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I'm about to join the Medicare Insurance system and need to make a decision about which type of private insurance to choose for the out of pocket costs that Medicare doesn't pick up.

I think I'm going to enroll with a supplement called Plan F.

Do any of you have it?

If so, are you happy with it?

I'm also considering Plan F - High Deductible. Same plan after a deductible of $2070, but the premium for this coverage is much lower overall.

It appears if you don't go to the doctor very often it's THE way to go as the premiums are less than half of Plan F with no deductible.

If any of you have experience in this arena I'd greatly appreciate your input.

Thanks!

Have you considered joining a Medicare HMO? That way, there's no 20% left to pay that Medicare doesn't, no premiums above your Medicare payment taken from your SS, but the down side is you usually have to go to an approved provider in the plan.

My total medical is $140 a year for doctor visit and tests and $9 every 3 months for medicine; so I went like 20 years uninsured without seeing a doctor.

So, I joined a Humana Advantage plan HumanaChoice R5826-026 (Regional PPO) http://www.senioreducators.com/plans/be ... 3?limit=17" onclick="window.open(this.href);return false; where they pay for health club membership http://www.silversneakers.com/" onclick="window.open(this.href);return false; and $10 doctor visit copay, $30 specialist copay and Max out of pocket is $3,400 per year if major stuff happens(unlike regular medicare where there's no max OOP)

The cost for this Medicare Advantage plan is .... zero more than regular Part B.
It does not cover medicines, but covers much more than plain Medicare Part B..and limits the max out of pocket

Everyone has different needs, what I did may not be for you, but I like not paying any extra over what Part B costs, and I really liked limiting max out of pocket, I haven't decided which health club to join and let them pay for yet ...

Disclaimer: I don't know what senioreducators is, I got it through Medicare's site, but that link explains the plan a bit, and it may or may not be right for you. I'm new to all this and just signed up last July after being uninsured for 20 something years.

Medicare is age discrimination.

Think clearly about your health, your financial position, and then decide. Plan F is generally the most expensive, if you decide on Medigap.

My understanding is that when you hit 65, you HAVE TO go on Medicare. At least that is what I was forced to do when I did awhile back. I have the A, B drug coverage and F. My F coverage was through Blue Cross. Given my health status, pulmonary fibrosis, coronary artery disease, a pre diabetic, I am getting my money's worth. I also suffer from chronic, persistent gluttony. When I had a bad cold and fell in a coughing attack, I crushed a thoracic vertebrae, ended up in the hospital for several days and months of recovery. My out of pocket has been zero for all this, except for some of the prescription medicines I had had to take.

JALLEN wrote:coronary artery disease, a pre diabetic, I am getting my money's worth. I also suffer from chronic, persistent gluttony.

I see a possible connection.

JALLEN wrote:My understanding is that when you hit 65, you HAVE TO go on Medicare. At least that is what I was forced to do when I did awhile back. I have the A, B drug coverage and F. My F coverage was through Blue Cross. Given my health status, pulmonary fibrosis, coronary artery disease, a pre diabetic, I am getting my money's worth. I also suffer from chronic, persistent gluttony. When I had a bad cold and fell in a coughing attack, I crushed a thoracic vertebrae, ended up in the hospital for several days and months of recovery. My out of pocket has been zero for all this, except for some of the prescription medicines I had had to take.

My issue with Medicare, besides having to leave the plan I had been paying for for 14 years, since I retired, which was better than Medicare, is that so many places don't "accept" it. I was feeling pretty bad last Monday, on my day off yet, so I decided to go to a "Doc in a Box" for the sore throat that was making it almost impossible to breathe much less swallow what I was beginning to cough up as the cough developed. Three different "urgent care" facilities refused me service because I am on Medicare (and one of them insisted on calling it "Medicade" over and over despite my constant corrections. I feel that this is age discrimination of the worst sort, I have been an occasional customer at the first one for several years, after firing my last personal doctor, but since my insurance is now Medicare, which I was forced to go on at age 65, I am no longer welcome there.

I went to the emergency room, and was diagnosed with pneumonia, and they of course want me to follow up with a personal physician. All of the family physicians around here are refusing "new patients" on Medicare.

At this point I am feeling very discriminated against.

That's ominous. I went from private insurance to Medicare coverage described above at age 65 and it was seamless. The only thing that changed is that I no longer am asked for co-payments.

I will be moving to pulmonary care at UT San Antonio. I've been seen by the head of the transplant program and Medicare was just fine, no troubles so far.

posse wrote:

JALLEN wrote:coronary artery disease, a pre diabetic, I am getting my money's worth. I also suffer from chronic, persistent gluttony.

I see a possible connection.

Since I have started losing weight, about 40 lbs so far, I am no longer getting calls to be the body double in Wilford Brimley's nude scenes.

JALLEN wrote:That's ominous. I went from private insurance to Medicare coverage described above at age 65 and it was seamless. The only thing that changed is that I no longer am asked for co-payments.

I tried to sign up online, but the system could not accept that I have been retired since 1995 but (was) still covered under the same plan I had been under when employed. Complicating factors were that I had retired from a company that no longer existed (New York Telephone Company) while still having medical from a company that no longer existed (Bell Communications Research) and my coverage was then picked up by three consecutive other companies (NYNEX, Bell Atlantic, and Verizon) and they could not seem to fathom that such a thing could happen in the world.

So the forms I attempted to fill out online first got all screwed up because I could not enter a County or State for my birthplace, which was still within the US, and not one of the islands. Social Security apparently never heard of anyone born in Washington D.C.

And then the forms would not accept that I could have medical coverage under the circumstances mentioned above.

And then the answers suddenly no longer aligned with the questions, so I gave up and tried to phone it in.

The local office denied me because I had started the process online and therefore I had to go through Albuquerque.

Albuquerque referred me to the local office, where a badge heavy kid insisted that my Leatherman type tool was against federal regulations and sent me out to put it in my car, and I lost my place in line, so I had to sit until almost lunchtime even though I was the third person in line at the opening of the office.

Only to be told that "blah blah blah" I had to call the Albuquerque office to finish the process.

And of course, not mentioned in the first contact with Albuquerque was the fact that there is never a live person you can talk to, and call backs can take days, which continued on the second attempt and got worse because now I was trying to contact a specific person, that McKinney had told me I was supposed to talk to, who never specifically returned my call because, in her words, "Yuh kin tawk to ennybuddy tuh doo tha" cutting me off and telling me I was rude when I tried to point out that the local office said I had to talk to HER!

So, because my medical provider cut off coverage a few weeks early (and doesn't that sound like a scam?) and the Social Security Administration played silly games, I actually wound up with no medical coverage for a couple of months (thank goodness it wasn't needed) but they charged me, retroactively, for a month of that coverage.

Maybe SSA is providing the current personnel pool for TSA?

Now my wife is going through the same. Her birthday isn't until next month, but when she went to fill a prescription, her coverage was cut off 29 days before her birthday. But that company has been paid a premium for that month.

jimlongley wrote:

JALLEN wrote:My understanding is that when you hit 65, you HAVE TO go on Medicare. At least that is what I was forced to do when I did awhile back. I have the A, B drug coverage and F. My F coverage was through Blue Cross. Given my health status, pulmonary fibrosis, coronary artery disease, a pre diabetic, I am getting my money's worth. I also suffer from chronic, persistent gluttony. When I had a bad cold and fell in a coughing attack, I crushed a thoracic vertebrae, ended up in the hospital for several days and months of recovery. My out of pocket has been zero for all this, except for some of the prescription medicines I had had to take.

My issue with Medicare, besides having to leave the plan I had been paying for for 14 years, since I retired, which was better than Medicare, is that so many places don't "accept" it. I was feeling pretty bad last Monday, on my day off yet, so I decided to go to a "Doc in a Box" for the sore throat that was making it almost impossible to breathe much less swallow what I was beginning to cough up as the cough developed. Three different "urgent care" facilities refused me service because I am on Medicare (and one of them insisted on calling it "Medicade" over and over despite my constant corrections. I feel that this is age discrimination of the worst sort, I have been an occasional customer at the first one for several years, after firing my last personal doctor, but since my insurance is now Medicare, which I was forced to go on at age 65, I am no longer welcome there.

I went to the emergency room, and was diagnosed with pneumonia, and they of course want me to follow up with a personal physician. All of the family physicians around here are refusing "new patients" on Medicare.

At this point I am feeling very discriminated against.

This has been a disturbing trend for a few years now, but the "Unaffordable Healthcare Act" has made it much worse, and it will continue to get worse. Obamacare is going to kill off medicare. And you can't really blame the doctors. As it was, Medicare was only paying 50¢ on the dollar, or something like that. By 2013, that's going to be about 20¢ on the dollar. A doctor can't pay his janitor on that kind of compensation.

The Annoyed Man wrote:

jimlongley wrote:

JALLEN wrote:My understanding is that when you hit 65, you HAVE TO go on Medicare. At least that is what I was forced to do when I did awhile back. I have the A, B drug coverage and F. My F coverage was through Blue Cross. Given my health status, pulmonary fibrosis, coronary artery disease, a pre diabetic, I am getting my money's worth. I also suffer from chronic, persistent gluttony. When I had a bad cold and fell in a coughing attack, I crushed a thoracic vertebrae, ended up in the hospital for several days and months of recovery. My out of pocket has been zero for all this, except for some of the prescription medicines I had had to take.

My issue with Medicare, besides having to leave the plan I had been paying for for 14 years, since I retired, which was better than Medicare, is that so many places don't "accept" it. I was feeling pretty bad last Monday, on my day off yet, so I decided to go to a "Doc in a Box" for the sore throat that was making it almost impossible to breathe much less swallow what I was beginning to cough up as the cough developed. Three different "urgent care" facilities refused me service because I am on Medicare (and one of them insisted on calling it "Medicade" over and over despite my constant corrections. I feel that this is age discrimination of the worst sort, I have been an occasional customer at the first one for several years, after firing my last personal doctor, but since my insurance is now Medicare, which I was forced to go on at age 65, I am no longer welcome there.

I went to the emergency room, and was diagnosed with pneumonia, and they of course want me to follow up with a personal physician. All of the family physicians around here are refusing "new patients" on Medicare.

At this point I am feeling very discriminated against.

This has been a disturbing trend for a few years now, but the "Unaffordable Healthcare Act" has made it much worse, and it will continue to get worse. Obamacare is going to kill off medicare. And you can't really blame the doctors. As it was, Medicare was only paying 50¢ on the dollar, or something like that. By 2013, that's going to be about 20¢ on the dollar. A doctor can't pay his janitor on that kind of compensation.

Makes me think I should get the money I paid into the plan back.

Thanks everyone for your input.

By electing to go the HMO or PPO type option instead of Plan F, (from what I've read here) I'll have access to a pool of doctors that WILL accept me. I was trying to avoid this approach as I thought I would have greater independence with Plan F.

If I understand correctly, my idea of going the Plan F option may not work very well now as many doctors (if not most at this point...) aren't accepting new Medicare patients.

On the face of it, Plan F sounds like greater independence, but NOT if it isn't accepted...so to have medical care I'm almost forced into going the HMO option.

Is my assessment accurate?

Thanks!

Abraham wrote:Thanks everyone for your input.

By electing to go the HMO or PPO type option instead of Plan F, (from what I've read here) I'll have access to a pool of doctors that WILL accept me. I was trying to avoid this approach as I thought I would have greater independence with Plan F.

If I understand correctly, my idea of going the Plan F option may not work very well now as many doctors (if not most at this point...) aren't accepting new Medicare patients.

On the face of it, Plan F sounds like greater independence, but NOT if it isn't accepted...so to have medical care I'm almost forced into going the HMO option.

Is my assessment accurate?

Thanks!

Front office people at doctor's' offices should know the difference in Medicaid and Medicare, but I'm not surprised many do not.

My "INSURANCE card" (Part B replacement-Medicare Advantage Plan) I present to doctors/hospitals front office people says
"HUMANA
HumanaChoice (Regional PPO)
A Medicare Health Plan" <-(smaller font)
Below that it says
"Copayments
Office Visit $10
Specialist $30
Hospital Emergency $65"

And my name, member ID etc.

I'd bet most doctors take "Humana PPO" if asked, even if the front desk person doesn't know the difference in Medicare and Medicaid.

The way I found it on Medicare's site is I entered that I wanted a ZERO amount more than already paid for Part B. They deduct enough already from my SS check and I have never actually used Medicare yet (I went 20 years without seeing a doctor) I might get all those "tests and checkups" next year. I got PSA and all sorts of blood tests last year, they said I'm healthy and will probably die for no reason at all some day. Doctor asked what I do to stay healthy and I said I don't take Prescriptions that have side effects and I avoid doctors who prescribe them ... he said keep it up, seems to be working.

But, I wanted to avoid a bankruptcy if all sorts of stuff happened ... Medicare B has no max out of Pocket; this plan Max out of pocket $3,400 per year. (But doesn't cover the prescriptions on this particular plan and I can't see paying $35 a month for one which reimburses part of the $9.00 I spend 4 times a year)

Oh. I have not found ANYONE in my city or surrounding cities who don't take my plan, my primary doctor's front desk and insurance people said their patients seem pleased with the plan I got (I checked with "my doctor" before getting it to be sure he'd get paid and accept it and ask what might be better)

Honestly, I don't know much about plan F and the other stuff, I've been Part A covered and "eligible for Part B" for years, but just started Part B/Advantage plan in July 2012 .. I started Part B because the "penalty" for not having it kept growing.

But I don't imagine my "Humana PPO Insurance card" will get a second look anywhere like a "Medicare card" might; and the additional cost to me was zero, but with health club memberships and additional available benefits not provided by Part B (which I don't use yet anyway)

So, I'm probably not the best to advise, haven't researched a LOT, but I'm happy so far. I simply wanted a no-ADDITIONAL-cost-to-me limit on my Maximum out of pocket (Mom had Leukemia, Dad had a couple types of cancers, Thyroid he beat, and 30 years later lung)