Medicare Madness! Why is it so difficult to find the right medical plan?

by Ron Wayne
(Gainesville,Fla. )

My mailbox and emails are overwhelmed with these solicitations.

My mailbox and emails are overwhelmed with these solicitations.

When I accepted the modest early retirement offer from my employer last fall, I didn’t anticipate the cost of medical insurance after I turned 65.

I focused on being sure I could pay the huge sum for health coverage from the time I retired until August when I turn 65 — a total of nine months.

I continued my employer’s excellent Aetna HMO plan, but it cost me $800 a month for four months.

In March, I got an Obamacare plan for $400 a month with my considerable subsidy from the government because of my relatively low income. The legislation passed by the Democrats this spring increased the subsidy, so I’m paying $288 for the final three months.

The total bill has wiped out the early retirement incentive and a few bucks more. But thankfully these plans have covered a lot of my medical bills this year, including the full cost for both cataract operations (Aetna HMO).

But in my zeal to retire from a job that was simply not a good fit, I didn’t think how much health insurance would cost after I turned 65. I might not have budgeted enough for it.

I long had this incorrect thought that Medicare would be free, or at least not more than the required premium for Medicare B, which is $148 for most people, including me.

Now I find that if you go the preferred route of Medicare A, B instead of Medicare Advantage, the Medigap or supplemental policies can easily add at least $100 or more a month to your Medicare B. And you want such a policy because there is no lifetime limit of what you could owe without it. Finally, you also need a drug coverage policy!

I’m still deep into trying to figure out this stuff with the clock ticking before I must choose.

The cheaper route in most cases is a Medicare Advantage plan. But there are negatives that concern me. Unlike the traditional Medicare, the administrators of these HMOs and PPOs have some say in your health care. They can second-guess your doctor! They also can compel you to use or at least try alternative drugs from what your doctors suggest. And rates can jump annually.

Although I’m thankful to all the elected leaders who pushed through Medicare, it has become needlessly complicated, and part of the reason is because they later allowed these Advantage plans, which are essentially private companies that cut corners on costs.

Anyone who is nearing 65 will know about the abundance of solicitations from companies such as Humana, United Healthcare and WellCare. A young woman representing a company came to my door, which is actually not allowed.

I was fortunate to have someone suggest getting help through the SHINE program. I’ve had two sessions so far with a counselor. At this point, I also think I will try an independent insurance broker.

I have enough health concerns but not enough money that I must be extremely careful in what I choose. Wish me luck!

Comments for Medicare Madness! Why is it so difficult to find the right medical plan?

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Free Health Care In Canada?
by: Bruce Hackert

Canadians are quick to boast about their "free" government run health care. We all know or should know, nothing is free. Our free health care cost us dearly and far too often lets us down.

Free health care is only useful if it is available. Far too often hospital are overflowing and long waits are common for elective procedures. Canadians die waiting for medical care. Delayed or mis diagnosis is all too common.

I equate free health care to a merchant advertising free shoes with every pair of socks. You rush in, only to find the free shoes are not available.

With health care being so scarce and hard to get, any Canadian that goes through the system with success is grateful for our "world class health care system".

Like citizen of most countries, Canadian's are proud of our country and tend to puff it up even when the evidence points out glaring deficiencies.


Wendy: My mothers best childhood friend died a few years ago, cancer, and simply had to wait for treatment. Mom never understood why she wasn't getting help. The friend was resigned to knowing it wasn't her turn yet... she died. So Sad.

medicare and drug plans
by: Carol from West Chester

Being healthy I did not take a drug plan when I started Medicare. I did take a supplemental plan.

My mistake not taking a drug plan. Starting years later there is a lifelong penalty fee each month for not starting a drug plan within a month or so or retiring. My penalty is something like $16 per month and that adds up. And the suppl plan cost does increases each year. About 10% is the increase. Prepare for these expenses.

Also, I suggest having a senior center or some place like that, not a salesperson, help you find the best plans at the least cost to you.

At first, I balked and cancelled a consult call with the senior center. Then I thought, oh well, it is free do the consult. The consult asked for my current plan/company and quickly found me two much lower drug plans.

We worked together, I was on my computer, and we input my current meds into two programs and chose the least expensive with the same benefits. You need to consider the monthly premium and how much the diff tiers pay for your medications.

Again, I was going to balk and not change my plan (over the phone) but then I said ok, change my plan and email me the info. Now I pay $50 less a month for my drug plan. I was paying for a tier that at this point in my life I do not thankfully need.

Afterwards, I called and thanked the appointment person who had encouraged me to talk with a consultant. Never think you know everything is what I found out about myself.

Plus I am saving $600 a year!

SHIP Counselors
by: Tracy/Midwest

Before I retired I used to be a SHIP (State Health Insurance Program) counselor. The Medicare & You book will list the SHIP in your state. They have a FREE service to answer your questions.
They do NOT get a commission so there is no sales.

You are correct in your research so far. The Medicare Advantage plans are very easy to get into however they are PPO/HMO so network-related.

The Medicare supplements are more per month but more freedom. You can get riders so you only have your Part B deductible per year. If Medicare covers 80% the supplement covers 20%.

These plans allow you to get in without underwriting when you first join Medicare, up to 6 months. You really don’t need to look at the plan again once you join a supplement.

Yes you do need a separate D plan for meds. The SHIP can enter in your meds and tell you the best D fit for your meds for 2021. You have to check annually to make sure you are still in a good D plan for your meds.

Med Insurance
by: Georgia

Retired in 2014. Lady in my office told me to try Humana. Her husband has multiple issues and Humana worked for them. The advantage plans Humana offers varies state by state/county by county.

I have Humana Choice PPO. I pay NO monthly premium, have $1000 deductible, primary doc visit $20, specialist, $50. I even go out of state to South Carolina for treatment for breast cancer. My meds at tier 1 level are free. I certainly am happy with my medical insurance.

Check out if Humana is in your area.

by: Sherry/ NC

Never, ever assume anything. If you don't understand something just ask. It doesn't cost anything to ask.

Here in America we have Social Security and Medicare agents who can answer our questions. This is the direct source to go to. Make an appointment and see them they are the experts.

Yes, you can see an insurance broker regarding supplemental insurance if you so desire. Medicare pays 80% and the supplemental will pay 20%. If you are healthy you may choose not to purchase the supplemental, but if you have to go to a hospital,$$$$$$$$, your 20% will be expensive.

Good luck to you and don't worry.

Help us!
by: Anonymous

This is very concerning to those of us reaching 65 soon so if any of you out there have advice we would love to hear it!

by: Jeanne Savelle/Atlanta

Try AARP free resources. Ask friends who have been through it. You'll find the right option for you.

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