Medicare vs IRMAA vs health care coverage

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ps56k
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Medicare vs IRMAA vs health care coverage

Post by ps56k » Fri Feb 14, 2020 2:34 pm

Just wondering.....
If you look at the Medicare IRMAA surcharge chart, it gets pretty expensive as your MAGI gets higher.
Are you required to take Medicare in retirement ?

Basically - can you chose to NOT take Medicare Part B- NOT pay the Medicare premiums + NOT pay the IRMAA -
If so, what do you do to handle health care coverage ....

SO... No Medicare, No IRMAA, and no implied health coverage from Medicare -
BUT... then - where and how do you get "something" to cover your health care needs ?

MAGI vs Medicare IRMAA surcharge
0 - 174k.. = $144
174 - 218 = $202
218 - 272 = $289
272 - 326 = $326
326 - 750 = $462
750 + .....= $491

neilpilot
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Re: Medicare vs IRMAA vs health care coverage

Post by neilpilot » Fri Feb 14, 2020 2:39 pm

In most cases, if you decide to forgo Part B (and also Part D) and years later change your mind and decide to start coverage, isn't there a "permanent" penalty tacked on to the premium since you failed to start coverage earlier?

prd1982
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Re: Medicare vs IRMAA vs health care coverage

Post by prd1982 » Fri Feb 14, 2020 2:47 pm

There isn't any ACA subsidy available either. Might be able to find insurance off the exchange.

You will also want either Medicare Advantage or a Medicare supplemental.

However, if you have to pay a MAGI, you can afford Medicare. It is still cheap compared to private insurance.

FactualFran
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Re: Medicare vs IRMAA vs health care coverage

Post by FactualFran » Fri Feb 14, 2020 3:57 pm

prd1982 wrote:
Fri Feb 14, 2020 2:47 pm
However, if you have to pay a MAGI, you can afford Medicare. It is still cheap compared to private insurance.
With the highest additional amount, the Medicare Part B premium covers 85% of what the government pays in benefits. The standard premium covers 25%.

adamthesmythe
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Re: Medicare vs IRMAA vs health care coverage

Post by adamthesmythe » Fri Feb 14, 2020 4:18 pm

neilpilot wrote:
Fri Feb 14, 2020 2:39 pm
In most cases, if you decide to forgo Part B (and also Part D) and years later change your mind and decide to start coverage, isn't there a "permanent" penalty tacked on to the premium since you failed to start coverage earlier?
That's one issue. The other is that any other kind of insurance will be very expensive, if available at all.

Now there is one important exception- if you continue to work and get "creditable" coverage (or continue to get coverage from a spouse working) you will not need to get part B, and there will be no penalty when you ultimately do get part B.

prd1982
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Re: Medicare vs IRMAA vs health care coverage

Post by prd1982 » Fri Feb 14, 2020 4:24 pm

FactualFran wrote:
Fri Feb 14, 2020 3:57 pm
With the highest additional amount, the Medicare Part B premium covers 85% of what the government pays in benefits. The standard premium covers 25%.
I have the impression that Medicare reimbursement rates are lower than private insurance. So I still believe you cannot find cheaper equivalent insurance.

We do pay IRMAA, although not at the highest level. I consider it a charitable gift to help those that could not afford Medicare otherwise.

Wricha
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Re: Medicare vs IRMAA vs health care coverage

Post by Wricha » Fri Feb 14, 2020 4:41 pm

Is one allowed to buy healthcare insurance if they are eligible for Medicare?

jj
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Re: Medicare vs IRMAA vs health care coverage

Post by jj » Fri Feb 14, 2020 8:54 pm

ps56k wrote:
Fri Feb 14, 2020 2:34 pm

MAGI vs Medicare IRMAA surcharge
0 - 174k.. = $144
174 - 218 = $202
218 - 272 = $289
272 - 326 = $326
326 - 750 = $462
750 + .....= $491
Take your IRMAA amount for the top tier $491, add in a low cost Part D (drug plan) for $15 and a Mutual of Omaha supplement, Plan G, with very comprehensive coverage with <$200/year deductible for $98 - this is for a 65-year-old male in my zip code. Total = $604 per month.

Compare that to the price of a 'private' Bronze ACA compliant policy with a much smaller doctor/hospital network and a whacking great $8150/year deductible for $698 per month - this is for a 60-year-old, non-smoker in my zip code. For similar, but slightly worse, coverage to Medicare, I could have bought a much more comprehensive Gold ACA policy at >$1500 a month.

I can't wait to be old enough to qualify for Medicare pricing!
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mhalley
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Re: Medicare vs IRMAA vs health care coverage

Post by mhalley » Fri Feb 14, 2020 9:06 pm

My insurance co sent me a premium for what my age 65 yo bronze plan for my wife and I would be. Over $3200 a month, for a plan that would not pay a dime for ANYTHING until 6k deductible. The maximum Medicare plus IRMAA plus part d would be about $1544 plus say $220 for supplement maybe? So $1400 cheaper.

ralph124cf
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Re: Medicare vs IRMAA vs health care coverage

Post by ralph124cf » Sat Feb 15, 2020 5:40 am

jj wrote:
Fri Feb 14, 2020 8:54 pm
ps56k wrote:
Fri Feb 14, 2020 2:34 pm

MAGI vs Medicare IRMAA surcharge
0 - 174k.. = $144
174 - 218 = $202
218 - 272 = $289
272 - 326 = $326
326 - 750 = $462
750 + .....= $491
Take your IRMAA amount for the top tier $491, add in a low cost Part D (drug plan) for $15 and a Mutual of Omaha supplement, Plan G, with very comprehensive coverage with <$200/year deductible for $98 - this is for a 65-year-old male in my zip code. Total = $604 per month.

Compare that to the price of a 'private' Bronze ACA compliant policy with a much smaller doctor/hospital network and a whacking great $8150/year deductible for $698 per month - this is for a 60-year-old, non-smoker in my zip code. For similar, but slightly worse, coverage to Medicare, I could have bought a much more comprehensive Gold ACA policy at >$1500 a month.

I can't wait to be old enough to qualify for Medicare pricing!
In addition to the max Medicare part B IRMAA of $491, there is a max IRMAA of $76.40 for part D, drug coverage.

Ralph

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Stinky
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Re: Medicare vs IRMAA vs health care coverage

Post by Stinky » Sat Feb 15, 2020 1:57 pm

If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
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Wricha
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Re: Medicare vs IRMAA vs health care coverage

Post by Wricha » Sat Feb 15, 2020 4:07 pm

Stinky wrote:
Sat Feb 15, 2020 1:57 pm
If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.

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Stinky
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Re: Medicare vs IRMAA vs health care coverage

Post by Stinky » Sat Feb 15, 2020 4:44 pm

Wricha wrote:
Sat Feb 15, 2020 4:07 pm
Stinky wrote:
Sat Feb 15, 2020 1:57 pm
If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.
This is one facet of the on-again/off-again push to make the tax code more progressive. It’s similar to assessing Medicare taxes on all wages, even though everyone receives the same Medicare benefits.

I’m not making a political statement, and not saying whether I agree with it or not. It’s just a fact - politicians often feel “the ‘rich’ can afford to pay more.”
It's a GREAT day to be alive - Travis Tritt

MJS
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Re: Medicare vs IRMAA vs health care coverage

Post by MJS » Sat Feb 15, 2020 4:50 pm

ps56k wrote:
Fri Feb 14, 2020 2:34 pm
MAGI vs Medicare IRMAA surcharge
0 - 174k.. = $144
174 - 218 = $202
218 - 272 = $289
272 - 326 = $326
326 - 750 = $462
750 +.....= $491
Nitpick time: Non matching data bothers me.
Column 1 = income of a couple filing jointly
Column 2 = Medicare pt B & IRMAA for one person
Revise to Column 2 to
Medicare Pt B & IRMAA + Medicare Pt D IRMAAs for 2
0 - 174k.. = $288
174 - 218 = $404+24
218 - 272 = $578+63
272 - 326 = $652+101
326 - 750 = $924+140
750 +..... = $982+153

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Re: Medicare vs IRMAA vs health care coverage

Post by Dottie57 » Sat Feb 15, 2020 4:52 pm

Wricha wrote:
Fri Feb 14, 2020 4:41 pm
Is one allowed to buy healthcare insurance if they are eligible for Medicare?
Once eligible for Medicare I think ACA goes away.

Monster99
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Re: Medicare vs IRMAA vs health care coverage

Post by Monster99 » Sat Feb 15, 2020 4:52 pm

Stinky wrote:
Sat Feb 15, 2020 4:44 pm
Wricha wrote:
Sat Feb 15, 2020 4:07 pm
Stinky wrote:
Sat Feb 15, 2020 1:57 pm
If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.
This is one facet of the on-again/off-again push to make the tax code more progressive. It’s similar to assessing Medicare taxes on all wages, even though everyone receives the same Medicare benefits.

I’m not making a political statement, and not saying whether I agree with it or not. It’s just a fact - politicians often feel “the ‘rich’ can afford to pay more.”
What they fail to do is define exactly what level is "rich".....

cas
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Re: Medicare vs IRMAA vs health care coverage

Post by cas » Sat Feb 15, 2020 5:22 pm

Wricha wrote:
Sat Feb 15, 2020 4:07 pm
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.
Unfortunately, the Medicare payroll tax funds Medicare Part A (hospitalization benefits) only. Everyone who is eligible (they or spouse paid 40 quarters of SS/Medicare payroll tax) gets 100% of their Part A premium paid. People with less than 40 quarters pay a premium for Part A.

Medicare Part B (doctor, outpatient benefits) and Medicare Part D (prescription benefits) were introduced in different legislation and have different funding mechanism. They are paid out of combination of premiums and "general revenues of the United States" (i.e. income taxes.) IRMAA determines how much of a subsidy a person gets off the Medicare B/D premiums. Everyone over 65 who is eligible to buy B/D , no matter what their income is, gets at least a 15% subsidy off the "true cost" of the Medicare B/D premium. Most people (the 90% -95% whose income falls in the first IRMAA tier) get a 75% subsidy off the premiums. The various IRMAA tiers determine whether the subsidy for the B/D premium is 75%, 65%, 50%, 35%, 20%, or 15%.

prd1982
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Re: Medicare vs IRMAA vs health care coverage

Post by prd1982 » Sat Feb 15, 2020 5:28 pm

CAS,

Thanks for the explanation.

quantAndHold
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Re: Medicare vs IRMAA vs health care coverage

Post by quantAndHold » Sat Feb 15, 2020 6:06 pm

Even if you can find alternative insurance, IRMAA is going to be cheaper than any of the alternatives.
Yes, I’m really that pedantic.

notinuse
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Re: Medicare vs IRMAA vs health care coverage

Post by notinuse » Sat Feb 15, 2020 6:24 pm

Medicare Part B is subsidized for most people. IRMAA is a reduction of that subsidy if your income is high enough. The medicare part of payroll tax paid when employed is for Part A, not Parts B or D.

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ps56k
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Re: Medicare vs IRMAA vs health care coverage

Post by ps56k » Thu Feb 27, 2020 3:32 pm

As always - thanks for the discussion and educational notes -

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cheese_breath
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Re: Medicare vs IRMAA vs health care coverage

Post by cheese_breath » Thu Feb 27, 2020 4:42 pm

Wricha wrote:
Sat Feb 15, 2020 4:07 pm
Stinky wrote:
Sat Feb 15, 2020 1:57 pm
If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.
It's the same logic as income taxes. The more you make the higher your tax bracket. Not saying I agree with it, but that's the way it is.
The surest way to know the future is when it becomes the past.

Wricha
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Re: Medicare vs IRMAA vs health care coverage

Post by Wricha » Sat Feb 29, 2020 8:03 am

cheese_breath wrote:
Thu Feb 27, 2020 4:42 pm
Wricha wrote:
Sat Feb 15, 2020 4:07 pm
Stinky wrote:
Sat Feb 15, 2020 1:57 pm
If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.
It's the same logic as income taxes. The more you make the higher your tax bracket. Not saying I agree with it, but that's the way it is.
I think the difference is IRMAA in not a “tax” it is reducing the value of benefit, to a select group of people, that has been been prepaid by the recipient.
Perhaps EZ pass/toll roads will have different lanes based on income.
My point is people now think fairness is base on whatever people can afford both in taxes and benefits.Yet we give the very wealthy a pass. Look at the IRMAA brackets and rules for participating it excludes the very wealthy. Personally I believe in a progressive income taxes, struggle with Differential prepaid benefits. This has a way of spreading into other areas like SS and other goods/services.
Just a thought.

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Re: Medicare vs IRMAA vs health care coverage

Post by Cyclesafe » Sat Feb 29, 2020 8:24 am

Wricha wrote:
Sat Feb 29, 2020 8:03 am
I think the difference is IRMAA in not a “tax” it is reducing the value of benefit, to a select group of people, that has been been prepaid by the recipient.
Tomato, tomaato.
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cheese_breath
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Re: Medicare vs IRMAA vs health care coverage

Post by cheese_breath » Sat Feb 29, 2020 8:58 am

The point isn't whether IRMAA is a tax or not. The point is the people who make the laws believe those who make more should pay more, whether we like it or not. Also, our Medicare coverage isn't prepaid. Our Medicare taxes paid for our parents' Medicare. Excepting what we currently pay ours is being paid for by our children.
The surest way to know the future is when it becomes the past.

M.Lee
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Re: Medicare vs IRMAA vs health care coverage

Post by M.Lee » Sat Feb 29, 2020 9:08 am

Stinky wrote:
Sat Feb 15, 2020 1:57 pm
If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
That is untrue. Suppose that Medicare beneficiary has a special needs dependent that is costing them a fortune to care for. Even suppose that beneficiary themselves has special needs.

The tax code and IRMAA and SS have rules that one could disagree with. Take for example the fact that a person with several children and a non-working wife gets to take a deduction for all of them as dependents and pay less taxes. Why is that fair? They chose that lifestyle.

I do not believe in a progressive tax or anything else based on income.

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Re: Medicare vs IRMAA vs health care coverage

Post by Stinky » Sat Feb 29, 2020 9:44 am

M.Lee wrote:
Sat Feb 29, 2020 9:08 am

I do not believe in a progressive tax or anything else based on income.
For better or worse, many parts of the US tax code are progressive in nature.

And I don’t expect that to change in my lifetime.
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Re: Medicare vs IRMAA vs health care coverage

Post by MathIsMyWayr » Sat Feb 29, 2020 9:50 am

cas wrote:
Sat Feb 15, 2020 5:22 pm
Wricha wrote:
Sat Feb 15, 2020 4:07 pm
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.
Unfortunately, the Medicare payroll tax funds Medicare Part A (hospitalization benefits) only. Everyone who is eligible (they or spouse paid 40 quarters of SS/Medicare payroll tax) gets 100% of their Part A premium paid. People with less than 40 quarters pay a premium for Part A.

Medicare Part B (doctor, outpatient benefits) and Medicare Part D (prescription benefits) were introduced in different legislation and have different funding mechanism. They are paid out of combination of premiums and "general revenues of the United States" (i.e. income taxes.) IRMAA determines how much of a subsidy a person gets off the Medicare B/D premiums. Everyone over 65 who is eligible to buy B/D , no matter what their income is, gets at least a 15% subsidy off the "true cost" of the Medicare B/D premium. Most people (the 90% -95% whose income falls in the first IRMAA tier) get a 75% subsidy off the premiums. The various IRMAA tiers determine whether the subsidy for the B/D premium is 75%, 65%, 50%, 35%, 20%, or 15%.
How are Medicare B/D and IRMAA premiums set? Since Medicare is partially funded by income taxes, is there any target percentage for self funding? Not a political question, but just curious.

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Re: Medicare vs IRMAA vs health care coverage

Post by Cyclesafe » Sat Feb 29, 2020 9:55 am

MathIsMyWayr wrote:
Sat Feb 29, 2020 9:50 am
How are Medicare B/D and IRMAA premiums set? Since Medicare is partially funded by income taxes, is there any target percentage for self funding? Not a political question, but just curious.
You'd also need to add in the effect of "what-the-market-will-bear" medical pricing when evaluating self funding. Medicare and other "private insurance" hopefully dampens some of the most egregious price gouging.
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Re: Medicare vs IRMAA vs health care coverage

Post by btenny » Sat Feb 29, 2020 10:03 am

Some older adults get along fine without any Medicare Group B or D insurance. They get Medicare Part A for free so they are covered for bad hospitalization events. Then they just shop for cheap drugs and negotiate low cash prices from the few Doctors they visit. If they are sorta healthy they do not take many drugs and only see the doctor 2-3 times year. So their direct costs are low. So they decide to not pay the Medicare premiums. My FIL did this for drugs many years ago. He found he spent less this way.

Good Luck.

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Re: Medicare vs IRMAA vs health care coverage

Post by ChrisC » Sat Feb 29, 2020 10:26 am

btenny wrote:
Sat Feb 29, 2020 10:03 am
Some older adults get along fine without any Medicare Group B or D insurance. They get Medicare Part A for free so they are covered for bad hospitalization events. Then they just shop for cheap drugs and negotiate low cash prices from the few Doctors they visit. If they are sorta healthy they do not take many drugs and only see the doctor 2-3 times year. So their direct costs are low. So they decide to not pay the Medicare premiums. My FIL did this for drugs many years ago. He found he spent less this way.

Good Luck.
I wonder how many older adults consciously make a decision not to enroll in Medicare Part B, if they are already receiving Social Security retirement benefits? I believe if you are receiving Social Security retirement benefits, you are automatically enrolled in Part B (and you have to opt out of Part B if you don't want it) -- this was my experience.

I think those who don't participate in Part B when they are older and beyond Medicare eligibility age 65 are more likely (as is the case with Federal or State civil service retirees) to have separate employer (or union) based health insurance for retirees, which would duplicate Part B coverage.

I just can't see how anyone would find it financially prudent to go without Medicare Part B and a supplemental plan or Medicare Advantage, if they can afford the Medicare premiums.

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Re: Medicare vs IRMAA vs health care coverage

Post by btenny » Sat Feb 29, 2020 10:41 am

Go to Sun City Arizona or some other low cost retirement community. You will meet older widows or widowers or older single adults who have lived long rich lives and spent all their money or never made enough in their lives. They are living in their paid for home on a single small Social Security check and have maybe $100K left in the bank. Others are living in rental apartments or retirement homes. So they watch expenses a LOT. And a $143 bill for medical insurance per month is a big cost. Especially if they just do not go to the doctor much. So they cancel that Medicare part B. What would you do if you got $1.5K per month from SS and had to live on it.......

stlrick
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Re: Medicare vs IRMAA vs health care coverage

Post by stlrick » Sat Feb 29, 2020 11:42 am

ps56k wrote:
Fri Feb 14, 2020 2:34 pm
Just wondering.....
If you look at the Medicare IRMAA surcharge chart, it gets pretty expensive as your MAGI gets higher.
Are you required to take Medicare in retirement ?

Basically - can you chose to NOT take Medicare Part B- NOT pay the Medicare premiums + NOT pay the IRMAA -
If so, what do you do to handle health care coverage ....

SO... No Medicare, No IRMAA, and no implied health coverage from Medicare -
BUT... then - where and how do you get "something" to cover your health care needs ?

MAGI vs Medicare IRMAA surcharge
0 - 174k.. = $144
174 - 218 = $202
218 - 272 = $289
272 - 326 = $326
326 - 750 = $462
750 + .....= $491

There is a typo in the table. The Part B rate for income of 276-326 is $376, not $326.

IRMAA is no big deal if you look at the practical issue for a couple, which is falling above or below any particular bracket. Suppose the issue is trying to stay below the increase when MAGI is above $326,000. The premium increase for going over $326,000 from an income of $325,000 is:
Part B 462.70 - 376.00 = 86.70
Part D 70.00 - 50.70 = 19.30

That is $106 per month per person, or, for a couple, $2544 annually. If your retirement income is in the area of $326,000, this ought not be something worth much worry.

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Re: Medicare vs IRMAA vs health care coverage

Post by M.Lee » Sat Feb 29, 2020 12:09 pm

btenny wrote:
Sat Feb 29, 2020 10:03 am
Some older adults get along fine without any Medicare Group B or D insurance. They get Medicare Part A for free so they are covered for bad hospitalization events. Then they just shop for cheap drugs and negotiate low cash prices from the few Doctors they visit. If they are sorta healthy they do not take many drugs and only see the doctor 2-3 times year. So their direct costs are low. So they decide to not pay the Medicare premiums. My FIL did this for drugs many years ago. He found he spent less this way.

Good Luck.
Yes, but Medicare Part A only pays for 80%. Have your seen a hospital bill lately? 20% is a lot to pay in many cases.

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Re: Medicare vs IRMAA vs health care coverage

Post by cheese_breath » Sat Feb 29, 2020 12:30 pm

M.Lee wrote:
Sat Feb 29, 2020 12:09 pm
btenny wrote:
Sat Feb 29, 2020 10:03 am
Some older adults get along fine without any Medicare Group B or D insurance. They get Medicare Part A for free so they are covered for bad hospitalization events. Then they just shop for cheap drugs and negotiate low cash prices from the few Doctors they visit. If they are sorta healthy they do not take many drugs and only see the doctor 2-3 times year. So their direct costs are low. So they decide to not pay the Medicare premiums. My FIL did this for drugs many years ago. He found he spent less this way.

Good Luck.
Yes, but Medicare Part A only pays for 80%. Have your seen a hospital bill lately? 20% is a lot to pay in many cases.
Yes, and especially if the "sorta healthy they do not take many drugs and only see the doctor 2-3 times year" changes to not very healthy, need several drugs, and sees doctors frequently as they age, not to mention possible hospitalizations.
The surest way to know the future is when it becomes the past.

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Re: Medicare vs IRMAA vs health care coverage

Post by ChrisC » Sat Feb 29, 2020 12:37 pm

btenny wrote:
Sat Feb 29, 2020 10:41 am
Go to Sun City Arizona or some other low cost retirement community. You will meet older widows or widowers or older single adults who have lived long rich lives and spent all their money or never made enough in their lives. They are living in their paid for home on a single small Social Security check and have maybe $100K left in the bank. Others are living in rental apartments or retirement homes. So they watch expenses a LOT. And a $143 bill for medical insurance per month is a big cost. Especially if they just do not go to the doctor much. So they cancel that Medicare part B. What would you do if you got $1.5K per month from SS and had to live on it.......
Well, I've been to Sun City Arizona (Glendale,AZ) and Sun City Carolina Lakes (Lancaster SC) and I wouldn't count 99% of the residents there as on the border line south of poverty. And by the way, I've visited a number of adult senior citizen centers the last 12 months in NC and rural parts of SC, where you do find impoverished seniors counting on subsidized lunch meals and other aging benefits, so I have a pretty good idea of what you're talking about.

But the fact remains, that even if one is living on a modest fixed-income or you're getting $1.5K per month in SS benefits, taking away $144 per month from that benefit (which you don't even see since it's automatically deducted), it does not make sense to cancel Part B and risk your health by not going to the doctor's office -- and Medicare B permits annual check-ups and other preventive care routines. Now, if these type of seniors are relying on Medicaid for health care that's another story.

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Re: Medicare vs IRMAA vs health care coverage

Post by HueyLD » Sat Feb 29, 2020 12:39 pm

ps56k wrote:
Fri Feb 14, 2020 2:34 pm
SO... No Medicare, No IRMAA, and no implied health coverage from Medicare -
BUT... then - where and how do you get "something" to cover your health care needs ?
That is the problem.

One is free to refuse Medicare. But no insurance company is going to insure an old person with pre-existing conditions. In addition, even if one is insurable, the insurance company will make sure the the premium is high enough to cover illness prone old people.

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Re: Medicare vs IRMAA vs health care coverage

Post by ncbill » Sat Feb 29, 2020 1:56 pm

btenny wrote:
Sat Feb 29, 2020 10:41 am
Go to Sun City Arizona or some other low cost retirement community. You will meet older widows or widowers or older single adults who have lived long rich lives and spent all their money or never made enough in their lives. They are living in their paid for home on a single small Social Security check and have maybe $100K left in the bank. Others are living in rental apartments or retirement homes. So they watch expenses a LOT. And a $143 bill for medical insurance per month is a big cost. Especially if they just do not go to the doctor much. So they cancel that Medicare part B. What would you do if you got $1.5K per month from SS and had to live on it.......
Yep, the above was my older relative, though they lived here in town.

When they were laid off around age 60 they did what they could to remain productive...refinanced their 15 year mortgage loan (5 years in) to a 30 year, went back to school to get a 4 year degree...at that age, however, they never were able to get re-employed.

They had to cash in their pension just to make it to age 62...also added a HELOC and slowly drained their home's equity just to live.

Then they started having serious back pain early 2018...got them signed up for Part B plus Plan G plus a drug plan but none of those kicked in until July 1.

Long story short they were diagnosed with terminal cancer that fall, enrolled in Hospice, and died just a few days into 2019.

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