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Subject: Who's On Medicare?

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Tim Daley(MI)    Posted 11-03-2020 at 07:52:04 [URL] [DELETE]        [Reply] [Email]  
  • Who's On Medicare?
  • Social Security & Medicare - is that the best plan? Do you need to subscribe to one of the hundreds of companies selling plans? HMO or PPO?

    Tim Daley(MI)

    Steve Dabrowski    Posted 11-07-2020 at 16:55:52 [URL] [DELETE]        [Reply] [No Email]  
  • Re: Who's On Medicare?
  • Hi Tim,

    I have been on Medicare for ten years now and believe it is the best option in the world period. As for the plans, you can elect to go with original Medicare which is just paying the $100+ per month and having your Medicare card as your ID. This is accepted in all major medical school health care institutions (I use this and have my doctor at Stanford University and it costs very little). This is good if you do not need a whole lot of care. The other option is Medicare Advantage plans, these run around $400/month, but give greater coverage in some ways if you have a lot of health care activity and they cover drugs which you have to add to Original Medicare coverage. This might be best for you. Also I am fortunate in that I am able to cover the basic 20% copay with Original Medicare on my own. That is not required with the Medicare Advantage plans. My wife has Stanford Heath Care Advantage and it works fine but costs more than mine since I only pay for individual visits and I do not have very many in the year.
    Remember all institutions that recieve Federal funds like Universities have to accept Medicare patients and these are the best places anyway. Most Health care institutions accept Medicare patients as well, it is mostly the small offices that tend to push them away because of paperwork and low payments.

    Also the 20% copay responsibility is only for the amount of the reduced amounts contracted by Medicare rather than the institution's normal fees so it is not too much. I usually have to pay about $25 for a visit to one of the highest rated heart doctors in the U.S., Stanford's bill for my heart surgery and attendant testing etc.,was well over a million dollars, my out of pocket was probably no more than $10K with original Medicare which, admittedly is more than filling up my Grand Cherokee, is not very much considering what went into it.

    Also for that supplemental insurance is available, but of course that adds to the cost.

    Best to consider what you need realistically from your experience-I'd guess a Medicare Advantage would be best for you and would not require added drug and supplemental coverage. Also consider the best University Health care system you can reasonably go to-I think that would result in the best care you can get.

    Joe in Texas    Posted 11-07-2020 at 19:30:34 [URL] [DELETE]        [Reply] [Email]  
  • Re: Who's On Medicare?
  • I know I already replied about my situation, but after reading other answers and thinking about what was said there, I thought I could add a little bit.

    My wife is six years younger than I am. She turned 65 this year. We live in Texas so here teacher retirement puts a damper on how much SS and other benefits are available. Other states may be the same, but I only have experience here.

    One of the things I want to say is that Humana in Texas is a big mistake. My doctors don't want to deal with it, saying they never get paid, etc. My wife's retirement policy was different from mine. I have used her insurance as mine down through the years. After she retired, and I was already established with Aetna through her retirement for my supplemental, everything changed. The dependents all went to Humana. The premium went from $30 a month to over $600 per month for the same coverage. And this was only for the 20% Medicare didn't cover. Of course, I had to drop out and find my own supplemental. In addition to that, what was free to her became $225 a month out of her retirement check each month.

    So, we backed completely out of the teacher retirement health coverage when she turned 65. Now it's basic Medicare for each of us, and the same Oxford Life for the supplemental. My insurance man, an independent, says we need to renegotiate the supplemental policies at the very least every five years. I don't exactly understand all the reasons, but basically it involves premiums going up as your age rises. Loyalty means nothing in those cases.

    Bottom line: We are both on Medicare, with a supplemental policy that costs about $130 for me and $104 for her. Same coverage, and both have a $200 deductible per year. No copays for normal doctor visits and procedures. There are three major hospitals in Lubbock, along with several specialty outfits. As one of you said, Medicare is the best thing around, considering the reduced pay for procedures and the required acceptance from anyone receiving government benefits. (I think I said that backwards, but I'm leaving it anyway)

    I had not priced any of the so called advantage plans, but I know for a fact that NOTHING is free. Just not the way the world works.

    Our only issue right now is dental. We both need extensive repairs, or dentures. No way around the costs on that kind of stuff. Pay up front or behind.

    Thanks for listening....

    steveVa    Posted 11-03-2020 at 11:08:43 [URL] [DELETE]        [Reply] [No Email]  
  • Re: Who's On Medicare?
  • This site is helpful.
    Once you see one clip you will see their other choices. Good info.

    Gaspump    Posted 11-04-2020 at 12:09:55 [URL] [DELETE]        [Reply] [No Email]  
  • Re: Who's On Medicare?
  • That's sad that MI Blue Cross is short changing folks in MI. Never dreamed it could be that unlike ours here in FL.

    John in Mich    Posted 11-05-2020 at 21:18:42 [URL] [DELETE]        [Reply] [No Email]  
  • Re: Who's On Medicare?
  • You should know that our governor grew up in a wealthy home. Her parents were involved with BC/BS, I don't remember if it was as legal or management.

    Tim Daley(MI)    Posted 11-05-2020 at 04:28:23 [URL] [DELETE]        [Reply] [No Email]  
  • Re: Who's On Medicare?
  • What is sadder is that the gubment is involved in healthcare. I'm getting a multitude of answers as I suspected on this topic. I have heard good things, like you, about plans for one person, then bad things for another, like me. B-I-L said all BC Advantage Plans suck. He has Aetna and said it sucks too. My buddy has Aetna and says it is great. Go to the site and it says most all other plans that are NOT BCN Advantage Plans only offer Part B with Part A and Part D available at extra cost. I already am on a plan but since I am turning 65 this year I have been swamped with all kinds of different companies begging me to join their plan. My sister said she heard "from friends" that they use Humana and like it so I am looking into them today. Ya gotta read the fine print no matter which plan you go with. Out of pocket costs, drug prescription coverage, specialist referrals, office visits, all are different. To me all the different companies only add to the confusion and suck.

    Tim Daley(MI)

    Gaspump    Posted 11-03-2020 at 09:47:53 [URL] [DELETE]        [Reply] [No Email]  
  • Re: Who's On Medicare?
  • Check out the Blue Cross Advantage Plan PPO. Perfect for us as all services are available near where we live. If you are in a remote area where you need to travel for special services you may need another plan, shop around to find what best suits your needs.

    Tim Daley(MI)    Posted 11-04-2020 at 05:39:29 [URL] [DELETE]        [Reply] [No Email]  
  • Re: Who's On Medicare?
  • Nope. I switched to BCN/ADVANTAGE two years ago and it was a big mistake. I was on straight SS Medicare and when the guv mandated you go to your own plan, I switched over. BCN is a PPO which mean YOU CANNOT choose your own doctor and hospital. Your PCP has to choose which outside specialist you can go to using the BCN list PLUS you first need to get a referral from the PCP/BCN to approve the specialist you would see. When I was on straight SS Medicare, I went to my own PCP in town -7 miles away. The hospital was 5 miles away. All the 'specialists' I saw; pulmonary, cardio, foot, ENT, et al were in the same area - no more than a few miles away and I could go to whomever I chose. With the BCN PPO plan I could no longer choose who I wanted to go to, had to wait for a referral approval the PCP had to send to BCN then could sent me to their doctors. I was then having to drive 35 - 75 miles to see a doctor I could have just been seeing in town locally, some for years even before I was on SS. So, NO, a PPO is not the way to go. I was on the phone with a BCN rep for an hour one day as she explained it all. She said I needed an HMO plan then and they didn't have one.

    Tim Daley(MI)

    SteveVa    Posted 11-04-2020 at 23:54:48 [URL] [DELETE]        [Reply] [No Email]  
  • Re: Who's On Medicare?
  • According to boomer benefits your best bet is regular Medicare A&B with a medigap supplemental from Blue Cross and a drug supplement from Wellcare. The last 2 will cost you about $125 per month. You can also get dental and eye extras from Blue Cross. This way you get a good max out of pocket and you can go to any Dr. You want...

    Joe in Texas    Posted 11-03-2020 at 08:29:24 [URL] [DELETE]        [Reply] [Email]  
  • Re: Who's On Medicare?
  • Interesting question. I am on Medicare (age 71). Started SS at age 66. I still work full time, so the reason for 66 was the age which I don't have to pay back for excess earnings.

    As to your question: Medicare plus a supplemental policy is best for me. At age 67 I had an aortal heart valve replaced. Total of bills, including doctors and hospital and rehab was a little over $310,000. My ultimate out of pocket expense was $3,500. I can't think of anything better these days. (other than what congress gets)

    You ask about other plans. I really don't know as I have not explored anything else. Why would I? Actually, I am so thankful for how all of my surgery turned out I was and am not considering any changes.

    I'm feeling great, doing well according to two doctors and my wife. Still working full time. Hope this helps....

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