Medicare and supplemental plans

[Frwinkley]

I will be retiring from teaching in 3 years at age 63. My health, dental and vision insurance will continue for my husband and I until I hit age 65.

I am beginning to investigate Medicare costs, supplemental plans, etc. I teach in PA where PSERS (the PA retirement pension system) offers supplemental plans. My DH and I are both in very good health, take no prescription meds (at this time).

I'm just trying to get a ballpark of what people pay per month (I realize this is extremely individualized).

I know Medicare Part B will cost us each about $175 per month, but was curious how much people were paying for supplemental coverage.

Sure makes me appreciate my employer-provided insurance.

 

[lucas]

I was employed by a university in the State of Florida system. An option was to continue with the employer-provided insurance as the supplement. So, I decided to stay with the same insurance, which includes the same drug coverage.

It is expensive, but I just stayed with the same for now. If you don't stay with it at the time of retirement, there is no option to go back at re-join it at a later date. But, I can always switch to something else in the future if I want to.

 

[tvguy]

Do you live in area with Medicare Advantage Plans? Those are private plans where Medicare pays a private insurance company to take you off their hands. Those companies throw in perks like free dental, free prescriptions, allowances for OTC medications, and some even kick back $144 a month of what Medicare pays them to cover back to you. I start my search next month as I will be 65 in June. Most of my friends are paying about $90 a month. That is in place of the $175 Medicare Part B costs.

 

[Frwinkley]

From what I've been able to gather so far, those plan are rather limiting in choice of doctors, etc. and don't cover when traveling out of your coverage area. They also seem to have rather high deductibles and out of pocket maximums. I am in PA.

 

[Bella the Ball 360]

I will be retiring from teaching in 3 years at age 63. My health, dental and vision insurance will continue for my husband and I until I hit age 65.

I am beginning to investigate Medicare costs, supplemental plans, etc. I teach in PA where PSERS (the PA retirement pension system) offers supplemental plans. My DH and I are both in very good health, take no prescription meds (at this time).

I'm just trying to get a ballpark of what people pay per month (I realize this is extremely individualized).

I know Medicare Part B will cost us each about $175 per month, but was curious how much people were paying for supplemental coverage.

Sure makes me appreciate my employer-provided insurance.

I am also retiring from teaching and I agree with your medicare price but I will pay 129 ea for my husband and myself for Harvard Pilgrim supplimental.

 

[tvguy]

From what I've been able to gather so far, those plan are rather limiting in choice of doctors, etc. and don't cover when traveling out of your coverage area. They also seem to have rather high deductibles and out of pocket maximums. I am in PA.

Well, no. Most have no deductible. Yes, you have to use an in network Doctor, but that's no different than Medicare which a lot of Doctors don't take. Actually, their network is likely much larger. I am still doing leg work, haven't seen a plan yet that didn't cover you anywhere in the U.S.
My mom had one. Her total out of pocket for the last 13 months of her life was $500, two $250 charges from the fire department for ambulance rides. Mind you, the PRIVATE ambulance company accepted what her United Healthcare Medicare Advantage plan paid for an ambulance as full payment.. That included 3 months in the hospital

 

[Frwinkley]

That’s terrific to know.

Although I’m years away yet, I’d like to get an idea of anticipated costs.

 

[longboard55]

Yes two options, I have straight medicare with a supplement plan. The total cost is around $300 with all costs paid no deductible except minor drug costs, like less than $5. I have the option to go to any doctor. But pretty much all doctors are in these big groups so if you stick with the plan covered by your local hospital you should be ok with the Advantage plans.

Two years ago before medicare when I was 64 it was like $700 a month with a $6000 deductible.

 

[Frwinkley]

Yes two options, I have straight medicare with a supplement plan. The total cost is around $300 with all costs paid no deductible except minor drug costs, like less than $5. I have the option to go to any doctor. But pretty much all doctors are in these big groups so if you stick with the plan covered by your local hospital you should be ok with the Advantage plans.

Two years ago before medicare when I was 64 it was like $700 a month with a $6000 deductible.

And is this just for single coverage? Is the $300 in addition to the Medicare cost or all inclusive? Thanks for the reply

 

[piccolopat]

There are a few things to watch out for. Coverage area can be limited. Most if not all will cover emergencies outside their coverage area but if you are a retiree and plan to spend a part of the year elsewhere, make sure the plan you look at will provide full coverage there. Advantage plans look good up front but there may be additional hurdles to coverage like pre-authorizations that might be there for some supplements. That may be important if you have a condition that requires frequent procedures like scans. Even though there is an annual open enrollment, some plans will require medical underwriting and can turn you down. I've heard this can be a problem if you are on an advantage plan and want to go with a supplement instead. For this reason, make sure you choose a plan that will provide the coverage you might need in the future.

 

[lynxstch]

Do you live in area with Medicare Advantage Plans? Those are private plans where Medicare pays a private insurance company to take you off their hands. Those companies throw in perks like free dental, free prescriptions, allowances for OTC medications, and some even kick back $144 a month of what Medicare pays them to cover back to you. I start my search next month as I will be 65 in June. Most of my friends are paying about $90 a month. That is in place of the $175 Medicare Part B costs.

Just be aware..that with Medicare Advantage plans,,they take your past and present medical condition into consideration before 'accepting ' you. My husband has medical problems that would have made them refuse to give him a policy with them. We called a local agent who specializes in Medicare coverage, and she went over all the policy's and what they entailed. We both chose Medicare Plan N,,which has supplemental (through Aetna), and drug coverage through Silver Script. For us it's working out very well.

 

[longboard55]

And is this just for single coverage? Is the $300 in addition to the Medicare cost or all inclusive? Thanks for the reply

Yes its $170 for medicare and $130 for the blue shield supplement and $8 for a drug supplement, per person

 

[Frwinkley]

There are a few things to watch out for. Coverage area can be limited. Most if not all will cover emergencies outside their coverage area but if you are a retiree and plan to spend a part of the year elsewhere, make sure the plan you look at will provide full coverage there. Advantage plans look good up front but there may be additional hurdles to coverage like pre-authorizations that might be there for some supplements. That may be important if you have a condition that requires frequent procedures like scans. Even though there is an annual open enrollment, some plans will require medical underwriting and can turn you down. I've heard this can be a problem if you are on an advantage plan and want to go with a supplement instead. For this reason, make sure you choose a plan that will provide the coverage you might need in the future.

This is what I am reading as well. I would much rather pay more in premiums upfront. PSERS (the teacher retirement system in PA) offers supplemental plans through something called HOPS (which is only available to PA teachers). It would cost my husband and I about $600 (together) and includes medical, dental, vision and rx. This would be in addition to Medicare. Coverage is available anywhere in the world--no deductibles, copays, etc. and no limiting network. In addition, HOPS adds another $100 per month to your pension amount. No underwriting, referrals, etc.

 

[tvguy]

Just be aware..that with Medicare Advantage plans,,they take your past and present medical condition into consideration before 'accepting ' you. My husband has medical problems that would have made them refuse to give him a policy with them. We called a local agent who specializes in Medicare coverage, and she went over all the policy's and what they entailed. We both chose Medicare Plan N,,which has supplemental (through Aetna), and drug coverage through Silver Script. For us it's working out very well.

I believe that is only the case if you are trying to switch Medicare Advantage plan providers. First time enrollment they can't exclude anyone for any reason.

 

[lynxstch]

I believe that is only the case if you are trying to switch Medicare Advantage plan providers. First time enrollment they can't exclude anyone for any reason.

We weren't trying to switch providers. We were first time enrollee's at the time (if that's a word, lol). That is what our insurance agent told us was the case with Medicare Advantage plans. So we didn't even bother looking at those. We have had Medicare and Aetna supplemental for the last 2 years (since we were old enough to have to be on Medicare.) That's just our experience with it, so I threw my 2 cents worth in on the OP''s thread.

 

[tvguy]

We weren't trying to switch providers. We were first time enrollee's at the time (if that's a word, lol). That is what our insurance agent told us was the case with Medicare Advantage plans. So we didn't even bother looking at those. We have had Medicare and Aetna supplemental for the last 2 years (since we were old enough to have to be on Medicare.) That's just our experience with it, so I threw my 2 cents worth in on the OP''s thread.

Just Googled it. Medicare Advantage plans must cover everything that Medicare covers and can't reject you. That is all anyone around here has anymore because of the great coverage at a low price.

 

[lynxstch]

Just Googled it. Medicare Advantage plans must cover everything that Medicare covers and can't reject you. That is all anyone around here has anymore because of the great coverage at a low price.

All I am saying is that is not what we were told when we were looking for a plan. Thanks for the info

 

[anjuan]

Just Googled it. Medicare Advantage plans must cover everything that Medicare covers and can't reject you. That is all anyone around here has anymore because of the great coverage at a low price.

This is correct. They can't turn you down if you meet the general eligibility requirements including being eligible for Medicare and living in the service area. There are a few special needs plans that have more requirements, but those are very specialized. The agent gave you incorrect information. If you really want unbiased information on Medicare coverage you can go to www.shiphelp.org and find a local counselor that can talk to you about your options including supplements, Medicare Advantage, Prescription Drug plans, etc. There is a SHIP office in each state. Insurance agents get paid for selling certain products.

Also, if you are interested in a certain Medicare Advantage plan they are required to list their Evidence of Coverage on their website which provides information on what the plan covers. What a plan covers can vary by plan so it is good to check it out ahead of time. Also, you can find on their site a list of covered drugs (formulary) and directory of providers and pharmacies.

I helped my mother sign up for a Medicare Advantage plan. She has diabetes and has had a very good experience.

I work for the Medicare program but I am not acting in my official capacity in this post.

 

[Ning Ning]

I have a Medicare Advantage plan through Blue Cross/Blue Shield at the Medicare rate of $170 per month. I don't have a supplement. All of my doctors and my local hospitals are covered. I'm only on cholesterol medicine, which is free for me. I'm just wondering why everyone chose to get a supplement. When I was working, I only had one insurance plan and it was an 80%/20% plan, as are most insurances. Why would you choose to pay a second premium in retirement if you didn't have secondary coverage while you were working? I just don't understand, so I'm sincerely asking.

 

[Frwinkley]

My current coverage as a teacher gives me 100% coverage. No deductibles, no copayments. I have never even seen a bill. I will be the first to admit that teachers have excellent medical benefits.

For me personally, I want the flexibility of choosing doctors and being coveted while traveling. I also do not want any surprise bills. 80% of a $10,000 hospital bill leaves you paying $2k out of pocket. I don’t want that. I prefer that my expenses be “fixed”, even if I am overpaying in certain situations. I also think that as we age, medical expenses can get significantly more expensive as our health worsens.

I think most people have supplemental plans to cover what Medicare doesn’t.