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When it comes to Medicare and medical insurance plans, I am learning premiums and coverage are determined by your location.
I am in central NY state. I pay $104 for Medicare (comes out of SS check). My advantage plan costs $178.50/month for medical, $52.10/prescription. I also have EPIC which is a NY state plan for low income people (I do not pay a premium for this). Once the deductible is reached on the Rx end, my prescriptions are pretty low.
Last year I had Medicare paid out of my SS check. I had a supplement plan with Blue Cross/Blue Shield (supposedly their "best" plan) that cost under $100/month (this included the Rx plan). But if I saw a specialist, copay was $25/visit (sometimes 3x week). PCP was $10/visit. Can't remember the hospitalization, etc. costs.
So even tho this year's insurance coverage is much better than the past year, I still pay a hefty premium for medical and Rx. I recently received a letter from this year's medical insurance informing me the premium will increase for 2016.
For someone with my financial situation (lots of high bills), the premiums are expensive but I have to have this insurance along with Medicare.
It also is dependent on what town a person lives in, a county one lives in, etc. They consider the population, how many of that population are enrolled in that particular insurance. It is very confusing.
Someone said it must be a scam. Sorry, you are wrong. These are the "facts" ma'am. In central NY.
Someone said it must be a scam. Sorry, you are wrong. These are the "facts" ma'am. In central NY.
That was me, and I was not saying you scammed anyone, but rather that you got scammed with a policy that pays no part of the 20% not covered by medicare, why would you pay for a policy that pays for nothing? medicare part B covers almost everything except the first 20%. I posted a link, here - did you check it for your zip code?
Quote:
Originally Posted by 2sleepy
Wow what was your supplement even covering then? Medicare pays all but 20% of the bills you mentioned, so they paid NOTHING on those? That sounds like a scam for sure! Medicare.gov is where I usually check the cost of plans but their site kept crashing so I tried this https://www.ehealthmedicareplans.com...10/ONEIDA/1/p1 And there were plans that offered benefits very similar to my husband's for zero premium. Your profile said 'central NY so I put in Utica)
That was me, and I was not saying you scammed anyone, but rather that you got scammed with a policy that pays no part of the 20% not covered by medicare, why would you pay for a policy that pays for nothing? medicare part B covers almost everything except the first 20%. I posted a link, here - did you check it for your zip code?
I think that NYgal2NC may have had an HMO last year where she had to pay the $25 co-pay for each visit to a specialist and that this year she's in the F or G plan which costs more in monthly premiums but is a probably a better deal for people living outside a large metro (like NYC or Buffalo or Syracuse) who may have to use specialists who aren't in the local HMO network.
When it comes to Medicare and medical insurance plans, I am learning premiums and coverage are determined by your location.
I am in central NY state. I pay $104 for Medicare (comes out of SS check). My advantage plan costs $178.50/month for medical, $52.10/prescription. I also have EPIC which is a NY state plan for low income people (I do not pay a premium for this). Once the deductible is reached on the Rx end, my prescriptions are pretty low.
Last year I had Medicare paid out of my SS check. I had a supplement plan with Blue Cross/Blue Shield (supposedly their "best" plan) that cost under $100/month (this included the Rx plan). But if I saw a specialist, copay was $25/visit (sometimes 3x week). PCP was $10/visit. Can't remember the hospitalization, etc. costs.
So even tho this year's insurance coverage is much better than the past year, I still pay a hefty premium for medical and Rx. I recently received a letter from this year's medical insurance informing me the premium will increase for 2016.
For someone with my financial situation (lots of high bills), the premiums are expensive but I have to have this insurance along with Medicare.
It also is dependent on what town a person lives in, a county one lives in, etc. They consider the population, how many of that population are enrolled in that particular insurance. It is very confusing.
Someone said it must be a scam. Sorry, you are wrong. These are the "facts" ma'am. In central NY.
It sounds very much as if you had a high deductible Medigap plan F (or an Advantage plan) last year and have now switched to the regular Medigap plan F for this year.
I looked at the Medicare find plan site and did not see any Advantage plan in the Syracuse area that was even close to $178.50 in monthly premiums.
I think that NYgal2NC may have had an HMO last year where she had to pay the $25 co-pay for each visit to a specialist and that this year she's in the F or G plan which costs more in monthly premiums but is a probably a better deal for people living outside a large metro (like NYC or Buffalo or Syracuse) who may have to use specialists who aren't in the local HMO network.
I understand that, and the only way I could check rates in her area was to go by her location as mentioned in her profile, which states: "Central New York", so I put Oneida County in and got quotes from esurance. (medicare.gov was down when I did this) https://www.ehealthmedicareplans.com...10/ONEIDA/1/p1 It looks like there are a number of plans which seem to be a much better deal than what she has now. I included the link in my post and asked her to put in her actual zip code to check. I'm not saying she did anything wrong, it might be that she is buying these plans from a brlier who only shows her the plans for which he gets the highest commission
The interesting point about this discussion is that I am not, in fact, "rolling in dough". I am a retired high school teacher and I have lived below my means for a lifetime including since my retirement, which is the reason that I do not feel any "pinch" from the very mild inflation that we have had over the past six or seven years. I am neither rich nor well-to-do nor wealthy. My lifetime earnings compared to a lawyer or doctor or CPA or middle management type are paltry. The whole point is that I am living comfortably but not at all lavishly despite lifelong earnings which are modest at best.
One area of discussion where it is easy to talk past each other is medical costs. People can be retired before the age of 65 and therefore be struggling with medical costs. But once we hit 65 Medicare covers most of those. I am 71, so I can say that I don't have any concern about medical costs, and that could be very misleading (leading to misstatements such as you made above), but it does not mean I am a fat cat who can afford to pay a lot of medical expenses; rather, it means I am on Medicare and I have an excellent Medicare Advantage Plan which makes it almost impossible to incur significant medical costs no matter what goes wrong with me.
Thats nice. I worked as an RN for decades and I can't afford the Medicare Advantage Plan. The premium and co pays and deductibles of plain old part B and the rising cost of food make the difference whether I get to live on beans and rice or something else. I do not just live on SS either. Inflation and the COL is high. The CPI the government is using is just a shell game and a way to lie to the people..
again , it isn't lying to the people. it just measures consumer trends and price changes. it has little in common with anyone's personal cost of living .
this country consists of 1500 mini economies and all are effected by different things at different rates .
there is nothing in existence that would measure what you use ,buy , how often and in what quality vs me .
That was me, and I was not saying you scammed anyone, but rather that you got scammed with a policy that pays no part of the 20% not covered by medicare, why would you pay for a policy that pays for nothing? medicare part B covers almost everything except the first 20%. I posted a link, here - did you check it for your zip code?
That is how it works in NY. The supplement or advantage insurances are in addition to medicare. With the supplement, they paid 80% and the patient 20%. With the advantage, 100% is paid.
Believe it or not, I did graduate high school and two-year college.
i am lost , a ny F-medigap plan pays 100% of that 20% medicare does not pay , unless you have a high deductible f plan something does not sound right .
we have a high deductible f-plan so we pay the first 2k but the plan is more than 2k cheaper than the regular f-plan and being we are healthy we will likely do better .
if you are saying your medigap plan did not pick up the 20% it isn't making sense unless you took a high deductible plan f .
unless you are not referring to having medicare and medigap but using an advantage plan instead vs just medicare and no medigap plan.
there is a lot not covered in advantage plans as well as they can dispute paying certain bills you get so you can't count on them paying 100% either all the time .. medigap plans must pay any expense covered by medicare , they have no say in the matter like an advantage plan .
the saying nothing is a problem until it is a problem was written for advantage plans because nothing could be truer ..
Last edited by mathjak107; 08-03-2015 at 02:16 PM..
Since January 1, 2014, most of Congress and most of the staff who work in Congressional offices have obtained their health care coverage through an Obamacare exchange in Washington DC.
And by the way, media overdosing is unhealthful. For example, nobody has "raided" Social Security, elective abortions do not cause cancer, evolution and global warming are real, and Saddam did not have WMD.
I disagree - I have a very good memory and Social Security funds were "borrowed" by Congress and never paid back.
As to Congress and Obamacare - its not as clearcut as you think - as usual its complicated just as they want it to be.
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