Turning 65- Medicare -shock and disappointment! (rating, doctor, Florida, million)
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The extra $30 is possible because we both have been collecting SS in addition to his employment wages. Since retirement our combined income will go way down ,but will his Medicare rate drop? I doubt that. However, mine is still the same $104 because it has been taken out of my Social Security for over a year before the Medicare rates were increased. Hold Harmless Clause of Social Security. I have heard others say on here that their Medicare Part B rates are $50/month, double mine. Older people perhaps, and again that Hold Harmless Clause. That is very, very NICE in comparison to private insurance including those Medicare Advantage Plans.
BTW, this year I got a notice from SS. While the COLA did not increase SS this year, I got a notice that they "miscalculated" and my monthly check would increase by $20. I got that same notice last year too. Huh? lol Not a lot of money, but what the hey, I will take "their" error for that any day.
If he is paying more because of your family income, and if he is now retired he can file this form to get it adjusted: https://www.ssa.gov/forms/ssa-44.pdf
I am a provider. There are two such plans in our area. How can they do that? They deny many medicines, studies, and procedures.
We have many patients with these plans who are denied many, many things. We spend tens of thousands of dollars in time, cancelled/wasted appointments, and paperwork going through appeals for them and explaining denials, which leads nowhere. They complain bitterly as a result. I used to feel sorry for them, then I found out they pay nothing for these plans that cost my practice a ton of money and they get for free. I am afraid I have no sympathy for them now, as they are asking me to incur marked additional costs and trouble for my staff because they are too cheap to buy a supplement.
We lose money on essentially every medicare patient we see in the first place. The "zero cost" supplements are just injury to insult.
What would you say to someone who can't afford to pay out for insurence, who should be able to get medicade if their state didn't have its head stuck in the 1800's? ONLY if every penny of the supplies I need was covered would I consider a copayment acceptable. I buy them myself on amazon and save quite a bit. And some of them I'm sure they wouldn't pay for at all, because I'm not supposed to 'need' them.
Thing is, you can't really tell what a person NEEDS if all you listen to are the manufactures of medical goods which the manufacturer makes TONS of of which take little material and are designed to be used for a few days and be tossed.
If I tell them I need double the supplies that are considered 'normal', and its because my medical condition is abnormal, and I need stuff like tape because there is tape on the stuff, but it doesn't stick, and they say no, shouldn't I be able to say then at least I can afford to buy it myself?
I just turned 64 and will have closely researched this before I have to listen to the claims I'm sure I'll hear. But I'd rather take a chance on the situation described in your post than the certainty that I would not have enough to take care of normal needs if I'm out that much money.
I'm still not clear on this, it sounds like you receive medicare, are you getting help with your part B premium? If you get $1337 or less a month the government will pay your part B premium. https://www.okhca.org/individuals.aspx?id=538
If you get $1010 or less your part b premium will be paid and you will get assistance with your premiums, co-pays and deductibles. All the information is in the link above. I don't know exactly where you live, but I checked and in an old post you said you live in Payne County. On medicare.gov there is one Medicare Advantage plan with no monthly premium in your area, Blue Cross Medicare Advantage Basic (HMO). But if you can get the premium and co-pays covered you might not even need an advantage plan.
At this point I'd say all bets could be off if dealing with the state medicade. They are doing cuts which could lead to half the hospitals closeing and a lot of the home care to dissapear, and I'm sure the coverage will be hacked considerably. If they have to guts to cut off the special money feed to the oil companies, it might help, but the state government right now is basically in disastor mode.
Those are federal programs but they are administered through the state medicaid program, I hope you will look into this as it appears that there is some substantial assistance available for you under the medicare savings plans
Thanks for the information. I have a plan through the Affordable Care system. They'd already slashed medicade in the state low enough I wasn't eligable. Who does the assistance come from? If its state then its not going to happen. Aside from the one condition, which if I was willing could be a big surgery and fix, but as long as I can do without that I do without that. I'd still need all the same supplies, just better luck with them working.
I'll check that. I think the plan I have with the ACA is Blue Cross.
Thanks for the information. I have a plan through the Affordable Care system. They'd already slashed medicade in the state low enough I wasn't eligable. Who does the assistance come from? If its state then its not going to happen. Aside from the one condition, which if I was willing could be a big surgery and fix, but as long as I can do without that I do without that. I'd still need all the same supplies, just better luck with them working.
I'll check that. I think the plan I have with the ACA is Blue Cross.
I thought you were on medicare and getting a supplement to medicare from medicaid, but you said you just turned 64, so you are too young for medicare unless you are receiving SSI or SSDI. If you do get medicare, the assistance that I listed is paid for by the federal government but the application has to be made through your state medicaid office. If you aren't on SSDI or SSI, it sounds like it would be real easy for you to get it and then you could get all the assistance that I mentioned and you wouldn't need an ACA plan.
If you aren't on medicare, since your state not only didn't expand medicaid but cut it for current recipients, you are probably stuck with the ACA plan until you turn 65, but when you do make sure you sign up for it AND the premium /co-pay assistance.
I'm sorry you are going through this, I read that the Federal Government is not going to give approval for these latest medicaid cuts, but I don't know if that will help you. Oklahoma
Somehow I thought that when I got old even though I knew Social Security offered very little security, I thought that Medicare would be a free way to get medical insurance. Later I heard there was a small fee.
Yesterday I found it it was approximately $400 a month - the same I was paying for private insurance ( albeit with a high deductible).
I'm not a Socialist - and though I read studies about how Scandinavians are happier than Americans, more educated and have much better health care-- I would not have liked their higher taxes and I'm an individualist -- I like competition. I made sure I got the best education I could on my own --when I saw the University of California was the highest rated public university in the world - I enrolled and graduated.
Nevertheless its not asking for too much to help our seniors... just a bit. I've done lots of volunteer work over the years -created jobs for people ( not a lot but more than a couple). I had hoped my bills would be tiny at this age.
Luckily and intelligently I was vocally opposed to the wasteful and immoral wars in Vietnam and Iraq or I would feel like even more of a sucker. We should have used that money for Americans not immoral ventures where we lost - support, lives, money and each war.
I see all this fanfare about Hillary v Trump - what's the real difference - they and their parties both got me here. I supported Ron & Rand Paul and Bernie Sanders. They would not have gotten us into those wars and would have stopped the wasteful use of taxes to enforce marijuana laws.
I have enough passive income from investments so I wont starve.
Its just that Medicare was one of those things I looked forward to when retiring and now I feel totally ripped off.
I agree with you on most points, especially the stupid wars we get into. The Vietnam war laid waste to that country, killed hundreds of thousands of them and us, mostly them, but at least it protected us from horrible communism right? - at least until the greedy fat cat CEOs discovered that they could award themselves 5-6 times the salaries of their European and Asian counterparts by outsourcing American jobs to communist China and India. Don't worry, the greedy fat cat Trump will save us... right?
Then we destroy Iraq and it's people by removing Saddam because he was a 'bad guy', and the unintended consequences manifested in ISIS, the devil's own minions, wreaking havoc and displacing millions, causing the European migrant crisis. We repeat our error in Libya and are dying to repeat it in Syria. Our meddling in the affairs of other countries has cost us trillions but the cost in human suffering is immeasurable. Either our elected officials are really that stupid, or the chaos is planned by the more insidious powers that shape our world.
Back to Medicare... if you have a younger wife, she is not covered until she reaches age 65, so what I take away from it all is to just keep working.
Medicare is cheap. All you need to buy is Part B if you want doctor and lab coverage. Most people in will pay about $105 monthly for that. Part D is optional. Also, you can buy into Advantage or Supplement plans which may be great or suck depending on your state. People paying $400 a month are either wildly wealthy or, more likely, buying expensive Part D drug plans and Supplement or Advantage plans. All of which are not necessary for most Medicare recipients unless they have continuing serious medical expenses.
Traditional Medicare Part B covers 80% of non-hospital medical expenses, after a deductible. The remaining 20% is the responsibility of the patient. Many people get Medi Gap (Supplement) Plans to cover the 20% and/or the deductible. Medicare supplement plans are standardized and identified by a letter, i.e., all insurance companies offering Plan F must provide the exact same coverage. The premium for supplement plans is based on the amount of coverage selected, where you live, and will vary depending on which insurance company you use. Prescriptions are NOT covered by traditional Medicare - if you wish to have prescription coverage, you can buy a Plan D policy. With traditional Medicare you can go to any doctor in the US who accepts Medicare.
I live in South Florida where medical care is very expensive. I have a full coverage Plan F policy purchased through AARP (the policy is underwritten by United Health). My premium is $268/mo (plus the $115 that's deducted from my SS check). My Plan D premium is $18/mo. My total cost for medical coverage is $401/mo. Dental and Vision insurance is purchased separately.
Many seniors choose to forgo traditional Medicare and instead enroll in an Advantage Plan. By doing so they assign their Medicare benefits to an insurance company which then manages their medical care. Advantage plans often have no monthly premium, no deductible, cover prescriptions, vision/dental care, and include benefits like health club membership. Some even reimburse the $115 that is deducted from your SS check. You are, of course, limited to the doctors/hospitals associated with your plan - they are essentially HMO/PPO plans for seniors.
I have found that many, many seniors do not understand the differences between advantage plans and traditional Medicare + a supplement. They do not know that if they choose an advantage plan upon their initial enrollment, they cannot switch to traditional Medicare + supplement without paying a higher premium and possibly being asked to undergo a physical.
How likely is that to happen? Only 3 cases per million people per year.
It's FAR more likely that I'll drown. I live near the Atlantic and avidly participate in water sports.
I was diagnosed with a chronic auto immune disease at age 66. For 65 years I lived a disease free life and rarely saw my primary care doctor. Now I have a stable of doctors that I have to see regularly. I get IV treatment once a month for which Medicare approves at $5000 (they are billed at $18,000). Because I have traditional Medicare with a comprehensive supplement plan, I do not have any out of pocket expenses for these treatments.
Health insurance plans should not be selected for the minimum health care you might need, but rather for the worst that could happen to you. My advice is to get the best health care coverage you can afford - why gamble with your health?
Traditional Medicare Part B covers 80% of non-hospital medical expenses, after a deductible. The remaining 20% is the responsibility of the patient. Many people get Medi Gap (Supplement) Plans to cover the 20% and/or the deductible. Medicare supplement plans are standardized and identified by a letter, i.e., all insurance companies offering Plan F must provide the exact same coverage. The premium for supplement plans is based on the amount of coverage selected, where you live, and will vary depending on which insurance company you use. Prescriptions are NOT covered by traditional Medicare - if you wish to have prescription coverage, you can buy a Plan D policy. With traditional Medicare you can go to any doctor in the US who accepts Medicare.
I live in South Florida where medical care is very expensive. I have a full coverage Plan F policy purchased through AARP (the policy is underwritten by United Health). My premium is $268/mo (plus the $115 that's deducted from my SS check). My Plan D premium is $18/mo. My total cost for medical coverage is $401/mo. Dental and Vision insurance is purchased separately.
Many seniors choose to forgo traditional Medicare and instead enroll in an Advantage Plan. By doing so they assign their Medicare benefits to an insurance company which then manages their medical care. Advantage plans often have no monthly premium, no deductible, cover prescriptions, vision/dental care, and include benefits like health club membership. Some even reimburse the $115 that is deducted from your SS check. You are, of course, limited to the doctors/hospitals associated with your plan - they are essentially HMO/PPO plans for seniors.
I have found that many, many seniors do not understand the differences between advantage plans and traditional Medicare + a supplement. They do not know that if they choose an advantage plan upon their initial enrollment, they cannot switch to traditional Medicare without paying a higher premium and possibly being asked to undergo a physical.
No physical that I am aware of. Medicare takes all, so why do a PE?
"Most seniors love medicare" I don't know if that is true or not, since I haven't spoken to "most" seniors.
I DO know that some seniors, because I HAVE talked with them, do NOT "love" Medicare.
New retirees turning 62 are having a hard time finding doctors that take in new Medicare patients.
62 year old retirees are not eligible for Medicare.
Do not confuse Medicare with Medicaid, which is run by the individual states. Almost all doctors/hospitals take Medicare, not so with Medicaid.
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