But what about robots?
One year, the first year of the ACA, IIRC — I enrolled in a $0 deductible Platinum plan.
It was the only year ever I had decent insurance. I had two cataract surgeries that year, and I also did 6 months of psychotherapy (when the insurance company told me my plan covered 5 visits at no charge and $15 copay per additional visit, I thought I’d misunderstood. “Excuse me, did you say $50?” )
But if I added up the annual premium difference in the policies, I was paying about 2K a year above the policy with a 2K deductible. There were other advantages like lower copays, though.
But it got me to take care of myself without worrying about money. Unfortunately, after the first year the rates skyrocketed and I couldn’t afford it anymore. But I had decent healthcare for a year and got a lot done.
Converting my coworkers to socialism, one chat at a time…
Bumping this because I’m in the process of selecting an MS plan, and I have questions that maybe others have/will have, too.
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If all the plans are the same, why are Medi-Gap premiums higher across the board (that is, for all plans) in some states than others? (It can’t be due to higher costs because with a Medi-Gap plan, I can go out of state for care, right?)
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I’m preparing to call companies on the Washington State Approved Medicare Supplement Plans list that offer Plan G. What do I need to ask, aside from whether the plan’s rating is community, issue, or attained?
I haven’t even started to look at Part D yet. 
- So, the ‘socialized medicine’ part of Medicare is Original Medicare which covers 80% of all Medicare expenses.
Medicare Advantage and Medicare Supplement plans are ‘private health insurance’ which is offered by private companies in accordance with the regulations in each State and, of course, Medicare.
It’s complicated how it’s done, but one thing holds true: states with significant senior populations like FL, CA, & AZ have far better plan designs, including pricing, than those without.
- Ask if the premiums are scheduled to rise over time. There are also Plan G’s which do have limited networks, but at a lower premium. These plans are called ‘Medicare Select’ are considered Part G, and don’t seem like a fit for you as they may not have out of state coverage (other than emergency room treatments).
Thank you! As always, invaluable advice. I’m not out of state that much. I asked because I was trying to make sense of why premiums are higher here (WA state) than some other places.
I so appreciate your posts on this. I’d have been sorely tempted to go for MA without your counsel. The farther I’ve gone down the Medicare rabbit hole, the more strongly I agree with you about this whole “choice” nonsense. What a shit show.
ETA: I don’t think Select plans would work for me anyway, as my rather complicated medical situation means I often have to go out-of network, and I’m sick of fighting insurance companies.
It is indeed a rabbit hole, and good to hear you got it figured out (my decision — A, B and F — was made easier by a SHIP rep telling me that my last employer would pick up half the cost of the Part F premium). I’ve had a couple of claims denied that were approved after being recoded and resubmitted; aside from that, I’ve only had to pay for one refraction and the wifi adapter on my CPAP.
Part D is a whole 'nother matter. Good luck with that.
Ugh. I dread Part D. I’m developing a fear of donut holes.
So you were lucky enough to get onto F before that option got removed? Good deal!
YES, DO THAT THING! Talk to a qualified expert before making a decision - the info given here is just general advice and my personal opinion, but talk to an actual Medicare expert… and NOT an insurance agent… about your specific situation.
This.
100% of the stuff you get in the mail and over the phone is from insurance companies who want your money.
And, unfortunately, it doesn’t stop once you make a decision and sign up. They will continue to hound you forever.
Here’s the link for SHIBA (the Soviet of Washington’s implementation of SHIP).
On a more general note, I offer this site advisedly since it looks like it wants to hook you up with a “licensed agent” (a/k/a salesbeing*). But it does appear to have links to SHIP in each state.
* No offense whatsoever intended toward JohnT, whose contributions to this thread topic have been invaluable.
Oh, I talked to an advisor at the Washington State weeks ago. She thought I’d been an insurance actuary because I was so knowledgeable! Hah. I couldn’t find my way around an actuarial table if you paid me. After that conversation, I was sure G was the right plan for me, and her advice on Part D was very similar to the advice here.
I also spoke to a friend who’s a financial advisor with training in Medicare. She concurred that a Medigap plan is better for me than an MA plan, steered me away from high-deductible plans, and said if I get stuck with Part D to call her. Her father just died, so I’m hoping I don’t have to trouble her but will if I really need to.
The above post has a link to each SHIP, which can help you with your Medicare decision w/o having the pressure of a salesperson steering you one way or another.
Mr VOW (used to be Sgt VOW, LOL) and I have had Medicare and TriCare for Life for a zillion years. (We both are disabled)
The prescriptions are the ONLY thing we pay for, except for the Part B (?) of Medicare.
Mr VOW vput up with unsufferable shit during his twenty. At times he hung on by his fingernails. We certainly will never get rich on his retired pay. My God, though, we are grateful every day for TFL and the prescription drug coverage!
The combo of Medicare and TFL goes with us everywhere. We go back and forth between SCal and AZ, with no worries!
When Mr VOW had his heart attack, he hadn’t been in the hospital twenty minutes before he was rushed to the cath lab, where he received four stents.
~VOW
(TFL: TriCare for Life)
To @VOW’s point, TFL is so popular and comprehensive that in my former company it was policy that we were not allowed to move any TFL recipient away from TFL. It was a fire-able offense if repeated.
Bumping this because it’s Medicare Open Enrollment time again… feel free to ask if you have any questions.
Here’s a question for you, to which I haven’t been able to find a definitive answer:
Although it’s not an imminent end-of-life situation, my Mother entered Hospice care a few months ago. Since that time, Hospice has paid for all of her prescription drugs.
So, can I cancel her Part D (prescription) plan? The savings would be not great, but she’s in health care, so every dollar helps.
I would definitely discuss this with the Hospice provider before you do anything like that - they could very well be rebated because she has Part D… meaning that if she loses her Part D, then they may not be reimbursed based upon her Part D coverage, then she would have to pay for her drugs.
Also, there is such a thing as a non-coverage penalty, where the monthly premium increases more the longer you are out of the program. Don’t really know the rules right off hand, but this may be a concern as well if she decides to go back on Part D, it will be more expensive.
I did just that, but the woman I spoke with wasn’t sure how their drug program actually works. But you bring up a great point in that they might be reimbursed because Mom has Part D insurance. I’ll have to check into that in more detail.
I’m not terribly worried about cancelling and then trying to get back in, as Mom turns 101 tomorrow. I doubt if she’ll ever leave Hospice care.
ETA: I found this link, which seems to state that it’s all covered by Medicare.
So don’t drop the Part D. That’s my advice.