The Medicare Thread

[Bunion 2020]

To clarify, in my post UHC was=universal Health Care or Medicare for All, not United Health Care. Sorry for any confusion.

[jm2e]

/\ /\ /\
Yea, in my case management job, I use UHC for United Health Care. As in, “Heads up, they have UHC MCR, it’s going to be a pain in the ass!”


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[Harry]

You started this thread two years and five months ago (it's been very helpful, thanks for that), questioning what to do when you reached medicare eligible age. This makes it seem like you chose wisely.

I chose traditional Medicare with a medigap supplement.

$170 per month for Part B (deducted from Social Security)
plus
$200 for supplement (Part D included)
————
$370 per month total



Monthly nut is large, but between my bad heart plus ortho problems like my knee from a lifetime of living like a badass, I would rather pay more per month and not get stuck with surprises.

My medigap supplement is from the same place as my Part D drug plan (AARP), so I pay $200 per month for both, but I don’t know offhand the breakdown.

This is by far the best insurance I have ever had.

[Bunion 2020]

^^^ I went Trad. Medicare as well. My premium is $ 185.00.
Supplemental is Part G with CIGNA @ $ 123.00
Took a bit of a hit on my Aetna Part D, went from 13.00 in 2024 to $41.00 in 2025.

total $ 349.00

Also the most I have ever paid for the most comprehensive insurance I have had. I am healthy currently, fingers x-ed.

I do want to point out that these decisions were made following the advice offered by Cono Este before he lost his mind.

[Cono Este]

Thanks Bunion.

These part d plans are a bit of a mess. Wellcare has a 0$ plan here, and some other states, but I heard that was mistake. They got sacked with all these changes and some plans left, and some plans hiked premiums, but some didn’t have time to file changes.

I’m also seeing less choices in insulin. They want you on the cheap shit for $35, not nice, but makes sense.

[Bunion 2020]

Was told my Part D increase was due to the IRA and the attempt at lowering prescription drug costs. Totally my fault for not checking the mailing Aetna sent out in the end of September.

[liv2ski]

Initially in 2024 I went for the straight Medicare and paid for a couple of supplements that were not too expensive and being in good health so far didn't cost me anything in copays.
This year I switched to an advantage plan with Sharp as it was a really great deal, no supplements to pay for and so far great coverage, as I was sicker than shit in January and everything worked out really well.

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[mcski]

Was told my Part D increase was due to the IRA and the attempt at lowering prescription drug costs. Totally my fault for not checking the mailing Aetna sent out in the end of September.

You pretty much have to check part D every single year because the MO is to start cheap and increase at renewal time and since most people don’t check it increases w auto renewal. I pretty much had to get a new plan every year for my dad to stay at the lowest cost. Most companies would increase and just add a new low cost plan for the next batch of new customers

[mcski]

Initially in 2024 I went for the straight Medicare and paid for a couple of supplements that were not too expensive and being in good health so far didn't cost me anything in copays.
This year I switched to an advantage plan with Sharp as it was a really great deal, no supplements to pay for and so far great coverage, as I was sicker than shit in January and everything worked out really well.

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I can’t even begin to say how bad advantage plans are compared to traditional Medicare. A good chunk of those horror stories you hear regarding UHC are Med advantage plans. Never any issues though w Standard Medicare

[Harry]

I’m really lucky that I am able to get one hundred percent of my healthcare from Mayo Clinic. I am locked into their system and I love it. Best care I have ever received by far.

Interesting fact: Mayo Clinic takes traditional Medicare, but they refuse to take any patient with Medicare Advantage. That should tell you something.

[muted reborn]

Thanks for all the info from everyone here - we moved my Mom off Medicare Advantage to Medicare yesterday. Medicare Advantage is some evil shit.

[Nobody Famous]

You pretty much have to check part D every single year because the MO is to start cheap and increase at renewal time and since most people don’t check it increases w auto renewal. I pretty much had to get a new plan every year for my dad to stay at the lowest cost. Most companies would increase and just add a new low cost plan for the next batch of new customers

This is true, partly.

The other, and bigger point to consider for each Part D plan is the plan's Formulary. The short definition of Formulary is it's a list of which drugs the plan covers. The lists change each year and not all plans cover the same drugs (sort of the exact opposite of original medicare + a medigap plan where all medigap plans cover the same thing).

If you don't want to put time in this yourself to compare the options yourself then talk to a good agent each year at time of renewal, they will know what questions to ask and how to look up whether the drugs you take are currently or will be in any plan. You want the plan with the total cost of ownership is the least, for one year, given covered drugs, tiers and copays and plan premium. Don't look at only plan premiums.

[Bunion 2020]

^^^ This is good advice. That good agent doesn't cost you a cent and who else really has the time and energy to understand all the ins and out?

[2bjenny]

So, one of my coworkers and I have been trying to figure out plan B when retiring. We’re federal employees, FEHB plan. I’m on BC/BS. My plan would be to sign up for A when it’s time and then continue my FEHB plan after retirement. What’s the best way to determine to sign up for B? Does it make sense to not sign up for B if the cost is more than the monthly employee premium for the FEHB plan? Drop the federal plan and take B? Continue to carry the FEHB plan and sign up for B?

I’ve been reading through the thread and it’s very helpful. I understand that a person has 12 months to sign up for B after first becoming eligible, but it confuses me with having the option to stay on the fehb plan after retirement. Lots of folks advises to not give up our fed insurance when retiring, but others say drop it and sign up for B. Is the decision basically driven by the cost of FEHB vs B?

[bobz]

^^ replying to liv2ski:

The main purpose of health insurance is to protect you from really, really big health problems. Proper Medicare (with a supplement plan) covers those (yeah, other than long term care, which Advantage doesn't cover either); Advantage puts you at the mercy of corporations that will have a big incentive to deny the most expensive healthcare scenarios. Of course, people who have small problems or no problems are going to be happy either way, and the companies want to keep you happy because healthy customers are a gravy train for insurance companies. And they save you a bit of cash, not much, but that can matter a lot if you're poor. If you aren't poor, pay a little more for the very best health care program this country has to offer.

[Gepeto]

I have been skimming this thread since its inception and set a few traps for my agent when the time came (thanx you assperts). She came through with flying colors.
.
I have Medicare B&C with G as my supplement from Mutual of Omaha.
.
Medicare B&C $177 (went up 6$ this year)
Part G runs me $164 (up 9$ this year)
Annual Deductable - Zero Copay $260 for 2025 (up 20$ from 24)
No drug support, but I have never taken cronic use prescription drugs.
.
GT - $341 + $260 annually
.
Should I be concerned about the drugs needed during my next serious impact?
.
Script Fentanyl and Morphine cannot be cheap.

[mcski]

Goodrx and Cuban’s cost PlusPharmacy may cover your needs at best cost overall.

[bobz]

You should have some kind of Part D regardless. The cheapest one is probably around $200/year now, and will be far better than zero coverage if you’re in for a bad health surprise.

[m2711c]

jeezus... what a complicated pile of shit. thank god we ain't socialist. imagine how bad that must be?

[Bunion 2020]

You should have some kind of Part D regardless. The cheapest one is probably around $200/year now, and will be far better than zero coverage if you’re in for a bad health surprise.

Yes indeed.

The Medicare Part D late enrollment penalty is a monthly premium add-on that's calculated based on the number of months someone was eligible for Part D but didn't enroll. The penalty is permanent and is added to your monthly Part D premium.
How it's calculated

The penalty is 1% of the national base beneficiary premium
The penalty is multiplied by the number of uncovered months
The result is rounded to the nearest 10 cents
The penalty is added to your monthly Part D premium

How it changes

The penalty is recalculated each year based on the national base beneficiary premium

The longer you wait to enroll, the higher your penalty will be

How to appeal

You can appeal the penalty or the amount of the penalty

You can request a reconsideration by completing an appeal form from your plan and sending it to C2C Innovative Solutions
You can include any evidence you have, such as proof of creditable drug coverage
The deadline to appeal is 60 days from the date you received the letter about the penalty

[mcski]

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Straight Medicare w a supplement is about as easy as it gets. A thousand times more straight forward than any private plan and once you’re signed up w the proper supplement you never have to worry about a medical bill again ever

[Nobody Famous]

You should have some kind of Part D regardless. The cheapest one is probably around $200/year now, and will be far better than zero coverage if you’re in for a bad health surprise.

Fully agree you should have a Part D plan as soon as you're age eligible. Even if you do not use it, in which case it becomes a placeholder to avoid late enrollment penalties later if life, that persist for life, should you enroll then. As in the blurb Bunion quoted.

Correction on the cheapest plans, they cost $0 per year this year. I have one of these plans. It went down from $6 per year (50 cents per month) last year. It's perfect for a placeholder. I'm sure costs probably depend on state and zipcode. As always you can look up costs (and drugs covered) on medicare.gov.

[whipski]

FWIW I buy meds directly from India at huge savings.

[Nobody Famous]

In the last week there’s been a lot of news and chatter about very big Medigap plan rate increases. This is the time of the year when annual rate increases are announced.

What I read is increases of 10 to 12% are the absolute low end. The high end is 40%, (Mutual of Omaha in Illinois). My N Plan went up 15.4%.

If you have 30 minutes to spare here’s a fairly decent YT video explaining it all, https://www.youtube.com/watch?v=6RAJc4XkuS0. Let’s refer to this as the Senior Savings Network Guy.

There’s some drama injected into that video, slightly more than the usual go to YouTube Medicare peeps (the Senior Savings Guy being one), like the story on the 77-year old couple who retired to FL.

I’ll give the senior savings network guy credit because his past predictions and reasoning on future rate increases, which he mentions a few times, across the different plans (F vs. G vs. N), seem to have held true. Even across a two-year sample timeline.

Per the video the reasons for the big rate increases are, 1) the usual medical care inflation, and 2) people delayed care, checkups and medical procedures, during covid -- think the millions of people having medicare and medigap plans stayed home.

When Covid shutdowns wound down people resumed checkups and medical procedures. Over the past two to three years the costs for all that delayed care worked through to the medigap carriers. Taking into account in any rate increase requires filings with each state’s regulatory agency, plus resulting approval cycles, the increases in costs to the carriers are just now working their way into the retail costs of the plans.

There’s one very highly useful detail in the video, especially so for those already signed up and on a medigap plan. At 03:40 the the senior savings network guy lists all the states with anniversary rule/birthday rule guarantee issue (GI) rules in place. I posted a summary of states with birthday/anniversayr rules above but that's now outdated. More states have enacted GI rules. And a few more are moving in that direction. If you are in a GI state, or in a state considering expanding GI issue, you have options for seeking out a less costly plan. The flipside in this is everyone in the GI states pays proportionally more for this benefit in the form of higher rates acorss all plans and all zipcodes. Or will pay more if the states considering expansion do so.

[mcski]

I’m surprised by the comment regarding deferred check ups. All indications I saw was that everyone took advantage of time at home to schedule doctor appts.