Medicare Open Enrollment

[John Ranalletta]

As plan benefits within the plan types (G, H, N, etc.) are identical, consider checking out alternative supplemental (MediGap) coverage.  I'm switching underwriters starting Jan/23 for a monthly savings of $70/mo.  Other savings possible in part D coverage.

 

We considered a local Advantage plan but decided against for a couple of reasons that may be be germaine for you.

 

YMMV.

[MichiganBob]

It's really complicated to figure out what is the best course of action as each decision has some risk. When I retired, my employer continued by Blue Cross/Shield coverage at a minimal monthly cost but wanted more than $900 a month for my wife to be on the policy. We both have Medicare so this is a supplemental plus Medicare does not cover for dental, vision, hearing, ambulances and some other services. We found a person who created a model based on my wife's health data, prescriptions, vision, dental, etc., call it a regression analysis where you try to forecast the future based on the past and present data and then find the best path. The analyst then took the model and compared about 40 different plans and combinations of plans to see how that best fit my wife's projected future needs. We ended up with three different insurance providers for different services. No way could we have figured this out on our own and so far it is working out okay. There was no fee for this service as the analyst gets a commission from the carrier.

[Scott9999]

12 minutes ago, MichiganBob said:

It's really complicated to figure out what is the best course of action as each decision has some risk. When I retired, my employer continued by Blue Cross/Shield coverage at a minimal monthly cost but wanted more than $900 a month for my wife to be on the policy. We both have Medicare so this is a supplemental plus Medicare does not cover for dental, vision, hearing, ambulances and some other services. We found a person who created a model based on my wife's health data, prescriptions, vision, dental, etc., call it a regression analysis where you try to forecast the future based on the past and present data and then find the best path. The analyst then took the model and compared about 40 different plans and combinations of plans to see how that best fit my wife's projected future needs. We ended up with three different insurance providers for different services. No way could we have figured this out on our own and so far it is working out okay. There was no fee for this service as the analyst gets a commission from the carrier.

Wow, that's a guy I need to find.  

 

We have a convoluted plan that combines Medicare with Medicaid (don't ask, it's a LONG, long story, beginning back in 2011 when California unilaterally cancelled my personally owned "Cadillac" health/dental/vision plan for our family of four, the day I was diagnosed with heart ailments, requiring "emergency" surgery which then had to be delayed 2 months, and kindly replaced it for me with a barebones Obamacare health-only policy covering just the wife and me for 25% higher rates, to the point where we were later covered with only a "medi-share" plan because Obamacare hit $2500 a month, a share plan which kicked in only after we applied for Medicaid; and have been trying to get away from that ever since, but they keep shoving Medicaid money at me, so 🙄😖).  We're going to move into some Medicare plan A+B+D thingy, right now focusing on an Medicare Advantage plan covering the B+D, featured by USAA.   Yep, it's all very confusing, and confusion invites ... mental paralysis.

 

I can wait until tomorrow to decide and make the move(s), or ... maybe the next day, possibly even the next week ....

[Rougarou]

I'm good, the VA treats me extremely, extremely well.  I'm glad I don't have to go through those messes that you all have to deal with

[John Ranalletta]

27 minutes ago, MichiganBob said:

It's really complicated to figure out what is the best course of action as each decision has some risk. When I retired, my employer continued by Blue Cross/Shield coverage at a minimal monthly cost but wanted more than $900 a month for my wife to be on the policy. We both have Medicare so this is a supplemental plus Medicare does not cover for dental, vision, hearing, ambulances and some other services. We found a person who created a model based on my wife's health data, prescriptions, vision, dental, etc., call it a regression analysis where you try to forecast the future based on the past and present data and then find the best path. The analyst then took the model and compared about 40 different plans and combinations of plans to see how that best fit my wife's projected future needs. We ended up with three different insurance providers for different services. No way could we have figured this out on our own and so far it is working out okay. There was no fee for this service as the analyst gets a commission from the carrier.

Bob,

 

I get it.  My situation is relatively simple, i.e. virtually no meds and no big health issues.  OTOH, my wife could open her own pharmacy.  A Type 1 diabetic, most costs (pump, pump supplies, insulin) are covered under Part B.  The rest of the Part D.  Then, there's the dreaded donut hole which goes away in '25 in lieu of a $2.5k max copay.

[Scott9999]

2 hours ago, Rougarou said:

I'm good, the VA treats me extremely, extremely well.  I'm glad I don't have to go through those messes that you all have to deal with

Supposedly, I have some kind of VA medical care available, but every time I try to figure out eligibility, it seems like I have to give away all I own, and show upon on the VA's doorstep, naked, homeless, penniless, and desperate enough to throw myself upon the VA's  tender mercies.  So ... uhh ... pass.

[taylor1]

VA doesn't base coverage on what you own. Only on your yearly income. I have both VA and Medicare. I use VA 90% of the time

[Rougarou]

I don't recall giving up my income to the VA when I started going and use them exclusively.   I had Tricare Prime, then when they got rid of that outside a 50 mile radius of a MTF, dropped to Tricare Standard (which ain't bad either), then the VA opened a clinic close by, so I started going to them and have been happy ever since.  

 

 

[scout6]

This is an interesting and timely topic.  I have ended up with a BCBS Medicare Advantage plan as part of my retiree package from the state of Michigan.  I have TRICARE for Life earned through military retirement.  Finally, I have VA coverage over just about everything due to being considered 100 percent disabled.  I keep reading about the hazards of the Advantage plans not approving things that should be covered through MEDICARE.  As things have shaken out, if I use the BCBS plan in conjunction with TRICARE, the later picks up the amounts the former does not pay (copay and deductible), leaving me with no out of pocket costs.  When I use VA (sometimes a pain to get things approved in a timely manner), I see no costs.  Of course medicines are interesting, as VA will cover all of them, but is hard to get quickly, without a few hour round trip to the pharmacy.   So, BCBS picks up the "get this prescription on the way home" stuff, but TRICARE's pharmacy does not pick up the copays - still figuring this out.

We just added Susan to the TRICARE coverage, and will wait to see how that works out (she has the BCBS full insurance from my civilian career).  She will not be on the same TRICARE as I am on, so the learning continues.

[taylor1]

30 minutes ago, Rougarou said:

I don't recall giving up my income to the VA when I started going and use them exclusively

You are retired military. I do not know all of the specifics, but I do know they have different coverages for combat vets. retirees etc.
I did not retire from the military but qualified for benefits. I have to make co-payments on meds. and services and the amount of my payment is based on my yearly income. Just 2 weeks ago, I sent them copies of my and my wife's 2021 returns so they could make determinations. They evaluate every year on me. It is cheaper for me to use the VA than Medicare. The only time I use Medicare is when I need to see a specialist quickly, and that has only happened once. KOW

[Scott9999]

21 minutes ago, taylor1 said:

You are retired military. I do not know all of the specifics, but I do know they have different coverages for combat vets. retirees etc.
I did not retire from the military but qualified for benefits. I have to make co-payments on meds. and services and the amount of my payment is based on my yearly income. Just 2 weeks ago, I sent them copies of my and my wife's 2021 returns so they could make determinations. They evaluate every year on me. It is cheaper for me to use the VA than Medicare. The only time I use Medicare is when I need to see a specialist quickly, and that has only happened once. KOW

Pretty much my situation, re: military.  4 years active, 11 years Select Reserve (i.e. weekend warrior plus periods of extended active duty, CONUS and overseas), and the rest of 22 years inactive reserve.  Not enough time in for retirement, but that's OK.  I joined to serve my country, and I did, not for the bennies.  When I was promoted to 05, I was already commuting 3000 miles each way to "weekend drills" on my own nickel, and it was only gonna get worse since most reserve billets (i.e. Navy jobs, MOS equivalents) for guys like me, were all over the country, unless I reported to a "volunteer training unit" and sharpened pencils all weekend. 🙄  I had fun, served in all kinds of units from shipboard, to SEALs, to SEABEEs, to office jobs.   It just got to be too much time and work, away from my "real" career and family, and again, at that point every nickel I earned went into travel to keep the job.

 

So, anyhow, yeah, VA medical is my fallback option.  I've told my family that if I develop a debilitating disease (like Alzheimer's), I'll divorce my wife, give her everything in the settlement, and ask 'em to drop me off at the nearest VA facility as an indigent.  😏  (That, or it's time for that one last, fast, Beemer ride ....).  I just won't have everything we worked for, for a lifetime, go up in smoke to the medical community, so that I can spend the last 18 months or whatever as a comfortable vegetable, so that my WIFE can be indigent. Naw, life don't work like that, not my life, at least.

[MikeB60]

1 hour ago, Rougarou said:

I don't recall giving up my income to the VA when I started going and use them exclusively.   I had Tricare Prime, then when they got rid of that outside a 50 mile radius of a MTF, dropped to Tricare Standard (which ain't bad either), then the VA opened a clinic close by, so I started going to them and have been happy ever since.  

If you are more than 50% there is no co-pay regardless of income also applicable for service connected issues even though the total percentage is less than 50. 

[Rougarou]

31 minutes ago, taylor1 said:

You are retired military. I do not know all of the specifics, but I do know they have different coverages for combat vets. retirees etc.
I did not retire from the military but qualified for benefits. I have to make co-payments on meds. and services and the amount of my payment is based on my yearly income. Just 2 weeks ago, I sent them copies of my and my wife's 2021 returns so they could make determinations. They evaluate every year on me. It is cheaper for me to use the VA than Medicare. The only time I use Medicare is when I need to see a specialist quickly, and that has only happened once. KOW

 

6 minutes ago, MikeB60 said:

If you are more than 50% there is no co-pay regardless of income also applicable for service connected issues even though the total percentage is less than 50. 

 

I guess I shoulda paid more attention to the retirement briefs

 

 

[MikeB60]

1 hour ago, scout6 said:

This is an interesting and timely topic.  I have ended up with a BCBS Medicare Advantage plan as part of my retiree package from the state of Michigan.  I have TRICARE for Life earned through military retirement.  Finally, I have VA coverage over just about everything due to being considered 100 percent disabled.  I keep reading about the hazards of the Advantage plans not approving things that should be covered through MEDICARE.  As things have shaken out, if I use the BCBS plan in conjunction with TRICARE, the later picks up the amounts the former does not pay (copay and deductible), leaving me with no out of pocket costs.  When I use VA (sometimes a pain to get things approved in a timely manner), I see no costs.  Of course medicines are interesting, as VA will cover all of them, but is hard to get quickly, without a few hour round trip to the pharmacy.   So, BCBS picks up the "get this prescription on the way home" stuff, but TRICARE's pharmacy does not pick up the copays - still figuring this out.

We just added Susan to the TRICARE coverage, and will wait to see how that works out (she has the BCBS full insurance from my civilian career).  She will not be on the same TRICARE as I am on, so the learning continues.

 All TRICARE enrollees move to TRICARE for Life at age 65.  DyAnne just moved from TRICARE Prime to TRICARE for Life last year. DyAnne had to enroll in Medicare B and just as in the case with your BCBS plan, TRICARE for life pays for the copay and deductible not paid by Medicare B.  I'm going with the VA once I turn 65, no since in paying for MEDICARE B when I am eligible for free health care from the VA.      

[scout6]

I have found that VA Healthcare is really a hit or miss thing in my part of the woods.  One clinic for a very large area, and appointments not so easy to get.  Using the Mission Act for services not available through VA has worked well for pain management shots and new hips.  Basically, they own just about all medical care for me due to disability.  Started Tricare for LIfe at 60 for the same reason.  One thing to be cautious of are the places that are not accepting Tricare.  Doc wanted me to go to a new MRI company.  BCBS, but no Tricare.  Knowing what people accept is important.

[taylor1]

The one headache in using the VA is that if there is no VA hospital close with different specialist, you have to use in community. These are Docs. that accept VA payment. Problem that I have seen is that your primary has to see you, agree, and set up the appointment, which is not usually a quick process. Thats where my Medicare comes in. I can set up my own appointments with the many more Docs. that accept Medicare. Alot of Docs. don't accept VA because of paperwork and slow process of getting paid. My wife works in our county hospital and says they hate working with the VA because of slow payment. Keep in mind also, that if you don't take Medicare at 65 and decide years later you want it, or it could be an advantage', it will cost thousands to enroll. I was enrolled with the VA before 65 and when I turned, they automatically enrolled me.When I asked, they explained all the pros for me, and really no cons. I know everyone's circumstances are different, this just works good for me.