belief in traditional medicine, much less the emotional energy or will, to repeat any extended treatment/convalescence experience. If I go, I go. Fatalistic to fault, possibly. jm2c
Last edited by Ariadne22; 05-05-2011 at 11:03 PM..
I think what most people who posted on this topic forgot when comparing plans is that much depends on the STATE that you live in--some states subsidize Medicare and their residents pay less of their own money
TX does not subsidize Medicare any more than it legally has to and Medicare in TX is not a great plan
but I will ask my friend again to get some independent advice regarding Advantage plans--
her main concern is that she will have to give up her doctors that she has had for the past 20+ years and move into another system--
Even if she DID want a cheaper plan and would try to move to HMO or PPO--just because you are ON the plan does not mean that doctors are required to take you as patient--
I know someone who moved into this area after living in Victoria TX and being on Medicare there--
she could not find doctors here willing to accept a NEW Medicare patient--even though they were acceptable to her plan...
TX is not a Medicare friendly state...
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