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I am unemployed in California and I become 65 in September so my Medicare ("Original Medicare") becomes active then. I already have my Medicare card. I think I know what clinic to choose but I do not know what to do next. Do I select the clinic or must I choose a plan first? Everything I find when I search are too general for me. I am not sure what applies to me.
I have a MyMedicare.gov account.
I assume that others have asked this question before but the search facility here seems to be too general.
Medicare has changed its site options, not for the better, making it too hard to locate what you need at first glance, imo.
Medicare pays 80% of your medical costs. You can insure the remaining 20% either via Advantage plan - which has designated providers - or choose a Medigap Supplement which allows you to choose any provider who accepts Medicare patients anywhere in the country.
Differences between Advantage and Medigap supplements, explained here:
Strongly suggest you contact your state SHIP people for guidance:
Quote:
California SHIP Website: www.aging.ca.gov/hicap/default.aspx
Phone: 800-434-0222
Program Name: California Department of Aging's Health Insurance Counseling and Advocacy Program (HICAP)
About: The California Department of Aging's Health Insurance Counseling and Advocacy Program (HICAP) provides personalized counseling, community education and outreach events for Medicare beneficiaries. HICAP is the primary local source for accurate and objective information and assistance with Medicare benefits, prescription drug plans and health plans. California HICAP is part of a national network of State Health Insurance and Assistance Programs (SHIP). SHIP is a Federal grant program that helps States enhance and support a network of local programs, staff, and volunteers. Local programs are charged with directly helping beneficiaries to understand how to use their Medicare benefits including Prescription Drug Plan coverage, Medicare Advantage plans, Medicare supplemental policies, Medicare Savings Programs, and long term care insurance. The Centers for Medicare and Medicaid (CMS) administers the SHIP grant programs nationally.
Medicare has changed its site options, not for the better, making it too hard to locate what you need at first glance, imo.
Medicare pays 80% of your medical costs. You can insure the remaining 20% either via Advantage plan - which has designated providers - or choose a Medigap Supplement which allows you to choose any provider who accepts Medicare patients anywhere in the country.
Differences between Advantage and Medigap supplements, explained here:
I have Original Medicare Parts A, B and D. Assume I cannot change that.
Both Parts A and B are required for enrollment in an Advantage plan or purchase of a Medigap supplemental plan. Medigap supplement plans and Advantage plans partially or fully offset the 20% exposure under Medicare Parts A and B.
Advantage plans which are offered and administered by private insurers (not Medicare) combine Parts A, B and D. Again read this link on the differences between the two plans.
It matters. Most people who can afford it choose a Medigap supplemental because of provider flexibility, no private-insurer oversight, and minimal to no copays. If you have ailments, Advantage can be very costly with copays and its very high max out-of-pocket limit, not to mention the oversight hassles.
Most Advantage plans have a drug benefit, therefore Part D is not necessary. If you ultimately choose Advantage with a drug benefit, you should cancel the stand-alone Part D.
Indeed, call your SHIP people asap - or find a good Medicare insurance broker.
If you have enrolled or will be enrolled in Medicare effective September 2019, yes, you already have both Parts A and B. Both Parts A and B are required for enrollment in an Advantage plan or purchase of a Medigap supplemental plan. Medigap supplement plans and Advantage plans partially or fully offset the 20% exposure under Medicare Parts A and B.
Advantage plans combine Parts A, B and D. Again read this link on the differences between the two plans.
It matters. Most people who can afford it choose a Medigap supplemental because of provider flexibility, no private-insurer oversight, and minimal to no copays. If you have ailments, Advantage can be very costly with copays and its very high max out-of-pocket limit, not to mention the oversight hassles.
Part D is drug coverage which many choose in addition to a Medigap based on their particular drug usage (not all formularies or pricing is to your benefit). What you want is a plan best for YOU based on your formulary.
Choosing Part D before selecting either Advantage or a Medigap is putting the cart before the horse, as most Advantage plans have a drug benefit, therefore Part D is not necessary. If you ultimately choose Advantage with a drug benefit, you should cancel the stand-alone Part D.
Indeed, call your SHIP people asap - or find a good Medicare insurance broker.
I did not say I assume. I said assume. I meant you should assume I will not change my parts A, B and D.
Nearly all the replies so far have not helped. I have already indicated what has helped. And if you say I was not clear, I am sorry. But in the thousands of programming discussions I have participated in, I know that it often helps for the person trying to help to first ask for clarification.
I will make this perfectly clear. I have parts A, B and D and that is not changing. Any suggestion about changing that is no help.
I did not say I assume. I said assume. I meant you should assume I will not change my parts A, B and D.
Nearly all the replies so far have not helped. I have already indicated what has helped. And if you say I was not clear, I am sorry. But in the thousands of programming discussions I have participated in, I know that it often helps for the person trying to help to first ask for clarification.
I will make this perfectly clear. I have parts A, B and D and that is not changing. Any suggestion about changing that is no help.
Wow, clearly we need to start over. So, let's go back to the original post:
Quote:
Originally Posted by Sam Hobbs
I am unemployed in California and I become 65 in September so my Medicare ("Original Medicare") becomes active then. I already have my Medicare card. I think I know what clinic to choose but I do not know what to do next. Do I select the clinic or must I choose a plan first? Everything I find when I search are too general for me. I am not sure what applies to me.
With Original Medicare Parts A and B, you don't need to choose a "plan" to see a Medicare provider. Your Original Medicare coverage is sufficient. You choose the Medicare provider you prefer.
I am unemployed in California and I become 65 in September so my Medicare ("Original Medicare") becomes active then. I already have my Medicare card. I think I know what clinic to choose but I do not know what to do next. Do I select the clinic or must I choose a plan first? Everything I find when I search are too general for me. I am not sure what applies to me.
What do you mean by "I don't know what to do next"?
Do you mean you want to see a doctor and you don't have one so you're thinking of going to a clinic? (You can certainly do that. Choose one and go.)
Do you want to know if the clinic accepts Medicare for payment? (Probably, but call and ask to make sure.)
Are you looking for a doctor? (There is a 'find a provider' search function on the Medicare.gov website.)
Are you looking to buy a supplement plan to cover the 20% co-pays required by Medicare? (You can find information on which ones are available in your area by looking on the Medicare website.)
Do you have some other question? What is it specifically?
Wow, clearly we need to start over. So, let's go back to the original post:
With Original Medicare Parts A and B, you don't need to choose a "plan" to see a Medicare provider. Your Original Medicare coverage is sufficient. You choose the Medicare provider you prefer.
Wow, you definitely are more forgiving than I am. If the OP had responded to me the way he responded to your attempt to assist him, I would have told him exactly and in no uncertain terms what he needed to do next, and then I would most likely have received a time out from TPTB.
Wow, you definitely are more forgiving than I am. If the OP had responded to me the way he responded to your attempt to assist him, I would have told him exactly and in no uncertain terms what he needed to do next, and then I would most likely have received a time out from TPTB.
I thought the same thing. Geesh. Ariadne is the best person on this forum on all things Medicare. What a completely unwarranted response from the OP.
Wow, you definitely are more forgiving than I am. If the OP had responded to me the way he responded to your attempt to assist him, I would have told him exactly and in no uncertain terms what he needed to do next, and then I would most likely have received a time out from TPTB.
I agree! He was over the top rude to her. And she went out of her way to help him. Unreal.
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