NFR For Those on Medicare/Specifically Kaiser Plan…. Help appreciated!

Non-fishing related
Clean Willy said:
All of this! After 65 years of literally perfect health, I found out the hard way that this was not to continue. Now aligned with SCCA and fortunate to have made the coverage choices (UHC Plan G) that will cover everything going forward.
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I'm in the same boat and thankful for my Plan G.
 
Jojo said:
I hope this is okay to put this here, but if not it can be deleted.

I do not understand how i can be of Medicare age when i feel like I’m 32.

Right now I have a stack of Medicare packets that i have been procrastinating about for weeks and weeks. We’ve been happy with our PEBB Kaiser Permanente (which i wasn’t sure about when Group Health sold out to them). So we are able to at least narrow it down to what we want. But they have different levels of Medicare Plans and I’m not sure just going for the most expensive makes sense to start.

It’s all very daunting. I did take a webinar class from Kaiser recently and took notes about copays and deductibles and coverage. But there are so many variables to weigh.

For those of you who are on Medicare, how did you navigate through all this? Questions are like: What should i be thinking about with prescription drug coverage if our medication is not very expensive And we can always add better coverage if that changes during an open enrollment.

If you have any advice, ESPECIALLY if you are covered by Kaiser for Medicare, i would appreciate it.
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By no means do I understand how all this works, but we have been with Kaiser for many years, but when we moved up to Poulsbo we had to change over to Group Health. Whe we got on Medicare we kept Kaiser but did not take the prescription plan ( we did not take any drugs) so we saw no need but when we started needing prescriptions we just added that part I think it D. Well we ended up having to go back to hhen we signed up and pay for about 3 years of no coverage.
 
Bagman said:
By no means do I understand how all this works,
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This is the sad part of this overly complicated process.
Given a person's condition, or the unknowns that can pop up, the wrong choice can end up being costly.
I struggle with decifering it all and then think of the many people like my 92 year old non-computer mother having to try to make heads or tails of it all.
 
Hey @Jojo. I will be in your shoes very soon so this a timely thread. I can vouch for supplemental coverage. My parents had UHC Plan F I believe. From the day I took over paying their bills after my dad went into the hospital (Nov. '18) until my mom passed away this past December, I have not paid one medical bill for office visits, hospital stays, and hospice. The only expenses I paid were to the dentist and prescriptions.

This year I have been seeing commercials for UHC for the first time. So out of curiosity, I looked them up. I was amazed that in Florida there were about a dozen different plans (at least it seemed like that) and Washington only had 1 or 2.
 
Bruce Baker said:
Hey @Jojo. I will be in your shoes very soon so this a timely thread. I can vouch for supplemental coverage. My parents had UHC Plan F I believe. From the day I took over paying their bills after my dad went into the hospital (Nov. '18) until my mom passed away this past December, I have not paid one medical bill for office visits, hospital stays, and hospice. The only expenses I paid were to the dentist and prescriptions.

This year I have been seeing commercials for UHC for the first time. So out of curiosity, I looked them up. I was amazed that in Florida there were about a dozen different plans (at least it seemed like that) and Washington only had 1 or 2.
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And what's available varies greatly from county to county.

Health care in this country is a quagmire.

As for dental...a common saying among independent brokers is that "with the right coverage you can turn a $200k medical bill into a $5k one, but about the best you can do with dental insurance is to turn a $10k dental bill into an $8k one".
 
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Jeanne recently retired a couple years ago and she has and always has had Kaiser. I don’t know netcost for it. I am on Medicare with a small monthly from Regence and I have been told by reception that it is great forthe cost per month at $43…. My only income is Medicare at less than $1900/month I will be 69. I think it is fine. This is my first year not to be required to file. I like that a lot.
 
with so many options for supplemental insurance coverage out there, it is convenient to have one that provides coverage near you. Having providers that are in network close to where you live can save you time, money and if you cant drive, ability to get care.
 
CRO said:
with so many options for supplemental insurance coverage out there, it is convenient to have one that provides coverage near you. Having providers that are in network close to where you live can save you time, money and if you cant drive, ability to get care.
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I walk everywhere here. I found a primary Peacehealth family practice a 15 minute walk from our front door
 
If anyone is close to signing up for Medicare I have a source that takes a lot of the confusion out of it. A Medicare advisor.Not the avalanche of endless communication one gets approaching retirement. If you live in the vacinity of Vancouver I walked across the street and spoke to MedicareHelpNow.com, Office@MedicareHelpNow.com
360-828-5544, 866-606-8093
I have a finite income with minimal bills
I provided that data at a meeting. No cost, no push. They are operationally supplemented by many health plan providers. They gave me all the plans I would be interested in based on my needs and gave me print outs. I reviewed them and had questions. They were amazingly helpful.
The 800 # would direct youto an office in your proximity. Ihave referred friends many times. I got tired of all the digital and snailmail plying me. Made it so easy. Seminars touted to clarify the endless possibilties- Hell no!
 
krusty said:
And what's available varies greatly from county to county.

Health care in this country is a quagmire.

As for dental...a common saying among independent brokers is that "with the right coverage you can turn a $200k medical bill into a $5k one, but about the best you can do with dental insurance is to turn a $10k dental bill into an $8k one".
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x2

Have spent 20K in out of pocket dental work in the past 7 years....wife's brother lives in AZ, goes to Nogales, Mexico for his dental work., US trained dentist...a half dozen implants that would have cost 30K here in the states cost him 10K.

Another probelm facing retirees is an increasing number of doctors will not accept MediCare patients due to the low reimbursement for visits, some even 'releasing' current patients as they aged over to MediCare.

Another issue are out patient procedures costs. Whereas hospitals accept MediCare and the supplemental plans, many private surgi-centers will not even bill MediCare, and if MediCare is not billed, supplemental plans won't pay a dime.

As stated earlier, the advice of an independent broker is invaluable in researching which health care plans work best for you. And an important factor isn't just the plan, it's the network within the plan - is it well represented in your area, does it cover your current primary care doctor or are you going to have to search for a new one. Does your doctor provide a free wellness visit with associtate tests each year that MediCare reimburses fully , or do they instead give you an annual physical which MediCare treats as an office appt.

I was in West Australia on a surfing trip in the 80's, got hammered on the reef, needed stitchs, went into a local clinic...once sewed up went to the counter and pulled out my wallet and asked what I owed...they said nothing...replied I'm an American, not an Aussie...they replied didn't matter, health care was free for anyone who needed it....what a concept
 
My employer insurance (which, as a retiree I no longer need) deliberately left the massively predominant network in Spokane...almost no providers or hospitals were 'in-network'. They also provided zero coverage for any preventative annual checkup. Which meant we had to fork over $500 apiece just for our annual wellness exams necessary for the few medications we take. Very punitive, and not very rational since good preventative care means that more costly later intervention may be avoided. I suspect they just hoped we'd die quickly without adequate care.
 
Good luck navigating the quagmire Jojo. I was a long time Group Health member because I liked the "one stop shopping" that made it convenient to me with my minimal medical service needs. I stayed with GH when Kaiser took over, but then went I went on Medicare as an official old fart I expected GH/Kaiser to reduce my premiums since Medicare becomes the primary bill payer. They didn't. GH/Kaiser kept charging me the same premiums while I now also paid a monthly premium to Medicare, and to top it off GH/Kaiser significantly reduced the benefits. So I left. Searching the quagmire left me baffled, but a good friend who is a consumate researcher when it comes to spending a dime told me to check GEHA (we're both retired federal employees), so I switched to GEHA, which I think is the gov't employee arm of United. Anyway, I got a lower monthly premium since Medicare gets billed first, and I haven't had any copays for office visits and pay an insignificant copay for a prescription.
 
krusty said:
My employer insurance (which, as a retiree I no longer need) deliberately left the massively predominant network in Spokane...almost no providers or hospitals were 'in-network'. They also provided zero coverage for any preventative annual checkup. Which meant we had to fork over $500 apiece just for our annual wellness exams necessary for the few medications we take. Very punitive, and not very rational since good preventative care means that more costly later intervention may be avoided. I suspect they just hoped we'd die quickly without adequate care.
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A couple hospitals in Vancouver. A lot of options here. Finding a regular provider took me 2 years during the covid peak
 
I've been retired for almost 23 years. I have Humana insurance. I haven't paid a premium for insurance now for going on two years. I get my meds from them. I only have a 10 buck co pay when ever I go to see a doctor, which is once a year to get my meds renewed. 5 different pills that run under 24 bucks a month. I could say I'm pretty healthy for an old man.
 
Old Man said:
I've been retired for almost 23 years. I have Humana insurance. I haven't paid a premium for insurance now for going on two years. I get my meds from them. I only have a 10 buck co pay when ever I go to see a doctor, which is once a year to get my meds renewed. 5 different pills that run under 24 bucks a month. I could say I'm pretty healthy for an old man.
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You certainly are! Probably from staying away from the dr office.
 
Old406Kid said:
The title of this might be taken as controverial, not my intent at all, but it has a lot of good info to give a person a better understanding.

medicarewire.com

11 Reasons Why Medicare Advantage Plans are Bad - MedicareWire

The biggest drawback of Medicare Advantage is high out-of-pocket costs. This article explores why Medicare Advantage Plans are bad for some people.
medicarewire.com medicarewire.com
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I compared them, and bypassed them, what I wanted in a plan was not there but you would pay for sheet i would never use. Went with a small Regence add on instead
 
Old Man said:
I've been retired for almost 23 years. I have Humana insurance. I haven't paid a premium for insurance now for going on two years. I get my meds from them. I only have a 10 buck co pay when ever I go to see a doctor, which is once a year to get my meds renewed. 5 different pills that run under 24 bucks a month. I could say I'm pretty healthy for an old man.
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Forum Legend's are compelled by the forum bylaws to stay healthy and keep going forward... :)
 
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