Wait or Go Ahead (plan, hospital, doctor, patient)

[BradleyB&D]

I'm 66 years old and still working. I have health insurance through my employer and Medicare Part A. I plan on retiring in August of this year so I've already applied for my Social Security and Medicare Part B to start August 1. I've already talked to a Medicare Specialist at Fidelity who has recommended some Medigap plans which I plan starting in August also.

This week I had an appointment with my neurologist who wants me to get an appointment with an ENT and wants me to have some swallowing tests done. There's no real rush to get these done so I'm wondering if I should wait until Medicare and the Medigap plans kick in to have these tests done. My current health plan has a $1200 deductible and then pays 75% plus a $60 copay for a specialist.

Thanks In Advance!

[Lillie767]

Have you already fulfilled your deductible?

[BradleyB&D]

No, I haven't fulfilled any of my deductible for the year so it's still $1200.

[Hemlock140]

You should look at what your medigap deductibles/copays are. Your annual of $1,200 seems like a great deal, mine is $2,000, and during the last two years with many hospitalizations Medicare Part A paid only $36 once, the rest was covered by my employer plan and me. For Medigap plans F & G the deductible is $2,370 for 2021.

[BradleyB&D]

Originally Posted by Hemlock140

You should look at what your medigap deductibles/copays are. Your annual of $1,200 seems like a great deal, mine is $2,000, and during the last two years with many hospitalizations Medicare Part A paid only $36 once, the rest was covered by my employer plan and me. For Medigap plans F & G the deductible is $2,370 for 2021.

I'm confused. I thought the deductible for Plan G was $203.

[teeej]

Originally Posted by Hemlock140

You should look at what your medigap deductibles/copays are. Your annual of $1,200 seems like a great deal, mine is $2,000, and during the last two years with many hospitalizations Medicare Part A paid only $36 once, the rest was covered by my employer plan and me. For Medigap plans F & G the deductible is $2,370 for 2021.

That's only if you get the High Deductible plans.

[CharlieAllnut]

Originally Posted by BradleyB&D

I'm confused. I thought the deductible for Plan G was $203.

You are correct, the annual deductible for Plan G is $203.

The annual deductible for a high-deductible Plan G is $2,370, except the term “high-deductible” is a misnomer, as Medicare Part B still pays its 80% first.

For example, if you were billed by doctors and for outpatient services $5,000 and the Medicare approved rate was $2,000, all you would owe with a Plan G is the Part B annual deductible of $203. With a high-deductible Plan G, you would owe the Part B $203 deductible, then Part B would pay 80% of the remaining $1,797 and you would pay 20%, or about $360.

[wildflowers27]

OP, if your neurologist wants these tests to rule out a serious condition then I would do them sooner rather than later. You said there is no real rush to do them -- if it is not serious then you could wait until August. If you choose a Medigap Plan G, you'll pay the $203 Part B deductible and from then on everything is covered for the year.

I would ask the neurologist if it can wait three months, or should you do it sooner. You can call and ask to speak to his nurse who will get the message to him (maybe they have MyChart is which case you can message the neurologist directly). If you are having symptoms of something that could be serious, I would do the tests now. Health comes first. Of course, the ENT might be booking out three months ahead, you don't know until you call.

Everything insurance related will be easier after August 1st as long as you choose a good Medigap plan. Good luck and congrats on your retirement!