I think he’s saying that you can’t contribute to an HSA while on Medicare. When he started SS late, they retroactively enrolled him in Medicare Part A dating back a few years. And thereby disqualified those years’ HSA contributions. Which he then had to back out of his HSA and also pay income taxes on. To undo the effect of making those now-wrongful pre-tax contributions in prior years.
I agree that you can’t contribute to an HSA while on Medicare. Even if you have, like I do, a high deductible medigap plan.
But I think something is garbled in the rest of that story about Medicare part A retroactivity. Or he got screwed by a clueless worker at SSA or Medicare.
I waited almost two years past age 70 to start SS, contributing to the HSA the whole time. If I wanted the retroactive SS, I had to take retroactive part A as well. Paying taxes on the HSA money was cheaper than giving up the SS. Sorting out the taxes was a pain.
No, I won’t. My nursing ethics forbids sharing details, I’m obligated to protect their privacy and confidentiality. I’ve been a nurse for 44+ years, that’s many thousands of patients. I’m going to honor their trust, their families’ trust and my employers trust.
Oh yes and figuring out which one to pick is interesting. As in living in interesting times interesting. Hoops upon hoops are put up for signing up. And finding a agent to enroll you who is not going to steer you where you don’t want to go is a challenge. This was especially so for Hubster this enrollment because he oh hell I can’t remember what it’s called. Anyway, he didn’t have to undergo underwriting and be told they either wouldn’t take him or charge him an unaffordable premium. We got him signed up finally. At almost the last second. Which I’m sooo happy for because he’s spent so much time in the hospital, and needs lots of equipment, specialists and therapy. We would have done all that, but our credit would be even worse than it is now.
It really shouldn’t be this complicated. None of this should be this complicated, but the money involved will never allow it to be simple with everyone covered. It’s one of the real sicknesses in this country.
There are 10 Medigap plans, a couple of which aren’t open to new enrollment and the remaining ones are pretty different from each other. The thing is, everybody offerring one of the particular plans (for example Plan A) offers the same benefits under that plan. In other words, several insurers may offer Plan A but everyone covered by Plan A will get the same coverage. Rates will vary by insurer. Individual insurers may offer minor extras (like gym membership) but the coverage will be the same.
As a Canadian, it absolutely astounds me how much it must cost to create and administer this vast complex network of interwoven health care “plans”, none of which, either in itself or in combination, is actually adequate.
Here is the “plan” I have in Canada. If I need medical care, I go to my doctor or to a hospital, receive treatment, and then I go home. No money changes hands at any point in the process.
Why is this so freaking difficult to achieve in the richest country in the world?
All the below assumes you do not live in one of the special states that do everything at least semi-differently (MA, MN, WI). I don’t know enough about those states’ differences to say anything about them or how well the below advice applies to them.
To cut to the chase, the “G” flavor of “medigap” (properly Medicare Supplement) plan is the most comprehensive. If you’re used to good-to-great corporate health insurance, and are not scrabbling to come up with the premiums, that’s probably the one you want. That will be available from several insurers in your state. As already said, big picture every G plan is the same in bulk. The difference is in minor add-ons and the price.
As a separate matter, Part G plans come in both low deductible and high deductible versions. I personally have a high deductible G plan and as a healthy person that saves me considerable money on the total premium + OOP costs every year. If I ever do have a very bad health year, the worst case OOP plus lower HDHP premiums will still amount to almost exactly the same outlay as the lower deductible + higher premium version. ISTM it’s a one way bet: HDHP for the win in healthy years, and a straight tie in bad years.
Another wrinkle is that unlike typical employee insurance where you have to choose the same plan for the entire family, Medicare is a totally individual system. If you want e.g. plan G HDHP from UHC, and hubs wants plan K low-deductible from BCBS, that’s totally fine.
Lastly, regardless of which Medicare Supplement you each choose, you each also need to choose a Part D prescription drug program. Which vary considerably in cost and formulary. If semi-unusual maintance meds are a big part of your lives, some attention paid to formulary is worthwhile. The good news is one can change Part D plans every year without penalty while chasing the best overlap between your ever-moving prescription needs and their ever-changing formularies.
As a data point, all of my maintenance meds are very ordinary generics, and I find zero issue with formulary from year to year. So I choose my Part D plan based solely on copay and premium.
That was not my experience when I was signing up for Supplemental. As Lare stated
The agent presented the plans and encouraged me to pick the one with the cheapest premiums. She took care of all the paperwork as well. Certainly, she got paid for her efforts by the insurer, but it cost me nothing and it was relatively painless for me.
but it cost me nothing and it was relatively painless for me.
You didn’t pay a fee to the agent - but that’s not the only way salesmanship can cost you. A few years ago, my mother’s premium shot way up, to more than she could afford. My sister and I had to help her find a new policy. We found out that she had Plan F which included a lot of coverage she personally didn’t need - she didn’t travel out of the country so she didn’t need any coverage for foreign medical care. Our state prohibits excess charges so she didn’t need coverage for excess charges. Covering the part B annual deductible was useful but it’s currently $283. Now, the agent may very well have directed her to the least expensive Plan F policy available - but my mother’s explanation when we asked why she had Plan F was that “the lady said it was the best one”. Which I’m sure it was for many people - but not for my mother. Not paying the deductible wasn’t worth the additional premiums. I can’t help but think which plan she signed up for affected the agent’s compensation.
If I have a choice, I’d much rather pay a fee than have the salesperson be biased by what benefits them.
I’m a few years away from needing to sign up for Medicare but given the vast amount of advertising for Medicare Advantage plans, I’m leaning towards sticking with traditional Medicare and forgoing any sort of Advantage plan.
I lucked out (finally it was all so convoluted I don’t remember how I got who I got) with the person I worked with. I told her up front I did not want an “advantage” plan. I said this to her because many times I’d get into details with an agent and find out they are trying to push me into advantage plans. It turns out she did not work with advantage plans at all. She only handled Medigap.
She asked many questions and recommended the least expensive and best coverage. Hubster qualified for F because of his age. He needs part F. His health is poor and complicated. The premium is affordable enough and cheaper than most work related insurance. Hell, I live in Michigan so up until last month my car insurance was a lot more.
I know now that there is some state run help with enrollment, but I was getting panicky 'cause we were running out of time, and I had forgotten about that option. I think I was lucky, she filled out the paperwork, explained everything to me, and made sure the letter I needed from his old insurer went where it needed to go. Considering his health this year I’m so glad I found this person.
What bothers me is someone less motivated, tenacious, or tech savvy (and seriously I’m not that savvy but for 67 I don’t do too badly) it would be a disaster. It’s confusing, complicated, the left hand doesn’t know what the right hand is doing. Some agencies that are supposed to help aren’t much better than going it on your own. It’s really a big mess, I think an intentional big mess
But here’s the thing: the agent carefully explained, in great detail, that all of the plans she was showing us covered offered exactly the same coverage. Cheapest plan was the same as the most expensive. All were Plan G.
If my agent was biased towards the most expensive, she would have pushed that plan. But she didn’t. Did she do anything that I couldn’t have done on my own? Probably not, but it made things a lot easier for me.
The consensus here is, and John Oliver’s report confirms, that Advantage plans are often very bad deals. Medicare Supplemental (ie Medigap) plans provide much better coverage, but often at somewhat higher cost than Advantage plans.
But relying on Medicare only does not seem to be a good idea because it leaves the patient liable for more uncovered costs.
And if you don’t opt for medigap within 6 months of your first open enrollment, you are subject to underwriting. If you are not a hale and hearty elder who is quite healthy this can cost a lot, or they can just decline to cover you. I couldn’t jog it free in my memory so I looked it up: Garanteed Issue Right. They have to take you health issues and all without boosting your premiums.
I’m going to try to get medigap this next enrollment. I’m pretty healthy, but I’m having more issues. My only problem is they don’t cover dental or optical.
I wanted to ask about this. I’m a few years away from these decisions but am trying to plan early. My parents are in their late 80s and are on the old plan F where they pay nothing out of pocket. They do not have any drug coverage. They use the same pharmacy where everyone knows them. They have regular medications they take plus they’ve had some health issues pop up from time to time. Yet they tell me they never pay more than $10-$20 per prescription. They report the pharmacists are always able to get them a coupon or reduction or something to get the cost down. For all my parents (or I) know, they’ve got them into one of the programs where you have some card or something to get cheaper prescriptions. My mom was recently prescribed a drug which had just been FDA approved the day before. Monthly cost at book prices were just over $1000 per month. That one took a few phone calls and requests and then some help from the pharmacists and they’re paying $30 per month. So thoughts on this? How bad are Part D prices? Anyone going without Part D and having success? Failures?
Seriously though 'cause money.