# Confused about Medicare



## Nomad (Dec 19, 2002)

I will be 65 in July and I guess I'll be forced to get Medicare. I don't know the first thing about it or how to go about getting it. Can anyone give me some information to allow the fog to lift? Obviously I will have to get something, and I'm hoping I can find out a bit so as to get the best deal...if that's possible. Thanks.

Nomad


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## fordy (Sep 13, 2003)

http://www.q1medicare.com


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## mnn2501 (Apr 2, 2008)

http://www.medicare.gov/default.aspx?AspxAutoDetectCookieSupport=1


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## fordy (Sep 13, 2003)

.....................Once you have entered your state , then county the available plans will be listed . Down , at the bottom the next to the last set of choices for display info will say something like........display the # of plan members enrolled in each plan............will tell you which plans are the "favorites" of all plans available !
.....................IGnore the plans that have....SNP.....=special needs plan , unless you have some special health problems . You will have to pay your Pt.B premium , which for me was $99.90 amonth . Basically , you can choose (2) pathways for medical care , (1) an advantage plan , (2)regular medicare which means you'll pay $100 for pt.B premium , then you'll need to choose a Supplemental plan too cover the deductibles...this will run around $150 a month , then a supplemental drug plan for about $30 a month......for a total monthly premium of =100+150=30 = $280 a month . 
.......................Now , The BEST PLAN AVAILABLE= Plan "F"(regular medicare) !!! This plan when combined with a supplemental plan will pay ....ALL....medical expenses PLUS all deductibles plus drugs ! That was the $280 a month I listed above . You have to qualify for plan F , as End stage renal disease will DISqualify you from this plan . 
.......................OTOH , IF you enroll in an Advantage plan , you cannot be rejected , IF you enroll within the time frame allowed . 
........................You need too spend several hours studying all the available info presented because it is too much too absorb in a short amount of time . Be advised there are lots of people available too explain the compleXities so you can make an intelligent choice , they are paid by the Insurance companies ! Cost you nothing ! , fordy:stars:


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## Nomad (Dec 19, 2002)

Thanks everyone. I think if it's going to cost me $280 a month, I may as well die now because I can't afford it. Since I have the VA, I wonder if I still have to sign up for all of that?

Nomad


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## tallpines (Apr 9, 2003)

We went to the Social Security office to sign up.

Part A is the part that you have already paid for -- won't cost you any additional payments..........

Part B is for doctor office visits and out-patient services.
This costs you extra and will be deducted from your SS payment.
You can decline Part B and not pay anything.

Part D is for perscriptions.......can be declined.


My DH has a good retirement insurance plan so we have taken only Part A.

There are many "supplement" plans out there which I know little about except that they send out an annoyingly amount of junk mail.


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## Nomad (Dec 19, 2002)

I went to the page for the Medicare Advantage Plan just to see what it cost. I don't know what this plan covers, but it had the providers listed for each county. One was Humana and if I stay in this county it is $0. If we move to the house we are trying to buy it will be a different county and Humana will be $89 a month. I can see this is going to take some time and a lot of reading to figure out. But based on such a difference, it would be something to consider before moving to a different county.

Nomad


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## Nomad (Dec 19, 2002)

tallpines said:


> We went to the Social Security office to sign up.
> 
> Part A is the part that you have already paid for -- won't cost you any additional payments..........
> 
> ...


I didn't see this post before I made mine. Thanks. I think I will decline the prescriptions for sure, because they only cost me $8 per month from the VA. I'll have to look into the part B before I decide on that. 

Nomad


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## Txsteader (Aug 22, 2005)

Please be aware that if you decide later (after that open enrollment period) that you want to sign up for Part B or D, you'll pay a higher premium (penalty).

Just something to be aware of.


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## Nomad (Dec 19, 2002)

Txsteader said:


> Please be aware that if you decide later (after that open enrollment period) that you want to sign up for Part B or D, you'll pay a higher premium (penalty).
> 
> Just something to be aware of.


I'm not even sure when I'm supposed to sign up. I guess it would be sometime before July.

Nomad


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## where I want to (Oct 28, 2008)

Do you have social security benefits? If so, you will be automatically enrolled. You have to sign the back of the card (or something like that) and send it back if you don't want part B. If you have benefits, you will have part A- it can't be declined in that case. If you don't have cash benefits, then you need to sign up for part A too.
The other parts I don't know anything about.


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## Nomad (Dec 19, 2002)

where I want to said:


> Do you have social security benefits? If so, you will be automatically enrolled. You have to sign the back of the card (or something like that) and send it back if you don't want part B. If you have benefits, you will have part A- it can't be declined in that case. If you don't have cash benefits, then you need to sign up for part A too.
> The other parts I don't know anything about.


I receive SS retirement benefits. From what I've seen so far, don't I have to choose what provider to sign up with? This stuff just gives me a headache.

Nomad


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## ldc (Oct 11, 2006)

Nomad, one is supposed to go start the sign up for Medicare 90 days before the 65th b'day. And Txsteader is right, if you don't take Medicare at 65 on time, and you decide you need it later, you are charged some amount more for the rest of your life. 

I couldn't get my neighbor to go til she was 70; she got a back lump some for Social Security, but has to pay an extra $125/month for the rest of her life for Medicare part A (that would have been free). Best wishes with this!


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## fordy (Sep 13, 2003)

Nomad said:


> I receive SS retirement benefits. From what I've seen so far, don't I have to choose what provider to sign up with? This stuff just gives me a headache.
> 
> Nomad



...........................Medicare will send you a sign up or rejection package , prior too your 65th. birphday ! Your coverage will begin on the first day of the month you turn 65 ! If , you choose an Advantage Plan you still have to pay your Pt. B premium.......UNLESS.......you meet certain low income guidelines.....You should fillout the paperwork too check on possible acceptance for this assistance . The paperwork will or should be in the same envelope you receive from medicare . Some Advantage Plans provide drug coverage with small CO-Pays for Tier 1 and tier 2 drugs . In my opinion Medicare might be better coverage than the VA . This is the first health insurance coverage I've had in 15 years and I feel much better about getting help now that I have coverage . , fordy:whistlin:


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## Txsteader (Aug 22, 2005)

Nomad said:


> I'm not even sure when I'm supposed to sign up. I guess it would be sometime before July.
> 
> Nomad


Medicare will automatically send your packet at the appropriate time, giving you plenty of time to make your decision(s). Like Fordy said, if you *don't* want Medicare, then you'll have to sign paperwork, that will be included in your packet, indicating that. Otherwise, you'll be automatically enrolled when you turn 65.

When your packet arrives, simply get out the booklet, grab a cup of your favorite beverage, settle into your favorite chair and start reading. It covers most every question you might have....and if not, there's always their 800 number or their website.


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## Nomad (Dec 19, 2002)

Txsteader said:


> Medicare will automatically send your packet at the appropriate time, giving you plenty of time to make your decision(s). Like Fordy said, if you *don't* want Medicare, then you'll have to sign paperwork, that will be included in your packet, indicating that. Otherwise, you'll be automatically enrolled when you turn 65.
> 
> When your packet arrives, simply get out the booklet, grab a cup of your favorite beverage, settle into your favorite chair and start reading. It covers most every question you might have....and if not, there's always their 800 number or their website.


Then I guess I don't need to stress over it now. I'll start worrying in April. Thanks everyone.

Nomad


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## Chixarecute (Nov 19, 2004)

An Advantage plan REPLACES Medicare A & B, plus offers some additional coverage. It is usually cheaper than original Medicare plus a supplement, IF YOU ARE IN GOOD HEALTH. An Advantage plan is a contract between Medicare and the insurance company, and changes from year to year. A supplement is a contract between you and the insurance company, and other than premium increases due to age, cannot change. Advantage plans have annual open enrollments, with no health history. With a supplement, you get up[ to 8 months after medicare eligibility with little underwriting, but if you want a supplement after that, there will likely be some type of health questionnaire.


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## Chixarecute (Nov 19, 2004)

Some states offer State Prescription programs (SPAP) for Seniors that are very affordable. Depending on your Rx needs, a SPAP may be better than a Part D plan. Or, if your Rx needs are very high, you can carry both, which helps when you hit the donut hole aka coverage gap.


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## po boy (Jul 12, 2010)

You will get a ton of info from medicare in advane of the 65th. birthday. In addition, insurance companies will send you 318.214 letters. When you get close, use the letter you get from medicare to shop for plans. If you are on tri-care, you might want to talk to your VA rep to see what your options.


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## Karen (Apr 17, 2002)

It can be very confusing. Best thing to do is not try to sort it out alone. Make an appointment (ASAP just to put your mind at rest) at your nearest Social Security office. You don't need to wait until it's time to sign up/opt out/etc. They will walk you through the entire process and explain all your options. They are also familar with VA benefits so they will be your best source of helping you to choose what works the best for you.


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## yikes (Jan 23, 2011)

part a is free
part b costs$120 month, 10% month penalty for each year you wait 
part d costs $30 month, $.30 times number of months you wait to get it

this is the simplistic answer. Actual numbers and amounts are easily found.


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## Nevada (Sep 9, 2004)

Nomad said:


> I went to the page for the Medicare Advantage Plan just to see what it cost. I don't know what this plan covers, but it had the providers listed for each county. One was Humana and if I stay in this county it is $0.


It's not really $0. You still need to contribute to Part B to have Medicare Advantage.

I signed Alma up for the Humana Gold Plus HMO for next year. The premium is $0 above Parts A & B. Prescriptions are included in the HMO so there is no Part D premium.

Medicare Advantage programs cost you a lot less in copays than regular Medicare, but you've got to stay on top of them if you get sick. Remember, they save money by denying treatment. They'll stop and nothing to save a buck if they think they can get away with it.


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## SueMc (Jan 10, 2010)

Nomad said:


> Thanks everyone. I think if it's going to cost me $280 a month, I may as well die now because I can't afford it. Since I have the VA, I wonder if I still have to sign up for all of that?
> 
> Nomad


I just went through updating my 79 y/o mom's coverage after she moved from CA to IL. I didn't know anything about medicare so we went to our County's Senior Citizen's Center. I thought they could explain stuff to me before we had to deal with the SS office. Turns out that the Senior Citizen Center has social workers/senior advocates who accessed what my mom had in CA, looked at all of her benefits and signed her up for what she needed here. They compared different programs and found the best one for her at the best price. Because she basically lives on her SS check, they also found additional state programs that helped her pay her Part D payments, etc. 
You might check with your Senior Center and see if they offer the same type of help. Ours made my mom's transition very painless.


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## Nevada (Sep 9, 2004)

Nomad said:


> Then I guess I don't need to stress over it now. I'll start worrying in April. Thanks everyone.
> 
> Nomad


When it comes to Part D, you don't want to tell them if you are taking an expensive medication. Inexpensive generics are a pretty good deal, but expensive meds will be out of sight.

Expensive meds have about a $30 copay with most part D providers. But that's not the end of it. They also crank-up your monthly premium for each expensive medication. It's not unusual to pay a $20 extra premium each month for just one expensive medication, and that's on top of the $30 copay.

That's were overseas meds come in. I source Alma expensive medications overseas and don't tell her provider that she's on them. It saves perhaps $200/month.

If you are taking an expensive medication and need help sourcing it inexpensively, let me know.


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## Txsteader (Aug 22, 2005)

SueMc said:


> I just went through updating my 79 y/o mom's coverage after she moved from CA to IL. I didn't know anything about medicare so we went to our County's Senior Citizen's Center. I thought they could explain stuff to me before we had to deal with the SS office. Turns out that the Senior Citizen Center has social workers/senior advocates who accessed what my mom had in CA, looked at all of her benefits and signed her up for what she needed here. They compared different programs and found the best one for her at the best price. Because she basically lives on her SS check, they also found additional state programs that helped her pay her Part D payments, etc.
> You might check with your Senior Center and see if they offer the same type of help. Ours made my mom's transition very painless.


A very good tip. Thanks.


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## Nomad (Dec 19, 2002)

Nevada said:


> When it comes to Part D, you don't want to tell them if you are taking an expensive medication. Inexpensive generics are a pretty good deal, but expensive meds will be out of sight.
> 
> Expensive meds have about a $30 copay with most part D providers. But that's not the end of it. They also crank-up your monthly premium for each expensive medication. It's not unusual to pay a $20 extra premium each month for just one expensive medication, and that's on top of the $30 copay.
> 
> ...


Lipitor is the only one I take that is expensive. The rest I can get from the VA for $8. I'll just switch to Simvastatin when my Lipitor supply runs out and it will also be $8. I'm hoping the cost of Lipitor will drop eventually and I can go back to it.

Nomad


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## Nevada (Sep 9, 2004)

Nomad said:


> Lipitor is the only one I take that is expensive. The rest I can get from the VA for $8. I'll just switch to Simvastatin when my Lipitor supply runs out and it will also be $8. I'm hoping the cost of Lipitor will drop eventually and I can go back to it.
> 
> Nomad


If you have any prescription insurance at all you probably can get Lipitor for a $4 copay.

https://www.lipitor.com/patients/LipitorCoPayCardRegistration.aspx

If you have no insurance then you need to look overseas.

https://www.alldaychemist.com/443_Lipitor-20-mg


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