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Medicare Annual Enrollment Period coming up!

Discussion in 'TUG Lounge' started by simpsontruckdriver, Oct 10, 2019.

  1. bogey21

    bogey21 TUG Member

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    Medicare can be relatively cost free if one signs up for a Medicare Advantage Program. Many of these have tight networks and require referrals to see specialists. To maximize the benefits of Traditional Medicare where one can use any doctor or hospital accepting Medicare costs more. You need to buy a Medicare Supplement Policy and a Prescription Drug Program. Depending on your income this can be somewhat costly. You have it backward vis-a-vis Medicare and Medicaid. Medicare is Federal and Medicaid is State. Medicaid is inferior to Medicare. A major problem with Medicaid is that many Doctors will not accept Medicaid patients due to low reimbursement rates...

    George
     
    mpumilia and Fredflintstone like this.
  2. VacationForever

    VacationForever Tug Review Crew: Rookie TUG Member

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    I just priced it out at your location... at $27k annual income, 0 premium for Blue Preferred Silver PPO 201. $150 deductible, max OOP $2700. Estimated annual cost $871 for average doctor visits.

    It works for early retirees with enough but not too much taxable investments to get by without drawing on their IRA.
     
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  3. Rolltydr

    Rolltydr TUG Member

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    I think we have sufficiently proven fredflintstone’s contention that the US healthcare/insurance system is indeed complex and it almost has to be intentional so as to confuse individuals and enrich healthcare providers and insurers. Read back through this thread and tell me how any of it makes sense if health and care are the primary objective.


    Sent from my iPhone using Tapatalk
     
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  4. Ewiike

    Ewiike Guest

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    Unfortunately.....yes.
     
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  5. Steve Fatula

    Steve Fatula TUG Member

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    Well, sure, if you only made 27k. They do silver loading in my zip code. As always, it depends on your income or the amount of money you have to withdraw from retirement that is taxable to live and vacation on, pay MF, etc. Of course, I am doing exactly as you say, using after tax money for some of the expenses so as to not withdraw too much until I get to medicare age. If you make more than the minimum and don't get the extra subsidy (forgot the term), that plan is actually still $0/month, but, $8,150 max OOP with $1,100 deductible and 50% co-pay beyond the deductible. But sure, if you could live on 27k, it is as you say. Depends if you own your home, and all sorts of factors. But as you can see, no sub $1,000 max oop here.
     
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  6. VacationForever

    VacationForever Tug Review Crew: Rookie TUG Member

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    We were able to make use of the premium and cost sharing subsidy for one year when we were not pulling anything from IRA and we had no SS income.
     
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  7. MULTIZ321

    MULTIZ321 TUG Member

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  8. MULTIZ321

    MULTIZ321 TUG Member

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  9. DrQ

    DrQ TUG Member

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    I just turned 64.5 and if I NEVER hear from another Medicare jeezer on the phone, I will be happy. :crash:
     
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  10. SmithOp

    SmithOp TUG Member

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    I’m a year older than my wife (FRA 66 next month), we’ve had calls and junk mail for two solid years now with no sign of relief.


    Sent from my iPad using Tapatalk Pro
     
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  11. simpsontruckdriver

    simpsontruckdriver Guest

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    Under CMS ("Medicare") regulations, no one is allowed to call you cold-contact. Insurers are allowed to put up ads on radio/TV and send you USPS or e-mail, because you can simply throw them out or change the channel. But some get around the "word-of-mouth" allowance by having a call center have a non-event call and ask if one of their agents can contact you.

    Since DrQ said he is 64.5 years old, this will all repeat when he (or any one else) hits 64 yrs 9 months.

    TS
     
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  12. b2bailey

    b2bailey TUG Member

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    I have taken the time to read every post in one gulp this morning. I've had a supplement plan that works for me, so no interest in changing.

    BUT... I have been dissatisfied with my Prescription Drug plan (which was chosen for me by agent) It's something called Humans Wal-Mart -- which is confusing to me because there isn't a Wal-Mart in my zip code.

    Anyhow, I pay a monthly premium, and then pay $10 per month for my thyroid meds. The frustration is because I used to pay less at Costco, with no insurance.

    I'm ready to make a change and saw reference to "lowest cost" prescription plan. How do I go about switching plans?
     
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  13. simpsontruckdriver

    simpsontruckdriver Guest

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    I'm not sure about your area (I am in Florida), but for 2020, Humana is rolling out a revised "WalMart" PDP. You can call Humana directly, an agent can get you set up on a less-expensive plan. The whole "WalMart" is just a saying, that it is usually the least expensive plan. *In addition*, you can save more by signing up for the Humana mail-order pharmacy (does not include specialty or narcotics), where 3 month generics are less than $5.00. Humana can point you in the right direction on both.

    TS
     
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  14. mpumilia

    mpumilia TUG Review Crew: Veteran TUG Member

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    I spoke with our Financial Advisor today. Mind you, he was the one that told me back in April- before this whole moving thing occurred- that staying on my husband's employer's health plan was probably the easiest option until I become eligible for Medicare.

    Then today out of nowhere he starts talking about exploring the NH exchange when we move. Telling me to make an appt with a navigator- of which I do not see if NH has them anymore since the Trump Administration sliced funding for it.

    I went on line and they have inexpensive silver ($87-$207) and gold plans ($345), some with low deductibles- but still copays- of which I could get a subsidy for - and a cost sharing reduction) since we will have little income as we will be living on cash for the first year mostly- unless I do not go on an exchange, then we would be withdrawing from IRA's and doing some Roth conversions out of hubby's account.

    But all the plans are EPO's and HMO's. No out of network care. Only emergency coverage out of state- and that is subjective. HMO's need referrals for specialists. Not liking it. Then there is the fact that I don't even know who my doctors would be in NH! So I would have no idea if the ones I would want would be in the network! I would have to choose from their list only.

    At least my Cobra would be a PPO and nationwide, so out of network care is available.

    I could explore a private insurance plan in NH after I move amongst the hundred thousand other things I have to do!

    Anyway- the FA wants to meet with us in January to revamp his plan for us- I guess in case I went on the exchange because that would affect how we draw down our money.

    Frankly- I am so sick of thinking and analyzing this stuff. :crash:
     
    Last edited: Nov 12, 2019 at 7:14 PM
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  15. VacationForever

    VacationForever Tug Review Crew: Rookie TUG Member

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    EPO plans are pretty good and do not require doctor referrals but are only local to the state unless in an emergency. My plan is technically an EPO plan and the best specialists take it.
     
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  16. simpsontruckdriver

    simpsontruckdriver Guest

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    Essentially, an EPO is an HMO without referrals. Where a PPO allows you to see any doctor, an EPO says you must go to a doctor who accepts your insurance. But, unlike HMO and PPO, EPO isn't standardized. For instance, Humana has plans in certain areas that are listed as HMO but they are like the EPO.

    TS
     
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  17. VacationForever

    VacationForever Tug Review Crew: Rookie TUG Member

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    The thing is where we are, HMO plans are crappy and only crappy specialists accept them. When we went to EPO in 2018 it was night and day. The best specialists accept our EPO plan. I switched out of a couple of bad specialists immediately.
     
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