Medigap Plans (benefits, Arizona, monthly, Walmart)

[BestintheWest]

Originally Posted by loveautumn

Now you're scaring me! I hope you realize this could change in a minute....

I guess you realize if things change, you can change coverage during enrollment periods

[Ariadne22]

The only issue w/not enrolling in a Part D plan now during the Medicare Initial Enrollment Period is a late-enrollment penalty is applied to the Part D premium when you finally do need to enroll - similar to late enrollment in Part B.

I get around that in WI by paying $30/yr fee to WI Seniorcare - which is considered creditable drug coverage so that if the day comes I need medication, I can enroll in a Part D plan without a late-enrollment penalty.

WI Seniorcare is a drug program for low-income people. If one's income exceeds the parameters, then there is a spenddown before Seniorcare can be used. My deductible/spenddown is a ridiculous figure - like $17,000???

For my purposes, Seniorcare works fine. Agent who enrolled me in my hd-F recommended Seniorcare as a workaround to the continuous creditable coverage requirement by Medicare.

That said, if I didn't have Seniorcare - I'd just deal with the Part D penalty when and if I ever needed to.

[BestintheWest]

any idea what the penalty might cost?

[Ariadne22]

Originally Posted by BestintheWest

any idea what the penalty might cost?

https://www.medicare.gov/part-d/cost...t-penalty.html

Of course, years of nonenrollment might increase that penalty substantially.

Alternative is buy the cheapest Part D plan around without regard to formulary - I think there are some for about $12-$15/mo. and switch to an appropriate plan when and if time comes.

You can search for Part D plans on medicare.gov.

[BestintheWest]

Originally Posted by Ariadne22

https://www.medicare.gov/part-d/cost...t-penalty.html

Of course, years of nonenrollment might increase that penalty substantially.

Alternative is buy the cheapest Part D plan around without regard to formulary - I think there are some for about $12-$15/mo. and switch to an appropriate plan when and if time comes.

You can search for Part D plans on medicare.gov.

so if I have had A&B and have had them for two years, there will be a small penalty if I sign up for drug coverage now?

Also does HD Plan F include or do I have to get drug coverage separate for the Plan F?

Sorry for all the questions, but the whole thing seems very intricate and a little confusing.

[Ariadne22]

Originally Posted by BestintheWest

so if I have had A&B and have had them for two years, there will be a small penalty if I sign up for drug coverage now?

Yes - if you are outside the Initial Medicare Enrollment period, defined here:

https://www.medicare.gov/sign-up-cha...s-a-and-b.html

Are you saying you've had Part A&B for a while and just now are considering a Medigap - or is the question purely rhetorical???

Know that if you delay enrolling in a Medigap beyond the Initial Enrollment Period, the Medigaps will have you complete a health questionnaire - and can deny coverage or impose waiting periods for preexisting conditions - unless you are in a Guaranteed Issue state. AZ is not a GI state (six East Coast states are), so if you delay choosing a Medigap and your health changes, you may experience some issues with getting Medigap coverage. Same is true if at a later time you want to switch Medigap carriers (unless you move - which in most states will allow you another GI period).

Medicare discusses this, here:

https://www.medicare.gov/supplement-...#collapse-2263

Advantage plans, on the other hand, don't require health questionnaires - so if you are denied Medigap coverage, Advantage is your other option - unless you have end-stage renal disease.

Most cost-effective way to get Medigap coverage now - assuming you are healthy - is the hd-F, plus cheapest Part D you can find (if you want to avoid penalty).

Originally Posted by BestintheWest

Also does HD Plan F include or do I have to get drug coverage separate for the Plan F?

Hd-F is a Medigap. Medigaps do not include drugs, as I mentioned here:

Originally Posted by Ariadne22

We've had many discussions on this forum on the pros and cons of either a Medigap + Part D, or an Advantage plan which includes drugs. A quick search should turn up many threads.

Generally, wigh a Medigap F/G, your Medicare-approved expenses will be paid 100%. For the most part, medical expenses are pretty much limited to Medigap premium (and Part D premium and copays if you take medication).

and here:

Originally Posted by Ariadne22

Medigaps and Advantage plans cap your out of pocket exposure should serious illness strike. Otherwise, hospital deductibles ($1,260 per admission) and Part B costs could run easily tens of thousands of dollars.

Advantage plans are cheaper - at first - because:

1. zero premium
2. include drugs w/copays (no need to purchase Part D)

In short, your choices are, either:

1. Medigap + Part D
2. Advantage plan which includes drugs (no need for Part D)

You may want to reread this, again:

//www.city-data.com/forum/41139758-post2.html

[BestintheWest]

[quote=Ariadne22;41463192]

Are you saying you've had Part A&B for a while and just now are considering a Medigap - or is the question purely rhetorical???

***not rhetorical, I have had A&B and got both 2 years ago at 65 years old, but chose not to get D for drugs as I take none and am in excellent health. Guess I was asleep at the switch, never knew about or considered any additional coverage,didn't even know they existed

Know that if you delay enrolling in a Medigap beyond the Initial Enrollment Period, the Medigaps will have you complete a health questionnaire - and can deny coverage or impose waiting periods for preexisting conditions -
***I have no preexisting conditions


Most cost-effective way to get Medigap coverage now - assuming you are healthy - is the hd-F, plus cheapest Part D you can find (if you want to avoid penalty).

***This is a quote based on your suggestions, seems to be very good pricing, do you agree?


Standard Life
67 Male NTU in the 851 zip code:
$ 32.66 Monthly Bank draft
$100.79 Quarterly
$194.11 Semi-Annual
$373.28 Annual


Hd-F is a Medigap. Medigaps do not include drugs, as I mentioned here:
and here:

In short, your choices are, either:

1. Medigap + Part D

***I think this is the best option for me and to get part D on the medicare.gov website, then I think this will cover all options





Almost done:


***Four follow up questions
My current Medicare card shows A&B, what do I get that shows the Plan F H/D??
Does my Medicare card change or do I get something else from the private insurer??

***I guess the enrollment date starts October 15 for both D and the H/D Plan F??
Do rates increase annually or increase on each birthday for both D and F??

[BestintheWest]

would this be an accurate amount for Part D with penalty?

On medicare.gov Humana has a drug plan for $18.40 a month. I did not sign up at 65 years old, this October will be an additional 31 months since I got part A&B. which would be a 31% penalty at 1% per month penalty.
$18.40 x 31%=$5.70

so total monthly premium for Part D would be $18.40 + $5.70 or $24.10 a month, more or less????

Wow I hope I am almost done and can make all the decisions, sign up and move on.

[Ariadne22]

Originally Posted by BestintheWest

***This is a quote based on your suggestions, seems to be very good pricing, do you agree?

Standard Life
67 Male NTU in the 851 zip code:
$ 32.66 Monthly Bank draft
$100.79 Quarterly
$194.11 Semi-Annual
$373.28 Annual

That's a great rate. My Standard Life quote, for a female, age 73, in WI - $63/mo. I would [almost] kill for $31/mo. I'd be paying this premium annually to get the discount and forget about ACH bank drafts.

Fwiw, I don't let anyone do auto charges against my account except my mortgage and credit card autopays. Put everything on a cashback credit card, instead, including my hd-F. Many of these insurers won't take credit cards, though. If had an opportunity to get an hd-F for $373.28/yr., I'd just write a check and be done with it. I pay all my insurance at the first of the year, anyway.

Originally Posted by BestintheWest

My current Medicare card shows A&B, what do I get that shows the Plan F H/D??

Standard Life will send you a separate insurance card.

Originally Posted by BestintheWest

Does my Medicare card change or do I get something else from the private insurer??

Original Medicare card remains unchanged. Standard Life will send you a separate insurance card.

Originally Posted by BestintheWest

***I guess the enrollment date starts October 15 for both D and the H/D Plan F??

No, it does not - not for either plan.

Your Medigap coverage can begin as early as November 1, if Standard Life can process your app that quickly. There is no specific period (Open Enrollment) which applies to Medigaps.

Open Enrollment for Part D begins 10/15. Actual coverage for Part D begins January 1, 2016.

Originally Posted by BestintheWest

Do rates increase annually or increase on each birthday for both D and F??

As I recall, Standard Life told me rates were subject to change once a year - anniversary date of policy. Verify that with them.

Part D coverage - rates change Jan 1. You will need to reshop for Part D each Oct. 15 enrollment period for the following year.

Originally Posted by BestintheWest

would this be an accurate amount for Part D with penalty?

On medicare.gov Humana has a drug plan for $18.40 a month. I did not sign up at 65 years old, this October will be an additional 31 months since I got part A&B. which would be a 31% penalty at 1% per month penalty.

$18.40 x 31%=$5.70

so total monthly premium for Part D would be $18.40 + $5.70 or $24.10 a month, more or less????

No. Penalty will be closer to $11.59 (34 months to 1/1/2016). Medicare stated it calculated the penalty on the basis of the average Part D plan cost - so the cost of YOUR plan would be irrelevant. Your Part D would be $18.40+11.59=$29.99 - as follows:

Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($33.13 in 2015, $34.10 in 2016) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.

https://www.medicare.gov/part-d/cost...t-penalty.html

Before you spring for almost $30/mo. for Part D coverage you don't need, why don't you see if there is some form of creditable Part D coverage - similar to my WI SeniorCare for $30/yr - you could buy through the State of Arizona or in your city and/or county that wouldn't cost $360/year. Talk to insurance people specializing in Medicare coverage in your area. It's silly to spend $360/yr. for nothing.

[BestintheWest]

Thank you for all your help. I can't tell you how much you have helped me and probably many others reading your posts.

Thanks to you, your information, links, and knowledge, and pointing me in the right direction, I now understand much more and am going to move forward with everything.