I'm getting Medicare on April 1, 2013.

[LeftofObama]

I got a letter in the mail today from Health and Human Services telling me my Medicare will start on April 1, 2013. The letter said I should be expecting more correspondence from them in the next couple of months and I should keep it in a separate file. They said I will have to make some decisions and to read all the correspondence carefully before I make a final decision as to what kind of coverage I want. I have a counselor at my doctor's office and she told me she would be happy to go over it and help me decide. I am just wondering if any DUers that have Medicare can give me a heads up on what to expect, or what I should definitely avoid. Thanks in advance for any advice.

[southernyankeebelle]

1. I start the 1 Jan 13. They have sent so much info that it is mind boggling. It was suggested

that I call the social security office in my local town. But I think am in good shape because I will be getting Tricare for Life plus Medicare both are government programs. My only thing is finding out when I need to see a specialist and who makes the appointments. I know with my regular Tricare I had to get pre authoritizations for specialist.

[LeftofObama]

6. Good point!

There are definitely a couple of specialists I need to see so I'll see how to go about making the appointments.

[southernyankeebelle]

16. I don't know if you realize if you all their office you can make an appointment on the phone for

someone to call you at your home at a certain time. I did that. There is so many ways today. But I will make an appointment in person.

[dimbear]

2. Perhaps rather than a file, a filing cabinet might be more appropriate.

Such a thicket of paper........ I envy you for having a counselor available. Likely to be your best bet.

You'll be getting a cheap looking paper card, the wrong size to fit in your wallet. Don't lose that card.

I got most of my good advice from my pharmacy. If they are your friends, that's a good source. Luck!!!

[LeftofObama]

7. Thanks.

I'm going to talk to her tomorrow and give her a heads up that the paperwork is starting to come in.

[Panasonic]

11. I laminated mine as soon as I got it.

It's still in my wallet, properly sized and laminated.

[question everything]

33. You should not carry it in your pocket just as you should not carry your SS card

If you have to, make a photocopy and block the last four digits.

[DURHAM D]

42. Exactly, because your Medicare card has your SS number on it.

They need to rethink our assigned number.

[randome]

3. You selfish slacker.

[LeftofObama]

8. LOL!

I wish I didn't need it, but I'm SO glad it's there. Paying some of these office calls and doctor's bills is financially killing me.

[DURHAM D]

4. Are you drawing SS yet?

[LeftofObama]

9. Yes.

I started drawing SSDI November 1, 2010. They told me that I had a 5 month waiting period and then 2 years after that I would be eligible for Medicare.

[DURHAM D]

14. The reason I asked is that when I turned 65 I was still working and not drawing SS.

When I called to enroll in Medicare they bounced me around to three different people to try and get me to take SS immediately even though I had not reached my full retirement age. They did this for two reasons: (1) It would reduce the amount of my SS by 12-14% for the rest of my life and (2) If you are drawing SS they just automatically take the Part B ($104.90 starting January 2013) from your SS check. If they can't do that then I had to pay three months at a time in advance. They try to save on paperwork by not generating a quarterly invoice.

The next decision is if you want to enroll in regular Medicare or in a Medicare Advantage program. But your situation is different and I don't really know anything about Medicaid/Medicare with SSDI. Good luck and I hope you have a large mailbox as it will fill up every day.

[LeftofObama]

15. Thanks for that.

Now I need to go look at the difference between Medicare and Medicare Advantage. I have a feeling this is going to get complicated.

[CTyankee]

19. I have found that AARP's United Health Care plan is best and cheaper. I rejected Medicare

Advantage because it was FOR PROFIT and AARP is NON PROFIT.

[trof]

26. United Healthcare is DEFINITELY "FOR' profit.

And they pay AARP well to push their policies.
Look up what the United Healthcare CEO makes.
It will make you vomit.
We went with Mutual Of Omaha for our Medigap policy.
It's a 'mutual' insurance company basically owned by policy holders.

[DURHAM D]

31. Amen about the "for profit" re: AARP/United Health care.

I am also with Mutual of Omaha.

[CTyankee]

66. I will look at Mutual of Omaha next year. I simply compared Medicare Advantage compainies

available to us here in CT and United came out best. I assumed it was nonprofit because of its alliance with AARP, which is a nonprofit.

[DURHAM D]

32. AARP offers both Medicare Advantage and Medigap (Supplemental) to regular Medicare.

I believe that originally they offered only Medicare Advantage plans (but called it by another name) but now they offer both. For that reason I signed up with Mutual of Omaha. I wanted to pick my own doctors and not need a referral for a specialist.

https://www.aarpmedicareplans.com/medicare-education/compare-health-insurance-plans/compare-health-plans.html

[question everything]

35. United Health used to pay its CEO $100 million a year!

Now it is "only" $50 million. As a matter of principle I did not use a for-profit when I had my individual policy and not when I switched to Medicare.

[pinto]

57. Yeah, that's standard. SSDI has a number of disability benefit considerations included.

If you are co-eligible for Medicare / Medicaid, Medicaid may cover your Medicare premiums. Plus some co-pays you may be billed for services. Check with your local office. If there's a specific rep noted, see he or she in person if possible. Have a list of your questions, billing issues and overall medical needs on hand.

Congrats. Medicare is overall a great program.

[elfin]

5. LAMINATE the card!

If you don't have access to laminating materials, kits are at Office Depot and the like. I think they will do it for you at places like Kinko for a small fee. The card will be in tatters if you don't do this.

Good luck and I hope you don't need to use it right away.

[LeftofObama]

10. To be honest

that was one of my first questions I was going to ask the counselor. I was wondering if it would be ok to laminate it.

[Panasonic]

12. Strongly recommended.

My wife has hers laminated as soon as she got it.

Go to Kinko's - it costs about $3-$5 to laminate it.

[LeftofObama]

13. Thanks.

I'll do that tomorrow.

[dlwickham]

54. I just stuck mine behind my driver license

only pull it out when I have to

my doctor's office has a copy on file so I might have to pull it out once a year if that

[TexasBushwhacker]

17. It's not that bad

Medicare Part A covers hospital bills and that's what you get free of charge. You paid into the fund when you were working.

Medicare Part B covers doctors and outpatient procedures. The premium for this in 2013 will be about $105 and they will take it out of your SSDI.

Medicare Part C is managed care, like an HMO, that's run by a private provider and takes the place of Medicare Part A and B. You have to choose this. It can have lower deductibles and co-pays, but you can only use the doctors and hospitals in their network. A lot of doctors are dropping out of these networks. I can't say I really recommend them.

Medicare Part D is for prescription drugs. If you choose to get this, you'll have to choose a provider. Premiums vary by location, but it should be less than $50 a month. If you have to take name brand prescriptions, it can be worth it.

If your income is low enough, you can qualify for Medicare and Medicaid. Medicare would be your primary provider and Medicaid would be your secondary. The limits for Medicaid should be going up soon because of Obamacare.

[LeftofObama]

18. Actually, that sounds pretty simple.

Thanks for posting that.

[TexasBushwhacker]

58. I used to sell Medigap insurance.

I had to know all that shit

[Kingofalldems]

20. I am supposed to start next year but

I found out I actually don't have to enroll as I have FEHB as a retiree. I have no clue as to my next move.

[doc03]

21. I got the same mail today. I also found out I will have to

pay an extra $40 premium a month for Medicare because I will be considered a high wage earner. They will use my 2011 tax return to determine my income. For a single if your MAGI is over $85000 a year you are considered a high wage earner. I didn't have that kind of real income and never did in my entire life. I happened to roll over $50000 from my regular IRA into a Roth IRA in 2011 which when added to my SS and pension it put me a few hundred dollars over $85000. I have to pay $40 extra a month for Medicare and my SS and pension income is way under half of $85000. I don't know if I can appeal the decision or if that figure is locked in for ever or what..

[DURHAM D]

36. The figure is not locked in.

I think they use a two year look back. So, if your 2012 was down you should get an adjustment. If you are receiving SS they will just deposit it in your bank account, if not, you will receive a check in the mail. At least that is what happened for me.

[doc03]

48. Will I have to pay that for the first year or can I appeal it. The SS web site says

they use the latest MAGI that the IRS supplies them. They say for 2012 they will usually use the 2010 tax return to determine the Medicare premium so I assume that in 2013 they will use the 2011 return. I never made that much in my entire lifetime in one year and in 2012 not even half that. All I know to do is get my tax return in as soon as possible and sign up for Medicare as late as possible hoping the IRS will give them the 2012 MAGI figure. I hope you are right about the 2 year look back thing or I am going to be paying out a total of about $350 a month for Medicare and our supplemental policy.
That's what happens with means testing I don't know when they started that with Medicare but I bet it was never adjusted for inflation. I found out after I retired on SS that being single and make over $25000 a year you are also considered a high wage earner now and you are taxed double, once on the extra income and again on your SS check. That $25000 figure was put in back in 1983 and has never been adjusted for inflation. I get penalized for having a union job where I fought for a small pension and planed for my retirement by putting money in a 401k. It seems like no matter what you try to do in this country they knock you down.

[DURHAM D]

50. If I recall correctly I had to go ahead and pay the higher amount for a year but

then received a refund after the fact. The inflated amount for Medicare & Part D for high income earners started during the last administration. I think it was 2006.

[doc03]

55. OK thanks for the information n/t

[madrchsod]

22. one the best insurance you probably have ever had

great customer service,your own webpage with all your info. once a year you`ll get a big book full of different plans for your plan b and drug coverage..i think it`s plan b,my wife does mine!,. so far i have had 0 problems with anything related to medicare.what sucks is no dental or eye glasses. it does pay for the eye doctor.

[mainer]

23. Congratulations! I hear from others that they're SO relieved when they get onto Medicare

I watched my mom get ill and eventually die of multiple medical problems. Medicare took care of everything. I will be forever grateful for it.

[Cleita]

24. Yes, stay away from the privatized Medicare Advantage programs and sign up for

traditional Medicare with a supplemental insurance. I know they sound good on paper, but people don't realize that they sign away their Medicare rights when they get them. When you get denied coverage Medicare cannot pick up the tab until the next enrollment period, which could be within a year. They will limit your doctors, your choices of other medical access and many of the doctors on their lists don't even accept patients from them. My husband got one when he was sixty-five and it was the biggest mistake he ever made.

I have traditional with a supplement. I have never been denied care by a provider. I can go to any doctor I want to anywhere in the country I want to. I don't have to be referred to a specialist if I want to see one. There are some limits on coverage like they don't cover dental or glasses, but it pretty much covers all necessary and basic health care needs a senior might have. Also, my supplemental started paying for my gym membership last year.

[DURHAM D]

40. I have previously noticed that you are up on medicare and medicare advantage.

Have you noticed among your circle of friends, relatives, and DUers how many of them are on a Medicare Advantage plan and don't even know it?

My own brother has a medicare advantage plan through his former employer and doesn't believe me when I tell him he is not on regular medicare. He complains about the really high deductibles that go up every year, the poor dental coverage, his choice of doctors in the network, and the need for a referral to go to a specialist. He does not understand that I don't have the same issues but then I also don't have a former employee "paying" for part of my plan. But honestly, his deductible is higher than my Part D and Part B combined for a full year.

[Cleita]

60. Not many here because none of the doctors in my area accept it.

Some even have signs in their waiting rooms that state they accept Medicare and a co-insurance but not the Medicare Part C plans.

The only people who get suckered in are people like my husband, who was healthy when he signed up, never used it because he had an aversion to doctors and found out what a piece of crap it was when he had a stroke and we were working as campground hosts in northeastern Washington. It turns out they would not pay for his emergency care because I called an ambulance first before I called the HMO office to get permission to call 9-11 because we were out in the middle of the wilderness with no cell phone service and only one pay phone within five miles. With regular Medicare it would have been covered, with no permission needed. His emergency care involved not only an ambulance and care by first responders, but a helicopter to lift him to the nearest city hospital and treatment there. It cost plenty. When we returned to California, the list of doctors they had given us all refused to accept the Medicare Advantage program so we again had to pay out of pocket until the next enrollment period.

Tell your brother to go on regular Medicare and get a co-insurance. I have AARP. They pay the deductible and co-pays. I think your brother might find out that the yearly premium is less than what his yearly deductibles and co-pays are now. He can go to any doctor he wants anywhere he wants. I have yet to find a doctor that won't accept that combination. If he goes on vacation or travels within the US it's accepted anywhere, unlike the MAPs where you have to stay put within the radius of doctors and hospitals they approve of.

[DURHAM D]

62. I have given up on my brother.

I have been trying to get him to help himself to more info and do some research for three years. I send him links but he finds it confusing and it is sort of like he believes the company is taking care of him because they would never ever screw him over. I don't know what his deductible is increasing to in 2013 but I am sure he will be complaining about it soon. He has met it every year since he turned 65.

He won't listen to me because I am the youngest child and we never know anything.

[Cleita]

63. Then there is nothing you can do but stand by for the crash and then maybe he'll listen.

My dad was the same way about the company he worked for all his life. When he retired, he got a gold watch for 44 years and a small pension that even with Social Security was inadequate for my mother and him. The company did pay for his Blue Cross. They had savings so they were all right for a while until he fell sick. Oh the company got sold and the new company felt no obligation to continue the pensions that had not been legally locked into a trust. They also discontinued the Blue Cross. My parents had to start going through their savings. My mother, a housewife all her life, had to go to work for the first time when she was already middle aged. Fortunately, LBJ signed in Medicare and when it was put in place it saved my parents because it was able to pick up the lion's share of my dad's increasing medical bills.

I spit on the company myself because you never know when it's going to be sold or dissolved and all its obligations with it.

[LeftofObama]

25. Thanks everybody for all of the replies.

Sorry I couldn't answer everybody individually. You've all been a great help.

[trof]

28. About Part D. Prescription drugs.

Even if you take no prescription drugs NOW, you might want to take out a policy.
On the advice of our doctor (she's also a close friend) my wife did.
You get the cheapest rates as soon as you turn 65.
If you opt out then, the rates go up for you, sometimes WAY up, for every year past 65 that you wait to opt in.

My wife takes NO maintenance prescription drugs...now.
But she may later. In fact, likely will.
On our friend's advice she pays about $30 a month for a plan she doesn't need...yet.
But later she could be on some cancer drug or whatever that costs hundreds of dollars a month.
Just sayin'.

[question everything]

38. You really HAVE to sign up for Part D.

From 3 months before you turn 65 to 3 months after. And then you have 63 days grace period. If you do not, you will have to pay penalty fee for the rest of your life.

Check with carriers to see who offer it. First year I was with a "blue" where I did not have any deductible or co-pay, but drug coverage was going to be an extra $37. So I switched to carrier - still no-profit and even with $15 office payment I am still ahead.

[DURHAM D]

41. Do you have a Medicare Advantage plan through your employer?

[question everything]

64. No. I am retired

but in the past 15 years I carried an individual policy. Got sick and tired of employers - mine or my spouse's - switching carrier on us. At one point, when my spouse changed employer, the new one said that they would not cover me. So this was an opportunity for me - while still relatively young and healthy - to get an individual policy from a "Blue" and it was relatively inexpensive but was getting more and more as I was adding the years.

Frankly, I think that if we will remove employers from the health insurance business, and if employees will have to carry their own, this will be the fastest way for a universal health care.

[ebbie15644]

27. I just got mine today too! confusing

I had to apply for SSDI. I worked all my life but I have spina bifida and because of complications, I was in a nursing home. My job with the state fired me after I used my medical leave. My disability retirement counselor told me that I had to apply for one of the part c packages, is this true?

[Cleita]

29. I hope it's not true. Part C is a privatized version of Medicare and when

you enroll in it you give up your Medicare rights. It seems you should qualify with a combination of Part A, Part B and your state Medicaid taking up the the co-pays. I would talk to someone else like a social worker at a hospital not connected with the same agency as your counselor.

[ebbie15644]

67. I will call the local hospital and ask for advice but I'm worried about paying for my prescriptions

[Cleita]

68. Maybe that's the problem. Part D is separate and it is the Bush plan

that gives the PhRMA companies the ability to charge the plan anything they want for drugs. It's something that needs to be fixed if they are going to fix Medicare because it's draining the fund. Most of the Medicare Advantage programs include drugs so that's probably why they are trying to pressure you into one of them. The problem with their drug coverage is that they exclude a lot of drugs, make you go to their approved pharmacies, many of them that are mail order. So really look into it. Since these are all private plans, they vary, and buyer beware.

[ebbie15644]

69. I will be looking into it but trying to decide is very scary!

[former-republican]

44. Be careful on what you sign up for. Do not give up medicare

just some friendly advise

[lillypaddle]

30. Yay for you!

expect a flood of "junk" mail from every insurance company that exists. I admit that, out of laziness, I didn't research as well as I should as to which supplementary insurance company to choose. Unfortunately, it's not a cut and dried decision. I decided, for purely financial reasons, to forego the supplementary medical policies, and instead went with a prescription drug policy.

Everyone is different, and has different prescription needs, so you have to just jump in and do some exploring. I opted for an Rx plan for which I pay $42.10/month. I had my first month's RX filled just yesterday - I saved a lot from my previous BC/BS coverage, but there is the "gap" to consider ...

Good luck to you!

[GoldenOldie]

39. FEHB employees can keep a FEHB contracted Health Insurer.

Along with this, take Regular Medicare and stay away from Medicare Advantage if at all possible. Medicare pays first and your Secondary Insurance should pay the difference. I believe Tricare handles it the same way.

And yes, you will be receiving plenty of trash mail from Insurance companies no one has ever heard of.

Also you can talk to your Primary Care Physician as they would be the one who will refer you to Specialists you may need. I think this is going to be one of the basic requirements of the new Health System.....the Primary Care Physician will be the contact for all individual care.....thus controlling the use additional unnecessary lab work, scans, etc., reducing health care costs. All your Specialists will have to make sure the Primary Care Physician gets results of any and all tests and procedures.

[DesertFlower]

34. my part B started 6/12 when my husband passed away.

because of his years with IBM i was eligible for some of their supplemental plans. i took one that covers my prescriptions same as they did before, but has a $4,000 deductible for docs. it's also a $4,000 max out of pocket a year. some of those supplemental policies i looked into had some high monthly fees and didn't cover some of the drugs i take.

next year it will cost me more because my husbands 401k went to me. because i'm 71 i turned it into an IRA and have to withdraw a certain amount of money every year. this will bring my income over the max for a single person and i will be paying more for my medicare, but i'm not complaining.

on edit: my supplemental runs $29 a month.

[liberal_at_heart]

37. that's great. I hope you get all the medical care you need

My husband is disabled so he will be getting Medicare as well. I can't remember when his is suppose to kick in. I think it is next year. We have private insurance as well but with the very high premium and the 20% left over that insurance doesn't cover Medicare will be a big help.

[former-republican]

43. Don't get fooled into signing away from Medicare like my father did

That was the reasons we couldn't put him in a nursing home close to home the last month of his life.

We thought he had medicare but had signed up for one of the private insurances companies approved by medicare.

[DURHAM D]

45. Are you referring to a Medicare Advantage plan?

[former-republican]

46. Yes , I believe that's what he had

I know for a fact it wasn't through his employer.

My mother told me a sales man had come over the house and talked to both of them.
He convinced my dad this was the best plan for him

[DURHAM D]

47. I think it is important to use the right terms because

the OP is trying to learn the basics. Thanks.

[former-republican]

49. roger that

Is the advantage plan the one that is private sponsored through medicare?
If that is the one where you sign away from Medicare then that's what he had.

It wasn't a supplemental insurance like my mom has.

She stayed with medicare but also chose a supplemental insurance to cover the costs of things Medicare doesn't provide

[DURHAM D]

51. The Advantage Plan is where you sign your rights away.

Your mother is smart to stay with a Medicare Supplemental or Medigap policy.

[Lone_Star_Dem]

53. My mother in law uses something called "Texan Plus" is that a Meidcare Advantage plan?

If so, I'm pretty sure she doesn't know that and I should mention that.

[DURHAM D]

56. I don't know the "Texan Plus" plan.

I assume she is in Texas and a poster upthread (TexasBushwacker) seems very well informed. I bet they can answer your question.

[donco]

52. Here is a good link

that will help you out.If you live in a large enough metro area dont scoff at the Medicare advantage plans.Some even pay your gym fee, eye glasses, and minimal dental. Lotsa luck.

http://www.medicare.gov/

[GoldenOldie]

61. Medicare Advantage was initiated by the GOP

It was the first step to the Privatization of Medicare. Just as the HMO's were sold as a bill of goods, in reducing the costs of Physician and Hospital billings, Medicare costs would be reduced with Medicare Advantage, by having the individual Insurance Companies, process all aspects of billing. This includes, approval/denial of care, processing any and all disputes of service. This has proved to be more costly as all of this is done for a FEE, which is an additional cost to taxpayers and thus much of the costs that the Obama Care wants to do away with....much of the 700 Mil that was often discussed during the campaign.

I am a member of an exercise class for the elderly and the majority of the Members "Silver Sneakers," fees are paid by their Medicare Advantage plans yet I constantly hear them complain of their increasing costs in co-pays and constant review of their benefits. I prefer to maintain my Original Medicare, Have Medicare determine my elegibility for care and then my private insurance must pay the difference.

Review Original Medicare cost with an added supplemental insurance to cover the difference. Then compare with a Medicare Advantage Insurance.

[donco]

65. I've been on medicare since 1999

and I find it rather convenient to have all of my drug,dental,and vision in one package. The cherry on top of the cake is that and I like my silver sneakers. Keeps the ole goat spry and frisky.

As for as medicare supplements go,most cost around two hundred a month but the major benefit is that you can see any doctor that excepts medicare without a referral.


That’s the only downside of the HMO that I’m in.A trade off that I willingly take for a plan hmo)that includes the Doctor that I have been going to for the last twenty years AND includes my gout pill(drug coverage) that I have been taking since my twenties. All of the above with Zero extra payments.

[pinto]

59. My suggestions - see the counselor, see a Medicare rep and take your time. Get the facts.

You have 3 months. Your enrollment in Medicare Part A & B will be activated at that time. One's in-patient care, one's out-patient care.

Critical and routine care will be covered. If you need more than that - medically, financially or otherwise - ask about options and resources.

Also, I would save all out-of-pocket cost documentation for medical care from the date of determination for your SSDI. Take care.