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Hubby and I have been on Medicare for a few years now. We both opted for an Advantage Plan which includes drugs and medical, at zero $$. But next year, we are switching to a Supplimental Plan F and D through UHC/AARP for a monthly fee.
We both happen to be getting the same plan, but each individual should assess a plan according to their particular needs. We will be paying about $150.@ for the two plans but will no longer pay copays and deductibles. We will just about break even on expenses, based on an average of the past few years, but if one of us has a serious illness or accident it will save serious money. Peace of mind is worth it.
One thing we found out is that, someone with a chronic medical condition has only a 6 month window, once you apply for Medicare, in which the supplemental plans have to accept you. They, unlike the Advantage plans, can turn you down after that. For example, my neighbor has a chronic mental illness which requires her to take very expensive drugs, and have lots of lab work and visits to a specialist. She and her husband, who is a physical wreck, signed up for the supplementals immediately, or they would have been turned down, for sure.
There is no need to go to any office and wait in any lines to sign up for Medicare. Info is readily available online, and all the insurance companies have hotlines to answer any questions. Sign up for Medicare 3 months before your 65th birthday, and the coverage starts on the first of the month your birthday falls on.
Another point I will mention, is that I found the Advantage Plan to be very controlling. It was a PPO, but still, on several occasions the company made me jump through hoops before agreeing to a procedure my doctor ordered. I believe (we'll see) that the new plan won't be this way.
UHC? I'd avoid that outfit. They deny, deny, deny...and even worse, are almost impossible to contact, either by you or your healthcare providers. And this was on an expensive platinum private plan. UHC? Never again. Not me.
I don't have experience w/them but I haven't heard good things about UHC either...
I dropped UHC after they cut 11,000 neurologists from their plan way back in 2011. I had to decide whether to fire them or my fantastic neurologist. The choice was a no-brainer. They've been trying unsuccessfully to win me back ever since.
UHC? I'd avoid that outfit. They deny, deny, deny...and even worse, are almost impossible to contact, either by you or your healthcare providers. And this was on an expensive platinum private plan. UHC? Never again. Not me.
UHC does not operate this way with its Medigaps. Many, many CD people have Medigaps w/UHC - some very big users of Medical care - never a problem.
UHC on a private pre-Medicare age plan or Medicare Advantage can be problematic - the issues are PROFIT and (lack of) government regulation.
Medigaps are an entirely different animal than Advantage plans- and UHC behaves very differently when processing Medigap claims.
I would never enroll in a UHC Advantage plan. On the other hand, I would not hesitate to buy a UHC Medigap. Further, in most states UHC Medigap is community rated which means a cap on outrageous premiums as you age. Big in difference in WI once one reaches age 75 and escalating thereafter.
I don't have a Medigap now but, if my health holds up, by the time I may want to buy one I'll be 80 y/o - and UHC, because of its community rating, will be much less expensive than other plans in my state. I've posted elsewhere the premium gap by age in my state. Don't let the name UHC turn you off when considering a Medigap.
Quote:
Originally Posted by Scooby Snacks
I dropped UHC after they cut 11,000 neurologists from their plan way back in 2011. I had to decide whether to fire them or my fantastic neurologist. The choice was a no-brainer. They've been trying unsuccessfully to win me back ever since.
Advantage plans are NOT Medigaps.
Quote:
Originally Posted by Flamingo13
The LARGE hospital system in my area doesn't participate with them - it was a no-brainer for me when I chose an Advantage plan.
Private plans and Advantage plans are NOT Medigaps. Night and day difference in UHC's behavior depending on which plan you have.
Last edited by Ariadne22; 12-11-2016 at 05:48 PM..
They did that because someone misunderstood you. Did you specifically state you didn't want Medicare Parts A&B until January b/c of the ACA subsidies?
Or, someone wasn't thinking and automatically made Part A enrollment retroactive to his birth month.
You can disenroll. Call SS or go to an office and have this changed. This happened to me at age 65, automatically put on Part A, went to an office, and they took me off.
Per Medicare - he can CHOOSE his enrollment date for Part A:If you can't get this handled over the phone, I would make an immediate visit w/no appointment to a Social Security office. Tell them b/c of ACA insurance hubby CANNOT be enrolled in Part A until Jan. 2017. Fwiw, I've never done anything w/SS over the phone - always went to a office - there are three w/in five miles of my house, including a big one downtown.
I called the SS office today and was told that his Part A enrollment date CANNOT be changed. Said that no matter when he signs up during the initial enrollment period his Part A start date will be the first day of his birth month, even if it has to be retroactive. Unfortunately hubby is out of town this week and can't go to the office until next week. I was hoping to get this fixed quietly. If we lose 3 months of his subsidies, probably about $2000, he is going to have a cow and I will never, ever hear the end of it. They push, push, push you to do stuff online but when you do you find out things that aren't explained properly on their website. We were told specifically by the woman at the DE insurance commission that this would work if we waited to sign up until after November 1st. And we actually went to see her! I checked on Medicare.gov and there is a "box" there that says if you get the free Part A it will start the first day of your birth month. But the chart below it seems to imply differently. I could swear that "box" wasn't there before, but it seems to also disagree with the chart.
I am so stressed out about this that I think I'm making myself sick. I have a massage scheduled in about 50 minutes but not sure that is going to help.
I called the SS office today and was told that his Part A enrollment date CANNOT be changed. Said that no matter when he signs up during the initial enrollment period his Part A start date will be the first day of his birth month, even if it has to be retroactive. Unfortunately hubby is out of town this week and can't go to the office until next week. I was hoping to get this fixed quietly. If we lose 3 months of his subsidies, probably about $2000, he is going to have a cow and I will never, ever hear the end of it. They push, push, push you to do stuff online but when you do you find out things that aren't explained properly on their website. We were told specifically by the woman at the DE insurance commission that this would work if we waited to sign up until after November 1st. And we actually went to see her!
I checked on Medicare.gov and there is a "box" there that says if you get the free Part A it will start the first day of your birth month. But the chart below it seems to imply differently. I could swear that "box" wasn't there before, but it seems to also disagree with the chart.
I am so stressed out about this that I think I'm making myself sick. I have a massage scheduled in about 50 minutes but not sure that is going to help.
Look, you did the best you could. You actually met with someone at the DE insurance commission. Had you verified what you were told with SS, you might have got a different answer - or maybe not. Call the govt and you can very easily get three different answers to the same question. Further, there was nothing on the Medicare or Healthcare.gov websites to indicate she had incomplete information.
Sorry to say the devil is in the details and unless one can dig up the actual regs, it is easy to come to an incorrect conclusion based on the information available at Medicare.gov and Healthcare.gov. As stated upthread, the actual CMS and IRS regs state:
Quote:
Originally Posted by SCGamecock
You can sign up for Part A anytime but the coverage effective date is restricted. "Your coverage start date will depend on when you sign up."
Quote:
Part A coverage begins the month the individual turns age 65, provided he or she files an application for Part A within 6 months of the month in which he or she becomes age 65. If the application is filed more than 6 months after turning age 65, Part A coverage will be retroactive for 6 months.
A person is no longer eligible for ACA exchange Premium Tax Credits (PTC) when they become eligible for Medicare Part A. It is based on eligibility for Part A, not when you want Part A to become effective.
Quote:
Instructions for IRS Form 8962:
Minimum essential coverage. Under the health care law, certain health coverage is called minimum essential coverage. Even if you have coverage purchased through a Marketplace, you cannot take the PTC for any individual in your tax family for any month when that individual is eligible for minimum essential coverage, other than coverage in the individual market. Types of minimum essential coverage include: Government-sponsored programs (including most Medicaid coverage, Medicare parts A or C, the Children’s Health Insurance Program (CHIP), and Tricare).
Form 8962, Line 10:
Example 2. Starting on August 1, Mike is eligible for Medicare and does not notify the Marketplace. Because Mike is eligible for other minimum essential coverage, their coverage family changed starting in August. As a result, Mike and Susan must update the premium for the applicable SLCSP (which changes PTC) reported in column B for the months of August through December (Form 1095-A, lines 28 through 32, column B). Since there will be a change for some months in column B, Mike and Susan must complete lines 12 through 23.
It won't do any good. The actual CMS regs state Part A is retro to birth month if he signs up within six months of turning age 65. IRS regs say eligibility for subsidies ends at that time. See above from CMS and IRS.
Now, Rothbear, if I were you I would go on with my life and wait for healthcare.gov to come after you for the subsidy. This is not an issue on which you need to be proactive. Just wait.
Last edited by Ariadne22; 12-12-2016 at 11:55 AM..
If you are collecting SS benefits, you are automatically enrolled in Part A at age 65. You will not be automatically enrolled in Part B.
That changed a couple of years ago. If you are already collecting Social Security, you are automatically enrolled in both parts A & B and will receive a red, white and blue card 3 months before turning 65. I never signed up for Part B. The Part B premium was deducted automatically from my Soc Sec check when I turned 65 last year.
Regarding Medicare Advantage, although I am not recommending it, I know plenty of snowbirds who live in both FL and NC who have plans like Humana Gold Choice and see doctors in both states who accept Humana MA plans. Of course if someone makes a permanent move, it's a good idea to look for plans in the new location.
I realize people here are trying to be helpful, and we all want to share, but each state and county is a little different. I hope I don't sound critical or argumentative, but someone contacted me regarding Medicare which prompted me to check out some threads.
The reason I think it's a good idea for people to use the Medicare website and contact a local SHINE or SHIP office is because thing change from one year to the next.
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