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Do I select the clinic or must I choose a plan first?
Hi Sam. With your Medicare card, in September, you can go to any doctor that accepts medicare. Medicare will pay 80% of the bill and you are responsible for the remaining 20%.
Ariadne has patiently tried to describe the two main ways to cover the 20% that Medicare doesn't pay:
1) With supplemental plans you can go to any doctor you want that accepts medicare. Supplemental plans in the greater LA area can be had for $60 to $250 per month. These plans don't cover prescription drugs so you'll need to keep your Part D plan.
2) Advantage Plans can found for zero monthly premium. These plans typically include prescription drug coverage, dental, and vision. You would not need your Part D drug plan. The disadvantage to these plans is that you must agree to use a network of doctors/hospitals provided by your plan.
The answer to your original question is - it depends. If you want to pay ZERO monthly premiums you must choose the plan first. Your Advantage plan will limit you to doctors in their network. If you want to choose your own clinic you will need a supplemental plan that will not be free.
The vast majority of people on this forum are eager to help. It takes a while to wrap your head around Medicare options. Ariadne22's post #2 has just about everything you need to start this process.
That costs extra, right? I said I am unemployed. I assumed it was understood that I cannot pay extra. Yes, I avoided emphasizing that I am unemployed. All this talk about so much that costs extra makes me feel ... well I won't get into that but I wish people understood what unemployed means.
I did not finish the previous post because I have been listening to coverage of the quake. This is the biggest seismic event for this area in nearly 20 years.
As for my health, I have been waiting 30 years or more for them to fix my sinuses. The ENT doctor says he can do the procedures in his office without anesthesia; Medi-cal won't pay for that and he says Medicare will pay for it, no problem. So since it is a matter of about three months I will wait for Medicare. But as it is, I assume that everything that costs extra is not possible.
But if we proceed from the fact that I am unemployed to the fact that I will be getting a small pension then perhaps I can pay a little extra. And my 4 years of military service might get me more than the small pension. But I wish people would have taken me literally when I said I am unemployed. I made that totally clear.
Check your local Medicaid income guidelines. You may or may not meet the threshold. That would fill in the gaps for you.
That costs extra, right? I said I am unemployed. I assumed it was understood that I cannot pay extra. Yes, I avoided emphasizing that I am unemployed. All this talk about so much that costs extra makes me feel ... well I won't get into that but I wish people understood what unemployed means.
I did not finish the previous post because I have been listening to coverage of the quake. This is the biggest seismic event for this area in nearly 20 years.
As for my health, I have been waiting 30 years or more for them to fix my sinuses. The ENT doctor says he can do the procedures in his office without anesthesia; Medi-cal won't pay for that and he says Medicare will pay for it, no problem. So since it is a matter of about three months I will wait for Medicare. But as it is, I assume that everything that costs extra is not possible.
But if we proceed from the fact that I am unemployed to the fact that I will be getting a small pension then perhaps I can pay a little extra. And my 4 years of military service might get me more than the small pension. But I wish people would have taken me literally when I said I am unemployed. I made that totally clear.
Sam. In your situation I would choose an Advantage Plan,,,,you still will be on A! B and D....but there is no..or less cost to you..
Medicare, which is not Advantage has a monthly premium...think the latest lowest cost per month is about 120 a month...even the cheapest supplement to cover the 20% might be out of your cash flow..
Yes there is Medicaid which you likely are eligible for....it sort of a pain to find a provider to except it..
You live in SFV..you may want to look into Kaiser....yes you have to use their facilities and providers, but they give excellent care..worked as an NP for them for 20 years..
Any other Advantage plans I cannot vouch for...
If you stay with the conventional Medicare..you will be billed for the monthly fee..or if on SS it will be deducted.
Yes you will have more choice...which to some like us is the key....nurses are like that!
But our premiums, supplemental and meds cost a good amount per year..
Medicaid would be your worst choice I think....a good Advantage plan sounds like your best financial answer..
Remember...you still get ABD. ..it is choice and cost that you need to consider
Good advice. We're I in Sam's situation I'd likely choose an Advantage plan especially in a large market with robust networks.
There might be a slight wrinkle in Sam's situation however. DW starts Medicare in the same month as Sam. We already knew which supplement plan and which part D we wanted. On June 3rd we applied for the Part D policy online. When we went to apply for the supplemental we found that we needed to go through a broker.
At the meeting the following week the broker signed us up for an F HD supplemental and then asked "what about Part D?" When we explained that we already applied for a plan online he said he couldn't change us to the plan he recommended until open enrollment in October to be effective January 1st.
If Sam already signed up for a Part D plan he may be stuck with the premiums until 1/1/2020. Still, a zero premium Advantage Plan + (hopefully small) Part D premium is probably more cost effective than a supplemental plan.
You live in SFV..you may want to look into Kaiser....yes you have to use their facilities and providers, but they give excellent care..worked as an NP for them for 20 years.
Please no Kaiser. No! I was employed at a major aircraft manufacturer in the 1980s and Kaiser refused to look at my sinuses. They only attempted to figure out why I had asthma and what my body was allergic too. When Kaiser finally looked at my sinuses my employer laid off thousands (literally thousands) of people and I lost medical coverage. Many years later the ENT doctors agree that my sinuses need to be fixed and the pulmonologist agrees that my asthma is caused by my sinuses. So now, about 30 years later, Medicare will pay for my sinuses to be fixed without anesthesia. I would have had a much better life if Kaiser were to have done what they should have done. Kaiser was lousy to me.
If Sam already signed up for a Part D plan he may be stuck with the premiums until 1/1/2020.
I did not sign up for a Part D; I was signed up automatically. I pay nothing for it and if you read my original post then you will know why. If my premiums stay the same until at least 1/1/2020 in spite of any increase in my income then that is fine by me.
I doubt that is true.
I doubt that too and I have explained why (but yes an additional explanation was after this).
Medicare pays 80%
End of story
Believe what you want
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