Medicare...maybe we should have stayed home

[SuzzeeeQ2012]

well, we're at Lake Pleasant heading in the next week to Quartzsite or maybe Glamis, not sure.

hubby is already enrolled in Medicare, turning 65 in December. We got the material before we left. So..that's ok. We don't have a supplemental, OR Part D med coverage. We're from Washington..is it possible to do this on the road stopping at the local Social Security office?

also, I found out the other day that I don't have 10 years (40 credits) of work history, so there's a question whether or not I can get Part A coverage when I'm elligible in 3 years. I've read two things...I can qualify under HIS 32 years, or I can't and I'm going to have to pay $244/month for Part A hospital coverage :M

All these years, and I never heard that I have to have 40 credits for Medicare sigh

So, I guess I find work at the age of 62, AFTER I retired, and I don't really want to do that, as I already DID retire urgh

[covetsthesun]

I am 64 and have Medicare envy. I have a private ins policy through United HC. 5k deductible with a 16k stoploss, 70/30 policy. Thought I was having a heart attack in June and stayed one night in the hospital for observation. My portion after insurance was still $5000.00. I pay about $450 a month. That's still better than anything I was offered on Obamacare. However, If it had been DH on his Advantage plan... the bill would have been quite minor.

Medicare isn't a rip off. It is a blessing. It does however have costs. Part D is not perfect by any stretch. Since Medicare can't negotiate prices we are all at the mercy of big Pharma. Write or call your rep's.

Going without a partC or supplement leaves you exposed to major out of pocket expenses since PtB does not have an out of pocket limit.

Single payer is what many gov't types have been trying to get done for decades. Everyone has gov't insurance and the gov pays the bills. And controls what is and isn't covered. And...who. And for how long.

I would rather take my chances with 3rd party pay. United Health Care is pretty good to deal with.

cts

[Scottiemom]

Well, Medicare has been a blessing for us. My DH has been on disability since he was 50. He was able to get on Medicare two years after that. Yes we had to pay for part B and the supplement. For many years, we had to pay for his drugs because there was no Part D. His drugs cost us over $6000 a year JUST FOR MEDS. He was worth it though 😉

Now with the Part D plan, we pay around $600 in premiums and co=pays for all his generic meds.

Fortunately, he was able to get very good medical care. He's even been through cancer treatment and his insurances all paid for his care. Medicare a rip-off? I don't see that.

Now we are both on Medicare, have the AARP United Healthcare Supplement, a Part D plan and we continue fulltiming, traveling for the last 11 years. We are covered wherever we go.

The Part D plans I have found need to be re=evaluated every year. It seems they give you a really good rate for one or two years, then hike up that premium the next year. You have to be alert to that and make the change to another plan.

If your meds are new and not covered in the formulary, take the formulary in to your doctor and have them look through the list of approved drugs to see if there is one or a combination of drugs that can be used to substitute. I know down here in the Rio Grande Valley, the doctors want to put you on the latest and greatest meds which are way too expensive for the average retiree if the insurance won't pay. I went through this with my Dad and I just flat out told the doctor they could not afford those fancy meds that cost more than their SS every month. Surprisingly there were other options.

If you think Medicare/supplements/drug plans are expensive, try being hospitalized for a week or going through cancer treatment.

Dale

[1968mooney]

I'm sure you know, no one is making you purchase a supplement. Just pay out of your pocket and avoid the supplement charges. :S

[CKNSLS]

SuzzeeeQ2012 wrote:

bbaker2001 wrote:
yes AARP is a supplemental plan, but check the price against others.
yes to Do not wait to sign up for prescriptions, they will penalize you

true.

so we called today the Medicare help line in Washington.

The copays are EXXXXXPENSIVE no WONDER people go to Los Algodones!!!


for 3 months on the meds my husband is on, it's a $300 copay.:E

$1200/year for medication.



oh, the premium is only $18/month though. BIG.DEAL.

what a RACKET!! :mad

Have you checked what you actually PAID in to Social Security vs. what your collecting? Maybe after you do this you would know who's getting ripped off!

[Gjac]

NeverHome2 wrote:

bob_nestor wrote:


Be very careful with the low cost Medicare Advantage plans as typically the low cost ones come with very high deductibles. If you're healthy and don't see the doctor frequently the low cost plans can save you money, but be careful.

This is good advice! We have a friend that had $0 plan and went to the hospital for a routine procedure. While there he contracted a staph infection that extended his stay another 8-9 days. He is now paying off a $60,000 hospital bill. Not fun when you are over 65 and don't have a job!!

. All of the advantage plans that I have seen have a max out of pocket cost which on average were $ 6000. I have seen them from $5700-$6700 in Ct.

[Dutch_12078]

SuzzeeeQ2012 wrote:

I find Medicare to be a total ripoff. We worked all that time for Hospital Part A. B you have to pay for, and the supplemental is MORE than the 80% that Part B payments cover. For 20%, you pay more than Part B payments. RIP OFF

Our out of pocket costs for my wife's cancer treatments came to just under $3000 over two years. The total billings were over $250,000. I'd call that quite a bargain. Our United Healthcare Medicare Advantage Plan costs nothing except the standard medicare deduction from our SS checks.

[2gypsies1]

SuzzeeeQ2012 wrote:

I find Medicare to be a total ripoff

...and what would you be paying out if you didn't have Medicare?

[BarbaraOK]

SuzzeeeQ2012 wrote:

I find Medicare to be a total ripoff. We worked all that time for Hospital Part A. B you have to pay for, and the supplemental is MORE than the 80% that Part B payments cover. For 20%, you pay more than Part B payments. RIP OFF

You have some unrealistic ideas of what insurance is all about. Did you expect to have 100% with no copays, etc. for anything? Is so, then you really didn't pay attention to what was happening for the past 50 years. Yes, you pay some each month for Part B. Was your insurance before you retired such that you never had a co-payment or never had to pay deductibles/pay part of the premium? Remember, when Medicare was first introduced, the big bills were for hospital care, because you could only get treated in a hospital. Now, most people never go to the hospital, they are treated as outpatients. So the structure has been amended over the past 50 years, but it isn't perfect.

You don't have to buy a supplemental insurance for Part A & B. In fact a lot of people, who are relatively healthy, have done the calculations and found out that they are better off not buying supplemental insurance but paying out of pocket.

As for Part D - the drug plans. That one was a total screw up by the Congress - - a real gift to the insurance companies and big Pharma. So, have you written your senators and representative with your complaints about it? And what was their response?

Barb

[SuzzeeeQ2012]

what is single payer?



I find Medicare to be a total ripoff. We worked all that time for Hospital Part A. B you have to pay for, and the supplemental is MORE than the 80% that Part B payments cover. For 20%, you pay more than Part B payments. RIP OFF

[s_N_s]

Johno02 wrote:
Welcome to the government insurance mess, SS & medicare. You have no idea what you are getting into. Good luck! Wait till you try to find supplimental insurance policies that will cover you wherever you are.

That's funny, I haven't had any problem with this. Take a deep breath and relax. You should be fine once the time comes. As suggested check with AARP. You can find some info on there site.

[Me_Again]

Anyone ready of a single payer plan for everyone?

[NeverHome2]

bob_nestor wrote:


Be very careful with the low cost Medicare Advantage plans as typically the low cost ones come with very high deductibles. If you're healthy and don't see the doctor frequently the low cost plans can save you money, but be careful.

This is good advice! We have a friend that had $0 plan and went to the hospital for a routine procedure. While there he contracted a staph infection that extended his stay another 8-9 days. He is now paying off a $60,000 hospital bill. Not fun when you are over 65 and don't have a job!!

[SuzzeeeQ2012]

So metformin no longer worked? What was his A1C running at over the past year? I ask because a lot of people are moved into new, high price drugs when a simple adjustment of their older generic would be just as effective and sure cost a lot less.

That said, when Dave had his stents put in, he was place back on Plavix, and it was then still a proprietary drug and we had to pay a lot each year until it became generic. It was like getting a pay raise when the generic version, Clopidogrel, was released. We are fortunate that all of our medications are generics.

Did you also look at Express Scripts - mail order pharmacies are often cheaper and Express Scripts has a Part D plan. We like having all of our maintenance meds through ES - order once every 3 months (Rx written for 90 days, with 3 refills) and have them sent to where ever we are or to our Escapees address - which ever is easier. Works very well for us.

Barb

his A1C is always around 7.8 or sometimes a bit lower. we can't use mail order on the road so far...it's been a little irritating. They've been mailed to home, then we have to figure out a place for our daughter to mail them to us. We've waited a few places while waiting, and one package never came 😞 the Dr. did say that he could put him on Tradjenta (no generic there yet either wonder if that's eventually coming) which is a tier 3 drug instead of 4 or 5 like the Januvia...maybe that would help...


a rude awakening awaits all people when they turn 65 if they've had a great plan through their employers. We paid MAYBE .20 per prescription after our deductibles were met each year.

[BarbaraOK]

SuzzeeeQ2012 wrote:

BarbaraOK wrote:
Obviously these are not generic drugs. Is there no generic drugs available for your husband?

Yes, name brand drugs are expensive. And $100/month isn't out of line if the meds keep you living.

How many Part D plans did you check? Walgreens, Wal-Mart, CVS, Costco, etc., all have Part D plans. Some better on some meds, some better on other meds.

Barb

not for Januvia which is over half of the co-pay...

we are going through a person that is helping us find plans in our area...so far 2 have matched....Transunion is the cheapest so far.

So metformin no longer worked? What was his A1C running at over the past year? I ask because a lot of people are moved into new, high price drugs when a simple adjustment of their older generic would be just as effective and sure cost a lot less.

That said, when Dave had his stents put in, he was place back on Plavix, and it was then still a proprietary drug and we had to pay a lot each year until it became generic. It was like getting a pay raise when the generic version, Clopidogrel, was released. We are fortunate that all of our medications are generics.

Did you also look at Express Scripts - mail order pharmacies are often cheaper and Express Scripts has a Part D plan. We like having all of our maintenance meds through ES - order once every 3 months (Rx written for 90 days, with 3 refills) and have them sent to where ever we are or to our Escapees address - which ever is easier. Works very well for us.

Barb