Medicare

Hi all,

I have not a stupid question but reflects my stupidity for retired Americans plz.

Since my job is to stay home and take care of my 90 year old mom, I elected to file for retirement at 62 even though I'm capable of holding down a job. I don't get paid for it because my mom would have to pay out of pocket first.

Ive been on Obamacare without any copay or premiums but since I turn 65 this year I'm being flooded with info on supplemental insurance to Medicare. I'm reluctant to respond to any of it because I know it will result in another flow of exaggerated info.

So can someone tell me do we have to buy supplemental insurance? Do I have to drop Calif. healthcare for Medicare at 65? One offer is telling me they will deduct from my itty bitty check to pay for Medicare.

I have tried to understand Medicare for my mom's sake but the books we get refer to each other. The Medicare book sez services offered depend on her supplemental insurance and her supplement sez all services comply with those approved by Medicare.

So it's my turn and I'm as confused as ever.

Thanks,

Charlotte

Chark63,

I can tell you from my ex-wifes experience with that. Roughly from her 1171 social security check take home, they are taking out roughly 250 for Medicare and AARP supplimental insurance to cover the 20 that Medicare does not.

I'm currently assisting her with applying for Medicaid as she can no longer take care of herself due to stroke, Vascular Parkinson's Disease, and type 2 diabetes. She now requires 24/7 care as she is not safe on her own.

I don't know if supplimental insurance is required, but it may not be a bad idea if you are racking up prescription and medical visit costs. It might be a good idea to contact social services. I would suggest you get a social worker involved as they understand the rules better than anyone. They have been wonderful helping out the ex. Unless someone else here has a better suggestion. Hope this points you in the right direction.

Bain

no, as far as i understand things, nothing requires you to buy the supplement...since you live in cali....who knows

im not sure of your states laws esp cali, but in most cases if you are on state paid "medicade" and become eligible for regular "medicare" either by age or 2 years post disability then you will most likely be put on medicare. most folks that have been employed have "paid in" to social security and thus medicare. think of medicade as a kinda "welfare" ...you were on welfare but now you are eligible to start drawing your "own" paid in money. hope this makes sense, and its just my take on how things have worked for me.

Bain,

Thanks for the info. I see I am due for a rude awakening! I only make 603/mo because I have to wait 4 years before my ex is at retirement age and I mostly stayed at home with the kids.

Of course I've been floating around w no cares dreading the day mom passes but not saving anything.

The government is going to stick it to me. I'm also trying to get my license back as I now have a car that hasn't been tagged for 2 yrs and insurance is required as well.

Much easier to exist with blinders on as a non-entity.

I will be contacting social services. That's state or social security? I've called them for mom before and yes they were helpful

Thanks again, Charlotte

Well that's a positive way to look at it. And you've given me the makings of a plan!

Ill just continue to take care of mom the best I can which is what I've already been doing and keep us together the next 4 years til I can be a normal citizen and draw on the commitments I made in my previous life.

And that is also what I've been hoping for.

Thanks, Charlotte

I am not sure where you will find this but look up ServiceLink -- there is at least one in every state and it is free -- it is a gov't aide program just for that type of info. My neighbor is in charge of the one here and i can get more info when she returns from vacation

The supplemental, or Pt. B, pays most of what Medicare doesn't pay. I don't know Calif. regulations. You can call or research it online.

Hi Charlotte, My retirement issues....as well as my friend's might help you understand the ins and outs of Government....a little more clearly.

First....my friend Tara...Lived in Pa, and was disabled at a young agein her 30's. ( issues with Ulcerative Colitis/ Ostomy Diabetes)

She was"disabled " when she moved to Fla, and received benefits there, ( about 900 a month.) plus medicare. ( state's version of medicaid) .as well as100 coveragethrough a state provider of surgical drug supplies ( She had a partner, who passed away, but they never married, and Fla does not recognize common law).

When she became too ill a few years ago, her sister moved her here ( to NJ) where we both live.When Tara reached age 65. she was automatically swiched toMedicare ( which only covers 80 of Medical. She had to "purchase" the related state approved supplemental insurance ( Blue Cross/ Blue Shield / Horizon / appropriate for those who are on Medicaid).It'svery complicated... EVERY STATE HAS IT"S OWN RULES and NAMES for the SAME THINGS!!!

Everyone in the country is elegible for Medicare at 65, even if yourofficial retirement age is 66/and a few months.

My story is a bit different.I was fully employed until I began having medical issues that kept me from working. When I qualified for Disability, I began to receive benefits, butI had to wait 2 years, before being elegible for Medicare.I think I was 58 when I qualified. At age 65 II was autimatically switched into the Medicare program....and had to purchase supplemental insurance to cover the 20 medicare doesn't cover.....and the drug plan that I could afford.My drug bills are very high ( insulin is expensive)and prior to medicare I was paying about 50 of my drug bills out of pocket. That was about 10,000 a year.Now that I'm on official "Medicare", I pay about 5,000 out of pocket for the year.

Be aware that the Governmentdoesn't stand by what you are told on the phone ( regarding Medicare/ Medicaid benefits )unless you have a scheduled appointment....( phone or in person) to document what they tell you. I found that out the hard way.So be aware!Sorry this is so long.. but it's a complicated issue.One has to know the right questions to ask, to get the answers you need/ want!!

Best of Luck to you Marsha

You are not required to buy supplemental insurance. If you have high medical or prescription costs then it could be cost effective since medicare only pays 80. You will need to do the math and add in a best guess. There are many plans with both medical and drugs and plans with only drugs or medical. Go only line to Medicare.gov and look at the plans, then decide based on your expected costs. I have been choosing a drug plan for my Mother since they became available, and needed to change several times based on the cost. So remember to check if year if you go with Part D. She is currently taking 7 drugs and the cost is very low.

Hi CharK,

I do have Med Part B coverage. It runs 20 dollars a month here in Ohio. You are well advised to attend a Seminar on the subject.

Although they are put on by providers, they are bound, by law, to tell you the "truth" in their presentations. The presentations will

help you understand the Part B programs. That will make you decision making process much easier. You will also feel more comfortable

with your decision.

Best regards

CharK63 No you do not need to drop your healthcare. When you turn 65 it should roll you over to Medicare. My husbands insurance automatically put us in a Medicare Advantage plan when we both turned 65. I do not know what would happen with yours but it would not hurt to ask. You need to go onto Medicare.gov and it will explain everything you are looking for if you have a computer. If not maybe attending a seminar or maybe Elder services could give you some help in this area. Also on your social security you can qualify for up to half of what your husband's payout would be even if you never a worked a day at all. But I do not know if you would have to wait until his kicks in, again you would need to ask. There are

plenty of people that will help you.Now that you are eligible for Medicare ;you definitely need to sign up otherwise you could face a penalty.

Best of luck to you.

When you get on medicare at age 65, does it cover ostomy supplies or only 80? How much do you pay out of pocket for bags?

Yes, it does pay for your ostomy stuff. I have never seen a charge for the bags but just the stuff that they consider not a necessity, like the odor spray, etc. But as I stated we are in a Medicare Advantage plan and not just medicare. Your best bet would be to go to Medicare.gov and ask or check with your physician, they would be able to tell you. Good Luck and hope this helped.

Thank you all for the info even though it's all different. I had no clue what was going on with my moms insurance when she first hit the "donut hole."

It hit in the month of May and she had to pay full price for her rx til December that year.

It boiled down to the 4 name brand rx she was taking out of 14 total rx. I struggled with making the decision on what to do about it though it would have been a no brained for myself.

I studied the information on the inserts and was amazed at what I learned about results of drug testing.

The drug actos first was tested on only 800 people and the second run was on 1500. And then I read the tests conducted were the results of people that took aspirin with actos compared to those who don't take aspirin.

When I finally called the office a nurse said "just give her an aspirin every day.

She was paying 600 a month for this!That is completely insane!

Anyway I got generics for one and ordered from Canada for 2 so they don't run up her insurance share of costs at all. I read the US patents last 20 years but other countries sell generics in ten or less years.

She has type II diabetes.

I did all that research and learned a lot but when reading the darn benefits books my eyes glaze over and I just don't seem to absorb a single word. And I can't help but complain that if I only make 600 a month and now have to pay for insurance I will never be able to support myself independently.

Like I said though I can draw on my husbands when he reaches retirement age. It was our joint decision for one of us to stay home with the kids and even though I had a college degree he made more in a factory without a high school diploma. Ah well, such is life and there's nothing new here.

As a matter of fact I'm preaching to the choir right now aren't I. I might as well complain about Donald Trump!

Just kidding! I promise! I'm not! I wouldn't dare!

Thank you all very much,

charlotte

I cannot believe I'm soon to be 65 years old! I don't feel like I'm 65 even though my body is breaking down now.

I was one of the flower children who tried to change the world! How did I get so old?

charlotte

Hi Char when i was young i didnt think i would live to 50, with partying, wrecking cars, riding motorcycles but here i am turning 66 in a few weeks, as for medicare i had the same reaction trying to understand it so i signed up for a seminar and it helped some but was still too much info so i read the booklet and read it some more and made a couple phone calls to figure it all out. good luck

Thank you Ron,

I do know one thing, I'm going to take advantage of my current insurance and I have 6 months to do it.

My colostomy was the result of dental problems. I had to wait until Obamacare added dental benefits to get a tooth pulled but the dentists who accepted it were backlogged for months. I went to my gp for antibiotics and Vicodin each time it flared up.

Once I finally got the tooth removed it was really bad and I got jammed up from the Vicodin until I exploded.

I had symptoms 3 times in the year I was waiting but Since got well after a couple of days, I didn't think I needed go to ER until my colon ruptured, I was fully septic and my kidneys failed. I'm lucky to be alive.

The dental coverage my mom can get is too expensive and only covers routine care and xrays so I'm going to eliminate the need for that insurance I hope and get full dentures. I am SO fearful of the dentist I can't believe I'm asking for this!

charlotte

I read all that didnt understand any of it.?? Seems like you have to jump through hoops to get anything a Uni degree to understand why you got it. So pleasedI live in UK . ... we have aNational Health service very little Private Insurance, althougnthis is available if youfeelyou ;need it .

Hi Everybody!

I have been on hiatus for the last 6 weeks and I used some of that time to get a sort of handle on the medi care situation.

We are eligible for Medicare 3 months before our 65th birthday. If we are receiving social security checks we will automatically be enrolled. If not, we have to sign up or we will be fined late enrollment fees.

It seems that though we are not required to buy supplemenal insurance it is pretty much expected to offset costs not covered by traditional Medicare.

Ive never been denied services on my state health plan but I think that is because the staffs only ask for things they know are covered. I think this because when I ask any of my medical staff they say That's great you are getting Medicare because they cover so much more!"

As far as the cost of supplemental insurance there are charts at the back of the Medicare book that itemize the monthly fee, doctor visit co-pays, specialist co-pays, the amount of deductibles and so on.

I saw one agency as low as 9 a month but the other costs were higher.

I feel I learned enough to make a decision ;now and hope I've clarified the issue somewhat. I'll let you know what I decide and any more tricks they have up their sleeve. But I'm not paranoid. I just don't trust the government, now more than ever.

Supplemental insurance is not required but can be cost saving! It you have traditional Medicare, part A (hospital only)is free and Part B ( all other medical care)cost about 135 a month and only pays 80 of you care leaving you 20 which is a large amount. There is no maximum amount so a supplemental plan will cover that 20 but it will cast you about 125a mont in addition to your traditional Medicare cost. But if your medical needs are great, which all of ours are, it is well worth the cost and a great savings. If you choose a Medicare Advantage plan, it pays the same as traditional Medicare but has a maximum out of pocket per year that varies with the plan but about6500 per year. You are not allowed to have a supplemental plan with and advantage plan. So taking outtraditional Medicare with a supplement plan will cost much less per year and you will not have people billing you constantly and having to figure out how to pay the bills. You must also find a part D plan for your prescription. Combination plans like are called plan E and F. The difference

This is to add to my last post( not a user friendly reply) The difference between E and F is that one of them you have to pay the Medicare deductible and the other you do not. I was a case manager/Patient Advocate for a large Oncology practice and this is what I did for my patients. Explain the choices and get them assistance if needed.

Puppylup

Thanks for that post Puppyluv. You make it sound like I can even grasp it. I'm not looking forward to dealing with any of it and 60 is a very short time away, ugh!

Hi Mrs A.

You mentioned 60. That is your age? Are you applying for Social Security disability? If you are, you will get your Medicare approximately 2 years and 5 months from your disability date. You have the same options of traditional Medicare or an Advantage Plan but unless you are 65, you cannot purchase a Medicare supplemental plan. It seems dumb but that is the law.you can have other insurance like a spouse that is still working like I do. That makes your Medicare secondary to the private insurance. If you have other retirement insurance you Medicare would be primary and the other insurance secondary. They really try to make it as difficult as possible right!?'