Health Care Plans Under Obamacare Will Cost Even Less Than Expected

[h2ebits]

17. Medicare is a complicated subject. . .

I turned 65 in March. Long before I got to that point I was receiving copious amounts of junk mail from many different insurance companies. By the time I enrolled I had collected a stack approximately 18-20" thick. (Not an exaggeration.)

So here is my advice to you:

Do NOT respond to any insurance brokers until after you have enrolled in Medicare Part A and Part B. The cost for Part A is zero and the cost for Part B for most people is currently $104.00/month (there are exceptions to this). You still have time after enrolling in Medicare Parts A&B to enroll in Medicare Part D so hold off on doing it TEMPORARILY until you decide your direction.

Once enrolled in Medicare, you will receive a booklet called: "Medicare & You", which is the official U.S. Government Medicare handbook. PLEASE take the time to read it from cover to cover and if you don't understand terms or need more information make phone calls and, if you can find one at your local rec center or elsewhere, take a class that explains it. I CAN'T STRESS THE IMPORTANCE OF THIS ENOUGH!

Here's a really basic summary:

Medicare does NOT cover everything 100%

Most people elect to take out additional insurance and there are two basic types:

1. Medicare Supplement Plans: Most of the insurance brokers are trying to sell you a supplement plan (sometimes called MediGap) and most of them are trying to sell you the Cadillac Plan--called Plan F. These plans sit on top of the regular Medicare and you will pay the premium for the MediGap policy AND the regular Medicare Part A&B. The supplement plans run from Plan A thru Plan N--ALL of them have been designed by the Feds and all of them are identical--regardless of which insurance carrier you choose. While Plan F is identical regardless of which insurance company is offering it; the insurance company can charge whatever premium they choose and the monthly premiums vary from high to very high. In addition, if you choose a supplement plan, you will need to enroll in Medicare Part D for prescriptions. Finally, you will need to administer two separate plans. For example: If you go into the hospital, the hospital will need to bill Medicare separately from the supplement plan. You will need to carry both cards with you in order for the billing to be done correctly.

2. Medicare Advantage Plans: Most of these plans are HMO's and operate like standard insurance plans. Most, but not all, include prescriptions so you will need to monitor if you decide to change your policy. (You may need to separately enroll in Medicare Part D if your new policy doesn't include prescriptions.) Coverage on these policies is at the discretion of the insurance company so the policy premiums change based on coverage, etc. and comparison shopping is important. The policies each have different deductibles and out-of-pocket limits. If you choose an Advantage plan, the insurance company will issue you a member card and all billing for services will go thru the insurance company. You will still have to pay for the Medicare Part A&B in addition to any premium for the Advantage plan but everything will process thru the insurance company so they handle the administrative details directly with Medicare rather than you.

One last thing. If you need Medicare Part D for prescriptions, go to the Medicare website before making your decision. They have an online program where you plug in your prescriptions and the computer program calculates which policy will be the most cost efficient for you in your area.

Truly a brief touchdown into the black hole (and most of which I learned the hard way). In the end I settled on a United Healthcare policy that has a -0- additional premium and includes prescriptions. I feel that I can handle the annual out-of-pocket and it's cheaper for me than paying a supplemental plan premium plus prescription plan.

Hope this helps.