23 Replies Latest reply on Apr 27, 2011 8:30 AM by JerryD

    Medicare

    abeckwith

      Do people have any suggestions as to what company offers the best additional coverage to Medicare in Rhode Island?

      Why do you recommend the particular company that you suggest?

      Thank you,

      ABeckwith

        • Re: Medicare
          drb3475
          Sorry, I don't have an answer for you, but I have a similar question:

          What company offers the best additional coverage to Medicare in Massachusetts?

          Why do you recommend that company?

          I live in eastern Mass. and have easy access to HMOs like Harvard Vanguard Medical Associates and Tufts Health Plan, as well as the usual commercial Medicare extender companies like AARP, BC/BS, and so forth.
            • Re: Medicare
              KatC

              I am STILL in the dark about medicare and will turn 65 later this year!  I don't trust the SS employees or website to give me the correct answer!  I will be working another 3 years and covered by my employer's lousy insurance plan.  Do I need to sign up for Medicare at all?  Part A perhaps?  If I don't sign up, is there a monthly penalty when I do go into Medicare?  I'd rather get the answer from some of you than from user-unfriendly websites!  Thanks!

                • Re: Medicare
                  worth249

                  I would like answers to your questions also.  My husband is retired and could get medicare but is on my health insurance since he has multiple health problems.  My mother also has many health problems and is on medicare and part B (??) and has little out-of-pocket medical expense.  We wonder if medicare would be better for him . . . or not?!? 

                  Anyone else in this position?  I would like to hear from someone in the "know."

                    • Re: Medicare
                      jkom51

                      It's recommended signing up for Medicare as soon as you are eligible. If you miss the 7 mo. window (from 65th BD), you will have to pay a penalty for Part B, effective immediately and for all future years.

                      Once enrolled in Medicare, your insurance becomes the secondary insurer; e.g., Medicare pays first, then insurer pays, and anything remaining is your responsibility. Your insurer should be notified when you receive your Medicare card so they can properly adjust their billing process.

                      I suggest you carefully read the information on this website, especially the second section "When to Sign Up for Medicare". You can use this link: http://gotoretirement.com/2009/05/medicare-eligibility-when-sign-up/

                      If you have any questions after that, talk to your HR dept. and check the Social Security/Medicare website at: http://ssa.gov/

                        • Re: Medicare
                          JRVohs
                          This medicare deadline only applies if you are not covered by other insurance from your employer.
                            • Re: Medicare
                              milfordwoodardsn
                              At what age can I apply for medicare and what about preexisting conditions
                                • Re: Medicare
                                  JerryD
                                  I believe that the answers are 3 months before reaching 65 and only a small number of situations like liver dialysis can be counted as preexisting INITIALLY for the desirable MediGap supplemental insurance addition. If you get in a supplemental plan and then change, I believe that they can force you through underwriting on the supplemental which brings up restrictions due to preexisting situations.

                                  There is some lengthy and fairly clear (for government documentation) on the process. Find it on the Internet or request from a big company like Blue Cross/Blue Shield.
                                    • Re: Medicare
                                      milfordwoodardsn

                                      I went online to ssa.gov to apply for medicare and a message appeared saying you must be 61 and 8 months.

                                      I will check again.

                                       

                                      Thanks

                                      Milford Woodard

                                        • Re: Medicare
                                          JerryD
                                          I may have interpreted your question too narrowly in regards to special disability situations. I also may have missed on the liver dialysis situation. Here is what I found right from the horse's mouth (CMS that runs Medicare): http://www.cms.gov/OrigMedicarePartABEligEnrol/

                                          I also found an excetion for drug coverage: "eligibility for the Low-Income Subsidy (also called "Extra Help") available under the Medicare Part D prescription drug program".

                                          I am definitely not an expert but the Internet is very helpful. Just be sure the source seems credible and understandable (the GOV fails on this point frequently).

                                          PS: You might go to the "Community" message board and request that the Community Manager have an expert add a Medicare piece in the "Resources" message board.
                                          • Re: Medicare
                                            Philipas
                                            You are confusing Medicare eligibility date with the early retiremaent date for Social Secuity benefits.
                                              • Re: Medicare
                                                Gregorio46

                                                I recently turned 64 but will probably continue working for the next few years.   However, I keep reading that, regardless of whether or not I continue working or apply for Social Security at 65, I should apply for Medicare 3-4 months before turning 65.

                                                Should I do this even though I am covered on my employer's health insurance?   What is the benefit to me of applying in this manner?    Are there costs or other considerations in terms of my health insurance coverage?  So far, the websites I've visited, including the government's Medicare website, haven't clearly addressed these questions.  

                                                Thanks,

                                                Greg S.

                                                  • Re: Medicare
                                                    peters43
                                                    There's a permanent fiancial penalty for not signing up for Medicare Part B when you become eligible.  You may have the penalty waived if your employer demonstrates that you have had coverage between your first eligibility and now.  Since you're not yet 65, you should go ahead and sign up for Medicare when you become eligible.
                                                      • Re: Medicare
                                                        Gregorio46
                                                        Thank you!   This brief reply is actually very helpful
                                                          • Re: Medicare
                                                            peters43
                                                            You're welcome.  We baffled our way through the maze this year (and my wife is an attorney!).  We worked out an arrangement where her employer (through which we had health insurance for years) reimburses our Medicare premiums up to the amount they would have spent on insurance for us.  When we retire, we will be on our own with Medicare costs.
                                                              • Re: Medicare
                                                                Gregorio46

                                                                Recently, I asked the community, as I approach 65,  what I should do about registering for Medicare even though I am still employed and covered on my employer's health insurance.  Here is a very helpful reply to this question directly from Medicare:

                                                                Thank you for visiting medicare.gov. This is in reply to your question regarding if you can wait to apply for Part B benefits, due to your coverage through your current employer.

                                                                 

                                                                If you a currently working, and you have group health coverage through your employer, you can wait to enroll into Medicare Part B, without incurring a penalty. A Special Enrollment Period is available if you wait to enroll in Medicare Part B because you or your spouse is working and you have group health coverage through a current employer or union. If this applies, you can sign up for Medicare Part B:

                                                                 

                                                                -While you are still covered by an employer or union group health plan, through your or your spouse's employment, or

                                                                -During the 8 months following the month when the employer or union group health plan coverage ends or when the employment ends (whichever comes first).

                                                                 

                                                                Most people who sign up for Part B during the Special Enrollment Period do not have to pay higher premiums. However, if you are eligible, but do not sign up during the Special Enrollment Period, you will only be able to sign up during the General Enrollment Period and the cost of Part B may go up.

                                                                 

                                                                Most people do not have to pay a premium for Part A, because they or their spouse has at least 40 credits of Medicare covered employment. Medicare covered employment is when Medicare taxes are withheld from your paychecks. One credit of Medicare-covered employment is equal to 3 months. 40 credits of Medicare-covered employment are equal to 10 years.

                                                                 

                                                                If you do not receive the Part A premium free, you can choose to purchase the coverage. For those who must pay for Part A:

                                                                 

                                                                -The monthly premium for people having 30-39 credits of Medicare-covered employment is $248 in 2011.

                                                                -The monthly premium for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 credits of Medicare-covered employment is $450 in 2011.

                                                                 

                                                                Everyone must pay for Medicare Part B if they want the coverage. Part B is medical insurance that covers doctors’ services, durable medical equipment, and hospital outpatient care. For 2011, the standard Part B premium is $115.40 per month for beneficiaries who file an individual tax return with annual income of $85,000 or less ($170,000 or less for those who file jointly).

                                                                 

                                                                Even if you keep working after you turn 65, you may want to consider signing up for Medicare Part A. If you have health coverage through your employer or union, Part A may still help pay some of the costs not covered by your group health plan. However, you may want to wait to sign up for Medicare Part B if you or your spouse are working and have group health coverage through you or your spouse's employer or union. You would have to pay the monthly Medicare Part B premium, and the Medicare Part B benefits may be of limited value to you as long as the group health plan is the primary payer of your medical bills.

                                                                 

                                                                If you work for a small company (less than 20 employees), you should talk to your employee health benefits administrator before making any decision not to take Medicare Part B. If your employer has less than 20 employees, Medicare is the primary payer and your group health insurance would be the secondary payer.

                                                                 

                                                                You can apply for Medicare benefits 3 months prior to the month of your 65th birthday, the month of your 65th birthday, or 3 months after the month of your 65th birthday. To apply for Medicare benefits, please contact the Social Security Administration (SSA). The SSA handles Medicare Part A and Part B eligibility, enrollment, disenrollment, and premium issues. You can reach Social Security at 1-800-772-1213, from 7:00 am to 7:00 pm, Monday through Friday, or visit your local Social Security office, for additional assistance. For the office closest to you, try the field office locator at http://www.socialsecurity.gov/locator.

                                                                 

                                                                If you need further assistance, please feel free to e-mail us again. You can also visit us on the web at www.mymedicare.gov to review personalized information about your Medicare coverage. Other useful resources, such as Frequently Asked Questions (FAQs), can be found at www.medicare.gov. Or you may call us at 1-800-MEDICARE (1-800-633-4227) to speak with a representative. TTY users should call 1-877-486-2048 for assistance.

                                                                  • Re: Medicare
                                                                    garyh911
                                                                    When you are 65 and qualify for Medicare, if you choose to live outside the US, Canada and Mexico, is there any way to get medical care through Medicare other than returning to the US periodically?  I plan to retire in Germany and the cost for private insurance over there at my age would be prohibitive.
                                                                      • Re: Medicare
                                                                        EJG
                                                                        Hello, gary911.  Excellent question.  I am planning to reside as a permanent retired resident in Scotland and would also like to know whether the US Medicare that I will have signed up for will cover me there as well as here in the US.  I need to research
                                                                        my options if not, but as you mentioned of your own experience, I fear that private
                                                                        insurance will be too costly.
                                                                          • Re: Medicare
                                                                            JerryD
                                                                            EJG, I believe that I read in a recent book on world healthcare systems by T. R. Reid that England covers you even as a non-resident there. Would Scotland do the same?
                                                                              • Re: Medicare
                                                                                EJG
                                                                                Hi, JerryD, and thanks for your reply.  I do need to research this,
                                                                                but my gut [no medical pun intended :)] reaction is that the NHS
                                                                                are having some serious fiscal problems themselves [although I
                                                                                don't believe the straits are as dire as those of Medicare at the
                                                                                moment].  As a result, while I would love it if there were some
                                                                                sort of  reciprocal agreement between the UK and the US regarding
                                                                                medical care for non-citizens, I doubt it's that easy.

                                                                                I would think that Medicare ought to be happy to pay for my
                                                                                medical care in the UK, as the cost of care there is lower, and,
                                                                                as an added bonus to the US,  I would not be using US medical
                                                                                facilities, which are understaffed and burgeoning with patients
                                                                                as it is.

                                                                                I just turned 63, so I have 21 months or so to do my Medicare/NHS
                                                                                research.



                                                                                  • Re: Medicare
                                                                                    jkom51
                                                                                    Medicare does NOT cover ANY overseas healthcare costs. Period. Sorry to say so, but that's how it is.
                                                                                      • Re: Medicare
                                                                                        EJG
                                                                                        Thanks, jkom51.
                                                                                          • Re: Medicare
                                                                                            Schmuzan
                                                                                            I am presently collecting Social Security and will be applying for Medicare in the next few months.  I am completely confused about Medicare - especially Part D (the Rx portion) - my understanding was that Medicare merely regulates the pricing but doesn't cover payment and you need to purchase additional/supplemental insurance.  For A & B, is Medicare considered the primary and the supplemental insurance (e.g., BCBS) considered the secondary?  What steps do I need to follow to do this?  (I just turned 64.)  Any advice would be appreciated.
                                                                                              • Re: Medicare
                                                                                                JerryD
                                                                                                Schmuzan said...

                                                                                                     
                                                                                                ...What steps do I need to follow to do this?  (I just turned 64.)  Any advice would be appreciated.      
                                                                                                                

                                                                                                Medicare, supplemental and Part D is typical government, less than clear. But they do have tools that allow you to research specific plans. The fact that you are on SS will get you automatically enrolled in basic Medicare and probably provide a stream of marketing info from a number of plans.

                                                                                                I am on Medicare with a BCBS supplemental and a Part D drug coverage from a 3rd party since my drug needs are low now. The Internet is a fabulous place to educate yourself followed by attending the marketing presentations put on by providers. I found the BCBS presentation very informative and there was no pressure to sign up but all forms were there for the taking. First, I suggest that you go to the Medicare site and orient yourself: https://www.medicare.gov/Default.aspx

                                                                                                Just be aware that your initial choice is flexible and has some change capability. Once signed up, your medical condition may force you through underwriting which is another way of saying they can say no to the change (but you can never lose your current plan, so don't worry about lose of coverage). So do your research before jumping in but also take advantage if the competition and your good health to upgrade coverage and cost as you learn.