PSA-65 year olds (Medicare Part A)---Remember to Sign up!
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Anonymous
+1 |
Anonymous
| It is extremely ironic that people have to navigate this complex and confusing system right when they are starting to lose their mental capacities. I think that's one reason so many end up signing up for Medicare Advantage plans despite all the info out there about what a bad idea that is. |
Anonymous
My impression is that the Medicare Advantage are a terrible deal for the taxpayers but generally a good deal for the enrollees and certainly for the plan sellers. The sellers pass some of their extra reimbursements back to the enrollees in the form of cheap/free prescriptions and/or cheap dental insurance or other benefits. |
Anonymous
No, they are horrible for enrollees. Many are scams. The ads sort of hint at that because they are too good to be true. Most people who see how they work (ie people who deliver healthcare) avoid them like the plague for themselves. Read the fine print people!! |
Anonymous
| I am eligible in like 13 months and have a reminder on my calendar. |
Anonymous
It's to keep people from choosing NOT to pay their premiums, until they know they are sick, and then signing up. |
Anonymous
The people I know who fell for the aggressive marketing campaigns for Part C have found out the hard way why this was a very bad idea. |
Anonymous
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You don’t actually have to sign up for Part A — you get it automatically when you turn 65 if you have your 40 quarters of taxed income, which the vast, vast majority of Americans do (or your spouse does). It’s Part B that you have to sign up for, unless you are already collecting Social Security, in which case in most cases they assume you want Part B and enroll you. But it is always best to contact SS and confirm, which you can do 3 months before you turn 65.
Medicare Advantage is definitely NOT a scam. It is a highly regulated program, with close and ongoing government scrutiny of almost every aspect of the program from the bids companies submit, how much they spend on medical care, how long it takes their customer service reps to answer questions, how quickly they pay doctors, and dozens and dozens of other areas. Medicare Advantage is a choice — in return for agreeing to a network of providers (with strict government rules and audits of those networks) and prior authorization, enrollees get much cheaper out of pocket costs and a range of additional benefits Medicare doesn’t cover. |
Anonymous
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These Medicare Open Enrollment FAQs from KFF (a health policy think tank) may be helpful to those who find the prospect of navigating Medicare daunting:
https://www.kff.org/faqs/medicare-open-enrollment-faqs/?view=1 |
Anonymous
| Many thanks to all who are contributing to this thread. I have a lot of decisions to make soon, and I appreciate the information— and the nudge. |
Anonymous
| Is it difficult to find or keep doctors who take Medicare? I ask because I’ve heard the government’s reimbursements are lower and the paperwork more onerus for medical practices. |
Anonymous
It is not hard. If you choose the original Medicare program (not a Medicare Advantage plan), you can go to any doctor that participates in Medicare, and about 98% do. Same with hospitals, outpatient clinics, etc. There are a few special areas where it can be hard, namely psychiatrists and similar mental and behavioral health specialists, because many of them don’t take insurance at all. If you choose a Medicare Advantage plan, specifically an HMO plan, you will need to stick with doctors in their network. It is the same as having a plan today — if you are with Cigna, you need to go to providers in Cigna’s network. Or Carefirst providers if you choose them as your plan. |
Anonymous
Right, and one of the nice things about traditional Medicare is that you never face prior authorization requirements. Your doctor thinks you should get an MRI? You don’t have to get an insurance company to sign off on it, you just get it. You do need to purchase supplemental insurance, however, like Medigap coverage. That helps pay for out-of-pocket costs not covered by Medicare. You will also need to buy a stand-alone Medicare Part D prescription drug coverage plan, since original Medicare doesn’t cover prescription drugs. All these premiums can add up, which is one reason some people opt for Medicare Advantage, which typically covers rx drugs and most of the out of pocket costs that a Medigap plan would cover — often for less money. There also is usually an annual out of pocket maximum with Medicare Advantage that you won’t get in traditional Medicare without buying a supplemental Medigap plan. The tradeoff with Medicare Advantage, with plans run through private insurance companies, is that you have to jump through prior authorization hoops to get some services (like an MRI), and you are usually stuck with the plan’s network of physicians and hospitals. That’s usually not a big deal if you are relatively healthy and don’t need much care. But if you do get sick with, say, cancer and want to see a specialist at Hopkins and have surgery there, the plan may say, sorry, that doc and hospital are not in network. You’ll have to have your surgery by one of these other docs, and at George Washington University Hospital (or some other hospital—I am just grabbing a name here). Also, once you have been on a Medicare Advantage plan for a while, you can’t switch back to traditional Medicare without facing medical underwriting for the supplemental Medigap plan that you will need to protect yourself against high out of pocket costs. So if you are sick and have pre-existing conditions, you may get charged much higher premiums for that coverage — something that no longer happens in the pre-age 65 private insurance market thanks to the ACA. (And you can’t switch to an ACA plan because if you are eligible for Medicare you can’t sign up for an ACA plan, at least not with federal subsidies.) So a lot of people who were happy with Medicare Advantage when they were 66 and relatively healthy feel trapped in it when they are 76 and sick. Medicare Advantage can be a good option, especially for seniors without much money who can’t afford supplemental coverage, but it’s definitely not a slam dunk and there are potentially big tradeoffs and drawbacks to going that route. |
Anonymous
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And Remember there are 10 different Medigap plans you can choose from A - N Each has different coverages like 3 pints of blood some cover that 100% others only 50%
Plus since this is DCUM and everyone has $5,000,000 in a IRA there is IRMAA penalties when you income reaches a certain level. |
Anonymous
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If you have fed health benefits upon retirement (through you or your spouse) you keep those, yes? That is your "medicare advantage" equivalent?
This is my understanding but can someone confirm? That is reason enough to stay federal until retirement. |