General Discussion
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We are just 65 and as first time enrollees do not have to pass any medical underwriting. I am grateful we will have Medicare. The cost is uncomfortable but manageable. I just want folks who are considering retirement to realize it is still expensive. I was surprised. Here are best options in my area
Original with Medigap (Plan G) and Drug Plan
Premiums $7,800
Out of Pocket Drugs $4,500
Dental all out of pocket $1,000
Doctor/Hospital Out of Pocket $0
Total - $13,300 anually
Original insurance is best you will ever get. Any doctor or hospital, no futher co-pays.
Advantage (Private)
Premiums $3,960
Out of Pocket Drugs $4,500
Dental (coverage included) $0
Doctor/Hospital Out of Pocket $1,000 - $5,000 (feel lucky?)
Total - $9,460 to $13,460 annually
Advantage is inferior insurance. Networks, delays, denials.
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MontanaMama
(24,734 posts)As a self employed family of three, currently pay $2000 per month for health insurance with a $7500 per person deductible. That’s as much as my mortgage and all my monthly household bills combined. Plans through the Healthcare.gov Marketplace are even more expensive. We are not eligible for any subsidies or tax credits. Medicare seems like a dream to me.
Casady1
(2,133 posts)The first year is based on your income. My current pay the the government is $170 per month. My supplemental from mutual of Omaha is $135 per month. My rx plan is $25 per month and my dental from
aarp( the only plan that does implants is $142 per month.
Mutual of Omaha is the least expensive. All supplemental plans are the same.
DemBlue76
(78 posts)No text
Casady1
(2,133 posts)And the dental is for 2. RX is pretty cheap. What state are you in? Mutual of omaha does a 12% discount if you are married. You do have a $235 deductible.
I am retiring at the end of the year and we start Medicare then. Mutual of Omaha would be $139 per person here. Cheapest is $113.
JanLip
(862 posts)And Medicare. We are both 74 and I can vouch for Mutual of Omaha. It’s not cheap but it pays what Medicare doesn’t. We go to the doctor go in and come out without a copay. So far so good. All of it goes up every birthday though. I guess if republicans get their wish and cut our Social security benefits and Medicare we will be up the creek with no paddle.
Jan.
Casady1
(2,133 posts)Me and my premium went down. If you are in AZ or FL all your premiums are higher.
In 2021 my wife had surgery for cancer. She stayed in the hospital for 25 days and the bill was $700,000. We paid $236. If we were pre- obamacare when we had 1,000,000 lifetime limits we would be at least 1,000,000 in debt.
elleng
(141,926 posts)Doctor/Hospital Out of Pocket $0 (what I'm paying now. My drug plan is via retaining my federal retiree blue cross/shield.)
Casady1
(2,133 posts)marybourg
(13,651 posts)“Dental all out of pocket $1000”?
DemBlue76
(78 posts)That Medicare original gives you no help with dental but advantage does
marybourg
(13,651 posts)Medicare premiums - $2040 annually
Annual deductible $250
Medigap high deductible plan subsidized by spouses frmr emplyr-$516
My usual 20% copays on dr. Visits until $2000 deductible kicks in- $78 (not a heavy user of doctors)
Total- $2884
I don’t count dentist and optician in Medicare costs, since they’re not covered.
Edited to add: Rx plan part of my supplemental, but usually just use discount coupons from internet.
Usual yearly regular and occasional meds: $96.
MOMFUDSKI
(7,080 posts)with high premium. Went to Advantage 9 years ago. My premium is about $9/month. Had spine surgery at best hospital in town 2/1/23. Co-pay was $88 walking in the door. Got read-out of total bill totaling $87,000. I paid none of that. I feel lucky.
snowybirdie
(6,719 posts)We discovered pretty much the same costs. And this month alone, without Medicare, we would have gone through a great deal of savings with two of us needing eye surgery. Got a have it, as much as you can afford. Healthcare costs are outrageous.
llmart
(17,658 posts)Medigap Plan G and Medicare do not cover dental, so not sure what you mean by "dental all out of pocket". If you mean that you have to pay for your dental visits, then yes, it is correct that it's "all out of pocket", but the $1000 doesn't make sense.
I have Medigap G (best coverage you can have) and it costs me $175 a month. After I pay the deductible, I pay nothing else. My drug plan is $28 per month.
In my opinion Advantage plans border on being a scam.
DemBlue76
(78 posts)
Progressive dog
(7,609 posts)since I retired. The most I ever paid for one (in addition to medicare premiums) was $140 per month per person. It has been several years since I paid any premium.
Now I get some dental coverage, some vision coverage and the big advantage is that yearly out of pocket costs for hospital and doctor (A&B) are limited to $7550 for in and $11,300 for in and out of network.
For the last 3 years I have received credit for OTC health purchases. This year it is $103 per quarter. I use it for vitamins, baby aspirin, cough medicine, toothpaste, toothbrushes, pain relievers etc..
I have never had a delay or denial. All hospitals and all specialists that I have seen are in network.
SickOfTheOnePct
(8,710 posts)I know a number of people who have wonderful Advantage plans - great care, low cost, dental, etc., and they simply loved them - wouldn't go to regular Medicare for anything.
And I know a very few who tried an Advantage plan, hated it, and went to regular Medicare.
And I know a lot of people who have always been on regular Medicare, never tried Advantage, but spend lots of time telling everyone else how horrible Advantage plans are.
People need to do what works best for them, regardless of what it is.
KentuckyWoman
(7,411 posts)The premiums are no fun but after that I have no surprises.
I will say, if I were unable to carry the gap insurance I would go straight Medicare. My situation is unique so I would not recommend that for anyone else.
Advantage plans are awful. They really should be outlawed. I tried to show a friend how her own unique expenses would have been for 2022 if she was on Medicare & Gap & drug. She would have saved almost $1200. She will have none of it. She insists her Advantage plan gives her all kinds of free stuff.
SickOfTheOnePct
(8,710 posts)And some are not. And no, they should not be outlawed - millions of seniors are very happy with their plans and shouldn't be forced off of them.
KentuckyWoman
(7,411 posts)On consideration I agree "outlawed" is surely too strong. However, I would like to see them all go away. Phased out. We should be supporting Medicare, not private insurance. It is the national best interest to do so, in my humble opinion.
We need a single national health plan. Advantage plans don't get us there. If they want to make money off old age let them phase into gap plans instead.
I'm pretty hard headed on that point. Unreasonable even. You'll unfortunately have to give me room to disagree with you on that.
Edit to add my husband was on UAW Advantage plan. He got absolutely great care. They even reimbursed him for $76 of the medicare premium taken out of his social security check. Even with that, the math at the end of every year would have been cheaper with Medicare & Gap & Drug.
SickOfTheOnePct
(8,710 posts)We’ll agree to disagree.
I’m not a big fan of telling others what is best for them.
Faux pas
(16,437 posts)I pay nothing. My state retirement reimburses what SS deducts, and my retirement pays for my supplemental insurance. Oops, I lied, I do have to pay $3.78 for 90 days prescription. Thankful as all hell that I retired UNION! 
PoindexterOglethorpe
(28,493 posts)I pay no extra premium for it.
I had a heart attack 2.5 years ago, and paid just a few hundred dollars (no longer recall the exact amount) on a $70,000 or so hospital bill.
I have zero co-pay on my three prescription meds, but I think that's because of some overall change to Medicare, not my plan.
Every time I go to a doctor, I have something like a $40 co-pay which then gets refunded a few months later.
I spend less than $500/year out of pocket. Actually, close to zero.
Yeah, Advantage Plans are terrible.
DemBlue76
(78 posts)is the accounts of care delay and denial. Your doctor wants you to have a hip replacement, but your plan says a pin or first see if months of therapy works. People getting pushed out of hospitals or skilled nuring too early. Cancer treatment delayed, etc.
Yet some people, like you, have a good experience.
Emile
(42,621 posts)a few dollars but the risks outweighed the savings. When open enrollment came up we eagerly got off advantage and went with the G plan. Next year we're switching to F plan.
DemBlue76
(78 posts)Did you learn more after starting on Advantage?
Emile
(42,621 posts)on an Advantage plan. You have to have referrals to see doctors out of network. You are limited to procedures and tests that you need done. You end up holding the bill if you have them done without approval. It's also a republican plan to do away with Medicare.
Just curious why you went with Advantage to start.
Emile
(42,621 posts)insurance broker who eventually came to our house and really pushed the private insurance Advantage plans. I'm sure he makes a good commission off each Advantage plan he sells.
Response to DemBlue76 (Reply #28)
Emile This message was self-deleted by its author.
moonscape
(5,784 posts)my specialty cancer group who have Advantage wish they could switch. They aren’t able to see specialists of their choice, and some places like Mayo won’t take Advantage for those who have wanted to get 2nd opinions.
DemBlue76
(78 posts)I am at risk of cancer recurrence and our agent called that out as a factor in recommending Original.
PoindexterOglethorpe
(28,493 posts)done by Advantage plans. Most health care plans do that when they can.
The other seniors I know with Advantage Plans are very happy with them, and I never hear them complaining about coverage delayed or denied.
So if you want to slam Advantage plans, please slam all other plans while you are at it.
DemBlue76
(78 posts)There are no pre-authorizations or denials. If your doctor prescribes it and it is a service covered by Medicare, you get it.
As mentioned above, the Mayo Clinic does not accept Medicare Advantage. At all. Not that you or I would ever have occasion to visit, but it illustrates the potential limitations.
My feeling is Original is often more expensive, particularly if you find your premiums rising over the years. But there are some medical situations that are better treated by Original.
PoindexterOglethorpe
(28,493 posts)original Medicare does, plus.
NowISeetheLight
(4,002 posts)What you're paying sounds very high for Medicare.
I'm on Medicare (due to SSDI) and have an AARP UHC PPO plan (Choice 1). I pay an extra $48 a month for it. A network but it's very large. All those hospitals in my area take it. Its the same plan my parents had in AZ years ago.
My specialist copay is $10 with no referals required. Primary provider copay is $0. I have dental up to $1500 and vision too. Out of pocket max is $2800 a year. I also get $40 a quarter to spend on health stuff. Twenty chiropractor visits a year with no copay.
DemBlue76
(78 posts)Out of pocket max around 5k.
mike_c
(37,072 posts)...my pension reimburses it, so effectively $0. Let me take this opportunity to advocate for good union jobs with decent retirement pensions! Our drug plan could be better, but it's not awful and it's free to us. Vision and dental are provided too. My wife spent seven weeks in the hospital and a convalescent care facility last year-- didn't cost us a dime. We never got any financial paperwork at all.
Medicare is awesome.
DemBlue76
(78 posts)That will be a big deal to us as you can see from the numbers in the OP.
My dream is Medicare for All without the premiums and co-pays. I'm don't know how people without a healthy 401k and pension to go with their social security do it.
mike_c
(37,072 posts)Ours is currently more than twice that, and that's the main reason I dinged the drug plan. On the other hand, I'm grateful I'm too healthy to cross their threshold. But yes, reducing it to $2k would help so many people.
elocs
(24,486 posts)I under the 100% Federal Poverty Level, have dual care coverage with Medicare and Medicaid along with extra help to pay copays and fees. It costs me nothing. And in the past year I did have an MRI and an EMG, but I take no prescription meds. Plus, my Medicare Advantage give me $200/month for healthy food, or over the counter meds and such, or could also be used to pay for utility bills.
When you are poor you need to go after every advantage you can get and follow through on it because the rich and wealthy have absolutely no problem in doing that.
former9thward
(33,424 posts)I have never had any of the issues you present "Networks, delays, denials". And given that you just turned 65 how would you know it is so "inferior"?
mvd
(65,934 posts)I think she pays too much for some prescriptions. I am sure there are worse Advantage plans than hers. I would rather she had traditional Medicare because I am big on supporting Madicare and not private insurance.
GoodRaisin
(10,969 posts)it’s about $5500 a year. Just for me.
It definitely ain’t free.