# Medicare Part A? B? D? HSA? What the?



## WinniWoman (Oct 10, 2018)

So hubby's open enrollment period for 2019 is coming up at his job and we have to make some decisions.

He turns 65 in April. Not retiring. He has always contributed (the max) to an HSA since he has a high deductible plan, but if he applies for Medicare in 2019 he will no longer be able to do so.

If he *does not* apply for Medicare, and decides to retire April of 2020- when he turns 66- he will have had to stop contributing to his HSA 7 months BEFORE that date-around October 2019- or face tax penalties. Then he is going to have to immediately apply for Medicare when he turns 66 upon retirement.

So- my question is: Should he apply for Medicare Part A in January 2019 or should he wait until he retires in 2020 (or whenever he does retire)? What about Part B? Should he apply for that also or wait? He would be keeping his health insurance through his job no matter what. His employer is a large one so the insurance would be primary over Medicare.(I am also covered under that plan.) I heard sometimes it is a hassle to apply for Part B later on when you do retire- it takes a while to take effect and you could have a gap in insurance coverage(?).

And- what about D then? How does that come into play? Since he has employer insurance with drug coverage I assume we can forgo that- or can we?- there are so many rules my head spins. Will it be an issue later on when he no longer has employer heath insurance and need drug coverage through Medicare? Yikes.

My thinking is that Part A is free anyway. His insurance is high deductible and Medicare, though it has a deductible also, could pick up for anything his insurance does not should something happen medically before he retires. With Part B, since he would not be contributing to his HSA, he could divert some of that money for the Part B premium. (He does not pay a premium for his insurance at his job- at least up until now his company pays for him in full. We do pay a premium for me). Then Part B could also pick up for things his insurance does not pay for as well. My husband could also divert some of the money he would normally have put in the HSA into his 401K, which he recently had to cut contributions because of my job loss. Or honestly we could use some of the extra money in our household budget so it wouldn't be so tight.

Know that we have been healthy so far. We get preventative care. Hubby is on blood pressure meds (cheap through his employer prescription plan) and has to visit the doc every 6 months and have lab work. Have to lay out for colonoscopies because we have both had polyps in the past.

So the downside is that he could not contribute to the HSA (well he could for the first 3 months of the year, but why even bother- the tax advantage would be minimal) if he goes on Medicare and if he *doesn't *he still cannot contribute to the HSA for the entire 2020 year either, though he can get a chunk of money in there- again- not worth the hassle and tax advantage I would think (our income in 2019 will be lower than this year, since I am no longer working).

I contacted his HR dept and the reps there were useless. I finally was directed to a retirement specialist at the company (even though hubby is not retiring) and she was somewhat helpful but couldn't help me on this particular issue. She then directed me to another company called Via Benefits which supposedly handles his company's employees in transition when they are eligible for Medicare and retire and so forth. That rep also said she could not assist me because my husband was not Medicare eligible yet and would be getting a card in the mail from SS in January and at that time I could call back and ask questions. She said their advisors were sales reps. and could not answer these questions at this time. Huh? I tried calling Medicare and was on hold so long I hung up. Then I tried the local SHIP office via phone and they were not there. OMG...

How can someone plan and  make decisions without the proper information? I don't get it.

Anyway, hoping someone here has some insight into this.


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## bogey21 (Oct 10, 2018)

I'm no expert on timing Medicare but would sign up as soon as eligible.  I think what happens is that Medicare becomes Primary and Employer Insurance becomes secondary.  There are penalty issues with Parts B and D which I don't thoroughly understand for not signing up when first eligible.  I think the penalty for Part D is waived if you get a letter from your employer saying that you had prescription coverage with Employer that was equal to or better than Part D.  Bottom line is that I would sign up as soon as eligible to avoid having to deal with Medicare to get penalties waived...

George


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## WinniWoman (Oct 10, 2018)

If an employer has more than 20 full time employees, I read that Medicare is secondary.

I did read something about your employer drug plan having to be "credible". In other words- equal or better than the Medicare drug plan.


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## FrankB (Oct 10, 2018)

Try this link...scroll down and go to Publications then go to Topics and select Medicare
https://www.ssa.gov/


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## b2bailey (Oct 10, 2018)

I agree all of this can be a bit overwhelming. However, no matter how much info you can gather from the sources mentioned, I don't think anyone can answer "what should I do". Also, it seems you are tangling up two questions -- one is health care related, the other is tax implications. Perhaps look at the two separately.


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## Talent312 (Oct 10, 2018)

(1) Your state may have a senior health insurance counselling program, as Florida does thru it's Department of Elder Affairs and local Agency on Aging. In Florida, it's called SHINE (Serving Health Insurance Needs of Elders).

(2) You need to be darn-sure that his employer group policy will still be primary when he's medicare eligible. When I turn 65 (a few months), my state employee/retiree plan becomes secondary. Thus, we are strongly advised to enroll when first eligible.

(3) Either way, he needs to enroll in Part A as it's free (no premium) during his "initial enrollment period" (starts 3 mos before the month he turns 65). If his employer group policy is still "primary," he can wait on Parts B & D until he retires or coverage ends. He can then enroll without penalty during a "special enrollment period" (his HR office needs to certify coverage). OTOH, if his coverage becomes "secondary," he needs to enroll in all parts during the initial enrollment period.

(4) If he enrolls in Parts B & D while still employed, dropping his employer's policy and electing a supplemental plan may provide a considerable savings. To enroll in Part D, he'll need to self-select a drug-plan. When I turn 65, I will switch from my state-employee/retiree plan to either the employee/retiree supplement plan or another medigap plan. 

Medigap and drug plans can be compared at...
https://www.medicare.gov/find-a-pla...rce=govdelivery&AspxAutoDetectCookieSupport=1
.


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## DaveNV (Oct 10, 2018)

I am no expert, but recently went through this when I turned 65 earlier this year.  After many years of having insurance through the military (Tricare Prime) as my only insurance, when I became Medicare eligible, everything flipped.  Medicare stepped in and became my primary (Part A) and Tricare turned into "Tricare For Life," and became my Part B.  I received a Medicare card in the mail just prior to the month I turned 65, and on the first of that month, Medicare became my primary insurer.  One advantage for me is that Tricare For Life also acts as Part D, so I did not need a separate prescription coverage plan.  It's been weird, because it's so different, but so far, seems to be working. Cross your fingers.

The one thing I wasn't prepared for, and am still not sure I fully understand, is I have to pay Medicare (CMS) a monthly premium of $134 for my Tricare coverage.  What was costing me a several hundred dollars a year as my primary coverage now costs me three times as much to be my secondary coverage.  I haven't been able to get a straight answer from anyone about that one.

The one thing I heard throughout is to be sure to sign up when first eligible.  If you don't, there are penalties assessed, which can delay coverage for the time you were eligible and didn't have coverage.  It's confusing, because nobody tells you what you should be signing up for, exactly.

As Alan Cole likes to say, "Is this a great country or what?"  

Good luck wading through stuff. It's a minefield, for sure.

Dave


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## Luanne (Oct 10, 2018)

Bottom line is, you HAVE to sign up for Part A when eligible.  If still working you can wait on Part B.


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## VacationForever (Oct 10, 2018)

DaveNW said:


> The one thing I wasn't prepared for, and am still not sure I fully understand, is I have to pay Medicare (CMS) a monthly premium of $134 for my Tricare coverage.  What was costing me a several hundred dollars a year as my primary coverage now costs me three times as much to be my secondary coverage.  I haven't been able to get a straight answer from anyone about that one.
> 
> Dave



$134 per month is the base cost of Medicare which everyone on Medicare pays.  Even if you have Tricare or whatever employer plan, you still have to pay the minimum $134 per month.  This amount is dependent on household income.


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## b2bailey (Oct 10, 2018)

VacationForever said:


> $134 per month is the base cost of Medicare which everyone on Medicare pays.  Even if you have Tricare or whatever employer plan, you still have to pay the minimum $134 per month.  This amount is dependent on household income.



is this the amount that is withheld each month from my social security payment? If yes, would this mean a person on medicare, but not yet collecting ss benefits would have to pay this amount?


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## VacationForever (Oct 10, 2018)

b2bailey said:


> is this the amount that is withheld each month from my social security payment? If yes, would this mean a person on medicare, but not yet collecting ss benefits would have to pay this amount?


Correct.  That is the monthly premium for Medicare.  It is independent as to whether you start SS or not.  If you start SS, then that monthly premium is deducted directly from your SS, otherwise it is from your bank account.


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## Passepartout (Oct 10, 2018)

All I know, I read on TUG, and that's that you MUST sign up for Medicare when you turn 65 or face penalties henceforth.


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## VacationForever (Oct 10, 2018)

Passepartout said:


> All I know, I read on TUG, and that's that you MUST sign up for Medicare when you turn 65 or face penalties henceforth.



Yep, that is my knowledge too.


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## JohnPaul (Oct 10, 2018)

Part A of Medicare is automatic when you turn 65 and does not have a premium.

Since Medicare does not discriminate for pre existing conditions, there are penalties if you wait to enroll (like until you get sick).  However, if you have "creditable" healthcare between the time you turn 65 and when you start Medicare the penalty is waived.  Insurance from you or your spouse's employer is an example of "creditable" insurance.

If you wait to enroll and don't have creditable insurance for that time you will pay a higher Medicare premium for the rest of your life.


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## DeniseM (Oct 10, 2018)

My husband was eligible for Medicare 2 years before he retired.  He applied as soon as he was elgible, so he had company insurance and Medicare for 2 years.  During those 2 years he had to have a couple of unexpected surgeries - between the 2 insurances, we didn't have to pay a cent.  

*An experienced and reputable insurance agent can walk you through it - we found that to be extremely valuable.


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## IngridN (Oct 10, 2018)

DH worked after he turned 65. As he had a cadillac plan thru work, he did NOT need to sign up for Medicare when he turned 65. He did sign up for part A shortly after 65 as it's free, covers hospital only and would act as secondary coverage if he was hospitalized. He signed up for Part B and D when he retired a few years later. There is NO penalty for signing up after eligible for Medicare as long as you have other coverage that complies. He did have to get a statement from employer verifying his coverage.

Ingrid


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## pittle (Oct 10, 2018)

Part A is not free - it costs $134 per month (they take it out of your SS check) and becomes your Primary insurance.  D is for drugs and is not included in A at all. (If you put this one off, there is a penalty for each year you do not have it. Neither of us take prescription drugs, but if we had waited until we do, we would have had penalties and paid much higher premiums.) B is our Supplemental insurance and we chose Plan F when the large corporation we worked for 30 years decided that they would no longer pay for 1/2 the medical insurance for retirees  because of the new healthcare laws implemented in 2012.  Plan F was better and less expensive than what we had paid for the high option plan offered by our company.  We have no deductible and no co-pay and can choose any doctor that accepts Medicare. I understand that in 2020, we will need to choose Plan G for close to similar coverage.


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## IngridN (Oct 10, 2018)

Original Medicare: Part A covers hospitalization and is free. Part B is doctor and base costs is $134/mo.; depending on income, you might be subject to IRMAA and pay more. Part D is Rx. If you have NO OTHER coverage and don't sign up at 65, you will incur a penalty forever and ever. If you have other coverage, no penalty, but will need to prove you had other coverage.

Advantage programs are somewhat different and I'm not that familiar with them.

You are getting a lot of wrong information in this thread. Go to Medicare.gov and read up. Or go to ER.org (early retirement forum). They have some great threads on everything you wanted to know about Medicare.

Ingrid


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## Talent312 (Oct 10, 2018)

Pittle, with all due respect, you are confused... Part A (Hospital Care) is free. There is no cost, whatsoever. Part B (Medical Treatment) is what your $134/month premium is for. Supplemental plans have an additional premium.

At age 65, my DW enrolled in Part A. She deferred enrolling in Parts B+D.* Only when she enrolled in Parts B+D did the $134/month premium kick in. Your supplemental plan (Plan F) is an add-on with an additional premium.
_
*If you keep primary employer group coverage, there's no penalty for waiting.
OTOH, if it's not going to be secondary, you need to enroll when eligible._

-----------------------------
JohnPaul, enrollment is "automatic" only if you're currently receiving SS (or RR benefits).
Otherwise, you have to enroll yourself.
------------------------------

.


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## Luanne (Oct 10, 2018)

pittle said:


> Part A is not free - it costs $134 per month (they take it out of your SS check) and becomes your Primary insurance.  D is for drugs and is not included in A at all. (If you put this one off, there is a penalty for each year you do not have it. Neither of us take prescription drugs, but if we had waited until we do, we would have had penalties and paid much higher premiums.) B is our Supplemental insurance and we chose Plan F when the large corporation we worked for 30 years decided that they would no longer pay for 1/2 the medical insurance for retirees  because of the new healthcare laws implemented in 2012.  Plan F was better and less expensive than what we had paid for the high option plan offered by our company.  We have no deductible and no co-pay and can choose any doctor that accepts Medicare. I understand that in 2020, we will need to choose Plan G for close to similar coverage.


I think you are wrong.  From what I've heard (and don't quote me) is that at some point plan F for NEW subscribers will be going away.  If you currently have Plan F you can keep it, and I think you can even change carriers.

Both dh and I have Plan F and use different companies for our supplemental plan.  We also have Plan D.  We are keeping Plan F and D.  I am in the process of changing carriers this year and dh will probably do so as well.

From information found online at medicare.com.  Here is link to entire article:

https://medicare.com/medicare-supplement/is-medicare-supplement-plan-f-going-away/

*Is Medicare Supplement Plan F being discontinued?*
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed by Congress and signed into law on April 16, 2015 changed the law on various aspects of health care, including some Medicare Supplement plans. The new law states that on or after January 1, 2020, a Medicare Supplement policy that provides coverage of the Part B deductible may not be sold or issued to a newly eligible Medicare beneficiary.  You can read more here. That means that people whose birthday is December 31, 1954 (turning 65 on December 31, 2019) may be the last group able to enroll in Medicare Supplement Plan F. After January 1, 2020, you will not be able to enroll in Medicare Supplement Plan C, one of the closest alternatives to Plan F, either, since it also covers the Part B deductible.  *If you already have Plan F, you can keep it. The law only affects new enrollees.*


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## IngridN (Oct 10, 2018)

boomerbenefits.com, a Medicare insurance broker, gets high marks. I will be working with them in the next few months when I become Medicare eligible. I am also interested in dental insurance as we've been paying ~4K+/yr for DH and will most likely continue at that rate or worse. DH currently has original Medicare with AARP's UHC and we are very happy with them. They also offer Silver Sneakers, which, when I'm on Medicare will save us $1.5K per year in gym membership costs. Other insurers also offer SS. Lots of info our there. Also, depending on your state, you may not be able to change Medigap insurers w/o medical underwriting once you make your decision. Some states including ours allow once a year changes to Medigap plans of equal or lesser coverage around the birthday month. If your state does not allow changes, make sure you are happy with your decision. There is no 'open enrollment' with Medigap plans, only with Plan D Rx which can be changed each year.

Again, some of the above may not apply to Advantage plans.


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## Patri (Oct 10, 2018)

IngridN said:


> They also offer Silver Sneakers, which, when I'm on Medicare will save us $1.5K per year in gym membership costs.


You have an expensive gym. Mine is about $300 a year if paid upfront. Includes a pool, weight rooms and classes. I see people who are members using their Silver Sneakers card.


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## IngridN (Oct 10, 2018)

Patri said:


> You have an expensive gym. Mine is about $300 a year if paid upfront. Includes a pool, weight rooms and classes. I see people who are members using their Silver Sneakers card.



$120/month for DH and me. Unfortunately, they don't participate in Silver Sneakers so we'll be joining one of the other 3 gyms in our area that participate.

Ingrid


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## IngridN (Oct 10, 2018)

Luanne said:


> ... ...
> *Is Medicare Supplement Plan F being discontinued?*
> The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed by Congress and signed into law on April 16, 2015 changed the law on various aspects of health care, including some Medicare Supplement plans. The new law states that on or after January 1, 2020, a Medicare Supplement policy that provides coverage of the Part B deductible may not be sold or issued to a newly eligible Medicare beneficiary.  You can read more here. That means that people whose birthday is December 31, 1954 (turning 65 on December 31, 2019) may be the last group able to enroll in Medicare Supplement Plan F. After January 1, 2020, you will not be able to enroll in Medicare Supplement Plan C, one of the closest alternatives to Plan F, either, since it also covers the Part B deductible.  *If you already have Plan F, you can keep it. The law only affects new enrollees.*



Of concern to many, especially in states that do not allow changes w/o medical underwriting is "once they close Plan F, will premiums sky-rocket because no new, younger, healthy people are allowed to join?" I will most likely go with Plan G which is the same as Plan F except you pay the $138/yr deductible. We'll see how DH's Plan F plays out. If premiums sky-rocket, he'll switch to G during his birthday month. Or, insurers will dump Plan F allowing all participants to join other same/lesser Plans w/o medical underwriting. Will be interesting to watch.


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## Talent312 (Oct 10, 2018)

Patri said:


> You have an expensive gym. Mine is about $300 a year if paid upfront. Includes a pool, weight rooms and classes.



DW got in on the ground-floor of the most popular gym in the area.
Her dues are only $170/year for life. Now, if she'd only go...

.


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## Luanne (Oct 10, 2018)

Patri said:


> You have an expensive gym. Mine is about $300 a year if paid upfront. Includes a pool, weight rooms and classes. I see people who are members using their Silver Sneakers card.


Price is relative.  My gym is more than that, BUT it's close and convenient and I go regularly.  If I tried to go to one of the less expensive chain gyms that is farther away most likely I wouldn't go.


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## MULTIZ321 (Oct 10, 2018)

pittle said:


> Part A is not free - it costs $134 per month (they take it out of your SS check) and becomes your Primary insurance.  D is for drugs and is not included in A at all. (If you put this one off, there is a penalty for each year you do not have it. Neither of us take prescription drugs, but if we had waited until we do, we would have had penalties and paid much higher premiums.) B is our Supplemental insurance and we chose Plan F when the large corporation we worked for 30 years decided that they would no longer pay for 1/2 the medical insurance for retirees  because of the new healthcare laws implemented in 2012.  Plan F was better and less expensive than what we had paid for the high option plan offered by our company.  We have no deductible and no co-pay and can choose any doctor that accepts Medicare. I understand that in 2020, we will need to choose Plan G for close to similar coverage.


Hi Pittle,

Part A is free. What you are describing is Part B which for you is $134/month and is deducted from your monthly Social Security.


Richard


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## Luanne (Oct 10, 2018)

IngridN said:


> boomerbenefits.com, a Medicare insurance broker, gets high marks. I will be working with them in the next few months when I become Medicare eligible. I am also interested in dental insurance as we've been paying ~4K+/yr for DH and will most likely continue at that rate or worse. DH currently has original Medicare with AARP's UHC and we are very happy with them. They also offer Silver Sneakers, which, when I'm on Medicare will save us $1.5K per year in gym membership costs. Other insurers also offer SS. Lots of info our there. Also, depending on your state, you may not be able to change Medigap insurers w/o medical underwriting once you make your decision. Some states including ours allow once a year changes to Medigap plans of equal or lesser coverage around the birthday month. If your state does not allow changes, make sure you are happy with your decision. There is no 'open enrollment' with Medigap plans, only with Plan D Rx which can be changed each year.
> 
> Again, some of the above may not apply to Advantage plans.


Interesting you say there is no open enrollment with Medigap plans.  I am opting to change carriers for my Plan F for next year.  Reason is if I go through the company that manages retiree healthcare for the company I worked for, they will give me a Health Savings Account of $2600, which will offset my premiums, plus more.  They used to do this if you got prescription and eye care through them, but they have reduced the amount to $500/year unless you get a medicare supplement or medicare advantage plan through them.  My premium will be slightly more than what I pay now, but the $2600 will more than make up for it.

Anyway, I was not even able to see what plans were available until open enrollment period.  So I don't think there was any way I could have changed plans before then.


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## Sugarcubesea (Oct 10, 2018)

pittle said:


> Part A is not free - it costs $134 per month (they take it out of your SS check) and becomes your Primary insurance.  D is for drugs and is not included in A at all. (If you put this one off, there is a penalty for each year you do not have it. Neither of us take prescription drugs, but if we had waited until we do, we would have had penalties and paid much higher premiums.) B is our Supplemental insurance and we chose Plan F when the large corporation we worked for 30 years decided that they would no longer pay for 1/2 the medical insurance for retirees  because of the new healthcare laws implemented in 2012.  Plan F was better and less expensive than what we had paid for the high option plan offered by our company.  We have no deductible and no co-pay and can choose any doctor that accepts Medicare. I understand that in 2020, we will need to choose Plan G for close to similar coverage.



We just went through a benefit meeting at work, and we were told that if your still working and your employer has more than 20 employees you can choose not to take Part A.  Our company only charges $95 a month for family coverage, so I would not want to pay more then I would have to... I have a HSA plan and love contributing to it...I did not know that you have to stop contributing to your HSA 7 months before you go on medicare....ugh so much to learn and I still have 8 years till I qualify for medicare....


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## Luanne (Oct 10, 2018)

Sugarcubesea said:


> We just went through a benefit meeting at work, and we were told that if your still working and your employer has more than 20 employees you can choose not to take Part A.  Our company only charges $95 a month for family coverage, so I would not want to pay more then I would have to... I have a HSA plan and love contributing to it...I did not know that you have to stop contributing to your HSA 7 months before you go on medicare....ugh so much to learn and I still have 8 years till I qualify for medicare....


Whoa!  That's not even close to anything I've ever been told or read.  The way I understand it is, you HAVE to sign up for Part A when you are eligible.  If you are still employed (or your spouse is still employed and receives medical) you don't have to sign up for Part B.

In doing some investigating it looks like the wording is that you "can" sign up for Part A, but it doesn't look like you have to.  But, since it doesn't cost anything I think most people go ahead and sign up when eligible.

https://www.medicare.gov/index.php/...how-do-i-get-parts-a-b/should-i-get-parts-a-b

When dh reached 65 he signed up for Part A.  We were both still working and we were both covered under my employer.  Nothing happened to my premiums because of him.

I also found out after I retired that my company provided me with an HSA plan that I pay nothing into and get $2600/year, with dh getting $1600/year as long as we go through the company retiree benefits group to get our medicare, eyecare and prescription.  It used to just be we got that much with just getting prescription and/or eyecare, but they are changing it for the coming year.


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## WinniWoman (Oct 10, 2018)

FrankB said:


> Try this link...scroll down and go to Publications then go to Topics and select Medicare
> https://www.ssa.gov/



Thanks. This was helpful.


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## WinniWoman (Oct 10, 2018)

Luanne said:


> Bottom line is, you HAVE to sign up for Part A when eligible.  If still working you can wait on Part B.


 
I called Medicare and got through this evening, And, just as I had read, you do not have to sign up for Part A if you are not on SS and are covered by an employer group plan.


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## WinniWoman (Oct 10, 2018)

VacationForever said:


> Correct.  That is the monthly premium for Medicare.  It is independent as to whether you start SS or not.  If you start SS, then that monthly premium is deducted directly from your SS, otherwise it is from your bank account.



Just to be clear-It is actually for Part B Medicare. Part A is free.


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## WinniWoman (Oct 10, 2018)

Passepartout said:


> All I know, I read on TUG, and that's that you MUST sign up for Medicare when you turn 65 or face penalties henceforth.



No- not if you are covered by an employer plan and not on SS.


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## WinniWoman (Oct 10, 2018)

VacationForever said:


> Yep, that is my knowledge too.



Nope. Not if you are covered by an employer plan and not on SS.


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## Luanne (Oct 10, 2018)

mpumilia said:


> I called Medicare and got through this evening, And, just as I had read, you do not have to sign up for Part A if you are not on SS and are covered by an employer group plan.


Thanks.  As I finally found out by checking the Medicare.gov website you are correct.  You do NOT have to sign up for Part A, as long as your company has more than 20 employees and you are covered by a group plan.

It's always best to go to the source.


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## WinniWoman (Oct 10, 2018)

JohnPaul said:


> Part A of Medicare is automatic when you turn 65 and does not have a premium.
> 
> Since Medicare does not discriminate for pre existing conditions, there are penalties if you wait to enroll (like until you get sick).  However, if you have "creditable" healthcare between the time you turn 65 and when you start Medicare the penalty is waived.  Insurance from you or your spouse's employer is an example of "creditable" insurance.
> 
> If you wait to enroll and don't have creditable insurance for that time you will pay a higher Medicare premium for the rest of your life.



Right, BUT-It is not automatic if you are not taking SS yet. You would have to enroll via SS on your own if you want Medicare Part A (and B)- which you would if you have no health coverage through an employer. You have 3 months before your 65th birthday, the month of your birthday and 3 months after your birthday to enroll.


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## WinniWoman (Oct 10, 2018)

pittle said:


> Part A is not free - it costs $134 per month (they take it out of your SS check) and becomes your Primary insurance.  D is for drugs and is not included in A at all. (If you put this one off, there is a penalty for each year you do not have it. Neither of us take prescription drugs, but if we had waited until we do, we would have had penalties and paid much higher premiums.) B is our Supplemental insurance and we chose Plan F when the large corporation we worked for 30 years decided that they would no longer pay for 1/2 the medical insurance for retirees  because of the new healthcare laws implemented in 2012.  Plan F was better and less expensive than what we had paid for the high option plan offered by our company.  We have no deductible and no co-pay and can choose any doctor that accepts Medicare. I understand that in 2020, we will need to choose Plan G for close to similar coverage.




No- that $134  premium is for Part B. Part A is free (though it has a deductible when it is used). Medicare is not your primary insurance if your employer has over 20 employees I think it is. It is secondary if you work a small employer. Supplemental insurance is not Part B.


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## WinniWoman (Oct 10, 2018)

IngridN said:


> Original Medicare: Part A covers hospitalization and is free. Part B is doctor and base costs is $134/mo.; depending on income, you might be subject to IRMAA and pay more. Part D is Rx. If you have NO OTHER coverage and don't sign up at 65, you will incur a penalty forever and ever. If you have other coverage, no penalty, but will need to prove you had other coverage.
> 
> Advantage programs are somewhat different and I'm not that familiar with them.
> 
> ...




Yes- I see that! I recognize the misinformation. 

LOL! I am also on the ER forum. And I have downloaded some info. from Medicare. org and even called them this evening. Though- I still have questions.


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## WinniWoman (Oct 10, 2018)

Luanne said:


> I think you are wrong.  From what I've heard (and don't quote me) is that at some point plan F for NEW subscribers will be going away.  If you currently have Plan F you can keep it, and I think you can even change carriers.
> 
> Both dh and I have Plan F and use different companies for our supplemental plan.  We also have Plan D.  We are keeping Plan F and D.  I am in the process of changing carriers this year and dh will probably do so as well.
> 
> ...




I did read somewhere that Plan F will eventually become more expensive since it is closed to new and younger enrollees and the current insureds will start to age out, driving up costs.


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## Luanne (Oct 10, 2018)

mpumilia said:


> I did read somewhere that Plan F will eventually become more expensive since it is closed to new and younger enrollees and the current insureds will start to age out, driving up costs.


As someone else already said, we'll wait and see what happens.  If it does become cost prohibitive we'll switch.


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## WinniWoman (Oct 10, 2018)

IngridN said:


> boomerbenefits.com, a Medicare insurance broker, gets high marks. I will be working with them in the next few months when I become Medicare eligible. I am also interested in dental insurance as we've been paying ~4K+/yr for DH and will most likely continue at that rate or worse. DH currently has original Medicare with AARP's UHC and we are very happy with them. They also offer Silver Sneakers, which, when I'm on Medicare will save us $1.5K per year in gym membership costs. Other insurers also offer SS. Lots of info our there. Also, depending on your state, you may not be able to change Medigap insurers w/o medical underwriting once you make your decision. Some states including ours allow once a year changes to Medigap plans of equal or lesser coverage around the birthday month. If your state does not allow changes, make sure you are happy with your decision. There is no 'open enrollment' with Medigap plans, only with Plan D Rx which can be changed each year.
> 
> Again, some of the above may not apply to Advantage plans.




But you can change with other supplement plans during open enrollment from what I understand, or from an Advnatge plan to a supplement plan.


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## WinniWoman (Oct 10, 2018)

Patri said:


> You have an expensive gym. Mine is about $300 a year if paid upfront. Includes a pool, weight rooms and classes. I see people who are members using their Silver Sneakers card.




Mine is really cheap- in my house (bike, weight bench and gazelle, floor mat) and outside on the road (for walking). Don't have a pool, though, and I would love one.


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## WinniWoman (Oct 10, 2018)

Sugarcubesea said:


> We just went through a benefit meeting at work, and we were told that if your still working and your employer has more than 20 employees you can choose not to take Part A.  Our company only charges $95 a month for family coverage, so I would not want to pay more then I would have to... I have a HSA plan and love contributing to it...I did not know that you have to stop contributing to your HSA 7 months before you go on medicare....ugh so much to learn and I still have 8 years till I qualify for medicare....




Right. But remember- Part A is premium free and if you have a high deductible plan at work- which you do- then Part A might pick up what your employer plan does not-as secondary- though Part A does also have a deductible.


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## IngridN (Oct 10, 2018)

Luanne said:


> Interesting you say there is no open enrollment with Medigap plans.  I am opting to change carriers for my Plan F for next year.  Reason is if I go through the company that manages retiree healthcare for the company I worked for, they will give me a Health Savings Account of $2600, which will offset my premiums, plus more.  They used to do this if you got prescription and eye care through them, but they have reduced the amount to $500/year unless you get a medicare supplement or medicare advantage plan through them.  My premium will be slightly more than what I pay now, but the $2600 will more than make up for it.
> 
> Anyway, I was not even able to see what plans were available until open enrollment period.  So I don't think there was any way I could have changed plans before then.



There is no on-going 'open enrollment' per se with Medigap plans allowing one to chose another plan w/o medical underwriting. The 'open enrollments' related to Medigap are either Plan or State specific. As I mentioned in an earlier post, in my state, you can change your Medigap coverage w/o underwriting during (and month before and month after) your birthday month as long as you chose a like or lesser plan. Hence, we have 'open enrollment' of a type during a certain month each year. Otherwise, you have to go through underwriting, which I would guess most people would not want to do. DH and I certainly wouldn't qualify if having to go through underwriting.


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## Luanne (Oct 10, 2018)

IngridN said:


> There is no on-going 'open enrollment' per se with Medigap plans allowing one to chose another plan w/o medical underwriting. The 'open enrollments' related to Medigap are either Plan or State specific. As I mentioned in an earlier post, in my state, you can change your Medigap coverage w/o underwriting during (and month before and month after) your birthday month as long as you chose a like or lesser plan. Hence, we have 'open enrollment' of a type during a certain month each year. Otherwise, you have to go through underwriting, which I would guess most people would not want to do. DH and I certainly wouldn't qualify if having to go through underwriting.


I can only go by my own experience.  I decided to change Medigap (medicare supplement plan) providers, not plans.  I couldn't get any information on the plans available to be through my employer's retiree benefit site until open enrollment started (which also happens to be the month of my birth).


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## WinniWoman (Oct 10, 2018)

Luanne said:


> Interesting you say there is no open enrollment with Medigap plans.  I am opting to change carriers for my Plan F for next year.  Reason is if I go through the company that manages retiree healthcare for the company I worked for, they will give me a Health Savings Account of $2600, which will offset my premiums, plus more.  They used to do this if you got prescription and eye care through them, but they have reduced the amount to $500/year unless you get a medicare supplement or medicare advantage plan through them.  My premium will be slightly more than what I pay now, but the $2600 will more than make up for it.
> 
> Anyway, I was not even able to see what plans were available until open enrollment period.  So I don't think there was any way I could have changed plans before then.




Are you sure that is an HSA and not an HRA? My husband's company has the same- VIA Benefits that manages retiree healthcare- and I was told when the time comes that he retires and also when I am 65 and on Medicare-they have an HRA where his employer will put in $60 (woo! woo!) per month for each of us and we can use it for medical expenses. I assume we can also put money into it, but not sure and neither was the rep. (smh)

There is no open enrollment for Medigap- the Medicare rep. told me that today. It's a one time deal. BUT- there is for other supplemental plans.


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## Luanne (Oct 10, 2018)

mpumilia said:


> Are you sure that is an HSA and not an HRA? My husband's company has the same- VIA Benefits that manages retiree healthcare- and I was told when the time comes that he retires and also when I am 65 and on Medicare-they have an HRA where his employer will put in $60 (woo! woo!) per month for each of us and we can use it for medical expenses. I assume we can also put money into it, but not sure and neither was the rep. (smh)
> 
> There is no open enrollment for Medigap- the Medicare rep. told me that today. It's a one time deal. BUT- there is for other supplemental plans.


To be honest I'm not sure what they call it.  Let me look it up.  Okay, it's an HRA.

I believe you when you say you've been told there is no open enrollment for Medigap.  But again, I wasn't able to see (on the employee benefit website) what plans were available to me until open enrollment started.  When I would go in and enter all of my information I kept getting a screen that said no plans were found.  When I called, I was told that in October I would be able to see the plans, and I was able to do so and to select a new plan.  

Maybe we are talking different things.  When you say open enrollment for Medigap, what do you mean?  I'm really confused when you say it's a one time deal.


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## pittle (Oct 10, 2018)

mpumilia said:


> I did read somewhere that Plan F will eventually become more expensive since it is closed to new and younger enrollees and the current insureds will start to age out, driving up costs.


Yes - plan F goes away in 2021. It has been great as it pays the deductible and anything that Medicare does not pay.  Plan G is similar, but you have to pay the first $184 or whatever the current deductible is.

Just before I turned 65 (in January 2012), was the year that my company suggested we look for other options, so I guess I got A, B, & F all at the same time.  Did not have much choice except for what supplemental plan we were going to choose.  So we each started paying the premiums required.  It was only $99 the first few years and then last year went up to the $134.  Since the only claims that I have had have been for the dermatologist and ophthalmologist.  I am going to need cataract surgery next year, so will make up for some of my premiums.  I suppose that someday, we will get some benefit from the insurance premiums, but for now.  We have both been incredibly blessed with good health.


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## Luanne (Oct 10, 2018)

pittle said:


> YEs - plan F goes away in 2021. It has been great as it pays the deductible and anything that Medicare does not pay.  Plan G is similar, but you have to pay the firsst $184 or whatever the current deductible is.


As I posted earlier, Plan F is going away for new enrollees. If you have Plan F you can keep it.  However, as others have pointed out, it's possible the premium costs could rise.


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## IngridN (Oct 10, 2018)

mpumilia said:


> ... ...
> 
> There is no open enrollment for Medigap- the Medicare rep. told me that today. It's a one time deal. BUT- there is for other supplemental plans.



This, this, this. Medigap has NO open enrollment. Plan D does and we review DH's meds each year at this time and chose the cheapest Plan D available. Advantage plans...I don't know.


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## Luanne (Oct 10, 2018)

IngridN said:


> This, this, this. Medigap has NO open enrollment. Plan D does and we review DH's meds each year at this time and chose the cheapest Plan D available. Advantage plans...I don't know.


Maybe because Open Enrollment and my birth month are the same that is why I think I'm being limited to changing carriers during open enrollment.  All I know is, I couldn't see any options until October.


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## WinniWoman (Oct 10, 2018)

Luanne said:


> To be honest I'm not sure what they call it.  Let me look it up.  Okay, it's an HRA.
> 
> I believe you when you say you've been told there is no open enrollment for Medigap.  But again, I wasn't able to see (on the employee benefit website) what plans were available to me until open enrollment started.  When I would go in and enter all of my information I kept getting a screen that said no plans were found.  When I called, I was told that in October I would be able to see the plans, and I was able to do so and to select a new plan.
> 
> Maybe we are talking different things.  When you say open enrollment for Medigap, what do you mean?  I'm really confused when you say it's a one time deal.




The Medicare rep told me that Medigap is like a supplemental plan but it is a one time enrollment only thing. If you don't enroll initially in it you can never get into it again- unless with restrictions and so on and depending on your state. BUT- I believe he is wrong based on what I have read looking into it further tonight. 

From what I see- supplements and Medigap are the same thing. https://medicare.com/medicare-supplement/whats-difference-medicare-supplement-plans-medigap-plans/

Supplements and Advantage plans are both sold by private insurers. 

BTW- Here is some info. regarding the difference between and HSA and an HRA. So with an HRA- only the employer can contribute to it.
https://fitsmallbusiness.com/hra-vs-hsa/


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## WinniWoman (Oct 10, 2018)

I found this, Luanne....

https://affordablemedicareplan.com/when-is-medigap-open-enrollment/

And..

https://medicare.com/medicare-supplement/when-can-you-buy-a-medigap-policy/


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## Talent312 (Oct 10, 2018)

I read somewhere (TUG?) that becuz Plan F premiums are derived from age-groups, premiums for a particular group should not change much due to the absence of new, lower-age subscribers. Dunno if that's true, but I like the sound of it...


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## Luanne (Oct 10, 2018)

mpumilia said:


> The Medicare rep told me that Medigap is like a supplemental plan but it is a one time enrollment only thing. If you don't enroll initially in it you can never get into it again- unless with restrictions and so on and depending on your state. BUT- I believe he is wrong based on what I have read looking into it further tonight.
> 
> From what I see- supplements and Medigap are the same thing. https://medicare.com/medicare-supplement/whats-difference-medicare-supplement-plans-medigap-plans/
> 
> ...


I always thought supplemental plans and Medigap plans were the same thing, just two different names.

Thanks for the additional info on HSA/HRA.  While I was working I had an HSA that I contributed to.  When I retired I was 62, so not eligible for Medicare.  My employer continued to cover me medically, but when I turned 65 I felt like I'd been cut adrift. Here I was on Medicare, paying both the Part B and a Medicare supplemental plan.  Luckily I accidentally discovered the HRA soon into my retirement.  I know at any time that could go away, for instance they are changing the requirements for next year, but it's been nice for the years it's been available.


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## WinniWoman (Oct 10, 2018)

And this.....

https://boomerbenefits.com/medicare-supplement-open-enrollment/


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## WinniWoman (Oct 10, 2018)

Luanne said:


> I always thought supplemental plans and Medigap plans were the same thing, just two different names.
> 
> Thanks for the additional info on HSA/HRA.  While I was working I had an HSA that I contributed to.  When I retired I was 62, so not eligible for Medicare.  My employer continued to cover me medically, but when I turned 65 I felt like I'd been cut adrift. Here I was on Medicare, paying both the Part B and a Medicare supplemental plan.  Luckily I accidentally discovered the HRA soon into my retirement.  I know at any time that could go away, for instance they are changing the requirements for next year, but it's been nice for the years it's been available.




Yes. I always thought they were the same and evidently they are the the Medicare rep. was wrong. Which is why I always research and analyze and question everything.

Why the heck does it all have to be so complicated?! Ugh!

As for the HRA- well at $60 per month from my husband's employer- better than nothing I guess. LOL! 

His HSA has been great, but if he applies for Part A than he will not be contributing next year. Not worth it just for Jan, Feb and March. Even if he doesn't apply, he could contribute until Oct. of next year- but- what if he gets laid off before then for example? Then he will have to apply for Medicare and he will be penalized for contributing. So- the heck with it. It's too much of a hassle anymore. We can keep that money- use it for his 401k and /or just a plain ol' savings account. Not as good a tax advantage, but simple.


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## Luanne (Oct 10, 2018)

mpumilia said:


> And this.....
> 
> https://boomerbenefits.com/medicare-supplement-open-enrollment/


All of this is just confusing me more. 

I'm understanding the "one time" open enrollment for a Medicare supplement plan, which may occur when you turn 65.

But what I'm still struggling with is if you want to change plans, or carriers.  Can that be done at any time?  Once a year?  Does it depend on who you are getting the plans from?


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## WinniWoman (Oct 10, 2018)

Luanne said:


> All of this is just confusing me more.
> 
> I'm understanding the "one time" open enrollment for a Medicare supplement plan, which may occur when you turn 65.
> 
> But what I'm still struggling with is if you want to change plans, or carriers.  Can that be done at any time?  Once a year?  Does it depend on who you are getting the plans from?




I believe you have to do it during open enrollment.  But I am wet behind the ears with all this. Lord knows what it will be like in a few years when I have to apply!


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## WinniWoman (Oct 10, 2018)

I have a friend who is on an Advantage plan and she told me she was thinking of switching to a supplement plan during open enrollment.


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## Luanne (Oct 10, 2018)

mpumilia said:


> I believe you have to do it during open enrollment.  But I am wet behind the ears with all this. Lord knows what it will be like in a few years when I have to apply!


I just keep going back to my, and my dh's experience.  He didn't sign up for Part B, or a supplemental plan until I retired since he was still covered under my insurance.  He went with a plan through AARP, but changed carriers last year.  I "think" I remember that he did it during the open enrollment period, but it's possible he could have done it at any time.  He kept Plan F, just changed carriers.

I retired at 62, signed up for Part B and a supplemental plan when I turned 65.  I looked into changing carriers last year, but decided not to.  Again this was during open enrollment period.  This year I am going to change carriers, sticking with Plan F.  Since I couldn't see any plan options on my employer's retiree benefits website until October, I figured I was limited to making he change until open enrollment period.  But it could also be I was limited to making a change until my birth month (which is October).


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## WinniWoman (Oct 10, 2018)

Luanne said:


> I just keep going back to my, and my dh's experience.  He didn't sign up for Part B, or a supplemental plan until I retired since he was still covered under my insurance.  He went with a plan through AARP, but changed carriers last year.  I "think" I remember that he did it during the open enrollment period, but it's possible he could have done it at any time.  He kept Plan F, just changed carriers.
> 
> I retired at 62, signed up for Part B and a supplemental plan when I turned 65.  I looked into changing carriers last year, but decided not to.  Again this was during open enrollment period.  This year I am going to change carriers, sticking with Plan F.  Since I couldn't see any plan options on my employer's retiree benefits website until October, I figured I was limited to making he change until open enrollment period.  But it could also be I was limited to making a change until my birth month (which is October).




I hear ya. I really don't know for sure, but I still think it is open enrollment that counts- but it doesn't matter either way in your case since it is your birthday month you don't have to worry about it.

Here is something else I found.

https://www.ehealthmedicare.com/med...changing-medicare-supplement-insurance-plans/

And....

https://www.medicaresupplement.com/articles/can-i-change-my-medicare-supplement-plan/


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## Luanne (Oct 10, 2018)

mpumilia said:


> I hear ya. I really don't know for sure, but I still think it is open enrollment that counts- but it doesn't matter either way in your case since it is your birthday month you don't have to worry about it.
> 
> Here is something else I found.
> 
> https://www.ehealthmedicare.com/med...changing-medicare-supplement-insurance-plans/


I can't read anymore.  It just keeps confusing me more!


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## WinniWoman (Oct 10, 2018)

Luanne said:


> I can't read anymore.  It just keeps confusing me more!




I get it. I am at that point also. I am going to call my friend one of these days very soon and pick her brain because she is going through it. She worked with insurance at a rehab. center and is very knowledgeable.


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## IngridN (Oct 10, 2018)

https://www.medicareresources.org/states/. This site provides add'l info on state rules wrt to 'guaranteed issue.' I don't know how accurate the info is as I simply did a search on birthday month states. The only birthday month states appear to be CA and OR. NY & CT (?) provide for guaranteed issue any time of year. Other states may provide other rules overriding federal requirements. You really need to do lots and lots of research prior to signing up for Medicare and it's supplemental policies. You may be unpleasantly surprised when you want to make changes and can not because of medical underwriting requirements.

Ingrid


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## Luanne (Oct 10, 2018)

mpumilia said:


> I get it. I am at that point also. I am going to call my friend one of these days very soon and pick her brain because she is going through it. She worked with insurance at a rehab. center and is very knowledgeable.


Before I turned 65 both dh and I met with our State Farm Insurance rep.  He had sent me a letter stating he was available.  He went through everything with us.  It was very helpful.  Although I'm sure he would have liked it if I'd purchased my supplemental plan through him, he seemed fine that I didn't.  The best piece of advice I received, from my sister and from a friend, was if you are going to get one of the supplemental plans, just go for the cheapest. They're all the same, Plan F from company A is going to be the same as Plan F from company B.  I wasn't interested in a Medicare Advantage Plan, although some people love them, and in some cases there is no monthly premium.  Since I didn't want one I didn't look into them so I don't know exactly how they work.


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## VacationForever (Oct 10, 2018)

In the first 2 years, i.e. 65 to 67 yo, Medicare Supplemental Plans are legally not allowed to reject an applicant.  If you miss this window and decide to apply for a Supplemental Plan later, they can then screen the applicant for health conditions and they are allowed to reject an applicant, or accept the applicant at Tier 1 (lowest rates), Tier 2 or Tier 3 rates.  We did not know about this law and when we moved out of California, we decided to apply for Plan F for him and since it was outside of the first 2-year window, they requested for prior medical records and they accepted him at Tier 2.  It was almost double Tier 1 rates and we passed on that.  He is now on a Medicare Advantage PPO plan and it is wonderful.  Every doctor that he wants to see accepts his insurance.  His co-pay and max OOP is quite low. His Medicare Advantage PPO monthly premium is $96. The Medicare Advantage PPO plan also includes Drugs, which is another savings over buying a Medicare Supplement Plan as with the latter you need to additionally buy a Drug Plan which costs a little under $100 per month.


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## Luanne (Oct 10, 2018)

VacationForever said:


> Also, the Medicare Advantage PPO plan includes Drugs, which is another savings over buying a Medicare Supplement Plan as you need to additionally buy a Drug Plan which costs a little under $100 per month.



I am paying $20.50/month for my Part D prescription plan.


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## VacationForever (Oct 10, 2018)

Luanne said:


> I am paying $20.50/month for my Part D prescription plan.


Maybe my memory is flawed, I thought it was more expensive than that.  We dropped my husband's Part D prescription plan immediately on hearing that he would be placed under Tier 2.


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## bogey21 (Oct 10, 2018)

All the comments regarding Plan F indicate that many of those posting her have it and like it.  I do too but I have what is called the "High Deductible" Plan F.  With it I am required to pay the first (something like) $1,800 of claims Plan F would otherwise cover.  That's the downside of it.  The upside is that my premium is a whole lot less than that for Regular Plan F.  It is very cost effective  for those like me  who don't have a lot of medical bills...

George


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## Talent312 (Oct 10, 2018)

bogey21 said:


> ... I have what is called the "High Deductible" Plan F.  With it I am required to pay the first (something like) $1,800 of claims Plan F would otherwise cover.  That's the downside of it.  The upside is that my premium is a whole lot less than that for Regular Plan F.  It is very cost effective  for those like me  who don't have a lot of medical bills...



For my DW (and a local hospital), Plan F has been very cost effective.
She was hospitalized for 3 days this year with pneumonia.
A few years ago, she was hospitalized for 3 days with a TIA.

.


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## uop1497 (Oct 10, 2018)

I just come in to read to understand how medicare and other program works. My DH has a few years more to reach the age to qualify for medicare. 

The more I read and try to learn, the more I get confused. However, I wonder by the time I reach 65 what type of benefit medicare offered at that time. Somehow I have a feeling, I will end up to pay more for all the program related to medicare compared whoever qualify for medicare this year or next year.


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## VacationForever (Oct 10, 2018)

uop1497 said:


> I just come in to read to understand how medicare and other program works. My DH has a few years more to reach the age to qualify for medicare.
> 
> The more I read and try to learn, the more I get confused. However, I wonder by the time I reach 65 what type of benefit medicare offered at that time. Somehow I have a feeling, I will end up to pay more for all the program related to medicare compared whoever qualify for medicare this year or next year.


The premium for Medicare does increase through time and it applies to everyone.  If your household income is high, it is also subject to IRMAA, which means even higher premium.


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## Steve Fatula (Oct 11, 2018)

Luanne said:


> All of this is just confusing me more.
> 
> I'm understanding the "one time" open enrollment for a Medicare supplement plan, which may occur when you turn 65.
> 
> But what I'm still struggling with is if you want to change plans, or carriers.  Can that be done at any time?  Once a year?  Does it depend on who you are getting the plans from?



To confuse you a little more, a person on SSDI below age 65 may also get a Medicare Supplemental Plan, or not. If they choose an Advantage plan instead, they can switch to Medicare Supplemental Plans when they get to the age of regular qualification just as if they were first signing up. There are advantages to both types of plans.

DW had a drug plan for a while due to very expensive medicines and high co-payments on a typical Advantage plan, they didn't cover the gap very well. We found it far cheaper for her to get an expensive drug plan, $130 or something like that per month, but that covered all medicines including the gap. She never ever paid more than $1 for any drug. It was simply too expensive on any other all inclusive Aadvantage plan offered here.

Overall though, Medicare in any form (perhaps other than basic Medicare only) is much cheaper than buying your own health insurance. At least in our experience.


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## Krteczech (Oct 11, 2018)

mpumilia said:


> So hubby's open enrollment period for 2019 is coming up at his job and we have to make some decisions.
> 
> He turns 65 in April. Not retiring. He has always contributed (the max) to an HSA since he has a high deductible plan, but if he applies for Medicare in 2019 he will no longer be able to do so.
> 
> ...





mpumilia said:


> So hubby's open enrollment period for 2019 is coming up at his job and we have to make some decisions.
> 
> He turns 65 in April. Not retiring. He has always contributed (the max) to an HSA since he has a high deductible plan, but if he applies for Medicare in 2019 he will no longer be able to do so.
> 
> ...


My recent experience- I didn’t apply for Medicare A when I turned 65 and neither did my husband. Reason? I was working and contributing to HSA account. Our health insurance was from my employer. I discontinued contributing 7 months before planned retirement date. Two months before retirement I applied for Medicare A and B effective following my retirement month. I paid for Medicare out of pocket until I started to collect SS benefits after New Year. When filing taxes I had to withdraw some $$ from my HSA because I went over limit.


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## Jan M. (Oct 11, 2018)

Both of us got Medicare part A when we each turned 65 but didn't take part B until my husband retired as we were still covered under his employer's healthcare p!an. My husband retired on February 2nd of this year and at that time he was 68 and I was 66. His employee health care continued through the end of February and our Medicare coverage began March 1. We did not apply months in advance either.

You must submit the form completed by the employer stating that you both were covered under their health care plan. You want to make sure that you have prescription coverage too and that information is also supplied as you will be charged a higher rate of you didn't have prescription coverage.


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## Sugarcubesea (Oct 11, 2018)

Krteczech said:


> My recent experience- I didn’t apply for Medicare A when I turned 65 and neither did my husband. Reason? I was working and contributing to HSA account. Our health insurance was from my employer. I discontinued contributing 7 months before planned retirement date. Two months before retirement I applied for Medicare A and B effective following my retirement month. I paid for Medicare out of pocket until I started to collect SS benefits after New Year. When filing taxes I had to withdraw some $$ from my HSA because I went over limit.



This is good information for me to know. In my budget plan I was going to contribute my max to my HSA till age 65 and then retire, so I wonder if I can contribute the max early in the year and then stop 7 months out from retirement?  Wow, so much to consider and think about...


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## Krteczech (Oct 11, 2018)

Sugarcubesea said:


> This is good information for me to know. In my budget plan I was going to contribute my max to my HSA till age 65 and then retire, so I wonder if I can contribute the max early in the year and then stop 7 months out from retirement?  Wow, so much to consider and think about...


I contributed max in January and February, retire in October, started Medicare A,B effective 11/1 and SS 1/1. As mentioned earlier, I went over limit on HSA and had to withdraw 2/12 of my contribution.


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## Krteczech (Oct 11, 2018)

Jan M. said:


> Both of us got Medicare part A when we each turned 65 but didn't take part B until my husband retired as we were still covered under his employer's healthcare p!an. My husband retired on February 2nd of this year and at that time he was 68 and I was 66. His employee health care continued through end end of February and our Medicare coverage began March 1. We did not apply months in advance either.
> 
> You must submit the form completed by the employer stating that you both were covered under their health care plan. You want to make sure that you have prescription coverage too and that information is also supplied as you will be charged a higher rate of you didn't have prescription coverage.


Correct, the form from your employer had to be submitted when you delay application past 65th birthday.


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## WinniWoman (Oct 11, 2018)

Sugarcubesea said:


> This is good information for me to know. In my budget plan I was going to contribute my max to my HSA till age 65 and then retire, so I wonder if I can contribute the max early in the year and then stop 7 months out from retirement?  Wow, so much to consider and think about...




No. I do not believe (but can't find info. on it) that you can contribute the max all in the beginning of the year. It is prorated. Otherwise you will have to take the money out that is over what is allowed and also pay a penalties and taxes.

And- just to add to all the complications, look at #4 ( and #7) in the link below. I would be interested to know how that works.

https://www.benstrat.com/downloads/HSA-GPS_HSAs-and-Medicare.pdf


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## WinniWoman (Oct 11, 2018)

Found this also:http://www.hsaforamerica.com/faq-contributions.htm

"The contribution limit is determined by the IRS and is based on the Consumer Price Index. If you do not keep your coverage for at least 12 months, the contribution limit will be pro-rated based on the number of months in which your HSA-eligible health insurance was in effect.  For example, if your coverage begins on March 1 and is in effect only through December, you will only be allowed to deposit 10/12 of the annual contribution limit."

"Individuals can contribute their entire contribution at the beginning of the year, up to the applicable contribution limit.  They might, however, have to make a corrective distribution later in the year if the individual's eligibility status changes during the year (for instance, if they become covered under another non-qualifying plan, or if their HDHP coverage ends)."


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## Krteczech (Oct 11, 2018)

mpumilia said:


> No. I do not believe (but can't find info. on it) that you can contribute the max all in the beginning of the year. It is prorated. Otherwise you will have to take the money out that is over what is allowed and also pay a penalties and taxes.
> 
> And- just to add to all the complications, look at #4 ( and #7) in the link below. I would be interested to know how that works.
> 
> https://www.benstrat.com/downloads/HSA-GPS_HSAs-and-Medicare.pdf


I contributed the max in first two months of year and started Medicare in November. I had to withdraw my prorated contribution for two months. Not difficult to do.


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## WinniWoman (Oct 12, 2018)

I just spoke to my husband's employer yet again and the rep. said when it comes time for open enrollment (can you believe they still don't know when it will be?) that there will be specific instructions with qualifications my husband must meet in order to enroll in the HSA. Bottom line is I don't think they will let him enroll to put in $ past March as she said he has to call in February to stop them- even if he is not enrolling in Medicare.. She alluded to the fact that most people forget to stop contributions when they need to and then they- and the company- have too many problems. So- I guess I will find out more once open enrollment starts with his employer, as they have their own rules.


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## Krteczech (Oct 12, 2018)

mpumilia said:


> I just spoke to my husband's employer yet again and the rep. said when it comes time for open enrollment (can you believe they still don't know when it will be?) that there will be specific instructions with quantification my husband must meet in order to enroll in the HSA. Bottom line is I don't think they will let him enroll to put in $ past March as she said he has to call in February to stop them- even if he is not enrolling in Medicare.. She alluded to the fact that most people forget to stop contributions when they need to and then they- and the company- have too many problems. So- I guess I will find out more once open enrollment starts with his employer, as they have their own rules.


I believe it is the employee who set the payroll deduction, not his employer. My employer would allow me to contribute in just one payroll deduction in January, but my salary was not enywhere near the family limit.


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## WinniWoman (Oct 13, 2018)

Krteczech said:


> I believe it is the employee who set the payroll deduction, not his employer. My employer would allow me to contribute in just one payroll deduction in January, but my salary was not enywhere near the family limit.




Right- but I mean- who has like a $7000 monthly paycheck? LOL!


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## Luanne (Oct 13, 2018)

mpumilia said:


> Right- but I mean- who has like a $7000 monthly paycheck? LOL!


That would be $84,000/year.  I know many people who make, or have made, that amount.


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## Krteczech (Oct 13, 2018)

Luanne said:


> That would be $84,000/year.  I know many people who make, or have made, that amount.


True, but most employers pay twice a month, which cuts 7k in half and one has to pay taxes. Sad but true, my paycheck was not in that category.


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## WinniWoman (Oct 14, 2018)

Luanne said:


> That would be $84,000/year.  I know many people who make, or have made, that amount.




LOL! I wasn't thinking. Of course! LOL! I was thinking take home pay!


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## Sugarcubesea (Oct 14, 2018)

I'm thinking that the year before I turn 65, I 'm going to have to find a medicare expert to help navigate me through all of this... I want to ensure I make the right decisions and not pay any penalty's.  My budgeted plan had me contributing the max to my HSA till the end of my 65th year.  My birthday is in July and I wanted to work that full year, so I was thinking I would retire that following January or February


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## Luanne (Oct 14, 2018)

Just to confuse, or clarify, things more I found the letter sent to me by the company that administers retiree health benefits for the company I worked for.  The big banner headline is:  Medicare Open Enrollment starts October 15th.

Body of the letter (I've left some details out just so this doesn't become too long):
It's almost time to renew your Medicare coverage for 2019. 

Open Enrollment is the time when you have an opportunity to review your plan and coverage details.

If you're happy with your coverage and it's available in 2019 there is nothing you need to do.  Your policies will automatically renew.
2019 plans will be available on October 1st.


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## Talent312 (Oct 14, 2018)

Open Enrollment:
For keeping original Medicare, a Medigap policy, and a drug plan...
Open enrollment is less than it seems.
About all you can do is switch drug plans (or go for an Advantage plan).

Changing Medigap plans is not a part of O-E (it's  done anytime).
With some exceptions, there is no guaranteed issue or premium limit.
So, even if they issue it, you're the premium is unlikely to be cheaper.


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## Sandra Huston (Oct 20, 2018)

Planning and making decisions without proper information is a big risk. As different Medicare plans include different terms and condition, it is will be beneficial for you to seek the advice of a real insurance agent from a Medicare-approved firm like https://www.thehealthexchangeagency.com. This is so because you can gain knowledge about the pros and cons of each plan through them which can help you in signing up with the proper plan in future. Hope this can help you. Good luck.


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## isisdave (Oct 20, 2018)

Also, for Medicare advice, https://www.seniorsresourceguide.com/directories/National/SHIP/


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## bogey21 (Oct 20, 2018)

My take from the peanut gallery --  If you have or are worried about getting hit with a serious medical problem, choose Regular Medicare and a Supplement.  If you are in relatively good health and have no inkling that you may be hit with some serious medical problem down the road, go with an Advantage Plan which is less costly.  The benefit of sticking with Regular Medicare is that you have so many more choices of where to be treated than with most Advantage Plans which have tight networks...

George


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## WinniWoman (Oct 20, 2018)

bogey21 said:


> My take from the peanut gallery --  If you have or are worried about getting hit with a serious medical problem, choose Regular Medicare and a Supplement.  If you are in relatively good health and have no inkling that you may be hit with some serious medical problem down the road, go with an Advantage Plan which is less costly.  The benefit of sticking with Regular Medicare is that you have so many more choices of where to be treated than with most Advantage Plans which have tight networks...
> 
> George




I think you are right about this. Though there are "Out of Network" benefits with Advantage plans. The regular Medicare plans are very expensive I hear.

Then there is the issue of traveling- care needed if something were to happen when you are away.  I guess something to also look into with Advantage plans. 

Plus, if you want to switch from Advantage to regular down the line, you would be subjected to pre-existing conditions and all that. Is that correct?


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## bogey21 (Oct 20, 2018)

mpumilia said:


> Plus, if you want to switch from Advantage to regular down the line, you would be subjected to pre-existing conditions and all that. Is that correct?



I honestly don't know but I'm sure someone else will tell you...

George


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## Talent312 (Oct 20, 2018)

_Here's what I found..._
Medicare Advantage plans are required to cover the same pre-existing conditions or disabilities as original Medicare they replace so they can be approved as a Part C plan. However, there are two criticisms: (1) narrow networks, and (2) poor service for seniors who are chronically ill or with serious medical conditions...

"The plans have denied such charges, but academic research has found patterns of sicker seniors switching out of MA plans into basic Medicare." -- "We found that a high proportion of beneficiaries with nursing home or home health care use choose to exit the Medicare Advantage program by the start of the next plan year."

-- _Sources:_ http://time.com/money/4347183/medicare-advantage-risks/
-- _https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.0272_

Also... For certain chronic illnesses, there are Chronic-Condition Special Needs Plans (C-SNP): These plans serve beneficiaries with certain severe or disabling chronic conditions, such as cancer, chronic health failure, or HIV/AIDS. Chronic-Condition Special Needs Plans may target a single chronic condition or more than one condition. Some SNP's offer a larger network of providers that specialize in treating a condition or have formularies tailored to cover drugs prescribed for the illness.
-- _Source: https://www.ehealthmedicare.com/medicare-advantage-articles/medicare-advantage-special-needs-plans/

---------------------_
As for me, before I enroll in anything, in ~18 months, I'm going to seek advice from a SHINE volunteer... A program sponsored by the state's Department of Elder Affairs.
.


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## VacationForever (Oct 20, 2018)

mpumilia said:


> I think you are right about this. Though there are "Out of Network" benefits with Advantage plans. The regular Medicare plans are very expensive I hear.
> 
> Then there is the issue of traveling- care needed if something were to happen when you are away.  I guess something to also look into with Advantage plans.
> 
> Plus, if you want to switch from Advantage to regular down the line, you would be subjected to pre-existing conditions and all that. Is that correct?


Not all Advantage plans are made the same.  The most restrictive of networks are typically called HMOs.  When we looked at various plans, we decided on Aetna Medicare Advantage Select PPO for my husband.  Every imaginable doctor that he may wish to see is on the PPO list.  We have yet to find the best specialists that we know of that are not on it.  It is very flexible.  We love his plan and his cost for his plan is $96 per month.  In fact it is dropping to $67 per month in 2019.  It does cover out of state and out of country medical care.

With Medigap/Medicare Supplement plans, there is no pre-existing condition consideration in the first 2 years of Medicare eligibility, i.e. 65 to 67.  They must take you if you apply for it during the first 2 years.   If you decide to switch from an Advantage plan to a Supplement plan plan after the first 2 years, then they will screen you for pre-existing conditions.  They can then decline coverage or accept coverage and charge the applicant Tier 1 or Tier 2 costs.  Tier 1 premium is the cheapest and Tier 2 is around double.

After experiencing a Medicare Advantage HMO plan for 1 year and then switching to a Medicare Advantage PPO plan, the experience is night and day.  We are finding that my husband's PPO is absolutely perfect - lower premiums than a Supplement Plan but having direct access to any doctor that he wants to see.  No restrictive doctor list and bs of a HMO plan.

One more thing to add, if there is a doctor that is not on the PPO list of doctors, the patient can see out of network doctors and incur a higher copay.

Many of the Advantage Plans also include a Drug Plan for no additional cost.


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## MULTIZ321 (Oct 20, 2018)

Medicare Open Enrollment: A 5-Point Check List
By Ken Moraif, CFP/ Retirement/ Kiplinger/ kiplinger.com

"Managing retirement money often includes managing health care costs. If you’re on Medicare, we suggest you take a look at those costs: from Oct. 15 through Dec. 7 you can enroll* or make changes to your plans.


It’s important to be aware of the time limitation so that you don’t miss your opportunity and have to wait until next year to make any changes. It’s also important to consider your plans carefully. This Medicare open enrollment checklist can help you to do just that...."








Richard


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## isisdave (Oct 21, 2018)

There are relatively few Advantage PPO plans, I think. Where I live, in SoCal, I can choose one PPO plan (Aetna), or one of 36 HMO plans.

I'm going to look into this more. It's $81 including drugs, and I pay Blue Shield $150 for a Plan-N supplement, and $22 more to Humana for drugs.


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## WinniWoman (Oct 21, 2018)

Then the question becomes- if there is only one Advantage Plan PPO- and that plan shuts down and is no longer offered the following year- are you allowed then to switch into a standadd Medicare plan without penalty/preexisting conditions and so forth? Or do you have to now go into an HMO?


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## simpsontruckdriver (Oct 25, 2018)

There is good info here, and there is bad info. I don't have time to go through each and every post, but I can answer most questions. I am a Florida Licensed Health Insurance Agent (not in any other state), and I know a lot about Medicare. I'm working on being recertified, so I can't sell yet, but I know it in general. For instance, technically Part-A is not "free", you pay for it working 10 years and having Social Security deducted. The easiest way to look at it, Part-A is in-patient (staying overnight), Part-B is out-patient (no overnights), and Part-D is drugs. Medicare Advantage Plans (with or without drugs) are where Medicare pays the insurer for each senior citizen, they (MA plan) takes over your healthcare, but they can not charge you more than Medicare. Medicare Supplements are not tied to government funding, and they all have a premium that may/may not go up (depending on the state).

For instance, back in 2012-2013, I was appointed to a Florida MAPD. They would pay a person's Part-B premiums and gave them low copays. They tried to get more people in, and tried to get more doctors in. In the end, doctors left in droves, and then the company filed bankruptcy. All those agents who were tied to them lost commissions. And those were the reasons: cut funding from government and paying out more than they took in. Companies like United Healthcare, Humana, Aetna, WellCare, and local insurers could weather the government cuts.

If you are about to hit 65, but you plan on continuing to work, talk to your benefits rep. If your plan is Medicare equivalent, you do not need to take Medicare yet. Just remember, you can get full Medicare and drugs for less than $180/month! Same thing if you have been on Social Security Disability (disabled) for 24 months. You can ask me by private message/e-mail any information you need, but like I said, I can't sell any plans if you're not from Florida (only general information).

TS


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## VacationForever (Oct 25, 2018)

mpumilia said:


> Then the question becomes- if there is only one Advantage Plan PPO- and that plan shuts down and is no longer offered the following year- are you allowed then to switch into a standadd Medicare plan without penalty/preexisting conditions and so forth? Or do you have to now go into an HMO?


Where we live there are a few Advantage PPO plans to choose from.  If the Advantage plan shuts down, PPO or HMO - does not matter, you can move to another Advantage plan - PPO or HMO.  Medicare Advantage plans MUST take you unless you are on end stage renal failure.  That is the law.  So you can be on an Advantage plan for 10 years and that shuts down, you can just pick a different plan or insurer.  There is no penalty, i.e. higher costs, based on pre-existing conditions.


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## WinniWoman (Oct 26, 2018)

VacationForever said:


> Where we live there are a few Advantage PPO plans to choose from.  If the Advantage plan shuts down, PPO or HMO - does not matter, you can move to another Advantage plan - PPO or HMO.  Medicare Advantage plans MUST take you unless you are on end stage renal failure.  That is the law.  So you can be on an Advantage plan for 10 years and that shuts down, you can just pick a different plan or insurer.  There is no penalty, i.e. higher costs, based on pre-existing conditions.




This I get. But my question is can you go into a standard Medicare plan instead?


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## simpsontruckdriver (Oct 26, 2018)

mpumilia said:


> This I get. But my question is can you go into a standard Medicare plan instead?



That is correct. Or, you can drop to "basic" Medicare between January and Valentine's Day by writing to your plan and/or Medicare.

TS


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## VacationForever (Oct 26, 2018)

mpumilia said:


> This I get. But my question is can you go into a standard Medicare plan instead?


My question is why would anyone want to go on a standard Medicare plan?


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## SmithOp (Oct 26, 2018)

VacationForever said:


> My question is why would anyone want to go on a standard Medicare plan?



Thats all I needed to sign up for because I have supplemental covered by a pension plan.  

Some people in good health might take the gamble to save money.


Sent from my iPad using Tapatalk Pro


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## bogey21 (Oct 26, 2018)

VacationForever said:


> My question is why would anyone want to go on a standard Medicare plan?



Three reasons.  First, no need for referrals from Primary Care Physician.  Second, no "Out of Network" issues when traveling.  And Third, ability to be treated at a "Center of Excellence" if something serious befalls you.  Note my comments reflect that the alternative is an Advantage HMO Plan.  Not as applicable if you can find an Advantage PPO Plan...

George


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## VacationForever (Oct 26, 2018)

bogey21 said:


> Three reasons.  First, no need for referrals from Primary Care Physician.  Second, no "Out of Network" issues when traveling.  And Third, ability to be treated at a "Center of Excellence" if something serious befalls you.  Note my comments reflect that the alternative is an Advantage HMO Plan.  Not as applicable if you can find an Advantage PPO Plan...
> 
> George


We have several Advantage PPO Plans here and we picked the one from Aetna last year for my husband and it is working out very well.


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## VacationForever (Oct 26, 2018)

SmithOp said:


> Thats all I needed to sign up for because I have supplemental covered by a pension plan.
> 
> Some people in good health might take the gamble to save money.
> 
> ...


Sure, but that is because you have other health insurance.  I am referring to Standard Medicare only with no other health insurance.


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## WinniWoman (Oct 26, 2018)

VacationForever said:


> My question is why would anyone want to go on a standard Medicare plan?



I am talking about the plans like G and N and so on. The ones you tack onto Medicare A, B and D.


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## VacationForever (Oct 26, 2018)

mpumilia said:


> I am talking about the plans like G and N and so on. The ones you tack onto Medicare A, B and D.


G and N are not standard Medicare.  They are Medicare Supplement, which is subject to pre-existing condition qualification if not obtained within the first 2 years of Medicare eligibilty, i.e. 65 to 67.  If you apply, say at 70, they will ask you alot of questions and also obtain your medical records.  They can reject you, or accept you into one of the 3 tiered rates.  Tier 1 rates are the lowest and tier 3 are the highest.  With Supplement plans, you also have to buy a separate drug plan.


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## Karen G (Oct 26, 2018)

If anyone who is shopping for a medicare supplement plan is eligible for USAA insurance (military veterans, active duty, and family), they offer a Medicare Supplement policy. We've been happy with ours.


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## WinniWoman (Oct 26, 2018)

VacationForever said:


> G and N are not standard Medicare.  They are Medicare Supplement, which is subject to pre-existing condition qualification if not obtained within the first 2 years of Medicare eligibilty, i.e. 65 to 67.  If you apply, say at 70, they will ask you alot of questions and also obtain your medical records.  They can reject you, or accept you into one of the 3 tiered rates.  Tier 1 rates are the lowest and tier 3 are the highest.  With Supplement plans, you also have to buy a separate drug plan.




Oh. Just worded it incorrectly, but the supplements were what I meant. So then that is what I thought. You start out with an Advantage plan, but then if you want or need to change to a supplement plan a few years later, it could be a problem which is why some people don;t take out Advantage plans in the first place. I knwo I will be considering that when we have to decide.

I don't trust these Advantage plans. Sound risky- their networks could change, etc. Just like insurances we have had in the past. All sounds great until they start messing around with what you initially signed up for in the beginning.


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## VacationForever (Oct 27, 2018)

mpumilia said:


> Oh. Just worded it incorrectly, but the supplements were what I meant. So then that is what I thought. You start out with an Advantage plan, but then if you want or need to change to a supplement plan a few years later, it could be a problem which is why some people don;t take out Advantage plans in the first place. I knwo I will be considering that when we have to decide.
> 
> I don't trust these Advantage plans. Sound risky- their networks could change, etc. Just like insurances we have had in the past. All sounds great until they start messing around with what you initially signed up for in the beginning.


There are many players in the Medicare insurance industry.  We have so many options here... several large insurers offer HMO as well as PPO plans.  The Aetna Advantage PPO plan is working out really well for my husband and apparently has been around for a long time.  We went to one of the insurance agents' seminar last year and met many attendees who have been on the plan for a long time and swore that the Aetna PPO plan is the best.


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## simpsontruckdriver (Oct 27, 2018)

mpumilia said:


> I don't trust these Advantage plans. Sound risky- their networks could change, etc. Just like insurances we have had in the past. All sounds great until they start messing around with what you initially signed up for in the beginning.



Under federal law, Medicare insurers can not change your plan. Adding/dropping doctors/facilities is on them, not the insurer. But, let's say you have MAPD from company x. If they need to alter copays and such, they will replace those plans in their offering for the next year. Your plan will not change. On the other hand, your insurer can cancel your plan, but they must give you notice, and you have 3 months to change to another of their plans or another company.

TS


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## Steve Fatula (Nov 12, 2018)

mpumilia said:


> Oh. Just worded it incorrectly, but the supplements were what I meant. So then that is what I thought. You start out with an Advantage plan, but then if you want or need to change to a supplement plan a few years later, it could be a problem which is why some people don;t take out Advantage plans in the first place. I knwo I will be considering that when we have to decide.
> 
> I don't trust these Advantage plans. Sound risky- their networks could change, etc. Just like insurances we have had in the past. All sounds great until they start messing around with what you initially signed up for in the beginning.



You could always get, at least in my area, an Advantage plan labelled PFFS, which means you can go to any doctor as long as they will file the insurance.


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