What I spent in 6 months on medicare

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Chaconne
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Re: What I spent in 6 months on medicare

Post by Chaconne » Sun Aug 12, 2018 8:11 pm

It's been an unusually active year for me, medically speaking.

I've been billed about $17,000.
I've paid about $400.

Not a bad deal at all, even with the roughly $3,000 I pay in annual premiums (Part B = $1,206. Part D = $317. AARP United Plan L Supplement = $1,540).

drawpoker
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Re: What I spent in 6 months on medicare

Post by drawpoker » Sun Aug 12, 2018 8:20 pm

hesson11 wrote:
Sun Aug 12, 2018 8:11 pm

........ AARP United Plan L Supplement = $1,540).
Wow. You're paying $128 a month for Plan L?

In many areas of the U.S. people are buying G for around $101
How long have you had Plan L?

Allan
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Re: What I spent in 6 months on medicare

Post by Allan » Sun Aug 12, 2018 8:33 pm

Wife and I are both 67 and on Medicare, have a supplement and drug plan. I am still working so we are paying high premium. Medicare, supplement Plan F, and drug plan are costing us $14,000 annually.

neilpilot
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Re: What I spent in 6 months on medicare

Post by neilpilot » Sun Aug 12, 2018 8:37 pm

Allan wrote:
Sun Aug 12, 2018 8:33 pm
Wife and I are both 67 and on Medicare, have a supplement and drug plan. I am still working so we are paying high premium. Medicare, supplement Plan F, and drug plan are costing us $14,000 annually.
Wow.... We're both 68, and Medicare, supplement Plan G, and drug plan are costing us $6,264 annually. After our successful IRMAA appeal.

Allan
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Re: What I spent in 6 months on medicare

Post by Allan » Sun Aug 12, 2018 8:44 pm

neilpilot wrote:
Sun Aug 12, 2018 8:37 pm
Allan wrote:
Sun Aug 12, 2018 8:33 pm
Wife and I are both 67 and on Medicare, have a supplement and drug plan. I am still working so we are paying high premium. Medicare, supplement Plan F, and drug plan are costing us $14,000 annually.
Wow.... We're both 68, and Medicare, supplement Plan G, and drug plan are costing us $6,264 annually. After our successful IRMAA appeal.
To add to the misery, I am self-employed, paying max Soc Sec (both sides), adds about $12/month to my benefits.

Chaconne
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Re: What I spent in 6 months on medicare

Post by Chaconne » Sun Aug 12, 2018 10:45 pm

drawpoker wrote:
Sun Aug 12, 2018 8:20 pm
Wow. You're paying $128 a month for Plan L?

In many areas of the U.S. people are buying G for around $101
How long have you had Plan L?
I've had it for 2.5 years. When my decision time came, it offered the best combination of value and coverage, to my mind. At the time I enrolled, the four Plan G policies offered in my area were priced at $177, $195, $214 and $235. That didn't make sense to me, and the annual out-of-pocket limits to Plan L also appealed to me.

drawpoker
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Re: What I spent in 6 months on medicare

Post by drawpoker » Sun Aug 12, 2018 11:47 pm

Wow. Guess it could be said you are within not just a HCOL area - but that special area known as HHMCOL
Those Plan G prices you encountered two and one-half years ago.... :shock:

Beware : High Hellish Medicare Cost Of Living

HHMCOL

Yikes Oughta be designated as an official Danger Zone :x

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dm200
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Re: What I spent in 6 months on medicare

Post by dm200 » Tue Aug 14, 2018 2:12 pm

Such a wide range of what folks pay for Medicare Supplements!

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Mlm
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Re: What I spent in 6 months on medicare

Post by Mlm » Tue Aug 14, 2018 3:06 pm

I just checked Medicare supplements in my zip code. For 2018 the lowest cost are Part G-$183 and Part L-$110 and then there is part D on top of that.

I am going to look closely at Medicare Advantage Plans when the time comes in 2020. In fact everyone I know has a MA Plan..I can see why.

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dm200
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Re: What I spent in 6 months on medicare

Post by dm200 » Tue Aug 14, 2018 3:19 pm

Mlm wrote:
Tue Aug 14, 2018 3:06 pm
I just checked Medicare supplements in my zip code. For 2018 the lowest cost are Part G-$183 and Part L-$110 and then there is part D on top of that.
I am going to look closely at Medicare Advantage Plans when the time comes in 2020. In fact everyone I know has a MA Plan..I can see why.
VERY location dependent. Most (but not all) MA plans include prescription drugs. So, watch that feature when doing evaluation.

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dm200
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Re: What I spent in 6 months on medicare

Post by dm200 » Mon Oct 22, 2018 10:29 am

likegarden wrote:
Fri Jul 06, 2018 2:57 pm
I did not read all comments, but in respect to some comments Medicare paid our colonoscopies and cataract eye surgeries.
Yes - eventually my wife and I will need cataract surgery. Apparently, Medicare fully covers the basic type -- and not the "fancier" lens implants. A longtime friend just had the basic type Medicare covers and he is very, very happy with the results. Our plan also fully covers colonoscopies (I have family history).

Nowizard
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Re: What I spent in 6 months on medicare

Post by Nowizard » Mon Oct 22, 2018 12:34 pm

If you think the quoted prices are high, take a look at the cost for Medicare, Parts B and D, with the additional cost for those with higher incomes, something that can occur relatively frequently if you have reached the age of MRD's.

Tim

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dm200
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Re: What I spent in 6 months on medicare

Post by dm200 » Wed Oct 24, 2018 5:57 pm

Next three months (July - September) - one $20 copay office visit :)

About $40 for these three months prescription drugs :)

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dm200
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Re: What I spent in 6 months on Medicare

Post by dm200 » Tue Jan 15, 2019 12:35 pm

Second six months of 2018 -
I am in my early 70's - and I just reviewed what I spent on Medical costs under Medicare. While this is anecdotal - it is an example of my low costs (so far at least).
Medicare Part B - $134/month - 6 months = $804
Medicare (Kaiser) plan premiums $30/month - 6 months = $180
My approximate prescription drug costs - 6 months = about $125 total. Now taking 3 prescription drugs.
My medical out of pocket - 6 months $60
My wife has incurred similar expenditures.

No charge for multiple blood and urine lab tests. Only $20 copay (included in $60) for XRays. No charge for several email contacts with several Physicians.
Last edited by dm200 on Tue Jan 15, 2019 6:30 pm, edited 1 time in total.

khh
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Re: What I spent in 6 months on medicare

Post by khh » Tue Jan 15, 2019 6:16 pm

Plan G - $115/month
Part D - $27/month
IRMAA - Medic!

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SeeMoe
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Re: What I spent in 6 months on medicare

Post by SeeMoe » Thu Jan 17, 2019 3:11 pm

Really cheap with top notch medical coverage in my opinion. We are your age and the costs you quote are close to ours. Really nice of the government to subsidize us so well. SS too.

Nice Reminder. Thanks.

SeeMoe.. :greedy
"By gnawing through a dike, even a Rat can destroy a nation ." {Edmund Burke}

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dm200
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Re: What I spent in 6 months on medicare

Post by dm200 » Thu Jan 17, 2019 3:26 pm

SeeMoe wrote:
Thu Jan 17, 2019 3:11 pm
Really cheap with top notch medical coverage in my opinion. We are your age and the costs you quote are close to ours. Really nice of the government to subsidize us so well. SS too.
Nice Reminder. Thanks.
SeeMoe.. :greedy
Perhaps "Low Cost" is a better term than "cheap" 8-)

Our (DW and I) lower costs and high medical care quality are also due to our near full understanding of our coverage and utilizing features available to us that BOTH keep our costs very low AND quality HIGH. We know others who have the same (or very similar) Kaiser Medicare coverage that pay more and get less quality care because they do not make the choices that we do.

carolynb2
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Re: What I spent in 6 months on medicare

Post by carolynb2 » Thu Jan 17, 2019 8:11 pm

Before medicare (only had it 3 months) I had a decent employer plan that was far superior to medicare and B+ gap (g) + D.

Here are some things I have learned that you might find helpful:

Garden variety medicare (Not advantage plan)

1) medicare alone is hospital only with a significant deductible each time

2) B medicare part B covers doctor office visits with a small deductible ($183 or 4 or something) but you owe 20% with no limit and anything over the medicare limit they charge if they are not "in network" with medicare.

3) Gap insurance - depending on which one it picks up deductibles, covers additional charges, etc. They are dictated by law so all companies' F' plans, for example, are identical.

4) Costs vary by state and "kind" of system the companies' plans use
a) age attained - rate is based on your age and goes up each year due to both age and cost changes
b) age you signed up. If you sign up at 65 and someone else picks it at 75 you pay less
c) community rated - everyone pays the same (although some companies give younger people discounts typically though age 75), this may cost a bit more when you are younger but is cheaper when you are older

5) drug plan - this is where the real expense comes in. #1 you are required to have ESP to know exactly what drugs you will be on the following year. Guess wrong and it can get very expensive very fast. #2 the formularies differ substantially between companies and even between plans within companies. #3 the .gov website defaults to community pharmacies and you need to go back in and choose in network only. Costs can change dramatically. Also check it out one pharmacy company at a time or prices suddenly get muddied. #4 run the drugs both generic and name brand. One formulary may have brand name only and the other have generic only. #5 Drugs you may be taking may not be on ANY formulary. #6 you can not use coupons and medicare in the same transaction. It is one or the other.

6) You are married to your company and gap plan for life if you can't pass medical underwriting (except in 3 states). You have 3 mo before and 3 mo after you turn 65 to change your mind (so 6 mo total). Failure to do that may mean you are out of luck.

7) Sign up late (if you are working you may or may not be required to sign up, if you are on COBRA that isn't good past 65) and you are penalized financially for life.

8) Failure to pay your premiums means you are dropped - but to get back on to gap you have to pass medical underwriting, to get back on D you have to wait until the next sign up year.

9) There are all sorts of things that are not covered - vision, dental, hearing aids, a number of common procedures and drugs including some of the newer, more effective chemo drugs, or you maybe forced to try less effective approaches/drugs first before you can use the effective ones. If they are not covered then you are effectively uninsured for that drug, procedure, treatment...

When choosing companies - remember risk underwriting. The more people in the plan the more people to spread risk between. If you are choosing F or C (which you will not be able sign up for beyond 2020) the costs will increase dramatically as those folks age as there will be no younger people continuing to enter the plan.

Some states keep track of complaints. Look at them even if not in your state. I found dramatic differences in complaints per100 (you will need to figure that out yourself but when a smaller company has 5x the complaints of a bigger one no need for math).

I ran into many people with the different companies who didn't know the rules, lied... This was a way bigger time sink to figure out how to intelligently sign up than I ever expected.

Advantage plans

1) Think Obama care. Limited networks and limited geographic area for care (for most of them anyway). So you live in a city with wonderful health care maybe you are then in luck. Maybe not. Depends on who accepts it. MD Anderson Cancer Center in Houston (the best cancer center in the country) accepts ONE advantage plan. Well guess what, if you really need them you really need them. Research indicates that outcomes are better for people with all kinds of cancer if their care is at or directed by a NCI comprehensive cancer center.

2) Planning to travel or live elsewhere part of the year - you may not have coverage. At all.

3) They may or may not cover vision, hearing, dental

4) The different plans are not identical so read all the fine print

Side comments, other tidbits

1) Humana requires you to e-sign BUT does not tell you that you can only do it on a laptop or PC using explorer. You get an error message if you try it on anything else and no explanation. Call them and they send you another link (without telling you how you have to sign), rinse and repeat 6 times for me such that I had to appeal then not being allowed to sign up in Oct. I won but it took 2/3 of the month and I had to cancel apts. I then needed to battle to get 2/3 of the premium refunded. I no longer use them and switched to a community risk plan (they were, in my state, age attained despite what was stated on the web and I stupidly underestimated just how complicated it is to research all this crap sufficiently, had to sign up and so did so figuring I could change and so did once I researched it better).

2) A very well designed study came out recently that found (for indolent cancers of a certain type) that the best outcomes were, not surprisingly, with people with private health insurance. Coming in second was, wait for this........, medicaid. They were 18% worse. TIED for last place was medicare and uninsured. They were 12% below medicaid. And I think I understand why. Medicaid office visits and drugs $3, hospitalizations $10/night. Medicare not everyone has gap or even B, lots more is done in offices and many drugs covered in the hospital are not covered in the doctor's office. Many drugs are not on the formulary and are incredibly expensive. You know, like $15,000/mo kind of expensive, just for example.

3) We will all be screwed if the deductible for part B goes up to, say, $5000/year to help solve the solvency issue in the future, since the folks in DC decided that there shouldn't be any more policies that cover the part B deductible.

So those of you waiting with baited breath for medicare be careful what you wish for. Eight days after the deadline to chose my drug plan for 2019 I had a new medical condition diagnosed. I will be paying nearly $3000/year more for meds than if I had a different plan than what I signed up for. Oops. And that is just for me with almost no conditions that currently require drugs. And the year has just begun.

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dm200
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Re: What I spent in 6 months on medicare

Post by dm200 » Fri Jan 18, 2019 9:58 am

Advantage plans
1) Think Obama care. Limited networks and limited geographic area for care (for most of them anyway). So you live in a city with wonderful health care maybe you are then in luck. Maybe not. Depends on who accepts it. MD Anderson Cancer Center in Houston (the best cancer center in the country) accepts ONE advantage plan. Well guess what, if you really need them you really need them. Research indicates that outcomes are better for people with all kinds of cancer if their care is at or directed by a NCI comprehensive cancer center.
2) Planning to travel or live elsewhere part of the year - you may not have coverage. At all.
3) They may or may not cover vision, hearing, dental
4) The different plans are not identical so read all the fine print
Medicare Advantage (MA) plans differ greatly from each other and can be very different from the same provider in different geographic areas. The net savings of a MA plan vs Original medicare + medigap+drug coverage is often very significant - and can offset cases where the MA plan has higher charges from utilization. Some plans (such as mine) have excellent out of area coverage in case of travel, BUT not if you actually "live" part of the year in such a location. It is also the case (from my experience with my plan) that many financial and health/risk benefits are not clear from reading the plan documents. Therefore, I believe it is a good idea to talk with informed participants. Let me give one example. If you read the documents of my plan, it seems that almost all office visits and care from a specialist must be authorized/referred by your Primary Care Physician. That could be very burdensome. In actual practice, however, it is not burdensome at all. Eight years ago, when I enrolled in this Medicare plan, at my first office visit with my PCP, I noted and requested two specialist referrals for ongoing conditions - one with Ophthalmology and one with Endocrinologist. My PCP made the referrals immediately and even scheduled two specialist appointments. Then, I needed no further referrals to these specialties - and I am now on my second Endocrinologist (first one retired) and third Ophthalmologist.

Cheyenne
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Re: What I spent in 6 months on medicare

Post by Cheyenne » Fri Jan 18, 2019 10:06 am

carolynb2 wrote:
Thu Jan 17, 2019 8:11 pm

1) Humana requires you to e-sign BUT does not tell you that you can only do it on a laptop or PC using explorer. You get an error message if you try it on anything else and no explanation.
I enrolled in Humana's Rx Plan last year on an iMac with no problems.

Mitchell777
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Re: What I spent in 6 months on Medicare

Post by Mitchell777 » Fri Jan 18, 2019 7:03 pm

dm200 wrote:
Tue Jan 15, 2019 12:35 pm
Second six months of 2018 -
I am in my early 70's - and I just reviewed what I spent on Medical costs under Medicare. While this is anecdotal - it is an example of my low costs (so far at least).
Medicare Part B - $134/month - 6 months = $804
Medicare (Kaiser) plan premiums $30/month - 6 months = $180
My approximate prescription drug costs - 6 months = about $125 total. Now taking 3 prescription drugs.
My medical out of pocket - 6 months $60
My wife has incurred similar expenditures.

No charge for multiple blood and urine lab tests. Only $20 copay (included in $60) for XRays. No charge for several email contacts with several Physicians.
I'm new to Medicare. So, instead of paying $100 to $200 per month for a Medigap policy, are you covered for the same at $30 per month through Kaiser?

OldSport
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Re: What I spent in 6 months on medicare

Post by OldSport » Fri Jan 18, 2019 10:09 pm

larsm wrote:
Fri Jul 06, 2018 9:09 am
reimann wrote:
Thu Jul 05, 2018 8:00 pm
I am 59 and BCBS health care insurance with $500 deductible for my family of 5 is $33k/year. (self employed) No health problems. No meds.
$33 thousand sounds like a lot. But it works out to $550 per month per person. Sounds a lot better that way. Just saying...
$33k per year just for premiums?? Wow - that is sickeningly appalling!!

My HSA compatible HDHP premiums for my family are fully covered by my employer. It is a HDHP so the deductible is higher at $2k. I contribute max to thr HSA.

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dm200
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Re: What I spent in 6 months on Medicare

Post by dm200 » Sat Jan 19, 2019 1:18 pm

Mitchell777 wrote:
Fri Jan 18, 2019 7:03 pm
dm200 wrote:
Tue Jan 15, 2019 12:35 pm
Second six months of 2018 -
I am in my early 70's - and I just reviewed what I spent on Medical costs under Medicare. While this is anecdotal - it is an example of my low costs (so far at least).
Medicare Part B - $134/month - 6 months = $804
Medicare (Kaiser) plan premiums $30/month - 6 months = $180
My approximate prescription drug costs - 6 months = about $125 total. Now taking 3 prescription drugs.
My medical out of pocket - 6 months $60
My wife has incurred similar expenditures.

No charge for multiple blood and urine lab tests. Only $20 copay (included in $60) for XRays. No charge for several email contacts with several Physicians.
I'm new to Medicare. So, instead of paying $100 to $200 per month for a Medigap policy, are you covered for the same at $30 per month through Kaiser?
No. But, I believe I am almost certain to be much ahead financially paying (in 2018) $36 per month. Do you have Kaiser as a choice in your area?

With Original Medicare and a Medigap policy, you may have somewhat lower risk of large expenses in a year. It all depends on the Medigap policy. With my Kaiser medicare plan, drug coverage is included as well. So, I am protected from very large drug costs. I must pay (in 2019) a $10 copay to see my PCP and $45 to see a specialist. I do get Optometry exams for $20 copay. Outpatient surgery is $250 (all included). In the unlikely event of lots of medical and hospital care, my out of pocket costs could go as high as about $6,000. If I expected large medical/hospital charges, I can switch (every fall) to "High Option" with a monthly fee of $142. The copays and out of pocket max are about half of my "standard option".

Other savings financially with Kaiser are no copay telephone appointments, "virtual housecalls" with a Smartphone and physician communication by email. There is a 24x7 advice nurse service available as well as an "Urgent Care" (24x7) facility that can deal with almost all situations where you might go to a Hospital Emergency department.

Because my healthcare and insurer are the same (Kaiser), there can never be an argument between provider and insurer.

Mitchell777
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Re: What I spent in 6 months on medicare

Post by Mitchell777 » Sat Jan 19, 2019 1:56 pm

Kaiser does not exist in my state. I thought I understood Medicare going in but it's more complex than I realized. I worked for a large corporation with very good coverage. With Original Medicare, Medigap, and Part D, I spend about the same out of pocket as when I worked. But the coverage is not as good, at least the drug coverage is not. The only reason I went with Original Medicare is I may require complex surgery at some point in the future and wanted the widest range of surgeon choice out of my area. With more docs dropping Medicare that may or may not work out.

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dm200
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Re: What I spent in 6 months on medicare

Post by dm200 » Sat Jan 19, 2019 2:05 pm

Mitchell777 wrote:
Sat Jan 19, 2019 1:56 pm
Kaiser does not exist in my state. I thought I understood Medicare going in but it's more complex than I realized. I worked for a large corporation with very good coverage. With Original Medicare, Medigap, and Part D, I spend about the same out of pocket as when I worked. But the coverage is not as good, at least the drug coverage is not. The only reason I went with Original Medicare is I may require complex surgery at some point in the future and wanted the widest range of surgeon choice out of my area. With more docs dropping Medicare that may or may not work out.
Yes - fully understanding all Medicare choices in your locality can be a challenge.

I suggest checking out all the Advantage plans available to you. There are several ways of looking at your potential surgery situations. At least, with a MA plan, the plan will find a qualified surgeon who participates. Yes, though, your choice of surgeons under Original Medicare might be limited if surgeons drop out of taking Medicare.

In this area, we know several folks who are very happy with their Humana Medicare Advantage plans.

Good Luck!

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Re: What I spent in 6 months on medicare

Post by michaeljc70 » Sat Jan 19, 2019 2:07 pm

deleted
Last edited by michaeljc70 on Sat Jan 19, 2019 4:01 pm, edited 3 times in total.

phxjcc
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Re: What I spent in 6 months on medicare

Post by phxjcc » Sat Jan 19, 2019 3:42 pm

To answer the question asked by the OP,

20,197

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legio XX
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Re: What I spent in 6 months on medicare

Post by legio XX » Sat Jan 19, 2019 5:08 pm

dm200 wrote:
Sat Jul 07, 2018 1:07 pm
Yes, comparing the payments by our Medigap insurer ($9,871) to our premiums ($15,397), you could conclude that we have overpaid for our coverage (Medigap Plan F), but I prefer the simplicity and consistency over the alternatives.
Just a reminder that the cost of insurance must be weighed against the risks being covered.
Yeh, this was my decision. Since F is being phased out I was motivated to do some figuring a few months ago. In the past three years I've received less from my Medigap than I paid them, and with one likely exception (broken bone, surgery, rehab) this is probably true for every year since I went off my employer's plan. In 2013 the employer's premiums nearly doubled - which they blamed on the ACA - no idea how that worked. Not complaining about comparatively good health, but I considered F+ but decided against it. Decided to avoid the temptation to "save" by putting something off. Good decision - last week had a talk with someone I work out with who has joint problems that really impact activity. Problem? "I have a high deductible I can't afford to pay for everything." So no diagnosis, no meds, no PT and limited activity while insured?

Thanks for the warning that deductibles can be hiked at any time - there goes the switch to G when the aging of F planners kicks the premiums up. Ahhh, bleeeeep!!

I've read this thread and others pretty closely. I know people like "insurance" because it sounds like business and not gub'mint, but I still think it's the wrong model for healthcare.

6 month cost this year (B, D, Gap) will be about $2634- plus whatever my new Part D gets for one cheap generic. Given my income, this is a major expense, second only to rent, and any SS COLA will be eaten by M'care. OTOH, without it I would be, at best, in the same boat as my workout bud. And up to my eyeballs in debt for the busted bone.

Just my tuppence.

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Re: What I spent in 6 months on medicare

Post by 22twain » Sat Jan 19, 2019 5:20 pm

Cheyenne wrote:
Fri Jan 18, 2019 10:06 am
carolynb2 wrote:
Thu Jan 17, 2019 8:11 pm
1) Humana requires you to e-sign BUT does not tell you that you can only do it on a laptop or PC using explorer. You get an error message if you try it on anything else and no explanation.
I enrolled in Humana's Rx Plan last year on an iMac with no problems.
Similarly, I had no problem enrolling in Humana's plan with the latest version of Firefox on my old Mac Pro a few weeks ago.
My investing princiPLEs do not include absolutely preserving princiPAL.

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SeeMoe
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Re: What I spent in 6 months on medicare

Post by SeeMoe » Sat Jan 19, 2019 5:23 pm

dm200 wrote:
Thu Jan 17, 2019 3:26 pm
SeeMoe wrote:
Thu Jan 17, 2019 3:11 pm
Really cheap with top notch medical coverage in my opinion. We are your age and the costs you quote are close to ours. Really nice of the government to subsidize us so well. SS too.
Nice Reminder. Thanks.
SeeMoe.. :greedy
Perhaps "Low Cost" is a better term than "cheap" 8-)

Our (DW and I) lower costs and high medical care quality are also due to our near full understanding of our coverage and utilizing features available to us that BOTH keep our costs very low AND quality HIGH. We know others who have the same (or very similar) Kaiser Medicare coverage that pay more and get less quality care because they do not make the choices that we do.
Cheap is ok , but low Cost sounds better. Reminds me when my dad was a janitor until one day the personal department changed it over to “ custodian.”
Our employer gave us choices between HMO’s ( cheaper costs) and Aetna PPO. We chose the PPO Medicare advantage plan, and it is wonderful per freedom of choice of doctors, specialists and hospitals too. I have premium V.A. Coverage as well, but the V.A. Is essentially an HMO, and they choose/assign you whom to see. Don’t like it at all!

SeeMoe.. :wink:
"By gnawing through a dike, even a Rat can destroy a nation ." {Edmund Burke}

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