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babylonsister

(170,962 posts)
Mon Nov 9, 2020, 05:31 PM Nov 2020

The dreaded 65 is fast approaching and I have

a few questions. First off, I don't require any medications at this time, so that's a plus.

I'm getting so much mail regarding supplemental insurance I don't really know what to do with it all.
I've read on here Advantage is not a good way to go, so am steering clear.

I am wondering what an average monthly payment might be. My neighbor claims she pays $350 for hers. That's way too steep for my blood and pocketbook as I 'make' less than $1K monthly for SS. So I'm on a semi-fixed income.

I am soliciting advice only. Is anyone in love with the provider they chose?

And what's the deal with glasses/hearing aids/dentists? Has anyone signed up for these, are they on Advantage plans, and are they worth it? Might be for me as I need all those things.

Disjointed this is, I know, but thanks for any feedback!

43 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
The dreaded 65 is fast approaching and I have (Original Post) babylonsister Nov 2020 OP
Every State is different. 634-5789 Nov 2020 #1
Listening in. Delphinus Nov 2020 #2
Did you get your big Medicare booklet in the mail yet? flying_wahini Nov 2020 #3
Yes, I got a booklet and will call soon, thanks! nt babylonsister Nov 2020 #31
I have an advantage plan, no monthly premium, just the medicare charges. 5X Nov 2020 #4
Ditto. Aetna Advantage in GA. Pay zero. There are copays but not awful. CurtEastPoint Nov 2020 #8
STep ONe... Eliot Rosewater Nov 2020 #5
Advantage plans can cover a lot, as you mentioned, ... JustABozoOnThisBus Nov 2020 #6
65 is in February so I have time. babylonsister Nov 2020 #32
Great idea, however, the stress repeats every Oct-Dec enrollment period. JustABozoOnThisBus Nov 2020 #41
Aw geeze, say it isn't so! babylonsister Nov 2020 #42
Well, before I was on Medicare, I was on the company's group plan ... JustABozoOnThisBus Nov 2020 #43
Your income maybe low enough to get financial support Big Blue Marble Nov 2020 #7
I turned 65 this past May. redstatebluegirl Nov 2020 #9
I was googling yesterday and babylonsister Nov 2020 #33
I did the same thing, it was awful! redstatebluegirl Nov 2020 #38
Results vary. babylonsister Nov 2020 #39
I do what they tell me about MD. My Dad and Uncle had it too. redstatebluegirl Nov 2020 #40
I wouldn't automatically write off Advantage plans. Hoyt Nov 2020 #10
I am 66 - one year on Medicare. I have an Advantage plan - costs me $0 a month. $0. stopbush Nov 2020 #11
What advantage plan do you have? redstatebluegirl Nov 2020 #14
I'm with Kaiser Permanente. stopbush Nov 2020 #15
I looked at that one, it only gave me one option for a back surgeon and it was a guy who looked 80. redstatebluegirl Nov 2020 #16
Sounds like you picked a great plan! nt babylonsister Nov 2020 #34
SHIP Counseling and other senior services Hela Nov 2020 #12
They were really helpful! redstatebluegirl Nov 2020 #17
I will be calling SHIP, thanks! nt babylonsister Nov 2020 #35
I'm in the same boat in about a year and have been trying to research online... wcmagumba Nov 2020 #13
Just for reference MLAA Nov 2020 #18
Call your local United Way. Ask for assistance negotiating Your medicare sign up. magicarpet Nov 2020 #19
I turn 65 in Jan, just went through it. NRaleighLiberal Nov 2020 #20
Thanks, and thanks for your offer. I am working on this. nt babylonsister Nov 2020 #36
Set up an appointment with an insurance agent who focuses on Medicare plans Bradshaw3 Nov 2020 #21
I went to the senior center in the next county south of me. murielm99 Nov 2020 #22
The type of Medicare insurance you can receive is dependent on your state. I, too, have read a lot in2herbs Nov 2020 #23
My doctor strongly suggested I get traditional Medicare and not Advantage. Patterson Nov 2020 #24
My Part B is $140 a month and my Part D supplement is $19 a month jpak Nov 2020 #25
I wouldn't pass on a Medicare Advantage program Sherman A1 Nov 2020 #26
This article from AARP may help: Big Blue Marble Nov 2020 #27
There should be a Medicare advisor in your area who can fill you in. hedda_foil Nov 2020 #28
Blue Cross Medicare HMO RicROC Nov 2020 #29
Advantage plans El Mimbreno Nov 2020 #30
Thank you all so much for responding! babylonsister Nov 2020 #37

flying_wahini

(6,527 posts)
3. Did you get your big Medicare booklet in the mail yet?
Mon Nov 9, 2020, 05:37 PM
Nov 2020

It has tons of insurance broken down. When I first signed up and had to call in to Medicare I was so impressed with how much time they spent with me. I had tons of questions, too.

Look thru the main book and familiarize yourself with lingo and differences to save yourself a ton of time. Then call.

5X

(3,971 posts)
4. I have an advantage plan, no monthly premium, just the medicare charges.
Mon Nov 9, 2020, 05:37 PM
Nov 2020

Depends on your state and what you sign up for.

CurtEastPoint

(18,549 posts)
8. Ditto. Aetna Advantage in GA. Pay zero. There are copays but not awful.
Reply to 5X (Reply #4)
Mon Nov 9, 2020, 05:39 PM
Nov 2020

I am on 5 meds and 4 cost zero and one is about 350/year. Primary doc = zero $. Spec doc = $45.

Eliot Rosewater

(31,097 posts)
5. STep ONe...
Mon Nov 9, 2020, 05:38 PM
Nov 2020

create an account here

account.mymedicare.gov

Not the main site for Medicare but this one...

It will allow you to look at all the different plans for a supplemental and the Part D RX plan that you must buy, I think you have to get one.

I pay $120 a month just for my medical supplemental with Anthem...you can pay less but this way I pay nothing other than the Plan B deductible which is around $190. I just checked it will be $203 next year, the deductible.

I pay $20 a month for Part D but this too varies quite a bit, so you need to look around on your personal Medicare site.


Advantage plans are restrictive. Advantage plans are unhealthy for Medicare in the long run, it is an end around to give more profits to the for profit system. Avoid it if you can, I say.





JustABozoOnThisBus

(23,283 posts)
6. Advantage plans can cover a lot, as you mentioned, ...
Mon Nov 9, 2020, 05:38 PM
Nov 2020

... medical, dental, vision, hearing, an allowance for household stuff: bandaids, etc.

But, they usually have a network. Make sure the company you pick has services in your area. There are brokers who can help you sort through this stuff, and they're paid by the insurers. I got help with my choices, so I know I have coverage where I live and where I usually go for vacations (remember those?).

The "normal" Medicare plans are medical and drugs, no dental, vision, hearing. If you pick that route, you STILL need to get Medicare D coverage even if you use no drugs. If you don't, then when you eventually need it, you will need to pay a penalty, monthly, forever. the Medicare web site has a "D" planner to select the lowest cost insurance.

How fast is 65 approaching? Do you have time to plan?

JustABozoOnThisBus

(23,283 posts)
41. Great idea, however, the stress repeats every Oct-Dec enrollment period.
Tue Nov 17, 2020, 04:09 PM
Nov 2020

My recycle bin is heavy with various offers, all of which are way better than all the others.

JustABozoOnThisBus

(23,283 posts)
43. Well, before I was on Medicare, I was on the company's group plan ...
Tue Nov 17, 2020, 07:18 PM
Nov 2020

.. so every fall, I had to pick which plan/insurer I wanted from my company's list.

It was the same headache, for decades. Medicare is just a new twist on the old game.

The big decision is between "normal" Medicare and medigap coverage (B and D), or the Advantage-type plan (Medicare C?).

I went with A, B, and D, so no vision/dental/hearing.

Big Blue Marble

(4,978 posts)
7. Your income maybe low enough to get financial support
Mon Nov 9, 2020, 05:39 PM
Nov 2020

for your supplemental through medicaid. You will still be required to
pay Part B from your SS payment. You can also look into Part C
to reduce costs and receive coverage for dental/glasses etc.

Advantage Care (Part B) are private HMO's subsidized by the government in
a back door attempt to privatize Medicare. You give up even more
of your right to influence your care, but with lover premiums.

I think you will have co-payments though which you did not have with
traditional Medicare.

redstatebluegirl

(12,264 posts)
9. I turned 65 this past May.
Mon Nov 9, 2020, 05:39 PM
Nov 2020

It was horrible trying to figure out what to do. I looked at advantage plans and they would not let me keep my back surgeon and I may need him again soon, I don't want one that is cut rate for that kind of surgery. My mother in law did use an advantage plan and it looked like she had less out of pocket than I have.

I went with United Healthcare through AARP, so far so good. My Medicare costs 145.00 and is taken out of my check every month. My supplement policy with United Healthcare is 115.00 per month and my part D plan (that pays for my prescriptions) is $33 a month. My supplemental plan doesn't pay for dental or vision, my husband is still working so I went on his policy for those as a dependent. I looked into getting my own and it was twice what it would be to go on his plan for now until he retires.

All of it was much more expensive than I had planned for. I have worked my whole life, but we have moved so many times, I had to start over every time we moved so I never got to a high salary. My Social Security is very low, even lower with the Medicare they take out.

It took us months and some help from a state agency in Oklahoma who helps you with the decision to determine what to do. So far they have paid most of my medical except for some of the charges from my pain management specialist. The copay for my drugs is much lower than it was with my insurance through the University. We will see how it pays if I need back surgery next year. I do think I am paying less out of pocket now than with insurance and we had a good policy at the University.

Take your time, don't take any of the phone calls from those stupid telemarketers, it will make you nuts.

babylonsister

(170,962 posts)
33. I was googling yesterday and
Tue Nov 17, 2020, 10:09 AM
Nov 2020

filled out a form online before realizing it was not a gov't link. Oye! Within 5 minutes they started calling and the calls didn't let up all day, total about 15. The irony is they were from GA; my phone number is from GA but I live in FL so no one could help anyway.
I need another cataract surgery so need to decide whether I get that done next month or next year.

redstatebluegirl

(12,264 posts)
38. I did the same thing, it was awful!
Tue Nov 17, 2020, 10:32 AM
Nov 2020

As far as cataract surgery, do it as soon as you can, I wish I had done it sooner. I had no idea how bad my sight had gotten until I had it done. Now I have Macular Degeneration, it is currently under control, no real loss of sight yet, but I am so glad I had those 2 years of great sight after cataracts!

Good luck!

babylonsister

(170,962 posts)
39. Results vary.
Tue Nov 17, 2020, 10:46 AM
Nov 2020

It's taken me 2 months to try to get back to 'normal' with my eye, and this was my good one. The doc finally gave me a prescription for glasses. My eyes are infinitely worse after the surgery though ok with glasses. I don't know if astigmatism or diagnosed dry eye has anything to do with it, but am disappointed this is the result. Cataract is gone and I can finally read a book, though that's not possible w/o the magnifying glasses I was prescribed. I still have not driven my car; luckily my so doesn't mind driving Ms. Daisy.
My other eye is a lazy eye; gawd only knows what the results will be with that!
My dad had macular degeneration; glad you're staying on top of that. Scares me silly I might be destined for that. Wear sunglasses!

redstatebluegirl

(12,264 posts)
40. I do what they tell me about MD. My Dad and Uncle had it too.
Tue Nov 17, 2020, 10:55 AM
Nov 2020

Mine was diagnosed at the very early stage because I am really good about getting my eye exams because of Dad. I am sorry you had a bad experience with cataracts. Mine was great, now, I still had to go in 6 months out to get some film removed from my lens an d I had to have readers after the surgery, but my distance vision is fabulous!

I take Alreds II for my MD, two a day, it is a supplement they recommend, and a strong multi vitamin. I started adding Restveratrol last year, my last exam a few months ago they told me they were amazed at how good my eyes were. I sure hope it keeps up, Dad was almost totally blind when he died.

Take care of yourself!

 

Hoyt

(54,770 posts)
10. I wouldn't automatically write off Advantage plans.
Mon Nov 9, 2020, 05:40 PM
Nov 2020

However, if you can swing it, traditional Medicare with a supplement and drug plan is more flexible if you want to have freedom to choose any doc you want. Advantage plans can eat you up with copays.

A supplement and a drug plan are going to cost you at least $200 month, likely more.

Some of the Advantage plans have limited coverage for glasses, hearing aids, and dental. But it’s minimal.

I would check with some of the senior organizations near you. They often have a counselor to help. There are some insurance agents who are helpful if they won’t steer you to policies that pay bigger commissions.

You are not necessarily stuck for life if you later find out your plans aren’t working for you, but switching can cost more than than you would otherwise pay.

Good luck.

stopbush

(24,376 posts)
11. I am 66 - one year on Medicare. I have an Advantage plan - costs me $0 a month. $0.
Mon Nov 9, 2020, 05:40 PM
Nov 2020

I pay the typical premium of $135 a month for Medicare, which is deducted from my SS check. I pay $20 a month extra for a dental/vision/hearing add-on to Medicare. With that, I get $350 every two years for new glasses with a free eye exam. I had my semi-annual dental check-up/cleaning last Tuesday. My cost: $15. Had my annual check-up with my Kaiser GP two weeks ago. My cost: $5. Just ordered 100-pill refills on 3 meds I take daily for afib, cholesterol etc. Cost: $6 per prescription.

Had surgery in January. Total bill came to over $15,000. My co-pay: $200. Yep, two hundred.

Had a colonoscopy a few weeks ago (results, normal. Yea!). My cost: $0. I had looked into the cost thru the KP insurance we had thru Obamacare, and my cost was anywhere between $1500-3000. My GP had suggested for a couple of years that based on my age, I should get a colonoscopy. Well, I simply couldn’t afford it, and the yearly fecal tests were negative, so why take on that expense? I rolled the dice and waited until Medicare kicked in - it worked out for me.

Medicare Advantage is great.

I live in SoCal.

stopbush

(24,376 posts)
15. I'm with Kaiser Permanente.
Mon Nov 9, 2020, 05:45 PM
Nov 2020

It depends on where you live. The same MA plan that costs me $0 living in SoCal would cost me $89 a month if I lived in NorCal. Go figure.

redstatebluegirl

(12,264 posts)
16. I looked at that one, it only gave me one option for a back surgeon and it was a guy who looked 80.
Mon Nov 9, 2020, 05:47 PM
Nov 2020

I decided to stay with what I have until after I have the surgery next year. I may go to that advantage plan after that.

Hela

(436 posts)
12. SHIP Counseling and other senior services
Mon Nov 9, 2020, 05:42 PM
Nov 2020

You want to talk to a SHIP Counselor. (State Health Insurance Program.) Every state has them; they can help you find the coverage you need and can afford.

You might also be interested in the Eldercare Locator for future needs. Get to know your local Area Agency on Aging! They are your link to services for seniors in your area, particularly if you are on a fixed or reduced income.

wcmagumba

(2,871 posts)
13. I'm in the same boat in about a year and have been trying to research online...
Mon Nov 9, 2020, 05:42 PM
Nov 2020

it is crazy the number of plans and parts A, B, C, D and more...supplements, what is covered/not covered...what too complicated for a modern industrial country....many traps and pitfalls and just plain old scams no doubt...I know in my state (and my income is just slightly over yours) there is supposed to be some "extra help" program that would cover some premiums and deductibles but you have to get on a list sometime in advance to be approved. Doesn't apparently work for Medicare Advantage programs though and those are the ones that cover vision and dental...so take your time and read everything you can about your state plans and find someone to consult with...that's my plan anyway...Buddha and Zeus help us all...

MLAA

(17,163 posts)
18. Just for reference
Mon Nov 9, 2020, 05:49 PM
Nov 2020

Husband has United Healthcare AARP supplemental.
It costs around $350 a month, so pricy. There might be slightly more affordable options. I just went with the one that Seemed to cover the most. A little over a year ago he had open heart surgery along with bleeding ulcer surgery a few days later that resulted in about 8 weeks in the hospital and two Weeks in rehab. This year just slipped and fractured his in two places so surgery and 1 week hospital stay, since COVID went for in home physical therapy. During all of this and all follow up appointments and tests. Guess how much it has cost us....not a single dollar. I paid one bill for $47 dollars that got refunded when they realized he had the supplemental insurance.

On prescriptions all are very reasonable except part of the year COPD enablers are expensive.

So if anyone has any health issues or family history of issues and can swing it, the AARP Supplemental is amazing.

magicarpet

(13,935 posts)
19. Call your local United Way. Ask for assistance negotiating Your medicare sign up.
Mon Nov 9, 2020, 05:53 PM
Nov 2020

There are local groups kinda like AARP,... here ours is called Seniors,Plus. They will help you review and decide the plans and which is the best route for you to go.

As stated previously,.. inquire about medicaid help to defray some of the costs and co-pays. That likely is available to folks with the low monthly SS check amount you get.

Good luck,.. it is not that bad if you read up and familiarize yourself with the lingo to some extent.

NRaleighLiberal

(59,940 posts)
20. I turn 65 in Jan, just went through it.
Mon Nov 9, 2020, 05:55 PM
Nov 2020

Book a call with a SHIP volunteer in your county.

Start by signing up for parts A and B on the Social security site.

Decisions are Medicare with a supplemental, or medicare Advantage. Then. your Pharma plan (part D).

for me cost will be approx (140 B) plus 110 (supplemental) plus 15 (part D) or approx 270 per month.

Bradshaw3

(7,455 posts)
21. Set up an appointment with an insurance agent who focuses on Medicare plans
Mon Nov 9, 2020, 06:00 PM
Nov 2020

In my experience they don't charge or favor one plan or another. Now if you call one of the ones who advertises that may be different. Just give you the info (there is a lot) and let you decide. Ask around to see if you can find someone you know who can recommend one. Advantage is cheaper per month but supplemental will cover most everything and is much better if you have a major medical issue. You also can change plans during your first year. Page 23 of the CMS booklet is good for info on that.

murielm99

(30,656 posts)
22. I went to the senior center in the next county south of me.
Mon Nov 9, 2020, 06:01 PM
Nov 2020

They have workers from the Department of Aging from the state of Illinois. They get on their computers and research plans and help you sign up for the best plan. They help with the paperwork, too.

I signed up as soon as I was 66. My husband, who did not plan ahead, did not sign up until a year or so ago, when he started to need regular meds. He has to pay a penalty for his Medicare D. I can't remember how much I pay, because I pay it up annually. My payments are low. I have everything set up with my local pharmacy. They give me the best prices on copays. I used to go to Shopko, but they went out of business.

Please ask around at senior centers for help. I am very happy with the help they gave me.

in2herbs

(2,942 posts)
23. The type of Medicare insurance you can receive is dependent on your state. I, too, have read a lot
Mon Nov 9, 2020, 06:07 PM
Nov 2020

of Medicare Advantage trashing on DU and I don't understand it. There are some who say if you have MA and want to change to a PPO you may not be able to if you have pre-existing conditions. I find no truth to this in the government-provided MA information. You must wait till the Medicare sign up period to change any insurance w/o penalty, but pre-existing is not a penalty. I have been on a MA since I went on Medicare almost 4 years ago and am very pleased, but like you I am not on a lot of RX meds, only thyroid. As a note, two months ago I fell and split my face open. The hospital bill was over $15,000 and my UHMA plan paid all but $90. I don't have a bill from the surgeon but he is a member of an accepted group under my UHMA plan so I don't anticipate being shocked at the bill. I have another surgery scheduled for January. These MA plans usually provide some kind of dental but had I required dental work as part of repair that cost would be all out of pocket -- no insurance plan pays for implants, etc., even in emergencies. They only pay a set amount, usually $1,000 - $1,500 and most Medicare plans pay in full for dental cleaning, etc., As for glasses, my MA plan paid for exam and glasses. Upgrades are always out of pocket. Hearing aids I can't address but it's a covered expense under my MA, how much is covered I don't know.

I pay nothing in monthly premiums. I have AARP United Healthcare Medical Advantage.

jpak

(41,741 posts)
25. My Part B is $140 a month and my Part D supplement is $19 a month
Mon Nov 9, 2020, 06:11 PM
Nov 2020

With LOTS of benefits.

Check out what's available in your state.

Sherman A1

(38,958 posts)
26. I wouldn't pass on a Medicare Advantage program
Mon Nov 9, 2020, 06:14 PM
Nov 2020

I am in one and I pay ZERO premiums beyond my monthly Medicare deduction from my SS check, which you never see anyway. My primary doctor is covered completely, my medications are currently Zero, specialists are $35.00 per visit (and that includes the dentist check ups and the eye exams) glasses just like my employer insurance provide some money towards frames and lenses.

It works for me.

hedda_foil

(16,368 posts)
28. There should be a Medicare advisor in your area who can fill you in.
Mon Nov 9, 2020, 06:47 PM
Nov 2020

Your income may qualify you to pay no Medicare premium. The Medicare advisor can help you with what you need and the best price (if any) for it.

RicROC

(1,202 posts)
29. Blue Cross Medicare HMO
Mon Nov 9, 2020, 07:16 PM
Nov 2020

My Blue Cross Medicare Supplement costs my $0 monthly premium but does not have dental, vision or hearing coverage. Since I was interested in dental, my advisor told me the copay and deductible would not be worth the premium. I'll trust her on that although I'd like to have some coverage for hearing.

At age 64 I was paying $480/month for health insurance. Now on Medicare, my premium is $0. And my medical copays and deductibles for 2019 didn't even add up to $480 for the entire year.

El Mimbreno

(777 posts)
30. Advantage plans
Wed Nov 11, 2020, 01:03 PM
Nov 2020

I've had a Humana Advantage plan for 5 years now, but planning to switch to United. At this time they seem to be offering more bang fol less bucks. Zero premium, $500 dental coverage, 0 copay for Primary provider, $35 for specialists, reasonable copays for diagnostic procedures (x-ray, CT, scope etc). 0 copay for tier 1 &2 meds through their pharmacy, $50 per quarter OTC allowance. They do have a plan that covers glasses, but it costs more and seems to fall short on other coverage.

My wife goes on Medicare in February and is looking forward to getting off of her current plan. Not a lot of options in our part of New Mexico. All of our current providers are in United's network.

Consider your own health, existing conditions, heredity, etc. as well as the $$ when deciding between advantage, supplemental or plain Medicare.

babylonsister

(170,962 posts)
37. Thank you all so much for responding!
Tue Nov 17, 2020, 10:15 AM
Nov 2020

I intend on getting this done soon so it's not lurking in the back of my brain. Your input helped tremendously!

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