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This article has been updated to reflect 2018 premiums, etc. I found this to be very helpful for my wife and I. She was diagnosed with advanced cancer in 2014 and was considered disabled because of the type and severity. Anyway, she became eligible for Original Medicare in 2016.
We looked long and hard as to what type of coverage to choose. Such as Medicare Advantage, buying a supplement, etc. Our state does not require under 65 SSDI recipients to be able to access a supplement plan. But, there are two or three supplements available at much higher than normal premium prices. The supplement she would qualify for was a Plan A at over $300 a month premium.
After reading this article, we thought it was in our best interest to go with just original medicare and no supplement. It has been a very positive experience. We went from paying $600 a month for her individual insurance to $134 a month for original medicare and $21 a month for Part D prescription.
Despite MRI's every three months, many doctors visits, physical therapy, emergency room, blood draws etc. She rarely owes more than $150 in medical bills a month on top of the premium costs. A physician visit is usually $9, a specialist $13, MRI $75, etc. Blood draws are $0. Physical Therapy about $3-5 a visit. In fact, I think the most we have paid for medical bills in any one month has been $273. Still below what just the supplement would have cost and it still would have co-pays on top of the premium itself.
Of course, once she reaches 65 we will buy a supplement but we would also buy the least expensive supplement available. At this time, it is Plan F high deductible. By the time she is 65 it will probably be Plan G high deductible because Plan F is being phased out. The main reason we would buy that particular high deductible is for the foreign travel coverage in addition to the maximum out of pocket a plan allows.
If you are thinking about what to do, I would highly recommend reading this article linked above!
Thanks for posting the article. It makes sense to me. I'll be eligible for Medicare this coming January and I intend to enroll for Part A and B only. No supplemental, and probably no part D.
From you're experience and research, what do you think will happen to premiums when Plan F ends enrollment? I know a few people who have chosen Plan G because they fear premiums for Plan F will skyrocket as the current enrollees drop out or age into expensive medical care. With no new younger/healthier blood mixing into the pot, historically it does appear rates will have to rise to meet expenses.
F may not necessarily skyrocket, but will experience higher percentage increases, for sure. Many companies are allowing insureds to downgrade to a G without underwriting. As it is, too many companies are charging far more for an F than the $183 Part B deductible it pays. It's silly to pay $250 or $300 a year more for the privilege of not having to write a check for a $183 deductible.
Quote:
Originally Posted by Mike555
Thanks for posting the article. It makes sense to me. I'll be eligible for Medicare this coming January and I intend to enroll for Part A and B only. No supplemental, and probably no part D.
OP's situation is NOT yours. He is talking about under age 65 SSDI Advantage and/or Medigap both of which charge a premium, Advantage which is expensive in its copays, and in which situation Medigaps are unavailable and/or unaffordable.
You do not know what the future holds. You can chance not purchasing Part D but, at the very least, you should buy a high-deductible Medigap F - usually much less costly than a full Medigap when you're younger. That way your maximum exposure is no more than the deductible (currently $2,240).
I am reminded again about a story I heard of a 67 y/o with no Medigap who developed cancer. He went to Mayo Clinic - and incurred almost $100,000 in excess charges and Part B copays which presented quite a burden on his estate - all of which would have been paid by the Medigap F. If he'd at least had an hd-F, his exposure would have only been the very low deductible.
I'm a big believer in not being over-insured. At the same time, I don't believe in taking unnecessary risks when your age is against you. An hd-F is a good compromise. Low premium, no provider networks (see any Medicare doctor), coverage against calamity should the worst happen.
Should the worst happen, unless you are in a guaranteed issue state, because of health underwriting, your only option will be an Advantage plan with its copays and limited provider network - not to mention other hassles which have been discussed here before.
From you're experience and research, what do you think will happen to premiums when Plan F ends enrollment? I know a few people who have chosen Plan G because they fear premiums for Plan F will skyrocket as the current enrollees drop out or age into expensive medical care. With no new younger/healthier blood mixing into the pot, historically it does appear rates will have to rise to meet expenses.
F may not necessarily skyrocket, but will experience higher percentage increases, for sure. Many companies are allowing insureds to downgrade to a G without underwriting. As it is, too many companies are charging far more for an F than the $183 Part B deductible it pays. It's silly to pay $250 or $300 a year more for the privilege of not having to write a check for a $183 deductible.
In addition to the spread between premiums, Plan G historically has smaller rate increases even before the 2020 changes.
Ariad22ne I agree wholly. My point was mainly about my spouse's situation as under 65. I would agree that a high deductible Plan F or in the future Plan G is the way to go once you are 65 and have to make a decision about supplements... my opinion for what it is. I would rather pay later (deductible) than pay up front (additional premiums) for something I may or may not use.
Thanks for posting the article. It makes sense to me. I'll be eligible for Medicare this coming January and I intend to enroll for Part A and B only. No supplemental, and probably no part D.
I would get a part D if it were me. You can usually get a prescription plan for under $30 a month that is sufficient in most cases. It is hard to know what your prescriptions will cost because a new medical condition can arise and then you have new meds you have never been on.
From you're experience and research, what do you think will happen to premiums when Plan F ends enrollment? I know a few people who have chosen Plan G because they fear premiums for Plan F will skyrocket as the current enrollees drop out or age into expensive medical care. With no new younger/healthier blood mixing into the pot, historically it does appear rates will have to rise to meet expenses.
To me Plan G is better anyway. Only difference is you pay a $163.00 deductible per year. Your savings on premiums more then make up for it. Then you don't have to worry about Plan F going away..
This article has been updated to reflect 2018 premiums, etc. I found this to be very helpful for my wife and I. She was diagnosed with advanced cancer in 2014 and was considered disabled because of the type and severity. Anyway, she became eligible for Original Medicare in 2016.
We looked long and hard as to what type of coverage to choose. Such as Medicare Advantage, buying a supplement, etc. Our state does not require under 65 SSDI recipients to be able to access a supplement plan. But, there are two or three supplements available at much higher than normal premium prices. The supplement she would qualify for was a Plan A at over $300 a month premium.
After reading this article, we thought it was in our best interest to go with just original medicare and no supplement. It has been a very positive experience. We went from paying $600 a month for her individual insurance to $134 a month for original medicare and $21 a month for Part D prescription.
Despite MRI's every three months, many doctors visits, physical therapy, emergency room, blood draws etc. She rarely owes more than $150 in medical bills a month on top of the premium costs. A physician visit is usually $9, a specialist $13, MRI $75, etc. Blood draws are $0. Physical Therapy about $3-5 a visit. In fact, I think the most we have paid for medical bills in any one month has been $273. Still below what just the supplement would have cost and it still would have co-pays on top of the premium itself.
Of course, once she reaches 65 we will buy a supplement but we would also buy the least expensive supplement available. At this time, it is Plan F high deductible. By the time she is 65 it will probably be Plan G high deductible because Plan F is being phased out. The main reason we would buy that particular high deductible is for the foreign travel coverage in addition to the maximum out of pocket a plan allows.
If you are thinking about what to do, I would highly recommend reading this article linked above!
Realizing that this is an older post, I wanted to comment on the article.
"Should you expect to ever be hospitalized for more than 60 days? No!
The average hospital stay in the US is 5-6 days and that number has been going down each year for more than a decade. Even people who need major surgery like a liver transplant or open heart surgery are usually home in about 7 days. I can’t say that 60-day hospitalizations never occur in the US, but they’re about as rare as jackpot lottery winners."
My parents are elderly, and on a small fixed income. My mother had back surgery in August of 2015. A couple of days after surgery they discovered she had a dural tear, and had to have a second surgery, which changed the entire recovery process. Due to seemingly endless complications, she wound up spending 82 days in the hospital, and 100 days in a rehab facility. There were additional surgeries, infections, you name it, it happened. Thank GOD they had a supplemental policy. They ended up with a total bill of around $12K. If they had not had the supplemental, they would have been financially crushed.
I'm absolutely planning on having such a policy when I go on Medicare.
I have Medicare A&B. They deduct about $220 a month from my Social Security.
I also have AARP supplemental that costs another $200.
I have had over a million dollars worth of surgery, hospitalization, and nursing home rehab.
I have a general physician, a cardiologist, a urologist, an orthopedic surgeon, and a neurologist.
I have never had to pay any deductible or anything else.
I have no drug insurance. That would cost more than what my prescriptions cost.
I pay $10 for 90 days supply. I have four prescriptions.
Including temporary prescriptions like anti-biotics, I pay less the $200 a year.
So for about $5,000 a year I get full coverage.
I am happy with that.
I thought Medicare A&B were somewhere around 134.00? I know it increased but I doubt I read 220.00 monthly.
I thought Medicare A&B were somewhere around 134.00? I know it increased but I doubt I read 220.00 monthly.
Why are you paying so much for it?
Could be IRMAA (Income-Related Monthly Adjustment Amount). If your Adjusted Gross income is over a certain amount you pay higher premiums. I think I'm getting hit with that next year- punishment for working hard and saving all my life.
Poster lists $220 which doesn't comport with tables which show either $187.50 or $267.90, but SS COLA rules may have affected the amount he is required to pay now.
Although my sister, a retired nurse, has a retirement income of about $52K a year, she still manages to withdraw enough from her IRA to put her over the $85K threshold and is paying $187.50 for Part B. Drives me crazy Could be avoided with better planning, budgeting and spending - but people are who they are.
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