lrob123 wrote: ↑Mon Jul 06, 2020 8:53 pm
I don't know if this is getting too off-topic (if so, please ignore this question), but Pugsy it would be helpful if you could explain why "the supplement would cost me an arm and a leg because I got Medicare prior to age 65. I am 68 now but the fact that I got on Medicare prior to age 65 is baggage I will carry my entire life and the prices for supplements are sky high for me."
I'm getting close to that age and am wondering why going on Medicare prior to age 65 continues to hurt you at age 68 and beyond? Is there an aspect of Medicare that is something like Social Security where if you take it early, it permanently lowers the benefit amounts thereafter? Are you 'safe' from whatever this problem is if you start Medicare at 65, or is there a benefit to waiting longer like I think is true for Social Security?
Medicare sounds complicated! I will have to learn all about this within the next few years. I wish we had Medicare for all, the same for everyone and all doctors/DMEs, but simplified, not several tiers for haves and have nots e.g. part D/B/Advantage/gap whatever those are.
The short version is that for traditional supplement policies....those medigap plans that pay after Medicare pays...they don't really want people who got on Medicare prior to age 65 so they price them very high. They only want healthy people and if you went on Medicare prior to age 65 they assume you aren't very healthy. They can't deny the coverage really but they can sure make it costly to get.
Medicare doesn't cost me any more than anyone else but the Medigap plans in the area where I live, are quite pricey for me if I wanted to get one. In my area there is a question "when did you go on Medicare"...and when it works out prior to age 65 you get a different rate structure.
Last I checked it was roughly 300 a month for a medigap supplement. Someone going on Medicare at age 65 and getting a supplement...they won't be charged 300 a month. That's what I meant. That "when did you go on Medicare" question will haunt me forever.
It has nothing to do with Medicare itself or my Medicare coverage though.. It's just those insurance companies only wanting to insure "healthy" people and they assume that someone who got Medicare prior to age 65 aren't healthy. This is only the supplemental policies. There was a time when I had Medicare only...it paid like it pays for everyone else.
Now it might be different in other areas of the country but that's the way it is where I live. And some counties you can do one thing or get something and the next county over you can. Big mess really.
I am okay with it though. The Medicare Advantage plan works out nicely for me. It includes all the meds I take and they cost me next to nothing and in the event I have something happen that is a rather large expense or could be...it's not that bad.
A few years ago I fell and broke my wrist...bad enough to require surgery. I added up all my out of pocket expenses that my Advantage plan said was my share to pay and it totaled $769. That's the ER visit and the specialist visit and the surgery in the surgery center.
If I had bought a medigap plan that year at 300 a month...that's 3,600 for the year. I still saved money on the deal and that was my worst year ever in terms of health costs out of pocket. My next worst year was $400 out of pocket for some special joint injections done in the surgery center. My PCP doctor visits...$5 this year...last year they didn't cost anything. That's okay...I see him only 4 times a year.
Next year they might go back to no PCP fee or they might raise it a little...doesn't matter.
I figure I have saved over 36,000 for sure out of pocket expenses over the last 10 plus years and spent maybe 2,000 total out of pocket.
I am way ahead of the game in my book.
Now if I was in bad health and looking at a lot of hospital stays...that's where the Advantage plan isn't so nice but even then it has a cap on out of pocket expenses. The cap isn't that much more than what a traditional medigap policy would cost me over that year. It's a risk that I assume....so far I have been betting I won't need that extra coverage and winning the bet.
Now someone not in my shoes (or living where I live) that goes on Medicare at the age 65....different story in terms of costs and risks and that's why people have to put a pencil to it and look at their overall health.
I pay nothing for my Advantage plan a month...nothing...it includes excellent medication coverage. $3 a month for each of the meds I take regularly which is really only 3.
So don't feel sorry for me whining about having trouble getting the Bleep ports covered....my choice to use them and if it took food off my table I could use something else. It doesn't though. I bitch just because the lazy ass DME makes it so difficult for me to get something my insurance would pay for. I still have that Medicare insurance amount coming out of my Soc Security check (long complicated story about who actually gets that amount when someone uses an Advantage plan) each month just like everyone else. I still pay for my insurance in that regard. I would kinda like to use it since I pay for it and I bitch when I can't because of a lazy DME. My insurance would pay for it...the DME just won't order it.
If I was on traditional medicare...that same amount would come out and I would need some sort of medigap plan and probably a part D drug plan....both would cost extra on top of the monthly amount coming out of my check to pay for Medicare.
So I opt for the Advantage plan where all I pay is that monthly Medicare deduction from my check.... and save the cost that a medigap plan and/or part D plan would cost me by having it included in the advantage plan.
I let my friend take care of it because he is like family and I know and trust him completely to advise what is in my best interest. He makes nothing at all when we change plans. 