USA Medicare Part B , Medicare Advantage , MediGap , - which is the best ?

[oldcarguy]

I am confused about Part B , Medicare advantage , Medigap etc

 

I live most of the year in California ,

 

First , I do not mind paying extra for a more "Gold" plan that covers more things ,

 

I have never been sick other than regular small things , non-smoker, non-drinker , so I look at the Medicare "extras" as just paying forward , because anything medical related in the USA is costly ,

 

If I get sick I want to see a specialist , and one of my choosing if possible , I would like as many costs paid for by the Medicare Advantage - Medigap , a small fee to see the Doctor is OK , it keeps the lines shorter than if it was free !     Do any of them have coverage for dental , hearing , eyesight ?

 

But what do I need to look for ?  I do not really have a family to take care of me when I am  real old and drooling in my oatmeal !

The info I got from AARP in the mail is confusing , and Google is overwhelming !

 

At one time there was a TV Member who worked in this field , maybe he is still around to help ,

 

Anyway please let me know what you think is important ,  maybe what you are signed up for ,

It seems I need to make a choice by  December 7th , hopefully I am less confused by then :)

 

Thanks for your help

[willyumcr]

In my case I use Kaiser Senior Advantage. It works well for me and they cover emergency's and urgent care when traveling. Last year I had a torn retina operation at Rutland hospital in BKK and they covered.

[Emster23]

I'd suggest looking on a forum in California about info. The MoFo powers that be don't cover us abroad, as once we leave USA, no one gets sick....

[elgenon]

3 hours ago, Emster23 said:

I'd suggest looking on a forum in California about info. The MoFo powers that be don't cover us abroad, as once we leave USA, no one gets sick....

See post #2

[tweedledee2]

     I have an AARP United Healthcare Part B supplement plan. Before I enrolled in Medicare I inquired from my Dr. about what  Medicare coverage to get. He advised me to enroll in Medicare for Part A and then add a Part B supplement and a drug plan.  United has several Plan B's to choose from,  with different benefits and co-pays. I chose the supplemental plan F which costs more but seemed like a better value for me. Somewhat like you, I consider myself reasonably healthy. The only prescribed medication I use is Androgel.  Shortly after enrolling in Medicare, I have also never been billed for office visits. I had cataract surgery on both eyes and 6 months later surgery for a macular tear, with no co-pays. I discontinued my drug plan due to me living 18 of the last 19 months in Thailand. From what I save in monthly premiums and co-pays, I can purchase anything locally when needed. The major difference between original Medicare with a Part B supplement and an Advantage Plan is being able to choose your own Dr or seeing a network provider.

[Lefty]

If you want 100% FULL COVERAGE With no copays or deductable go for a medigap policy planF.Have 2 bouts of cancer about $250,000 each--my cost zero.choose any doctor/hospital. Cost me $220 month and prices vary so check with a Medicare broker-google.

Lefty

[oldcarguy]

2 hours ago, Lefty said:

If you want 100% FULL COVERAGE With no copays or deductable go for a medigap policy planF.Have 2 bouts of cancer about $250,000 each--my cost zero.choose any doctor/hospital. Cost me $220 month and prices vary so check with a Medicare broker-google.

Lefty

the copays are the scary thing ,  some you have to pay 20% , which in  your  case would be a lot  of $$$$

same with some expensive drugs......

 

the future is only going to bring more health issues  ,   the day to day things are OK, its the major issues that you want to have covered ,

 

I will look into the Medigap plan F ........thanks

 

 

[Wake Up]

13 hours ago, willyumcr said:

In my case I use Kaiser Senior Advantage. It works well for me and they cover emergency's and urgent care when traveling. Last year I had a torn retina operation at Rutland hospital in BKK and they covered.

I am not on Medicare but hope to be one day. I always heard Medicare does not cover medical bills outside the USA if you live outside the USA. Am I just wrongly informed?  Any further details of how you got Medicare to pay medical bills in Thailand would be helpful to me. I also go to Ruthin Eye Hospital in Bangkok. 

[Sheryl]

39 minutes ago, Wake Up said:

I am not on Medicare but hope to be one day. I always heard Medicare does not cover medical bills outside the USA if you live outside the USA. Am I just wrongly informed?  Any further details of how you got Medicare to pay medical bills in Thailand would be helpful to me. I also go to Ruthin Eye Hospital in Bangkok. 

unfortunately what you heard was correct. Medicare does not pay for care outside the US, full stop.

 

Where you live is irrelevant, it is where you get care. You can live outside the US and Medicare will still pay for your care in the US but of course you have to travel back for it.

 

 

[willyumcr]

As I mentioned in post #2 my eye care was covered by Kaiser Senior Advantage (Urgent care as not able to fly). I am 76 years old and have been on Medicare with Kaiser Senior Advantage  Plan (Medicare supplement) for 10 years. Go to Kaiser website and check. I pay $44 a month Kaiser in addition to $109 for medicare. The Kaiser I use is not California but California does have Kaiser and the op says he spends most time there. He needs to reside in an area within 50 miles of a Kaiser facility. I have not claimed Medicare covers outside of USA, what I am saying is Kaiser Senior Advantage (Medicare Supplement) does in some circumstances.

[ericthai]

OP I have my insurance license in the USA and specialize in Medicare.  I'll outline a few things.   When you turn 65 you have a 7 month window to enroll in part B (3 months before your birth month,your birth month, 3 months after) . If you dont enroll during this time there is a penalty if you ever enroll in the future. You also need to purchase a part D plan, if not there will be a penalty applied if you ever purchase in the future. Part B premium for 2017 is $134 you will have a $183 deductible meaning you pay the first $183.00.. After that Medicare covers 80% you pay 20%.  There is no medical exam and you cant be turned down for any pre-existing conditions. This is original Medicare operated by the US govt. Then you have options with private insurance companies that offer Medicare plans. These companies are regulated by Medicare and must follow strict guidelines. For the type of plans there are two types of plans  Medicare Supplement plan (medigap) or Medicare Advantage plan. This is were things start to get complicated.    So I'll tell you what I would do if I was buying for me.  I would get a medicare supplement plan from United Healthcare or Humana, these plans are not cheap. You have to pay your part B premium (typically taken out of your socials security)then you have a plan premium around $150-$400 per month(different plans A,B,,F etc.) and a drug plan (part D) about $30-$50  (these numbers are based on Florida, plans are different all over the US and can differ from county to county in a state. ) so you have a total of about $500 a month, but you are very well covered.  However there are some issues Medicare will not pay if living outside the USA (some private companies offer worldwide emergency coverage, this is meant for traveling not someone living overseas) so you will need an address in the USA and would need to come to the USA for non-emergency treatments.  The other option would be a medicare advantage plan, with these plans you are now only dealing with the insurance company. You still need to pay your part B then depending on the plan you might have a month premium as low as $0 per month and as high as $120 a month,. These plans can include part D coverage. Plan types are PFFS, HMO, PPO   most are HMO which means you have to stay in network for coverage. PPO you have a network but can go out of network at a higher co-payment. I could go on and on.  Digest this and if you have any questions let me know.   

 

PS:  You might want to ask around to your friends if any of them have an insurance agent they use. I would go with an independent agent (same as me) as they are usually contracted with every local plan.  Agent commissions are regulated by medicare so all the plans pay the same commission so the agent is going to put you on the best plan he has.  A agent from Humana / United etc can only offer their company products which may not always be the best plan in your area. 

[Blue bruce]

I have a plan F on my part B. It is with BCBS,  i pay $216.00 per month. No deductables at all,no co pays.  I choose my own doctors anywhere in the U.S. I had prostate radiology 3 years ago over $ 100,000.00 i paid nothing.

For what i pay for medicare and my plan f i am fully protected with no co pay or deductables.

Best way to go

[James2020]

"OP I have my insurance license in the USA and specialize in Medicare.  I'll outline a few things.   When you turn 65 you have a 7 month window to enroll in part B (3 months before your birth month,your birth month, 3 months after) . If you dont enroll during this time there is a penalty if you ever enroll in the future. You also need to purchase a part D plan, if not there will be a penalty applied if you ever purchase in the future.'"

 

This only applies if you're not working.  If you currently have coverage through an employer, you can switch to Medicare at any time as long as you're 65 or over.  I currently work very part-time in our family business and have BCBS coverage through my employer that covers me for routine things in the US or Thailand as long as I go to a Participating Provider (Bumrungrad and Samitivej are on BCBS's list).  If that option is available to you, it's worth looking into.

[ericthai]

19 hours ago, Blue bruce said:

I have a plan F on my part B. It is with BCBS,  i pay $216.00 per month. No deductables at all,no co pays.  I choose my own doctors anywhere in the U.S. I had prostate radiology 3 years ago over $ 100,000.00 i paid nothing.

For what i pay for medicare and my plan f i am fully protected with no co pay or deductables.

Best way to go

Yes you have a medicare supplement plan type is F which is the best one to get. As you said this covers everything.  You can go to any doctor that accepts medicare. Medicare is your primary they pay their 80% and then your insurance company picks up the 20%.   Make sure you also have a part D plan for medications as there is a late enrollment fee.

[ericthai]

2 hours ago, James2020 said:

"OP I have my insurance license in the USA and specialize in Medicare.  I'll outline a few things.   When you turn 65 you have a 7 month window to enroll in part B (3 months before your birth month,your birth month, 3 months after) . If you dont enroll during this time there is a penalty if you ever enroll in the future. You also need to purchase a part D plan, if not there will be a penalty applied if you ever purchase in the future.'"

 

This only applies if you're not working.  If you currently have coverage through an employer, you can switch to Medicare at any time as long as you're 65 or over.  I currently work very part-time in our family business and have BCBS coverage through my employer that covers me for routine things in the US or Thailand as long as I go to a Participating Provider (Bumrungrad and Samitivej are on BCBS's list).  If that option is available to you, it's worth looking into.

Correct, as long as you have creditable coverage you will not be penalized.  Make sure you have creditable drug coverage too. I have seen employer plans that were creditable but not the drug coverage. 

 

I was speaking about the OPs current situation, as if I started going into details it would be way too much..

[NancyL]

On 11/30/2017 at 9:31 AM, ericthai said:

OP I have my insurance license in the USA and specialize in Medicare.  I'll outline a few things.   When you turn 65 you have a 7 month window to enroll in part B (3 months before your birth month,your birth month, 3 months after) . If you dont enroll during this time there is a penalty if you ever enroll in the future. You also need to purchase a part D plan, if not there will be a penalty applied if you ever purchase in the future. Part B premium for 2017 is $134 you will have a $183 deductible meaning you pay the first $183.00.. 

I'll turn 65 in a little over a year, but don't plan to apply for SS at that time.  In fact at this point the "SS full retirement age" isn't 65.  Yet, I do want to apply for Medicare, including Part B, so I have the flexibility to return to the U.S. for travel or a health emergency and to avoid the future penalty for not signing up.  How does someone pay for Medicare when not receiving SS?

 

 

[NancyL]

On 11/30/2017 at 9:31 AM, ericthai said:

 I would get a medicare supplement plan from United Healthcare or Humana, these plans are not cheap. You have to pay your part B premium (typically taken out of your socials security)then you have a plan premium around $150-$400 per month(different plans A,B,,F etc.) and a drug plan (part D) about $30-$50  (these numbers are based on Florida, plans are different all over the US and can differ from county to county in a state. ) so you have a total of about $500 a month, but you are very well covered.  

Argh -- $500 per month is $6000 per year per person.  Hubby and I spend all our time out of the U.S.  He currently is paying for Part B and I plan to when I turn age 65, "just in case", but I can't see us returning to the U.S. if it means forking over $12,000 per year to be "well covered". 

 

Here, we have an international policy, admittedly with a high deductible and no outpatient or drug coverage for less than $4000 per year for the both of us.  But drugs and outpatient costs are fairly cheap here and access to treatment in Chiang Mai is brilliant at places like Bangkok Hospital.  I can get in to see a specialist, usually the same day I decide I need to see one and have a problem treated in less time than than I would have waited on hold and navigated the voicemail tree to try to make an appointment for several weeks out in the U.S.

[Langsuan Man]

1 hour ago, NancyL said:

How does someone pay for Medicare when not receiving SS?

From personal experience I can tell you it is a PITA and more common than one would think since Medicare age is 65 and many are not eligible for full SS until age 66

 

You will receive a bill every three months for your Part B premiums and will have several options on how to pay.  I paid via EFTS from my US bank, until I started to receive SS and from then on the deductions were automatic 

[lopburi3]

2 hours ago, NancyL said:

I'll turn 65 in a little over a year, but don't plan to apply for SS at that time.  In fact at this point the "SS full retirement age" isn't 65.  Yet, I do want to apply for Medicare, including Part B, so I have the flexibility to return to the U.S. for travel or a health emergency and to avoid the future penalty for not signing up.  How does someone pay for Medicare when not receiving SS?

 

 

That should be quite common as many of use on Federal Retirement do not receive social security but can have Medicare if we want. 

[Sheryl]

It is no problem at all to enroll in part A, i just did and also have not collecting SS. You can enroll in Part B and D as well but will have to make arrangements for payment.

[ericthai]

On 11/30/2017 at 11:02 PM, NancyL said:

Argh -- $500 per month is $6000 per year per person.  Hubby and I spend all our time out of the U.S.  He currently is paying for Part B and I plan to when I turn age 65, "just in case", but I can't see us returning to the U.S. if it means forking over $12,000 per year to be "well covered". 

 

Here, we have an international policy, admittedly with a high deductible and no outpatient or drug coverage for less than $4000 per year for the both of us.  But drugs and outpatient costs are fairly cheap here and access to treatment in Chiang Mai is brilliant at places like Bangkok Hospital.  I can get in to see a specialist, usually the same day I decide I need to see one and have a problem treated in less time than than I would have waited on hold and navigated the voicemail tree to try to make an appointment for several weeks out in the U.S.

There are other options.  I was giving an idea for a medicare supplement plan.  You can enter into a Medicare Advantage plan which most have a low to no monthly premium, however you need to have a US address.  I had my mom on a medicare advantage plan for 13 years. She paid her part B premium and that was it.  She had a $0.00 premium that included part D drug coverage.  She was happy with it.  To see her primary she had a $0 co-pay and a specialist was $35 , Hospital was $95 per day for days 1-7.  Also this plan has a max out of pocket which was $6500 so no matter what happens the max she would be in a 12 month period would be $6500. 

 

Trying to speak to the insurance companies is difficult. I spend allot of time on endless loops and on hold. If you need any help let me know. 

[ericthai]

On 11/30/2017 at 10:44 PM, NancyL said:

I'll turn 65 in a little over a year, but don't plan to apply for SS at that time.  In fact at this point the "SS full retirement age" isn't 65.  Yet, I do want to apply for Medicare, including Part B, so I have the flexibility to return to the U.S. for travel or a health emergency and to avoid the future penalty for not signing up.  How does someone pay for Medicare when not receiving SS?

 

 

When you sign up for part B they will ask you how you want to pay. Most people select to have it deducted from their Social Security but you can arrange for a monthly bill or auto pay from a checking account, credit card etc. 

[Wake Up]

6 hours ago, ericthai said:

There are other options.  I was giving an idea for a medicare supplement plan.  You can enter into a Medicare Advantage plan which most have a low to no monthly premium, however you need to have a US address.  I had my mom on a medicare advantage plan for 13 years. She paid her part B premium and that was it.  She had a $0.00 premium that included part D drug coverage.  She was happy with it.  To see her primary she had a $0 co-pay and a specialist was $35 , Hospital was $95 per day for days 1-7.  Also this plan has a max out of pocket which was $6500 so no matter what happens the max she would be in a 12 month period would be $6500. 

 

Trying to speak to the insurance companies is difficult. I spend allot of time on endless loops and on hold. If you need any help let me know. 

Thank you for your input. One day I will be eligible for Medicare. My issue is I have Cigna Global health insurance, a one million dollar limit and 10,000 deductible for 1174 USA dollars a year. Covers me in every country with the agreement that I cannot be in the USA more than 90 days in the coverage year. Hard for me to see paying a lot for Medicare supplement policy as I prefer Bangkok doctors. Hospital  visits in BKK run about 50 USA dollars or less. What I have heard is I have to make the decisions at age 65 about Medicare supplements or I am somehow penalized if I change my mind and want to buy part D or F after age 65. Anyway you could help me understand this information. I have a USA address but I am only in the USA about 30 days a year with no intent of moving back there but who knows things in life change. 

[ericthai]

5 hours ago, Wake Up said:

Thank you for your input. One day I will be eligible for Medicare. My issue is I have Cigna Global health insurance, a one million dollar limit and 10,000 deductible for 1174 USA dollars a year. Covers me in every country with the agreement that I cannot be in the USA more than 90 days in the coverage year. Hard for me to see paying a lot for Medicare supplement policy as I prefer Bangkok doctors. Hospital  visits in BKK run about 50 USA dollars or less. What I have heard is I have to make the decisions at age 65 about Medicare supplements or I am somehow penalized if I change my mind and want to buy part D or F after age 65. Anyway you could help me understand this information. I have a USA address but I am only in the USA about 30 days a year with no intent of moving back there but who knows things in life change. 

What you have sounds great! 

so when you turn 65 you have a 7 month window to enroll if you dont you will be penalized, unless you have creditable coverage through employment, retirement package etc. (To be creditable the insurance needs to be equal or better than what Medicare provides. Most employer drug plans are not creditable)

Part B for 2018 is $134 (this goes up almost every year) the penalty is 12% for each 12 month period you are not enrolled.  for Part D the penalty is 1% of the national average (for 2018 $35.02)for each month not enrolled.    There are other options than a medicare supplement.  You can get a medicare advantage plan for a low or even $0 monthly premium (you still must pay your part  and allot of the medicare advantage plans include drug coverage. You can always PM ,me your zip code in the US and I can look up plans for you.  However the plans change every year, sometime for the good sometimes for the bad. It's a very competitive market in allot of places so the copays stay low and benefits increase.  Just saw last year in Florida for the first time that full dentures are covered.  Hope this helps!

 

 

[gk10002000]

On 12/1/2017 at 3:41 AM, Sheryl said:

It is no problem at all to enroll in part A, i just did and also have not collecting SS. You can enroll in Part B and D as well but will have to make arrangements for payment.

Yes.  They deduct the medicare B or D or any other Medicare supplement from your social security.  In your case, since you did not do social security yet,  will they automatically start deducting your B or D from your social security when you start taking social security or will you have to do something special to setup payments?

[ericthai]

Just now, gk10002000 said:

Yes.  They deduct the medicare B or D or any other Medicare supplement from your social security.  In your case, since you did not do social security yet,  will they automatically start deducting your B or D from your social security when you start taking social security or will you have to do something special to setup payments?

When you enroll in part B and D and not taking SS yet you can make arrangements to get a monthly bill, auto deduct from your checking, credit card etc.  However when you turn 65 and dont enroll there is a penalty for part B & D even if you are working. To avoid the penalty you must have creditable coverage.  As long as you have coverage as good as medicare then your good.  You can always check out http://www.medicare.gov   or if confused about something can ask here or PM me. 

[Langsuan Man]

On 12/1/2017 at 1:05 PM, lopburi3 said:

That should be quite common as many of use on Federal Retirement do not receive social security but can have Medicare if we want. 

Only if you were on the old system, Federal Employees in the Federal Employee Retirement System  ( FERS  ) since 1986,  now pay into and receive Social Security 

[gk10002000]

10 hours ago, ericthai said:

When you enroll in part B and D and not taking SS yet you can make arrangements to get a monthly bill, auto deduct from your checking, credit card etc.  However when you turn 65 and dont enroll there is a penalty for part B & D even if you are working. To avoid the penalty you must have creditable coverage.  As long as you have coverage as good as medicare then your good.  You can always check out http://www.medicare.gov   or if confused about something can ask here or PM me. 

No no, I get the Part B and D part.  What I was curious about was if I have them, then later start taking social security, will they start deducting the premiums automatically from my social security or will they leave the part B/D payment setup just as it was?

[Langsuan Man]

29 minutes ago, gk10002000 said:

will they start deducting the premiums automatically from my social security or will they leave the part B/D payment setup just as it was?

Yes. they will automatically start deducting the premiums from your SS payments  and your current billing and payments will stop, since it was only a stop gap method of payment in the first place   

[tweedledee2]

17 hours ago, Wake Up said:

Thank you for your input. One day I will be eligible for Medicare. My issue is I have Cigna Global health insurance, a one million dollar limit and 10,000 deductible for 1174 USA dollars a year. Covers me in every country with the agreement that I cannot be in the USA more than 90 days in the coverage year. Hard for me to see paying a lot for Medicare supplement policy as I prefer Bangkok doctors. Hospital  visits in BKK run about 50 USA dollars or less. What I have heard is I have to make the decisions at age 65 about Medicare supplements or I am somehow penalized if I change my mind and want to buy part D or F after age 65. Anyway you could help me understand this information. I have a USA address but I am only in the USA about 30 days a year with no intent of moving back there but who knows things in life change. 

Good luck paying that low yearly premium when you turn 65. I got a quote last year for around $400 a month, which was more than I pay for Medicare with parts B and D.