Medicare, not for the faint of heart

[RandyR]

I turn 65 next month, and my current medical insurance policy terminates when I become medicare eligible on the first day of December (the month of my birthday).

 

What a complicated lawyer and accountant sucking system this is.

 

With the govt paying a significant part of my hospitalization and subsidizing out patient type care, my personal insurance costs are more than tripling from November to December.

 

And there are plans, and parts, and copays, and deductibles and exceptions out the wazoo. I've spent a couple weeks trying to make sense of it all and have decided a lot of it will never make sense.

 

Prices from one insurance company to the next vary a lot of $$$

 

I've had medical with the same HMO for 35 years, but my zipcode isn't in the table they gave to social security as being in their coverage area, never mind that they have a doctors office and major hospital only 20 minutes from my house. So after going round and round with them, the HMO will file an exception (of some kind) on my behalf so I can stay with them. I have to move into their Medicare Advantage HMO Plan at age 65

 

I did come real close to jumping ship and getting a medicare plan F supplement policy from an insurance company, it would be slightly more costly, but a bit more flexible than my HMO. But after 35 years with the same plan, I'd prefer to stay pat. And my HMO has their own pharmacy, so I wouldn't need a Medicare Plan D for pharmacy insurance.

 

Dental insurance at age 65 goes up 50% even staying with the same company (nothing to do with medicare).

 

My advice to those age 64, is start to read everything you can about the system instead of waiting until the last month like I did.

 

and. try not to take this thread too political.

[friesman]

you American guys and your healthcare confuse me.

I love just being able to walk up to a hospital or doctor and get things taken care of with a minimum of paper work and hassle.

 

With That said Randy, i hope they treat you well, and that they dont try and make you pay too much. And congrats on making it to 65.

 

Brian

[MiCarl]

I'm not quite there yet but I hear all the ads this time of the year about "open enrollment" and my eyes just glaze over. Not clear to me why you can only change in some arbitrary window Oct. - Dec.......

 

Fortunately I have a stepdaughter starting law school next year. Hopefully by the time we need to sort this stuff out she'll be able to do it for us.

[SilvrT]

you American guys and your healthcare confuse me.

I love just being able to walk up to a hospital or doctor and get things taken care of with a minimum of paper work and hassle.

 

With That said Randy, i hope they treat you well, and that they dont try and make you pay too much. And congrats on making it to 65.

 

Brian

 

Just wait Brian .... when you reach 64 and panic starts setting in LOL

[hydraulicman]

I am not real happy with Medicare, however it is not that bad. I am paying about 500.00 per month for medicare, type F and D for my wife and I. Where I worked last the company paid the medical 100%, but the job before that, 8 years ago I was paying 250.00 per month for just myself and that was just 30 to 40% of the total cost.

[dingy]

you American guys and your healthcare confuse me.

I love just being able to walk up to a hospital or doctor and get things taken care of with a minimum of paper work and hassle.

 

With That said Randy, i hope they treat you well, and that they dont try and make you pay too much. And congrats on making it to 65.

 

Brian

 

What you get in the way of medical insurance is offset by what you pay in the way of vehicle insurance.

 

I have seen prices way above a $1000 a year for bike insurance in Canada, I pay just over $100 for full coverages with fairly high payment coverages (250,000/500,000 coverages).

 

Granted this is apples and oranges comparison, but it goes both ways.

 

 

Gary

[Flyinfool]

Well it is obvious to even a lowlife like me........

 

 

 

 

 

 

.........Just hold at 64........

[BradT]

I have seen prices way above a $1000 a year for bike insurance in Canada, I pay just over $100 for full coverages with fairly high payment coverages (250,000/500,000 coverages).

 

Gary I pay just over a 1,000 per bike and it is expensive but it costs the same for the cars. Most insurance company's do not have 500,000 Public liability anymore most are 1 or 2 million.

 

100 bucks is a good deal but full coverage for an 1983 ??? (is full coverage collision as well ?)

 

Brad

[dacheedah]

Funny thing, My wife had back surgery at CINN a few years ago. I sat in the waiting room with two families from Canada (that couldn't get the surgery there) and another foreign man who was from the mid east.

In another unrelated medical matter I took her to MAYO Clinic. We saw a lot of people from other countries who flew in to be diagnosed.

 

My father was a Hospital Administrator and has seen huge changes in our medical system. The American Medical system wasn't broken until politicians decided they could run it better. If it ain't broken, give it to a politician and it will be. . . .

[Yammer Dan]

I'm not sure how much I pay total. I just know its TOO MUCH!!!

[bongobobny]

Yah! I turn 65 in August. I'm seriously considering relying on the VA for health care...

[GAWildKat]

I'm 37, on medicare, and have a college degree and I still don't understand medicare plans. I spent 4 hrs today trying to change my medicare coverage (have to do it yearly) I didn't make ANY progress towards my goal

[friesman]

What you get in the way of medical insurance is offset by what you pay in the way of vehicle insurance.

 

I have seen prices way above a $1000 a year for bike insurance in Canada, I pay just over $100 for full coverages with fairly high payment coverages (250,000/500,000 coverages).

 

Granted this is apples and oranges comparison, but it goes both ways.

 

 

Gary

 

Youre right, I am not saying we have free health care, i just like not having to deal with the issues of paying for health care upfront like you do. Its just a different way of funding the same thing.

 

Brian

[BOO]

I think it's a conspiracy, the US Government waits until you are to old to learn or understand anything and then throws Medicare at you.

Everyone I talk to really has no idea what plan they should have or what company they should be with. Me included.

BongoBob, I have been going to the VA for my medical for about a year now and I am real happy with them. They have great hospitals and clinic's here in the Chicago land area. State of the art equipment and goooood drugs. And the price is right.

So if anyone figures out Medicare and can explain it in 500 words or less I hope you post it here.

BOO

[naturbar]

Yah! I turn 65 in August. I'm seriously considering relying on the VA for health care...

this is what i have done and when i become eligible for medicare i'm just going to refuse it and keep the $ in my S.S. check.......

[CaptainJoe]

Sooner or later the US will be forced to provide health care for everyone, just as our friends in Canada and England have done.

 

Companies can't be relyed upon to carry the burden as it creates an unfair burden on them when it comes to competing in a world wide market.

 

Everyone needs to pay their fair share, but I'm hoping its not going to create another gov. beauracy...

 

Perhaps we need a 7,7,7,7 plan? with the last 7 going towards health care(fully funded, expanded version of medicare). Even with that, I'd still be paying less in taxes and health care than I do now...

 

I know one thing for certain, If they don't fix the mess soon, theres going to be a lot more people that drop their health insurance because they can't afford it, and then go into the ER's and get the services for free because the Hospitals MUST help you if it is life threatening. At some tipping point all H-ll is going to break loose...

Edited November 4, 2011 by CaptainJoe

[relic]

Sorry, we pay just a bit more than you ($300) for full bike insurance, fire, theft, medical coverage, etc., etc., etc. and it's a million dollars, not 250,000 or 500,000. The only people who pay that much are those with bad driving records. Don't believe everything you're told, eh?

 

There's no way in heck anyone in Canada will ever lose their home, go bankrupt, lose all their retirement funds, etc., etc., etc. because they get ill. That's what makes Canada so wonderful.

 

Vehicle insurance in Canada has as much to do with where you live as it has with driving record. This is totally unfair but that is what it is and the insurance companies will tell you direct that it is because you live here!!!

In Ontario in the Toronto area most pay $1000 or over for the Venture with full coverage. If you get out of this area the cost goes down signifigantly. Be happy you live in Nova Scotia and pay what you pay and don't believe everything you're told. We have great health care but be assured that not all the drugs and medicines are covered to the full extent. People can spend big money to get healed on stuff not covered by our health insurance even in Canada, or except what is offered under our government health plans free. Not all workers have extra health plans.

[hillrider]

If you chose not to use the Medicare card, check with your doctor to see which of the available insurance co plans he accepts. Hospitals are generally not a problem. Over here the only company the my doctor accepted was Humana. But there were half a dozen offered.

 

Good luck - have fun!

[dacheedah]

U R Right BOO, I have been doing the VA thing for some time now. I know a lot of vets who don't but the VA has been very good to me. My only issue was that before they would give me hearing aids they made me have a colonoscopy. In the end, no pun, I ended up with the hearing aids.

 

Hines is a little trip but I had an unexplained episode of AFib. The local cardiologists medicated me to where I could barely function. I went to the VA and they did some tests and all my labs were good. A specialist saw me and asked if I had a sleep study and they found I had apnea. One of the affects of Apnea is afib.

 

I would encourage all vets to get signed up and just get in their system. Even if you only see the doc once a year or get the free flu shot it's worth your time.

[RandyR]

I don't think I'm eligible for VA health benefits with 3 years active duty and 8 years reserve and guard. But never served in a combat zone and no medical discharge.

 

VA has an automated eligibility checker at:

 

http://www.va.gov/healtheligibility/eligibility/DetermineEligibility.asp

 

based on what was said above I found it and it says 'probably no, but apply to be be sure. There appears to also be a low income criteria if the other stuff doesn't apply.

 

VA has a hospital on the north side of Atlanta, so might have been a good choice.

 

One thing I learned is that if you don't get medicare at age 65, and then want it later, you will pay a stiff monthly penalty in cost -- unless you can show other creditible coverage, perhaps written VA eligability constitutes that creditable coverage?

 

In any case you may want to see if the VA covers prescriptions/drugs? If not then you may want a medicare part D drug plan in addtion to VA coverage.

 

------

 

Medicare part A = hospital (free to all who apply, but big gaps in what it covers and large co-pays)

 

Medicare part B = outpatient and outside Dr visits ($115/mo and again big gaps and high copays)

 

Medicare part D = prescription drug insurance (varied)

 

You can get insurance plans for parts A & B or both to fill some or most of the gaps.

Usually a D plan is separate.

 

also medicare part C insurance plan = medicare Advantage Plan is either a Prefered Provider plan or HMO. varies in coverage and usually includes part D in addition to A&B.

 

There are standardized medicare supplement plans that cover varying portions of the gaps in parts A & B that are lettered A-B-etc. At first I confused parts and plans.

[Condor]

I'm not sure what all the flap is about when it comes to getting Medicare. We've been with the same HMO for...??? a very long time... About 3 months before turning 65 we received an app to apply, and at 65 we slid over to Medicare and signed up for Senior Advantage with our HMO. Pretty seamless. The nice thing about it was we were paying $925 a month premium for the two of us, and it dropped to.. at the time $80 for medicare and $75 for Senior Advantage with the HMO times two About $300 total. We still have the co-pay for visits and pharmacy, but it sure beats the 'H' out of over the counter prices.

Last month I had to rush the wife to the hospital with appendicitis. In at 3pm and in the OR at 11:30. The whole thing ran us a $175 co-pay. Not to shabby. Hate to think what it would have run.

On the Veterans Health Care. I've had to deal with service coverage for two in my family. My grandfather, and my older brother. Obviously Gramp is now gone, and so is my older brother. Let's just say the care sucked. But I guess you get what you pay for....

Glad I have Medicare.

[naturbar]

U R Right BOO, I have been doing the VA thing for some time now. I know a lot of vets who don't but the VA has been very good to me. My only issue was that before they would give me hearing aids they made me have a colonoscopy. In the end, no pun, I ended up with the hearing aids.

 

Hines is a little trip but I had an unexplained episode of AFib. The local cardiologists medicated me to where I could barely function. I went to the VA and they did some tests and all my labs were good. A specialist saw me and asked if I had a sleep study and they found I had apnea. One of the affects of Apnea is afib.

 

I would encourage all vets to get signed up and just get in their system. Even if you only see the doc once a year or get the free flu shot it's worth your time.

one thing vets must know - if your income/assets is to high your application for medical benefits will most likely be turned down. i know this because that is what happened to me. i filed a hardship and the person reviewing my case noticed that i had a medical discharge from the Marine Corps and called me to say that he didn't see any reason i would not receive benefits.....which i did as tier 3.

 

http://www.military.com/benefits/content/veterans-health-care/va-health-care-eligibility.html

[BOO]

I don't think I'm eligible for VA health benefits with 3 years active duty and 8 years reserve and guard. But never served in a combat zone and no medical discharge.

 

I never served in a combat zone but I was active duty for 5 years.

 

VA has an automated eligibility checker at:

 

http://www.va.gov/healtheligibility/eligibility/DetermineEligibility.asp

 

based on what was said above I found it and it says 'probably no, but apply to be be sure. There appears to also be a low income criteria if the other stuff doesn't apply.

 

I'm not sure what the criteria is right off hand but you should be eligible for the bottom tier which I think is 8. That's what I am and I do have to pay copays but hecks it's $15 for a doctor call, $50 for a specialist and $1,134.00 for the first 90 days in the hospital. And if you see 3 specialist in one day you only pay for one. Any drug from them is $9 month.

This is cheaper than most Medicare programs unless you pay big bucks for the plan.

 

 

VA has a hospital on the north side of Atlanta, so might have been a good choice.

 

One thing I learned is that if you don't get medicare at age 65, and then want it later, you will pay a stiff monthly penalty in cost -- unless you can show other creditible coverage, perhaps written VA eligability constitutes that creditable coverage?

 

Yes the VA is considered Creditable Coverage so there is no penalty if you change your mind.

 

In any case you may want to see if the VA covers prescriptions/drugs? If not then you may want a medicare part D drug plan in addtion to VA coverage.

 

------

 

Medicare part A = hospital (free to all who apply, but big gaps in what it covers and large co-pays)

 

Medicare part B = outpatient and outside Dr visits ($115/mo and again big gaps and high copays)

 

Medicare part D = prescription drug insurance (varied)

 

You can get insurance plans for parts A & B or both to fill some or most of the gaps.

Usually a D plan is separate.

 

also medicare part C insurance plan = medicare Advantage Plan is either a Prefered Provider plan or HMO. varies in coverage and usually includes part D in addition to A&B.

 

There are standardized medicare supplement plans that cover varying portions of the gaps in parts A & B that are lettered A-B-etc. At first I confused parts and plans.

 

 

As far as the quality of Doctors: It's a known fact that 50% of the Doctors graduate from the lower half of their graduating class.

BOO

[BOO]

one thing vets must know - if your income/assets is to high your application for medical benefits will most likely be turned down. i know this because that is what happened to me. i filed a hardship and the person reviewing my case noticed that i had a medical discharge from the Marine Corps and called me to say that he didn't see any reason i would not receive benefits.....which i did as tier 3.

 

http://www.military.com/benefits/content/veterans-health-care/va-health-care-eligibility.html

 

 

Unless things have changed I think everyone is eligible for some benefits.

As far as assets they do not count your home or vehicles. It mostly evolves around cash on hand and that amount at one time was over $200,000.00 I believe.

I'm not going to go and read all that mumble jumble but that's what I sort of remember.

Where am I and how did I get here?

BOO

[RandyR]

Looks like I learned something here on Venturerider again besides how to grease my splines.....

 

I'll make a trip to VA next week and apply for eligibility, and see what they say.

 

btw. I don't view anything VA may give me as free. The military got a big piece of my hide hanging on the wall.