Medicare Enrollment Q's:

So I'ma creeping up on 65 (wow - that can't be!!!) & I'll need to enroll in Medicare. I'm getting ALL KINDS of mail from random companies wanting to sign me up. What's in it for them??? I thought this was strictly government stuff - like Social Security. These other companies are obviously in it for $$.

ANYWAY, WHO do you sign-up through?

It's zip code dependent, as I understand it. For instance, my Dad in New Mexico loves Humana, independent agents here in DFW tell me there's better choices. Lady at work signed up w/ United Healthcare's solicitation, from what she's told me, ($400 month? can't recall the exact number) she's paying thru the nostrils. Medicare Advantage plans were being quoted to me @ $280 / month two years ago. I'll be 67 later this month and still not signed up. As was explained to us, you just need to be covered after 65 to avoid the Medicare late sign up penalty. For us, insurance through her employer is still significantly cheaper.

Talk to some independent agents with no loyalty to one company.

First off, you're not obligated to purchase supplemental medical insurance (I'm sure you know that). Do you currently have medical insurance?
If so, you likely don't need (or want) any supplemental insurance, assuming it remains after you're Medicare eligible.

For example, I'm 57 and my medical insurance covers me 100% unless I have other medical insurance (such as Medicare, coverage from a current job, etc...). If/when I acquire other medical insurance, my current insurance will only cover the deductible of my (now) primary insurance. So it depends I guess.
There are deductibles associated with Medicare. Are you prepared to pay them, or would you rather make a monthly payment to cover some of that?

Those are plans on top of Medicare. Sign up through Medicare (Social Security office). If you want an add-on shop around. I have coverage through my retirement that will be secondary when I turn 65. I do not need an "advantage" plan.

When you turn 65, you need to either sign up for Medicare, or have a qualifying medical insurance that covers you through work or where ever. When you get past the enrolment time frame, the possibility exists that you may need to medically qualify for Medicare, if you don't have existing qualifying medical coverage at whatever point your existing coverage no longer covers you. For instance, my wife is older then I am, she was covered by a very good insurance at her place of employment, that also covered me (at additional cost) until I reached 65. Even after she retired from that place, as long as she paid the retirement coverage on herself, they would continue to cover me at the same rate as before. When I turned 65, that policy ended, and we both had to sign up for Medicare. Because she was covered by an approved insurance plan, delaying the signup for Medicare wasn't a problem for her, but she did have to provide proof of that insurance coverage to Medicare when she turned 65. Had she not had the approved insurance, and had waited to sign up for Medicare, she may have had to qualify for Medicare like you would for starting most any other insurance policy, with medical questions. When you sign up for Medicare at 65, there are no medical questions, everyone is covered.

The time frame from converting from "privet" insurance and Medicare is within 30 days of your 65th birthday. You open one, and close the other, it is one of the more precise government operations out there. You really need to look into your options 60 to 90 days before you turn 65, so your decision can be made by your birthdate.

Most company insurance offers other options for the company insurance policy once you get past 65, they may or may not be a good deal.

Medicare part A (major medical basic coverage, you pay the first 20% up to a limit) is pretty much required, and they take from your SS check $468 (I think without looking) each month. That number is adjusted nearly every year.
Medicare part B (a supplement designed to pick up most of that 20%, +ER coverage and has a few extra perks) is an option you pay extra for, also deducted from your SS check.
Medicare part D (this would be prescription drugs and such) is another option deducted from your SS check.

In IL there are basically 3 companies that have IL approved " Advantage Supplemental Insurance Plan" options you can choose rather then Medicare, during the "enrolment period time frame" that rolls around every year. Its likely your state is set up the same way. You can join any of them when you turn 65, but then have to re-signup when the next enrolment time comes around. I turned 65 in September, I had to enroll in a Medicare approved policy, then when the enrolment period came around in Dec, I had to signup again, and all the deductibles started again.

Those 3 insurance companies are the only options other then Medicare in IL. Everyone trying to get you to enrollee is pushing one or more of those companies, and each of their prices vary widely. I think the current company choices is Aetna, Humana, or Blue Cross/Blue Shield. Each of those companies have a couple of options, every option has advantages and disadvantages, or you can choose to stay with Medicare (with or without the supplement, or prescription coverage). Next year you can choose again during the enrolment time, but starting with one of the insurance companies then going back to Medicare introduces the medical questions. Choose wisely.

If you choose one of the insurance policies, the government will deduct the monthly premium from your SS check and send it to the insurance co.

Poor boy is correct. I also turned 65 I last September. I chose regular Medicare and have to send in the premium. I got a supplement too for cheap. Its only 85 a month or so. I got the prescription plan that is 8.00 a month, even though I don’t take any meds right now. You pay a higher premium at a later time if you enroll as a penalty. My mother in law has Humana plan and is separate option of SS of a private company approved by the government. She does not like it as her premium is higher and some things they don’t pay for. Her deductible is higher as well. I think it’s a rip-off. I advise against it. I had to have a surgery that I put off until I got on Medicare. The bill was $67,000! I paid about $300 and Medicare and my supplement paid the rest. All the supplement policies cost the same and regulated by the gov. All this is so much better than my crooked blue cross insurance. My premium was almost 1500 a month with huge deductible that I never met. The same operation would have cost me 10,000 and blue cross negotiates the price where they don’t pay anything. Good luck.

It is the Federal Gov,
so it is complicated,
and you might want to Hire & Pay For professional help.

Two tips that trip many up:

Tip 1
There are other, lesser cost options, than the Typical Plan A

https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies

Pay attention to Plan K and L as money savers if you are relatively healthy.

Tip 2
If you sign up for Supplemental (like AARP etc)
AT THE VERY FIRST
they must by law give you the lower cost “Community Rating” where they cannot look at your past medical bills
and just go by the national average bills of USA citizens at age 65.

If you sign up for Medicare Advantage Plans first
then get dissatisfied by the many restrictions
and want to switch in a later year back to “Traditional Medicare”
you will have to pay what will probably be a higher premium than “Community Rating” where they can look at your medical history.
This can be a “Big Deal” cost and surprises many.

Medicare Part A is hospital insurance. Medicare Part B is health insurance. Part C is basically an HMO, and Part D is prescription drugs. There are numerous supplemental plans that cover the 20% deductible in Medicare Part A and B.

Part A and B
Part C
Part D
Supplemental Plans

My wife and I live in a rural community and didn't want to take the chance of not being to use medical facilities that aren't in a Part C plan. So we have Part A and B. We both have supplement health insurance plans from different providers. The costs of these plans vary from provider to provider but the coverage is the same as it is mandated by the Feds. Part D, we go to our drugstore and they look at our drug usage, do the research, and recommend a plan.

So far after six years of this arrangement we have only paid about $20 out of pocket (other than the supplemental policies) for a drug that Medicare didn't cover.

my wife and i have a lady that walks us through all these plans every year, then we choose what plan will work for us the best in the coming year.
some times our plans change, sometimes not. it just depends on what medications we are taking, and if a particular plan will cover it or not, and what the co-pay will be.
also, around here, the hospitals are being bought up and absorbed into different health organizations. we need to be sure our plans cover the hospital network[s] and the doctors associated with them.
it can get sticky fast, and without her professional help, we could make a choice that would/could be disastrous for us if something happened.
we both have severe health problems, so going about choosing health plans this way is vitally important for us.
now if a person is reasonably healthy with no pre-existing conditions, it is an entirely different matter choosing a plan that is right for you.

A key point about the MediCare supplemental plans(HMOs) is that U need to choose a primary doctor.
Then he becomes the contact with the supplemental carrier and any specialized treatment is then usually done through their network.
The tough challenge is finding a primary doctor that cares and takes the time to understand your needs.
MediCare is not perfect but in my experience it does work well...
Regarding Part D for prescriptions, good idea to take this up front as if needed later U will pay some significant monthly penalties...

Just my $0.02....

Gee - it all sounds so easy. My wife & I do currently have health insurance through my employer. My wife turns 65 in another 3.5 years approx., so I intend to keep working for at least another 3.5 years. I was told by several friends that I need to sign-up regardless if I need the insurance or not, or else there will be some pretty significant cost penalties. I'm going to seek out an insurance broker who can try to simplify all of this & explain my options. Thanks for all your advice so far. It's still as clear as mud to me.

Here's the scoop straight from medicare.gov

What else do I need to know?

Your 8-month Special Enrollment Period to sign up for Part B starts when you stop working, even if you choose COBRA
or other coverage that’s not Medicare.
If you lose your job-based health coverage before you or your spouse stop working, you have 8 months to sign up.
If you want Medicare coverage to start when your job-based health insurance ends, you need to sign up for Part B the month before you or your spouse plan to retire. Your coverage will start the month after Social Security (or the Railroad Retirement Board) gets your completed forms. You’ll need to fill out an extra form showing you had job-based health coverage while you or your spouse were working.

Choose "check when to sign up" from this linky

Another thought, here locally we have a very active Senior Citizen Center (I think its county). They have people that have been in the "industry" for years there that help explain the processes and the ins and out of it. If your area has such a thing, that might be a good resource. The one here has a generic class, then recommends two different seminars held by different insurance companies (don't sign up for anything until you hear at least a second option)!
Through those processes (total cost of $0 and about an hour of time each, helped us a lot. Then we chose an insurance broker that actually handled all three choices for "acceptable" Medicare options. We chose an acceptable Insurance plan over the gov Medicare for ourselves because it was more cost effective over a 10 year run, for us, in our situation. My wife and I each have different options with the same company because of each of our medical conditions are different.

The only out of pocket expenses for me is the government take for Medicare, and prescription deductible with each 3 month shipment. My wife pays the government take away, an additional $25/ month, and the prescription deductible, which for some of her medications is pretty high. We will look into a different choice for her during the next enrollment cycle, but having both of us through the same insurance makes some stuff much easier.

When you are looking at the prescription coverage, make note that the companies will only give you an estimated cost of each prescription you take. For some of my wife's prescriptions, that estimate was quite low, the real numbers are much higher. There is a thing called a Doughnut Hole that some prescriptions fall into. If one or more of your prescriptions fall into that Doughnut Hole, be ready for a disaster!

Their probably trying to sell you supplemental insurance and Part D for drug insurance.
Medicare started taking their monthly charge out of my Social Security check on my 65th birthday even though I called them and told them I didn't want it due to being cover by my wife's Cal Pers medical benefits for another six months before she turned 65 yrs. old
Our Government is trying to grab every dollar they can from us taxpayers, time for a insurrection like the Boston Tea party LETS GO

[
Our Government is trying to grab every dollar they can from us taxpayers, time for a insurrection like the Boston Tea party LETS GO [/quote]

We haven't seen anything yet on tax increases ---- the federal deficit is over 30 trillion dollars and this administration is intent on increasing taxes in the future. Inflation itself is a tax. Take a look at prices today on almost any consumer good or service and compare today's prices to two years ago. Medicare will continue to increase premiums as they have no choice given they also will pay more for basic goods and services.

Going on 73, Medicare is right around $200 and plan F supplement is $180 drugs is $7. All out of Social Security each month. IF you have major health issues get the Plan F supplement, they pay ALL nothing out of your pocket. If healthy get the one with no payments but the copay. But you’re screwed if something catastrophic shows it self. I had no health problems before 65 after upwards of $600,000 worth of problems, glad I had total payment and piece of mind. I had BCBS first 4 years $$ now CVS-Aetna for half their price. Check around for prices for same sup plan. Medicare pays most all the bill supplement catches what’s left (ripoff), but that’s what cleans you bank out. Luckily I found an independent agent to go over ALL the companies plans not just one.

The problem with Plan F is that it is not available anymore. It is grandfathered to people that had it prior to 2020 but after that it was gone. Plan F paid all the deductibles and the Feds couldn't have that, it made people tend to use health care too much. If you look at the history of Medicare it has been on a constant path to ration healthcare.

I am in the same boat, just turned 64 and everyone I know says to start now getting my ducks in a row. I have no private insurance as I qualified for state sponsored insurance last year, Illinoise is a welfare state after all. It is going to be interesting for me as I plan on moving to another state before I turn 65 so whatever I do in Illinoise won't make any difference in the next state I go to, so it seems that all I can do is go through the Medicare site until after I move, true?

I just signed up a couple weeks ago. If you or your wife are still working and have insurance you don't have to sign up for part B until you retire but you should sign up for part A. It's free and you can sign up on SS online in minutes. They ask the question do you are your wife currently have employer sponsored insurance click yes and it'll let you sign up for A only.

If a person is taking SS you're signed up automatically for A & B and it will come out of you check.

Supplements are different by location and cost are all over the place.

You might look into healthcare.gov to bridge the gap. Depending on your income level last year you may pay nothing for their insurance depending on which plan you select.
I will add that i have been with Aetna for several years and they have been 110% to deal with. I avoid BCBS as they strung me out a few years back

the first two yearsIi went with a supplemental plan that cost about 200 a month. After not really using it (2400.00) but having a lot of other expenses that an Advantage plan would have covered I was out over 4500.00 x 2 = 9K
So the 3rd year Switched to an Advantage plan at 0 cost but a 5K deductible.
I have used 3-4 K of "Free" included coverages ( hearing aids, dental, glasses). So if I have a catastrophic problem and hit that 5K deductible I will break even or possibly be ahead. (Premiums saved + freebies)
Had I done this the first two years I would likely be about 8-10K further ahead ( 2 years premiums + freebies).

Don't make the mistake of not having medicare D or a medicare advantage plan with drug coverage. If you fail to sign up or have coverage it is a lifetime penalty of 1% a month for every month you didn't have it when you do sign up. Lots of people find this out the hard way and at 12% a year for each year it's a big penalty and it's for life. Just missing 3 years will be a 36% penalty.

[quote=second 70]I just signed up a couple weeks ago. If you or your wife are still working and have insurance you don't have to sign up for part B until you retire but you should sign up for part A. It's free and you can sign up on SS online in minutes. They ask the question do you are your wife currently have employer sponsored insurance click yes and it'll let you sign up for A only.

If a person is taking SS you're signed up automatically for A & B and it will come out of you check.

Supplements are different by location and cost are all over the place. [/quote

Both of us are self employed and have insurance through the state, that's why I don't have a clue. Guess it is time to go back to the welfare office and ask them...

It is worth knowing that you do not have to be a Costco member to buy drugs at the Costco pharmacy.

It is worth knowing that long ago the founder of Costco made a decision to sell the cheapest drug available at roughly a 5% markup as “a public service.”
This is a useful way to find the wholesale price of most drugs.

A couple of years ago Costco started a Medicare Part D plan,
but you should always ask the Costco employee “what would this drug cost if I paid cash instead instead of using my plan.”

Walmart decided to “one up” Costco’s policy by making some selected generic drugs “free” and later Target matched that Walmart policy.

I'm guessing the state will make you sign up for medicare and shift it's cost of your health care to the feds. Once you turn 65 even retiree insurance won't pay for charges that medicare would have paid.

Thanks for all the tips & advice. I'm going to find a broker who knows all the ins & outs & go from there.

I thought I saw somewhere there is no penalty if enrolling late if you are covered under the VA system? I get 10% compensation so only I am covered. The wife will probably have to enroll in time to avoid a penalty. We will have health insurance when I retire through work.

Not sure on VA but I also had insurance through work when I retired and once a person turns 65 it becomes a supplement and only pays what medicare doesn't. Better check because you could easily be stuck paying 80% of you're medical bill if you don't sign up.

OK, I guess it is time to go ask at the medicare office...

Be careful of "Advantage" plans. They require that you use only providers that are members. This can be a problem especially if you travel.

we have had humana for some years- we pay 'ZERO' every month, our main doctor is free, specialists , 45buck co-pay - i take '3' drugs, 2 for high blood pressure, n 1 for high cholesterol .... all r sent to me in the mail ,, 90 day supply... my cost 'ZERO'...

i don't understand how it works, but it does...

Advantage plans are nothing more than the old HMO's with a new coat of paint. How well did they work out?