03-06-2019, 04:33 PM
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#1
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Senior Member
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Join Date: Aug 2007
Location: S Oregon
Age: 70
Posts: 1,406
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Senior Member
Join Date: Aug 2007
Location: S Oregon
Age: 70
Posts: 1,406
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Medicare starts soon
So Medicare is a $135 hit to my Soc Sec. OK. Now I have to decide on Traditional or Advantage --G care. I am almost 65, decent weight and health, one generic med and controlling diabetes with diet and exercise. Asking on other forums, I see that my State--Oregon is a bit different. No big HMO's.
My wife will be at this point and $265 a month in plans is fine with her. I'm in good health and do not want to give up all my fun $ to this. ideas? thanks
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03-06-2019, 05:29 PM
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#2
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Elite Member
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Join Date: Nov 2002
Location: Eastern USA
Posts: 18,770
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Elite Member
Join Date: Nov 2002
Location: Eastern USA
Posts: 18,770
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Since you’re not on any expensive meds, get plain old regular Medicare.
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03-06-2019, 07:21 PM
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#3
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Member
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Join Date: Feb 2019
Location: Upstate NY
Posts: 105
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Member
Join Date: Feb 2019
Location: Upstate NY
Posts: 105
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Quote:
Originally Posted by ran
So Medicare is a $135 hit to my Soc Sec. OK. Now I have to decide on Traditional or Advantage --G care. I am almost 65, decent weight and health, one generic med and controlling diabetes with diet and exercise. Asking on other forums, I see that my State--Oregon is a bit different. No big HMO's.
My wife will be at this point and $265 a month in plans is fine with her. I'm in good health and do not want to give up all my fun $ to this. ideas? thanks
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I'm all ears on this thread as I'm turning the clock to 64 this year!
All insights most welcome too.
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03-06-2019, 10:33 PM
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#4
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Member
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Join Date: Nov 2017
Location: Campton, New Hampshire
Age: 42
Posts: 401
Real Name: Jordan B
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Member
Join Date: Nov 2017
Location: Campton, New Hampshire
Age: 42
Posts: 401
Real Name: Jordan B
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So this is my business, I am an advisor and have been helping folks with this for about 7 years now. state insurance laws vary greatly and I am not licensed anywhere close to you. as a general rule advantage plans are cheaper to own but more expensive to use particularly if you end up in the hospital and or need surgery. where Medicare Supplement plans or Medigap plans are more expensive to own but cheaper to use, lower out of pocket expenses. if you just go to the doctor once or twice a year you'll wonder what you're paying for. but if like a close relative of mine you find yourself after being hospitalized for your second heart attack having a combo defibrillator and pacemaker installed in your chest, which is about a $500,000.00 surgery and you walk out of the hospital with zero out of pocket you'll understand why you've been paying more for the supplement plan. what is right for you is dependent on a myriad of variables. think long term, most people once they make this choice don't really change it, so your health now matters, but so does your future health. people as a general rule don't get healthier as they age. on the other hand one bad (expensive) year and four good years averages out. bottom line is it's complicated. Chatting with someone who really truly knows the ins and outs of these systems is quite valuable. Please don't confuse that with people who have been to the same "picnic" folks that have one anecdotal story about this one time and one situation and think it translates to everyone all the time. hope this helps.
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03-09-2019, 10:48 AM
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#5
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Member
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Join Date: Mar 2017
Location: Kolorado
Posts: 432
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Member
Join Date: Mar 2017
Location: Kolorado
Posts: 432
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It shouldn't be complicated, but is. Or probably more like speaking a different language that you are used to. My wife turned 65 a year ago, I turn 65 this month. I retired in November after several good earnings years. None of that fits into their mold, so we have been fighting with them for a year to get it all correct. Every time we deal with them, they agree we are right. Then they return to the old decision. I literally have a book of documentation we have provided for them. They still can't get it. I think part of the problem is, you are dealing with government, and then you are dealing with 2 different government agencies, they don't always communicate effectiveliy with each other.
Medicare handles the medical stuff, social security handles the money.
As for the other parts, You have paid into it for your working years, so you already paid for part "A", the premium you pay is for part "B" and possibly part "D". You need to know and understand what the different parts mean and what they are for. Then the options to cover other things that medicare doesn't cover.
Also important to know. If you plan to travel, make sure you have coverage. Some supplement policies won't cover you out of your area. Some will. If you are out of the country, Medicare MAY reimburse you, but make sure everything, all receipts, and documentation is in English.
I am slowly getting educated on the ins and outs, but knowledge is expensive and can be hard to come by. I think finding a decent "Broker" to help you might be a good idea.
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03-09-2019, 07:10 PM
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#6
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Senior Member
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Join Date: Aug 2007
Location: S Oregon
Age: 70
Posts: 1,406
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Senior Member
Join Date: Aug 2007
Location: S Oregon
Age: 70
Posts: 1,406
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I am basically going thru a Broker. All these years with insurance thru work or my wife when my right arm was messed up, this is the first to pay for Medical out of pocket. does hurt that way. I will do Medicare Advantage now. the Part D Aetna is $15.40 a month. My generic meds are $2.00. I can't see paying that much for $2.00 of meds. yes, I know, the future is unknown.
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03-10-2019, 10:39 AM
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#7
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Member
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Join Date: Mar 2017
Location: Kolorado
Posts: 432
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Member
Join Date: Mar 2017
Location: Kolorado
Posts: 432
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With a double incomes, you could have tipped the scales of income. So worth understanding what MAGI is and IRRMA. That's where they over charge you for what you have already paid for. It's pretty simple, but worth knowing. And if it effects you, it looks simple to deal with, but SS has trouble with it.
Also worth knowing. Many govt workers pay into medicare. So check your SS statement when they tell you that you are "A Govt worker, and not eligible"!
We were told that multiple times. My wife was not eligible because she didn't have enough credits. However when totaling up her GOVT part time job, she did. Plus she was eligible because of my work history. Took six months and some denied claims, numerous phone calls, trips to the SS office to get that straightened out. We are still hopeful...………………….
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03-10-2019, 12:47 PM
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#8
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Member
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Join Date: Mar 2017
Location: Kolorado
Posts: 432
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Join Date: Mar 2017
Location: Kolorado
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Something else. get acquainted with how their websites work. Get registered on their websites. They work pretty well for most things. Get your passwords etc set up. If you have not used them, the security codes are sent every time you log in. Works well. Better than sitting on the phone for hours waiting. They also have the ability to call you back. So if you call on the phone, they can give you an estimate of when they will call you back. Then they do, you don't have to sit on hold/voice response for hours.
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03-10-2019, 04:27 PM
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#9
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Member
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Join Date: Jan 2019
Location: Asheville
Posts: 46
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Join Date: Jan 2019
Location: Asheville
Posts: 46
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Quote:
Originally Posted by Oldmanb777
With a double incomes, you could have tipped the scales of income. So worth understanding what MAGI is and IRRMA. That's where they over charge you for what you have already paid for. It's pretty simple, but worth knowing. And if it effects you, it looks simple to deal with, but SS has trouble with it.
Also worth knowing. Many govt workers pay into medicare. So check your SS statement when they tell you that you are "A Govt worker, and not eligible"!
We were told that multiple times. My wife was not eligible because she didn't have enough credits. However when totaling up her GOVT part time job, she did. Plus she was eligible because of my work history. Took six months and some denied claims, numerous phone calls, trips to the SS office to get that straightened out. We are still hopeful...………………….
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All federal workers who don’t pay into social security (if there are any like that left) under the old civil service retirement system, did pay into Medicare, just not social security. Medicare itself should have that on your record. Also, if you are a retired Fed, you can keep your federal employee health plan (the govt pays 70 percent of the premium) as a backup for the free part A Medicare. Since my wife won’t be eligible for Medicare for a few years, I am going part A only and keeping my govt health insurance, for a little under $400 a month for both of us. Plus, as a retired public safety officer, the first $3000 of the premiums can be used to lower your annuitant income by $3000, for a significant tax savings. It works out to about $350 a month with the tax savings. Plus it’s good anywhere in the US and covers me for international travel.
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03-11-2019, 11:06 AM
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#10
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Join Date: Mar 2017
Location: Kolorado
Posts: 432
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Join Date: Mar 2017
Location: Kolorado
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These are good conversations to have. It helps me learn the ins and outs of the system. Get more of a working knowledge than a "book" knowledge.
We are paying just over $300 each for our supplement that includes most drugs, or part "D", and should be paying the $135 for part "B". But even though they agree that we should be paying that, they are still billing us $265/mo each.
They have denied my wife's "Welcome to Medicare" physical payment. Says she isn't eligible for Medicare. but she has just enough credits on her own. And would be eligible under mine anyway. They says she isn't eligible, but are still billing us for it.
Something else. You are eligible for a physical once a year. Not so fast...…..Your first physical isn't called a yearly physical. It's called a "Welcome to Medicare Physical". I think pretty much the same thing, but coded differently. Amazing how many people get denied the claim because of the code. Also, know this, the DR must prescribe the EKG and have a reason for it, in order to include it in your physical. It's available to you in your physical, but must be prescribed separately.
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03-13-2019, 06:33 PM
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#11
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Senior Member
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Join Date: Aug 2007
Location: S Oregon
Age: 70
Posts: 1,406
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Senior Member
Join Date: Aug 2007
Location: S Oregon
Age: 70
Posts: 1,406
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I am going thru a Broker from my wife's old employment. Part C is Regence, a big 36 state coverage, for $15 a month and Part D coverage for Dental, Hearing and Vision is $20 a month. Starting this month $135 comes out of my Soc Sec. Parts C&D is a bill sent monthly. Like most of you, we went thru life with Insurance and stuff taken out of our paychecks. We never cared. I turn 65 in a few weeks. I guess this is the last big thing in life to happen. time to redo my budget. fun.
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03-13-2019, 10:04 PM
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#12
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Member
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Join Date: Mar 2017
Location: Kolorado
Posts: 432
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Join Date: Mar 2017
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Hppy Birthday Couldnt find a birthday jingle, so that will have to do...I'll be 65 in a few weeks my self. Whole new world of health care. I think one of the main reasons its out of control, is like you said, it was supplied. So we never really paid enough attention to the escalation of the prices.
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10-19-2020, 06:32 PM
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#13
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Member
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Join Date: Mar 2017
Location: Kolorado
Posts: 432
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Member
Join Date: Mar 2017
Location: Kolorado
Posts: 432
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Bringing back an old thread. Sometimes its good to review, and also to get expert advice. I think it is pretty much ironed out,at least for now. But enrolment period is here, so who knows what next year will bring. Our supplement administrator for dental is changing. The plan isn't just the administrator. I have not heard about the major medical supplement yet.
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11-16-2021, 01:02 AM
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#14
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Join Date: Mar 2017
Location: Kolorado
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Join Date: Mar 2017
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It's the ONLY platform so I guess it's better than the others.
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12-31-2021, 09:15 PM
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#15
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Join Date: Mar 2017
Location: Kolorado
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Join Date: Mar 2017
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It's another gubermint sponsored disaster. Having a good supplement to help is probably a must. They can be confusing at best. Dealing with SS and Medicare is a real mess. They play a shell game that you can't decipher. WE have had problems from, "your not eligible, or you applied late and therefor pay a penality" neither was true. Tooks months to sort out. To IRMAA hassles. Our January bill for Medicare is $3160 each, for one month premium! No explanation included. We have gotten 5 letters since late Oct telling us what our premium will be for 2022. every letter indicated a different amount. Then this bill. Dues on Christmas day. Merry Christmas from your gubermint. WE are trying to find out what the bill is for, so far no one can tell us. Medicare says it's a Social security problem, social Security says its a Medicare problem. But no one can tell me who made the decision and what the bill is for. It absolutely makes no sense. So good luck!
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