Another Medicare Thread

We’re not 65 just yet, but the wife and I are only a couple years away from having to make Medicare decisions. I know what Parts A, B and D cover, am a little mystified by Part C. The whole thing seems daunting, and I’ll need to do some research. Am starting here.

Our plan is to work until I’m 70, then retire back to Thailand. Knowing Medicare does not cover one outside the US, I’m thinking of for sure opting for Part A, and if anything super serious springs up, then hightail it back here to Hawaii to check into a hospital. (The wife has free lifetime medical care in Thailand, as she worked under the Thai government.) But I’m wondering if I can have Part B for a few years, then drop it once we return to Thailand. Can a Part be dropped once opted for?

I’m also wondering about the various supplemental plans one can get. Advantage etc. As I said, the whole thing seems daunting. I welcome any advice, personal experience etc regarding all things Medicare.

To answer your question about Medicare Part C, that’s also known as Medicare Advantage. A Medicare Advantage plan is generally a combination of Medicare Parts A, B and D, covering hospital, outpatient medical and prescription drug coverage. Coverage for MAPDs must be as good as or better than that offered under the individual parts of Medicare. Many Medicare Advantage plans that offer prescription drug coverage (there are very few that do not) also offer other perks like gym memberships, eye care, dental care, etc., though there may be an additional charge.

With regard to needing to do something to get Medicare, yes, you generally need to sign up for Medicare. You’ll be notified that you have the option to enroll in Medicare, typically a couple of months before turning 65. Part B (outpatient medical) is the part you’ll have to pay for; Part A is “free” and paid for already by FICA taxes.

If you defer enrollment in Part B, you might pay a penalty in addition to the monthly Part B premium (which is not covered by Medicare Advantage - those plans are sold in the private market and are cheap, but you can’t have one unless you’re also paying for Part B) in the event you decide you want to enroll later.

You can disenroll from Part B if you want to. You generally can’t jump in and out anytime - you’ll need to wait for an enrollment period to make changes.

Most people do really well with a Medicare Advantage plan. Anecdotally, my mom required a liver transplant a few years ago and cancer treatment just recently and it was incredible the amount of coverage she had. You could theoretically just have Medicare Parts A and B and opt for a Part D plan separately for your prescription drugs, but sometimes Parts A and B don’t offer as much coverage as a Medicare Advantage plan (depending upon how you use your coverage), so you might find yourself interested in a different supplement like Medigap.

It’s dizzying how many parts and pieces there are to Medicare. I’m not sure how the federal government expects us to make sense of it, and I work in regulated healthcare.

Well Medicare Advantage plans also have disadvantages: 1. In general almost every medical provider accepts traditional Medicare while significantly fewer take a particular Medicare Advantage program. 2. Medicare Advantage is going to require pre-approval for surgeries–my neighbor needed a stent–but he had to wait several days before his Medicare Advantage insurance would approve it.

The popularity of traditional Medicare vs Medicare Advantage program varies tremendously by state.

Like you said, it really does depend on the offering in our particular county. There are many Medicare Advantage plans that do require prior auths, but there are also quite a few PPOs or RPPOs who do not except on certain very large, expensive surgeries and/or tests.

It also depends on your health status - if you only need the basics plus prescriptions, then it may not make sense to get an MAPD and to just stick with traditional Medicare (Parts A & B) and a Part D plan; if you’re expecting a large medical expense coming down the pike, that may change your decision. It really does depend on the individual. What sucks is how confusing it is and the crap ton of information about it. But, that’s how the government wants it sent, so that’s how they have to send it or risk getting fined or prohibited from operating.

As it happens, I spoke yesterday to someone about the various and sundry Medicare plans, including supplements and advantage plans. I was very surprised to learn that there are no advantage plans available where I live - not sure why. I was also very surprised to learn that it made more sense for me to keep the insurance I took into retirement (I was a federal employee) than to sign up for any of the plans.

I also found this, tho I haven’t gone thru in entirely yet. Maybe it will help you make decisions.

I’m nowhere near Medicare eligibility yet- but I will be retiring soon. And I found out a few surprising things about my employer’s health insurance and Medicare. First, if I choose coverage through an HBO that offers a Medicare Advantage plan , I will automatically be enrolled in the Advantage plan. Second, my employer health insurance plan will reimburse the Part B premium for both myself and my husband . And third- if I somehow enroll in an advantage plan or Part D ( prescription) outside my employer’s health insurance program, I will be unenrolled from my employer’s coverage.

Thanks for all the replies. It’s somewhat comforting to know I am not alone in being confused. Gee, I can’t wait until I start getting bombarded with e-mail info.

I’m replying just to tag @JohnT . I’m pretty sure he does this for a living.

What, 20,000 words weren’t enough for ya? You want me to write more??? :stuck_out_tongue:

Go to the thread below, posts 2, 10, 30, 32, 39, and 78 are particularly helpful.

Not going to retype it out, but effectively:

  1. Plans vary by county. Go to, enter your zip code, select for the county, and then review plans.
  2. As a general rule, a Medicare Supplement (MS) plan + a Part D prescription plan is better financially than a Medicare Advantage (MA) plan (which usually has a Part D attached to it).
  3. You will pay that Part B premium for the rest of your life. Just accept it.
  4. If you have creditable employer coverage, and it’s subsidized, keep it as long as you can.