OT: Applying for initial Medicare coverage

[MSGRET]

Thank God I don't have to go through all these hoops. As an 80% disabled vet the VA takes care of everything except my dental which I have through the Federal Govt retiree plan, since DOD merged with them a few years back. The thing that pisses me off is that SS still takes out my Medicare payments even though I don't use them.

 

[uconnfan68]

Thank God I don't have to go through all these hoops. As an 80% disabled vet the VA takes care of everything except my dental which I have through the Federal Govt retiree plan, since DOD merged with them a few years back. The thing that pisses me off is that SS still takes out my Medicare payments even though I don't use them.

Why do they take them if you aren’t signed up for Part B?

 

[UcMiami]

I turn 65 in a week and just went through this - ugh!!!
I travel enough and have enough medical issues and hate HMO type insurance because of the restrictions they impose on providers, so I went traditional medicare over the advantage plan. You can sign up for medicare 3 months in advance, though the coverage begins on the first day of the month you turn 65 (or the date when you lose private insurance after age 65.) I went with A and B (you need both if not on an Advantage plan), plus D for drugs, plus a supplemental plan. In CT you have a choice of 3 part D plans and about 6 supplemental plans. In all because I went with the highest coverage I could get, the cost per month is about a third of what my private plan was (I was retired so paying my own coverage through the CT run Obamacare plan.)

Insurance is a minefield - used to review the insurance plans for my company each year and the process is similar for the medicare choices. I have always felt that if your budget can handle it, the highest levels of insurance are worth the expense - medical emergencies can and do destroy people's finances, so paying a bit more each month for the peace of mind is worth it.

 

[bluedevil]

One can get an Advantage Plan or a Supplement but you can't have both....its either one or the other..

 

[Kaizen]

One can get an Advantage Plan or a Supplement but you can't have both....its either one or the other..

In general you are right, you cannot get both Medicare Advantage Plan and Medicare Supplement plan.

My sisters get Medicare Supplement plan and Kaiser Senior Advantage plan both. Not sure the difference of Kaiser Senior Advantage and Medicare Advantage plans. Don't understand why they are so complex ....

 

[MSGRET]

Why do they take them if you aren’t signed up for Part B?

Because it's the law. Once you are 65 SS takes out Medicare from retired military to subset costs. That's what was explained to me by the SS Admin.

 

[Fairfield Fan]

OMG, you're right about the Boneyard being the source for all knowledge! I turn 65 in Sept. and my wife is retiring from teaching. I was told I need to sign up for Medicare 3 months before so I was just on the SSA website and signed up for Part A and (I think) Part B - It's a little confusing since my employer provided health care doesn't end until August 31!

I signed out of the SSA, checked out the BY and saw this post!!!!

I'm in the same boat. Just beginning to try to understand all of this. I am absolutely appalled. It's as if we're supposed to predict which diseases or conditions will afflict us in the coming year or years.

The Part D is driving me nuts. How in the world are we supposed to know which drugs we will need some day? And the insurance companies have the right to eliminate drugs at will, or shift them into more expensive categories. That's fair?

Haven't signed up for Social Security yet. Sheltering at home. But I suppose will need to go to the office and sign up.

What happens when people get Alzheimers? They're supposed to be able to figure this stuff out?

 

[Fairfield Fan]

I am on Kaiser too and I really like Kaiser's service.

Kaiser has medical office, lab., pharmacy and most of the test equipment in one building. So just one visit you can have almost everything done. My sisters are on Kaiser Senior Advantage with Supplement plan. They pay only $1.30 for every prescription (Kaiser will select the brand of drugs for you, mostly generic if available not brand name).

But I don;t think Kaiser has offices in CT ( Kaiser Permanente areas: parts of California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington (southwest part of the state), and Washington, D.C. ).

Heard good things about Kaiser, too. But don't think they're offered in CT...

 

[MSGRET]

I'm in the same boat. Just beginning to try to understand all of this. I am absolutely appalled. It's as if we're supposed to predict which diseases or conditions will afflict us in the coming year or years.

The Part D is driving me nuts. How in the world are we supposed to know which drugs we will need some day? And the insurance companies have the right to eliminate drugs at will, or shift them into more expensive categories. That's fair?

Haven't signed up for Social Security yet. Sheltering at home. But I suppose will need to go to the office and sign up.

What happens when people get Alzheimers? They're supposed to be able to figure this stuff out?

I did SS via my phone a few years ago, don't know if you can still do it due to COVID.

 

[EdSaid]

Impressive. This is a great source of knowledge. I have a few years to go. Now I know where to turn for the Medicare Birthday help.

I would imagine there is a great deal of life experience and education sitting on this site.

 

[bluedevil]

I'm in the same boat. Just beginning to try to understand all of this. I am absolutely appalled. It's as if we're supposed to predict which diseases or conditions will afflict us in the coming year or years.

The Part D is driving me nuts. How in the world are we supposed to know which drugs we will need some day? And the insurance companies have the right to eliminate drugs at will, or shift them into more expensive categories. That's fair?

Haven't signed up for Social Security yet. Sheltering at home. But I suppose will need to go to the office and sign up.

What happens when people get Alzheimers? They're supposed to be able to figure this stuff out?

You can sign up for social security on line and it is simple. Don't let part D bother you. Most adv. plans if not all provide drug coverage or you can get part D if you just want Medicare...You can change plans if your drug needs change in the future so don't stress out!!!

 

[bluedevil]

I'm pretty much an idiot and I got through it..lol

 

[JRRRJ]

I'm in the same boat. Just beginning to try to understand all of this. I am absolutely appalled. It's as if we're supposed to predict which diseases or conditions will afflict us in the coming year or years.

The Part D is driving me nuts. How in the world are we supposed to know which drugs we will need some day? And the insurance companies have the right to eliminate drugs at will, or shift them into more expensive categories. That's fair?

Haven't signed up for Social Security yet. Sheltering at home. But I suppose will need to go to the office and sign up.

What happens when people get Alzheimers? They're supposed to be able to figure this stuff out?

There's no need to go to the SS office -- well, at least there wasn't for Colleen & I. Here's the link we used:

Medicare Get Started Page

 

[uconnfan68]

In general you are right, you cannot get both Medicare Advantage Plan and Medicare Supplement plan.

My sisters get Medicare Supplement plan and Kaiser Senior Advantage plan both. Not sure the difference of Kaiser Senior Advantage and Medicare Advantage plans. Don't understand why they are so complex ....

It’s just a game to see how many people they can snooker.

 

[uconnfan68]

I'm in the same boat. Just beginning to try to understand all of this. I am absolutely appalled. It's as if we're supposed to predict which diseases or conditions will afflict us in the coming year or years.

The Part D is driving me nuts. How in the world are we supposed to know which drugs we will need some day? And the insurance companies have the right to eliminate drugs at will, or shift them into more expensive categories. That's fair?

Haven't signed up for Social Security yet. Sheltering at home. But I suppose will need to go to the office and sign up.

What happens when people get Alzheimers? They're supposed to be able to figure this stuff out?

The good news is that other than Part A (free), and Part B ($198/mo), the rest can be changed each year if your coverage needs change. Most plans do not cover long-term care.
If I get to that point, I’ve instructed my executor to take me on a whale watch from P-town, and push me off the boat. Might wear my seal costume too.

 

[uconnfan68]

Because it's the law. Once you are 65 SS takes out Medicare from retired military to subset costs. That's what was explained to me by the SS Admin.

Rule of law. You signed up to defend it. Ironic.

 

[Drumguy]

The good news is that other than Part A (free), and Part B ($198/mo), the rest can be changed each year if your coverage needs change. Most plans do not cover long-term care.
If I get to that point, I’ve instructed my executor to take me on a whale watch from P-town, and push me off the boat. Might wear my seal costume too.

Not that it matters that much but Part B cost is dependent on your other earnings. Here's a table:

File individual tax return	File joint tax return	File married & separate tax return
If your yearly income in 2018 (for what you pay in 2020) was	You pay each month (in 2020)
$87,000 or less	$174,000 or less	$87,000 or less	$144.60
above $87,000 up to $109,000	above $174,000 up to $218,000	Not applicable	$202.40
above $109,000 up to $136,000	above $218,000 up to $272,000	Not applicable	$289.20
above $136,000 up to $163,000	above $272,000 up to $326,000	Not applicable	$376.00
above $163,000 and less than $500,000	above $326,000 and less than $750,000	above $87,000 and less than $413,000	$462.70
$500,000 or above	$750,000 and above	$413,000 and above	$491.60

 

[Ubobconn22]

In the chart above they use your income from your tax return that is two years prior to the date you retire. If your income is now lower, due to retirement, you can apply for a one time exception to use your current income. That saved me a couple hundred a month for a year.

 

[cohenzone]

A lot of good advice. When I first signed up, I chose an Advantage plan available in CT called Connecticare that covered A and D. OT included optional dental for a low fee. There were no additional premiums, the cost being the same as the Medicare premium. Supplemental plans had premiums over a hundred a month. One of the main differences was that for the extra cost, Supplemental plans required no co pays for doctor visits but they often didn’t cover full annual physicals, only so called wellness visits. Because I was in good health with few MD visits, the amount of my yearly co pays under my Advantage plan was far lower than premiums I would have paid into Supplemental plans. My rusk was a sudden bad turn in my health well before the annual open season window. Over the years. the Advantage plans started charging monthly premiums for services, but still much less than a Supplemental plan. I was able to easily use my plan in out of state or international travel if I needed an MD visit. Never needed a hospital.

When my wife, a teacher, became eligible, she chose the plan offered in CT by the CT Teachers board which was a Stirling Supplemental Plan. It had those higher monthly premiums included Dental and Scriot, and was better for her because she had many more medical needs than I so the lack of co-pay and a few other coverage features were better for her than an Advantage plan. Then the retirement board switched to an Anthem
Plan which I examined more closely during my wife’s cancer treatment last year. It’s a plan that is a definite hybrid. It has mostly features of a Supplemental plan but includes some co pay requirements , although lower than an Advantage Plan. But I decided to change to her plan during the last open season (eligible as a spouse) but for reasons that are definitely worth it whatever plans you consider.

The hospitalization coverage, was way better than my plan had been related to the initial days exclusion and the annual max out of pocket was way lower. You need to compare those features carefully.See if annual physicals are covered. If you need equipment including things like hearing aids (I need them) and sleep apnea CPap machines are covered. The Anthem plan includes a dental option which is provided through a separate company. It’s pretty good for things like crown co-pays. The devil can be in the confusing details when choosing.

 

[bluedevil]

A lot of good advice. When I first signed up, I chose an Advantage plan available in CT called Connecticare that covered A and D. OT included optional dental for a low fee. There were no additional premiums, the cost being the same as the Medicare premium. Supplemental plans had premiums over a hundred a month. One of the main differences was that for the extra cost, Supplemental plans required no co pays for doctor visits but they often didn’t cover full annual physicals, only so called wellness visits. Because I was in good health with few MD visits, the amount of my yearly co pays under my Advantage plan was far lower than premiums I would have paid into Supplemental plans. My rusk was a sudden bad turn in my health well before the annual open season window. Over the years. the Advantage plans started charging monthly premiums for services, but still much less than a Supplemental plan. I was able to easily use my plan in out of state or international travel if I needed an MD visit. Never needed a hospital.

When my wife, a teacher, became eligible, she chose the plan offered in CT by the CT Teachers board which was a Stirling Supplemental Plan. It had those higher monthly premiums included Dental and Scriot, and was better for her because she had many more medical needs than I so the lack of co-pay and a few other coverage features were better for her than an Advantage plan. Then the retirement board switched to an Anthem
Plan which I examined more closely during my wife’s cancer treatment last year. It’s a plan that is a definite hybrid. It has mostly features of a Supplemental plan but includes some co pay requirements , although lower than an Advantage Plan. But I decided to change to her plan during the last open season (eligible as a spouse) but for reasons that are definitely worth it whatever plans you consider.

The hospitalization coverage, was way better than my plan had been related to the initial days exclusion and the annual max out of pocket was way lower. You need to compare those features carefully.See if annual physicals are covered. If you need equipment including things like hearing aids (I need them) and sleep apnea CPap machines are covered. The Anthem plan includes a dental option which is provided through a separate company. It’s pretty good for things like crown co-pays. The devil can be in the confusing details when choosing.

I hope your wife is doing well. Best wishes...

 

[cohenzone]

I hope your wife is doing well. Best wishes...

Thanks she’s been in remission since Dec. still gets scanned for now every 3 mos. Hers is rare and aggressive cancer, but she’s so far defying odds.

 

[boontonbomber]

When I turned 65 I enrolled in Blue Cross of Mass. supplemental(Medex), to go along with Medicare A and B. Now paying a bit over $200/mo for BC. I've had multiple surgeries, colonoscopies, MRIs, chiropractor visits(covers 50 per year), physical therapy visits(also 50 per year), etc. . With Medicare+BC, all it's ever cost me is the gasoline to get to wherever. Could be a bit expensive, but what price do you put on peace of mind?

 

[uconnfan68]

In the chart above they use your income from your tax return that is two years prior to the date you retire. If your income is now lower, due to retirement, you can apply for a one time exception to use your current income. That saved me a couple hundred a month for a year.

Any form number or article to check this?

 

[Ubobconn22]

Use form SSA-44 to file the appeal to use your current income rather than the income you made when you were working. Saved me thousands!

 

[uconnfan68]

Use form SSA-44 to file the appeal to use your current income rather than the income you made when you were working. Saved me thousands!

I looked that up. Not sure if it’s applicable, but it’s worth a phone call. Thanks!