Part of the reason it’s such a PITA is that the government has sold everyone out to a thousand private insurance companies for part of the medical insurance. The Medicare part works just fine – it’s the private insurance that is such a PITA to try to sort through. I thank my lucky stars every time I need medical help, that I have my husband’s medical insurance from his former employer paying for not only the private insurance (same plan we had when he was working) but also reimbursing us for what we pay for Medicare. Mind you, insurance is still a PITA but this is all much simpler for me, and for my husband, who unfortunately REALLY needs medical insurance.
Which reminds me that there’s a movement afoot to enroll seniors automatically in Medicare Advantage (a reversal from the current practice). It comes, as you might imagine, from Dances-With-Worms and his merry crew. One version I saw a while back would place new enrollees in the plan with the lowest premium in their service area and lock them in it for three years, no matter what changes to premiums or networks may occur. There would supposedly be a window to opt out and transfer to traditional Medicare, but I have a feeling it would be a) very short, and b) buried in fine print somewhere.
I turn 65 in Nov so this is on my mind too.
It’s ESPECIALLY on my mind at the moment since my husband is recently unemployed (my health insurance was through his work), and I’ll be laid off soon, probably in August when my store closes for good.
Thanks for all the links. I’m not sure I have all the mental bandwidth needed to wade through it right now, but I’m very glad to know there’s more help than the government websites.
This, this, a thousand times this. My husband went on Medicare a few years ago and I studied up on it. As a former health insurance broker I’m not intimidated by this stuff, and since we live in northern NJ I figured that an Advantage plan would serve us fine since the networks here are so dense with high-quality providers. Well, in the first year he ran up against more than one snafu requiring my time and trouble to untangle and get covered–and this wasn’t even for anything complicated. That’s NEVER going to get better, so as soon as we could he switched to a Medigap plan. (There’s a one-time, no-questions-asked opportunity to switch after your first year. After that switching from Advantage to Medigap requires a special circumstance or underwriting.)
When I start Medicare in November I’m not futzing around, I’m going straight to a Medigap plan. Since I’m not taking SSI yet I will be paying out of pocket for Medicare, Medigap, and Part D, a likely total of almost $450/mo for health insurance. But I’m paying $285 right now for a shitty Bronze plan on the Marketplace with high deductibles and an OOP of more than $10K. I just hope I don’t break my leg or something in the next few months. That $450/mo will cover me WELL, with a grand total of $283 out of pocket for the full year.
That depends on your age * , whether it’s employee coverage or retiree coverage, and if it’s employee coverage, the size of the employer (or multi-employer group) matters. When I’m old enough for Medicare , my retiree coverage will be primary ( which is why that coverage will reimburse my Medicare premiums) and my retiree insurance will function as a supplement for prescriptions, etc This will tell you which is primary/secondary for your particular situation.
*There are situations where people under 65 are eligible for Medicare - for example, people receiving SSDI are eligible for Medicare after 24 months.
Jesus christ!.. Medicare used to be real simple and easy. You’d turn 65 and sign up…If you needed extra coverage… like for dental and vision, you’d pick a supplement plan from one (private) insurance outfit or another.
I believe that this whole Medicare Advantage thing is designed to get us all ready for the complete privatization of actual Medicare.
Well it’s a beautiful day this morning! I did a lot of reading yesterday, and also discussing with Mrs.Bullitt, and my plan for today is straightforward: sign up for Plan D, and sign up for a Medicare Supplement plan. And with that I should be set for Monday the 1st when my Medicare coverage goes live.
Bring on 65! I turn 65 next month.
Thanks so much for all the help here, and also many thanks to @JohnT and his excellent Medicare explanations in his 2021 thread (➜ https://e7t.s.gy/BU8xuU ■ ; I use a URL shortener, this link is safe, I just created it).
Dopers are a great bunch of people. Thanks again!
I have the Medical Supplemental Plan F through Catholic Life. (I’m not Catholic, but they don’t discriminate.) The plan is no longer offered but I’m grandfathered in on it.
Where I live – about 100 miles from the nearest major hospital – the Advantage plans are major mistakes. If I had an Advantage plan, I would not only have to get approval from the insurer for just about anything, I would have to travel to the city about 100 miles away to find a doctor who will accept the Advantage plan. With the Supplemental Plan, I don’t need approval from anyone. I don’t even need to have a doctor’s referral to see a specialist and have it covered.
My younger brother signed up for an Advantage plan so it is a 200 mile round trip for him to go to the doctor unless he pays out of his own pocket. My trip to the doctor and back is about 30 miles from the office or 70 miles from the farm. His father-in-law has an Advantage plan and they put him through hell.
While I pay a set amount per year (increases with age), my worst case is far less.
I also have memberships in the two local medevac by air companies. If I need to hauled to the hospital by helicopter and it is either of those two companies, they settle for whatever the insurance pays.
A friend and neighbor of mine got bitten by a rattlesnake about four years ago. His medevac charges were approximately $60,000. That included evacuation in a King Air rather than a helicopter and the ride in the ambulance from the airport to the hospital. The ride in the ambulance by itself was about $5,000.
His total medical bills ran about $300,000 in addition to the medevac fees. He had no insurance at all. The medevac company settled for about $8,000 and the hospital settled for about $6,000. His $14,000 out of his pocket was enough to cover my total Medicare insurance charges for about six years.
I have read that more and more doctors and hospitals are dumping Advantage plans.
As retired military, it was dead easy. No part XYZ or any of that shit because Tri Care covers for free whatever Medicare doesn’t.
Except dental, of course.
That’s exactly what it is. For now, they’re employing “carrot,” with up-front perks to tempt people onto Advantage (vision, dental coverage, etc.), but they’re already moving to “stick,” as referenced by @OttoDaFe here:
IMHO, it’s best to hang onto your Supplement (Medigap) plan for as long as you can.
My BiL just retired and has gone through this and would absolutely, 100 million percent agree with the OP. Fortunately for me, he said he can be my guide when I get there so I will have an easy(er) time of it.
Being the youngest sometimes has its advantages (honestly…I think most of the advantages but that is a different discussion).
So… I actually have a photo of @JohnT. Turns out that when Mrs.Bullitt and I were in Texas for the eclipse in 2024, we had a mini Doper Fest in San Antonio organized with @ThelmaLou, and John and @InnaInna (wife, I think) were there. @FloatyGimpy too, and also @Velocity soon joined us. We shared a nice lunch together. The Gristmill in Gruene, New Braunfels TX, a nice place of you’re in the area. Tell them Bullitt sent you. And they’ll say Bullitt WHO?
Our photo is here, from my SDMB post last year, and John and Inna are on the right.
➜ https://e7t.s.gy/Tz6hCC ■ I use a URL shortener and this is safe, I just created it.
Anyway, John, You Da Man and thanks for all your help!
You’re quite welcome, and call me any time!