I am starting Medicare next month. already the $135 seems like a lot. Advantage or traditional plans? Friends have commented from California, but now I see the Oregon, where I am located, seems different. I am decent health and weight, parents lived to 90's, and only one generic med. Border line diabetic, working on that. thanks all
Starting Medicare very soon
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The subtext of what you have written is that you're thinking of declining Part B (good health, parents to 90s, B's kinda pricey, etc.) Listen to me, get Part B.
Here's Medicare in a nutshell. There are five parts, A,B,C,D and LBJ. We start with LBJ and thank him mightily else there woul be no Medicare at all.
Part A everybody gets automatically for free when they turn 60 something. It covers hospitalization and catastrophic stuff.
Part B (your quibble) is what you really need Medicare for. Routine or not-so-routine doctor visits. Buy it. $135 A month you say, okay, worth it. (If you're on Social Security it's taken out prior to the SS bank deposit.)
Part D is prescription drug coverage. Thank GWB. It costs extra.
But it's part C you're interested in. Called Medicare Advantage. It's A and B together; but, oddly, managed and delivered thru private companies. You shop around for this. With all Part C Advantage plans you still have to pony up the monthly Part B $135. So what's the advantage?
With Medicare, you pay 20% of the bill, the government picks up the rest. Here's an examlple (from my 77 year-old brother). Three days of high fever, nausea, etc. Doctor's away, he hauls himself to the ER. Three hours later they spit him out all well. Cost? Just shy of $5,000. Medicare talks it down (approves) to $3,000, pays 80%, so brother pays $600. l have Part C Advantage where the max I would have paid for the ER is $80 (a regular doctor visit $40). That's the advantage. Despite what SG67 above says, Advantage plans can be different. Different doctor networks, different locations, different services, (tho they all hit the CMS baseline), different prices. The company I'm with charges a $40 monthly premium in the next county over; in my county I pay zero.
Medicare Advantage is up to you. Taking Part B really isn't because there is a penalty if you don't take it when first eligible. 10% increase for each year you opt out and the penalty lasts until you die. Stay well. Though that's not entirely up to you. Gawd, I hate these long posts.
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37,122 Posts
Sign up for the Medicare. I did when I turned 65 and it costs me a whole lot less than the premiums I paid for Blue Cross/Blue Shield FEB plan coverage for the wife and I before that. My supplemental coverage for our medicare is provided by the TriCare for Life coverage I receive through my military retirement.
Kudos to member Peak and Pine for that very thorough and helpful response. and to SG 67 for his professional perspectives on the coverage! :happy:
Kudos to member Peak and Pine for that very thorough and helpful response. and to SG 67 for his professional perspectives on the coverage! :happy:
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14,999 Posts
Thank you, but I just want to reiterate that my perspective is from that of a provider. Each person should weigh his/her particular healthcare needs and base coverage on that.
I will say that Medicare, Tri Care and other government funded health plans come with many restrictions and regulatory burdens and at times the delivery of care may not be as efficient or timely as with private insurance.
I know some colleagues who have stopped accepting Medicare for this reason; the regulatory burden and the costs associated with it outweigh the meager payout provided by Medicare for certain procedures.
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29,124 Posts
Another Tricare veteran. I have nothing but good things to say about the way I've been handled (and my late wife!) under the program. Staying in the military long enough to retire was the second best decision I ever made. But of course, Eagle and I paid for it up front for (in my case) 29 years.
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5,799 Posts
I can't imagine any kids learn about Medicare.
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I have medicare advantage through my government-funded Kaiser membership. Service is excellent and communication within the network is instantaneous. I am unaware of any burdensome government impingements on my treatment.
Gurdon
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The burden is more on the provider.
Also, try seeing two different specialists at the same practice on the same day.
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The provider is a non-profit HMO. Practitioners are free to make medical decisions.
I'm not sure how to address your second comment as Kaiser Permanente is not the same as a private for-profit group practice, which is what I presume you mean.
In my experience, if something is urgent, patients are seen quickly, as in the same day; if not, follow-up is within a matter of days. Records are computerized, and readily available throughout the system to whomever needs them.
Gurdon
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I'm not familiar with the Kaiser system so I'm glad it's working out for you.
I'm not anti Medicare, but the system is making it more and more difficult.
I'm 66, own a manufacturing plant. My wife is 60 and a teacher. Neither of us plan to retire until age 70 (both in good health). Neither of us have contemporaries that speak of Medicare, etc., so reading through this thread is helpful.
Since first perusing it, the thought has occurred to me, that I missed/ignored signing up! Further, I have ignored everything about Social Security! The spark was lit last week at my annual physical, with the nurse saying something about avoiding "the donut hole". I'm more interested in the area outside the donut hole!
So, even though drawing a check every week, I am planning on signing up for SS, after a bit more research, particularly the mandatory part of needing to also sign for Medicare.
To the assembled here in the know, any advice? I'm not n a hurry, preferring to gather all facts, speak to my attorney and accountant prior to signing on the dotted line. Wife and I will have been married 40 years this August, with three daughters, 38, 36 and 19 (the youngest is and engineering student at Penn State, intending to take over our business).
Thanks in advance!
Since first perusing it, the thought has occurred to me, that I missed/ignored signing up! Further, I have ignored everything about Social Security! The spark was lit last week at my annual physical, with the nurse saying something about avoiding "the donut hole". I'm more interested in the area outside the donut hole!
So, even though drawing a check every week, I am planning on signing up for SS, after a bit more research, particularly the mandatory part of needing to also sign for Medicare.
To the assembled here in the know, any advice? I'm not n a hurry, preferring to gather all facts, speak to my attorney and accountant prior to signing on the dotted line. Wife and I will have been married 40 years this August, with three daughters, 38, 36 and 19 (the youngest is and engineering student at Penn State, intending to take over our business).
Thanks in advance!
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6,630 Posts
^
When you apply for Social Security you are automatically applying for Medicare. But you've not signed up for SS, so you should have applied for Medicare anytime 3 months before or after your 65th birthday. But you didn't do that either and now you're 66. Still, if you have private or employer provided coverage you're allowed to apply for Medicare later. I presume that would be you. Go to the dot gov sites for SS and for Medicare. They're well put together and very helpful. Medicare Part A (catastrophic illness and/or hospitalization) is gratis. Part B (routine doctoring stuff) is not. Around $120 a month. If you don't sign for B when getting starting and decide on it later, there is a lifetime penalty for your indecision. Get B now. And join my I Love Big Government Club. I'm the only one in it. Then there will be two.
When you apply for Social Security you are automatically applying for Medicare. But you've not signed up for SS, so you should have applied for Medicare anytime 3 months before or after your 65th birthday. But you didn't do that either and now you're 66. Still, if you have private or employer provided coverage you're allowed to apply for Medicare later. I presume that would be you. Go to the dot gov sites for SS and for Medicare. They're well put together and very helpful. Medicare Part A (catastrophic illness and/or hospitalization) is gratis. Part B (routine doctoring stuff) is not. Around $120 a month. If you don't sign for B when getting starting and decide on it later, there is a lifetime penalty for your indecision. Get B now. And join my I Love Big Government Club. I'm the only one in it. Then there will be two.
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