Medicare Sign Up

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Leroy Jones
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Medicare Sign Up

Post by Leroy Jones » Tue Dec 04, 2018 8:43 am

Well open enrollment ends in 3 days. Has anyone made a big change in there health insurance? I started with a Medicare Advantage plan last year and so far it has worked out ok. Next year they are cutting the cost of prescriptions, primary care office visits, specialist (cardiologist, allergist) office visits and leaving the maximum out of pocket the same $6700. Adding dental for cleanings and eye exams. Minor increase in the cost of the first 5 days in the hospital of $10.00 per day. All for no premium except the $135.50 for part B Medicare. Looked at a bunch of other plans but decided to stay with the current plan because of the vastness of the network. Some of the best hospitals in the country are included in the network. You are also covered nation wide if you should be traveling for emergency services as you the client determines the emergency. What are others doing?

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munemaker
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Re: Medicare Sign Up

Post by munemaker » Tue Dec 04, 2018 9:06 am

Leroy Jones wrote:
Tue Dec 04, 2018 8:43 am
What are others doing?
I also have a Medicare Advantage plan that has a $750 deductible. For 2019, I changed to a new Advantage Plan from the same provider that has no deductible, but a higher premium.

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dm200
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Re: Medicare Sign Up

Post by dm200 » Tue Dec 04, 2018 9:07 am

Leroy Jones wrote:
Tue Dec 04, 2018 8:43 am
Well open enrollment ends in 3 days. Has anyone made a big change in there health insurance? I started with a Medicare Advantage plan last year and so far it has worked out ok. Next year they are cutting the cost of prescriptions, primary care office visits, specialist (cardiologist, allergist) office visits and leaving the maximum out of pocket the same $6700. Adding dental for cleanings and eye exams. Minor increase in the cost of the first 5 days in the hospital of $10.00 per day. All for no premium except the $135.50 for part B Medicare. Looked at a bunch of other plans but decided to stay with the current plan because of the vastness of the network. Some of the best hospitals in the country are included in the network. You are also covered nation wide if you should be traveling for emergency services as you the client determines the emergency. What are others doing?
I have been in the Kaiser Medicare plan for eight years - no plans to change. Premium is going up from $30 to $36 per month and most costs to me stay about the same - a few things go up. The max annual out of pocket is going up to $6,700. Primary care office visit copay is actually going down from $20 to $10 and they are adding "Silver Fit" membership.

Nowizard
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Re: Medicare Sign Up

Post by Nowizard » Tue Dec 04, 2018 9:23 am

Having just evaluated the 28 plans in our area, we are changing, though only in Part D, so the following may not apply in your case. What we noticed is that it is very important to evaluate the medications you are taking and to ignore any deductible accompanying prescription plans.

In the case of the former, one of us takes a medication that has a significant co-pay after insurance. Entering this medication into plans on the Medicare.gov site revealed that the total annual cost to us (Monthly premium, deductible and co-pay) varied by $1,800, with the only difference being the cost of this single medication! In other words, there may be medications that are quite inexpensive on one plan and very expensive on another. This presents a conundrum since you may be prescribed a new medication in a given year within a less expensive plan that ultimately makes it more expensive.

The deductible question is also confusing in that plans with none certainly appear to be less expensive at first glance. However, we chose a plan with a $415 deductible for one of us when our current plan has none due to the medication that person is taking being inexpensive. The total cost, including the medication, monthly premium, and co-pay will be less than $300, since the medication itself will be approximately $40 for the entire year(Unless another, more expensive medication is prescribed during the year).

In short, the medication costs vary from plan to plan, and the presentation is confusing, particularly in regard to medication deductibles. We feel very sorry for those who do not have the ability to evaluate the plans carefully. In your case, a huge issue is the difference in the provider panels for Advantage Plans and others. They are less expensive and have more benefits, but they have the downside of restricted panels. One friend who has a relative who advises on plan suggestions has recommended he choose an Advantage Plan initially that covers all or part of hearing aids and then switch to a Traditional Medicare Plan the following year.

Tim

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dm200
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Re: Medicare Sign Up

Post by dm200 » Tue Dec 04, 2018 9:41 am

Also, our Kaiser Medicare plan includes drug coverage, although we do not take many drugs and the ones we take are not expensive.

One change we noticed this year (2018) is that one of the drugs my wife takes and one that I take now are in the lowest cost "tier"and cost us zero.

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Watty
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Re: Medicare Sign Up

Post by Watty » Tue Dec 04, 2018 9:50 am

Leroy Jones wrote:
Tue Dec 04, 2018 8:43 am
What are others doing?
I have not started Medicare yet but when we were signing my wife up we decided to go with traditional Medicare with a "G" supplement that covers about as much as possible.

The main reason was that we were concerned what any Medicare Advantage plan would look like in ten years or more and by then it would be difficult or impossible to switch back to traditional Medicare and get a good supplement.

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cheese_breath
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Re: Medicare Sign Up

Post by cheese_breath » Tue Dec 04, 2018 10:18 am

I kept both DW and myself in the same Plan D prescription plans we have this year. I don't remember that ever happening before, not both of us in the same year.
The surest way to know the future is when it becomes the past.

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dm200
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Re: Medicare Sign Up

Post by dm200 » Tue Dec 04, 2018 10:22 am

Watty wrote:
Tue Dec 04, 2018 9:50 am
Leroy Jones wrote:
Tue Dec 04, 2018 8:43 am
What are others doing?
I have not started Medicare yet but when we were signing my wife up we decided to go with traditional Medicare with a "G" supplement that covers about as much as possible.
The main reason was that we were concerned what any Medicare Advantage plan would look like in ten years or more and by then it would be difficult or impossible to switch back to traditional Medicare and get a good supplement.
Who knows? Several years ago, there were many posts and discussions here predicting gloom and doom for MA plans - BUT I don't think any of those things happened.

Shallowpockets
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Re: Medicare Sign Up

Post by Shallowpockets » Tue Dec 04, 2018 11:16 am

Like OP I have a Medicare Advantage plan. I factor in the free Silver Sneakers at my gym which saves me an additional $200 year. The biggest factor I see and hear about a non MA plan is that people want to keep their own doctors and they want coverage for everything and they think they will get it with G and F plans. Here on BH that F is mostly mentioned in regards to travel. You have to run some numbers and probabilities to find what best suits you.
The main advantage I see for my network is that I do not have to search out for XRs, a lab for blood draws, or even a pharmacy. It is all of the same. I would not even want to go searching for a specialist for some problem after a regular MD visit. That sounds like a lot of work on my part.
When you have a plan that allows you to go anywhere, it is like having multiple, multiple choices and this is not always a good thing. Studies have shown that the more choices someone has (on anything) the more paralyzing the decision becomes.
So, no changes for me according to those thoughts above. if sometime in the future I want to go to a supplemental plan, I will find out the added costs that may arise from the change. I would think it might be mitigated by the savings over the time I did not pay any more than my $134 a month.

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dm200
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Re: Medicare Sign Up

Post by dm200 » Tue Dec 04, 2018 11:43 am

Shallowpockets wrote:
Tue Dec 04, 2018 11:16 am
Like OP I have a Medicare Advantage plan. I factor in the free Silver Sneakers at my gym which saves me an additional $200 year. The biggest factor I see and hear about a non MA plan is that people want to keep their own doctors and they want coverage for everything and they think they will get it with G and F plans. Here on BH that F is mostly mentioned in regards to travel. You have to run some numbers and probabilities to find what best suits you.
The main advantage I see for my network is that I do not have to search out for XRs, a lab for blood draws, or even a pharmacy. It is all of the same. I would not even want to go searching for a specialist for some problem after a regular MD visit. That sounds like a lot of work on my part.
When you have a plan that allows you to go anywhere, it is like having multiple, multiple choices and this is not always a good thing. Studies have shown that the more choices someone has (on anything) the more paralyzing the decision becomes.
So, no changes for me according to those thoughts above. if sometime in the future I want to go to a supplemental plan, I will find out the added costs that may arise from the change. I would think it might be mitigated by the savings over the time I did not pay any more than my $134 a month.
Yes - in my opinion and experience, getting appointments with specialists( on your own) can often result in delays, while I experience no delays with my plan. My plan also includes Optometry (including refractions) appointments for $20 copay. There is also a small dental benefit.

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munemaker
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Re: Medicare Sign Up

Post by munemaker » Tue Dec 04, 2018 9:44 pm

Shallowpockets wrote:
Tue Dec 04, 2018 11:16 am
Like OP I have a Medicare Advantage plan. I factor in the free Silver Sneakers at my gym...
How do you figure this is free? The cost is included in the premium you pay and the amount that Medicare pays to your insurance company.

Grasshopper
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Re: Medicare Sign Up

Post by Grasshopper » Wed Dec 05, 2018 6:46 am

Changed supp F to G in 2018, and Humana D to Aetna for 2019.

late to the party
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Re: Medicare Sign Up

Post by late to the party » Wed Dec 05, 2018 4:26 pm

I'm actually taking a break now from fiddling with the part d options. This is the 5th year I'm on medicare, and each year I've switched plans to get the lowest total costs. The last 2 years, with the cheapest overall cost, I switched from CVS as the preferred pharmacy to Walgreens. And I've gotten spoiled. The Walgreens closest to me is a larger one with a 24-hour phamacy, which is nice to be able to go to the drive-thru at any time. The CVS isn't as convenient, is smaller, and occasionally didn't have the quantity on hand to completely fill a prescription, so I would have to make an extra trip back. So, this year, the two cheapest plans are Aetna plans with CVS as the preferred pharmacy.

Overall, it's probably going to be about two to three hundred dollars more per year, (could be more if one of my doctors puts me back on a branded drug, which we recently discontinued but might go back to if a certain condition gets worse). I also don't want to switch pharmacies, because of the hassles of changing the pharmacy info at each of my doctors' offices as I get prescriptions from four different specialists.

Finally, I wanted to mention for anyone who gets a higher priced rx, such as xarelto, I see where some plans have considerable savings if I use mail order, if even for just that one drug. That's part of my problem too, as I worry about the reliability of mail delivery of an expensive drug.

Almost there
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Re: Medicare Sign Up

Post by Almost there » Wed Dec 05, 2018 7:37 pm

I used Medicare Advantage Plan for one year and then, an advisor recommended Medicare Supplemental Plan (N) with United Healthcare and I am happy I changed. Soon after, I broke my wrist and only paid the doctor $20 for the office visit and zero for the surgery. Medicare took care of the rest. I can choose to go to any doctor or specialist as long as they accept Medicare (with the Medicare Advantage Plan, you first have to go to your Primary Dr and then they choose the specialist). One year later, I switched to Aetna (had to go through underwriting) and saved $25.00/per month. Remember no matter which healthcare company you choose for supplemental insurance, the coverage is the same. I also changed drug plan company from Humana to Aetna. Paying less than half.
Please go to the Medicare.gov site and inform yourself accordingly.

Good Listener
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Re: Medicare Sign Up

Post by Good Listener » Wed Dec 05, 2018 8:44 pm

I hate Medicare Advantage. Not because you're committed for a year, which if the network or things go against you, you can get out. (My company retiree plan enrolled me and after 2 months I left for a supplement plan. I had 1 thing that required prior authorization which I did get but could have had an office procedure done in 1 visit otherwise. And what if they said no?). Rather because as we age we become unable to pass underwriting and Medicare supplements can reject you. It costs maybe $150-200 per month for a great supplement and maybe $25 or so for a drug plan. And then you have complete freedom.

I really suggest you go the supplement routs if you can afford the $2000-3000 per year. And by the way, once you buy the supplement, everything is covered except with Plan G the $185 deductible. . In most MA plans there are meaningful deductibles plus out of pocket maximums up to $6500 or so.

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dm200
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Re: Medicare Sign Up

Post by dm200 » Thu Dec 06, 2018 1:00 pm

Good Listener wrote:
Wed Dec 05, 2018 8:44 pm
I hate Medicare Advantage. Not because you're committed for a year, which if the network or things go against you, you can get out. (My company retiree plan enrolled me and after 2 months I left for a supplement plan. I had 1 thing that required prior authorization which I did get but could have had an office procedure done in 1 visit otherwise. And what if they said no?). Rather because as we age we become unable to pass underwriting and Medicare supplements can reject you. It costs maybe $150-200 per month for a great supplement and maybe $25 or so for a drug plan. And then you have complete freedom.

I really suggest you go the supplement routs if you can afford the $2000-3000 per year. And by the way, once you buy the supplement, everything is covered except with Plan G the $185 deductible. . In most MA plans there are meaningful deductibles plus out of pocket maximums up to $6500 or so.
Yes - that is true with some MA plans, but some others do not require it, while others (like mine) have a more flexible and reasonable requirement. This referral requirement is a function of the particular plan (whether Medicare or not) - and is not part of all MA plans.

dollarsaver
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Re: Medicare Sign Up

Post by dollarsaver » Thu Dec 06, 2018 8:23 pm

Good Listener wrote:
Wed Dec 05, 2018 8:44 pm
I hate Medicare Advantage. Not because you're committed for a year, which if the network or things go against you, you can get out. (My company retiree plan enrolled me and after 2 months I left for a supplement plan. I had 1 thing that required prior authorization which I did get but could have had an office procedure done in 1 visit otherwise. And what if they said no?). Rather because as we age we become unable to pass underwriting and Medicare supplements can reject you. It costs maybe $150-200 per month for a great supplement and maybe $25 or so for a drug plan. And then you have complete freedom.

I really suggest you go the supplement routs if you can afford the $2000-3000 per year. And by the way, once you buy the supplement, everything is covered except with Plan G the $185 deductible. . In most MA plans there are meaningful deductibles plus out of pocket maximums up to $6500 or so.
+1. Yes, with Medicare and a supplement plan just pay the $185 deductible and you are finished for 2019. After having an employer plan forever, now no pre-authorizations or referrals for any medical service. With Medicare Advantage plans most people have an out of pocket max of 6K and need pre-auths for procedures and a referral from a PCP.

One procedure or hospital you are stuck for your out of pocket max with a Medicare Advantage Plan and hopefully your procedure gets authorized. Have complete freedom to make my own choices of specialists and what hospital I want to go to for a procedure.

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dm200
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Re: Medicare Sign Up

Post by dm200 » Fri Dec 07, 2018 9:16 am

With Medicare Advantage plans most people have an out of pocket max of 6K and need pre-auths for procedures and a referral from a PCP.

One procedure or hospital you are stuck for your out of pocket max with a Medicare Advantage Plan and hopefully your procedure gets authorized. Have complete freedom to make my own choices of specialists and what hospital I want to go to for a procedure.
Yes. Our plan has an annual out of pocket max of $6,700 in 2019. The referral issue is zero problem for us.

For an added $110 per month, we can switch to he same providers "high option" plan and the out of pocket max would be somewhat lower.

Leroy Jones
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Re: Medicare Sign Up

Post by Leroy Jones » Fri Dec 07, 2018 5:06 pm

My Advantage Plan does not require any referrals as long as the doctor is in network. The plan covers almost all the doctors in Western NY from Monroe County in the east to all the counties to the west and the Northern tier of PA. You should be able to find a competent high quality doctor in this region. All the hospitals are also in network. So being able to find the necessary services should be easy enough. We've had no issues with finding necessary doctors or services yet. Hopefully this will continue in the future and if it doesn't we'll change then. I understand in NY there is no underwriting delay for pre-existing conditions if you go to a supplement from Advantage.

Yankee53
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Re: Medicare Sign Up

Post by Yankee53 » Fri Dec 07, 2018 5:29 pm

Just signed up for Medicare this month to be effective Jan 2019. Went with standard Part A, Part B, AARP UHC Plan G Medigap, Aetna Rx plan for a total cost of about $270 per month. Only responsible for $185 deductible cost as far as I can tell. We are planning to spend several 2-3 month periods throughout the year traveling in the US so Medicare Advantage didn't work for me. Also have read many times that if something serious happens you may not be able to get to the best specialist in your area if they are not in the MA plan network.
Just read that UHC Plan G is dropping Silver Sneakers membership, not happy about that but not much I can do about it.

Edit: As cheese-breath indicated below I do have a Part D Rx deductible and co-pays!
Last edited by Yankee53 on Fri Dec 07, 2018 6:52 pm, edited 1 time in total.

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cheese_breath
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Re: Medicare Sign Up

Post by cheese_breath » Fri Dec 07, 2018 6:06 pm

Yankee53 wrote:
Fri Dec 07, 2018 5:29 pm
Just signed up for Medicare this month to be effective Jan 2019. Went with standard Part A, Part B, AARP UHC Plan G Medigap, Aetna Rx plan for a total cost of about $270 per month. Only responsible for $185 deductible cost as far as I can tell...
Your Aetna Rx plan might have a deductible. Most of the Part D Plans do. And there will be copays on most of the drugs except for some generics.
The surest way to know the future is when it becomes the past.

RetiredInvestor47
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Re: Medicare Sign Up

Post by RetiredInvestor47 » Fri Dec 07, 2018 10:49 pm

Yankee53 wrote:
Fri Dec 07, 2018 5:29 pm
Just read that UHC Plan G is dropping Silver Sneakers membership, not happy about that but not much I can do about it.
I had UHC Plan N for the last several years. I was not happy they are dropping Silver Sneakers. I was able to go to Medical Mutual Plan G without underwriting. They still include Silver Sneakers. Was also a few dollars less than UHC. You may be able to change horses. UHC will most likely be less than Med Mutual due to the discounts they offer for younger people. I guess I got lucky - used their discounts for several years - then as the discounts were less they were more than Med Mutual.

Understand that the no underwriting is thru June 2019 I believe.

Shallowpockets
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Re: Medicare Sign Up

Post by Shallowpockets » Sat Dec 08, 2018 10:52 am

munemaker wrote:
Tue Dec 04, 2018 9:44 pm
Shallowpockets wrote:
Tue Dec 04, 2018 11:16 am
Like OP I have a Medicare Advantage plan. I factor in the free Silver Sneakers at my gym...
How do you figure this is free? The cost is included in the premium you pay and the amount that Medicare pays to your insurance company.
It is free to me. My ONLY Medicare cost is the $134 month we all pay. That is it. So if we all pay the $134 it is a wash. You have to. Thius, for me it is free. Otherwise I would be paying it out of pocket.

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