Medicare is so freakin’ great! Since you already signed up with a gym, I’ll add they sent Leah a free Fitbit. She’s finding it more accurate then the iPhone’s free iHeart app and it gives her a nice little zap when she crosses 10,000 steps. Oh, and her cataract surgery — which went very well!—dropped in cost from many thousands of dollars to hundreds once she crossed the invisible border. Medicare4all, right?
Congrats on joining medicare! As a state of Cal employee, I had excellent health insurance, and now that I'm retired, I have excellent supplimentary care for all the little things medicare doesn't cover. Like heating aides. Dental care. One weird thing about medicare is that it covers a yearly medical check in that is not supposed to be a medical exam. Most docs will push the limit by claiming they suspect a heart condition so they can listen to your heart, etc. It's still a game!
From what I understand, it’s super important to get your supplemental coverage secured and keep it up if you have any assets at all. The uncovered 20% can be huge.
I’m happy with my ACA coverage from Kaiser, but I’m really looking forward to Medicare in 14 years!
Please explain how the uncovered 20% can be huge - I’m not convinced yet, but I’m open. The only thing I’ve found so far that could be huge is a longer-than-30-day hospital stay (which is pretty much unheard of these days). What else?
Well, I am not as expert as the broker I consulted. But I have been bowled over by Emergency bills from the past. I’m conservative about it. And, this is important, the Medigap policy I got (in my region) is so cheap, it’s like “why not?” I just laughed at all the numbers, they seemed like pocket change. Maybe I’ll change it next year, I don’t know.
Starting my 4th year on Medicare. Beware of Medicare advantage plans. They will sell you on the low cost monthly premiums and inclusive RX coverage and then hit you with out of pocket costs depending on the care you need. I got the best supplemental plan I could afford and have had no out of pocket costs for my care which includes monthly infusions to offset unwanted chemo effects from lymphoma treatments 10 years ago (how’s that for a pre-existing condition?) and cataract surgery (I did pay out of pocket for specialized lenses to cure my astigmatism and extreme near-sightedness). No eye glasses needed after 60 years! Welcome to Medicare!
First of all, stay away, stay very far away from Medicare Advantage plans. They are private insurers pigging out at the Medicare trough. They promise ‘extras’ (eye, dental etc) and make up for it in big coverage loopholes. They’re a ripoff. Stick with “original Medicare”.
There’s a legit question of whether to get supplemental coverage, and given you’ve been without for a while and have some pent up demand, I would say go ahead and get it (a ‘reasonable’ plan) for a year and see if you use it much. They pay for the 20% of non-hospital fees that Med doesn’t cover and and other non-covered things. I took it for the first couple of years and then dropped it because I realized I was paying more in premiums than I was using. I may regret that — but other than covering hospital stays after 30 days (Medicare’s limit) I couldn’t get anyone to tell me what I needed it for. Not a recommendation cuz I’m sort of waiting for the other shoe to fall, but so far I have saved many thousands.
Beyond that, the manual (available online and hard copy) is decent. Read carefully through the various plan comparisons — it’s ridiculously complicated but if you are patient and take a few days to get used to all the terms etc., it finally makes sense. I couldn’t find any friends who were expert and I’m certainly not. You can change/adjust plans once a year, so you are better off playing it safe at first (it's better to get too much coverage and drop it later than to deal with penalties for signing up later).
The good news is that it's been a few years, but I found that the people on the other end of the official Medicare help line were actually kind, patient, friendly and knowledgable — all of them. Makes it so much easier to call.
Hey, thank you for all these “been there, done that” perspectives. I love it.
Here’s my initial take on the grift and horror of the predatory “Advantage” program — *everyone* know it’s dangerous crap, anyone who reads.
*Why is it still legal?* Seriously!
The Advantage-mongers are literally preying on the illiterate, the ill, people with no media access or social support.
I am appalled at all the con artist mail I’ve gotten at my doorstep about Medicare, that wasn’t remotely legit. I mean, I’m a high-info person, I wasn’t fooled, but I was furious! I would like to protest it, on the policy level.
As everyone pointed out, there’s a lot of paperwork to sign up, a lot of “alphabet” plans. It’s appalling that there isn’t ONE PLAN that covers EVERYTHING and that it’s a shell game to torture seniors. Fuck that!
But, thank goodness, I knew I could call a (state-licensed) independent broker in my region, who did ALL the hard parts. She does not have any vested interest in the various companies, she will work with them all. She knows who is offering the best deal at the best moment, etc, it’s her GIG. She cut to the chase about the major decisions and comparisons and listening to what mattered to me.
Believe me, I know seniors who stayed up all night reading ten thousand documents with a magnifying glass, but that was not me! The pros with a fiduciary duty are a GODSEND. Next year I’ll call her again and we’ll see how things have changed.
So, the details in my case: I am signed up for Plan A, like everyone, and Plan B. I got my Plan D for drugs, and my Plan G (Medigap) which covers everything A&B don’t quite meet! LIke I said, my total costs have plummeted to comically small.
Today, I got a full eye exam — covered. My lens and frames will be — covered. My prescription was so out of date! No wonder I have eye pain.
Then I went to the gym and joined this “Silver Sneakers” thing — covered. They allow you to use their huge facility during the afternoons, which is fine with me. The sun was pouring through the windows and the barn doors. They have a “Sneaker” class twice a week I’m going to try — I need to do weight-bearing exercise, on the CHILLED PUNK GRANNY end of the scale. Maybe if I get stronger I’ll get more ambitious, but this will be a good start.
What I really want is a very shocking “silver” lame outfit to wear to the “Silver Sneaker” sessions. I had to sign a promise I would dress appropriately, but HEY what does that MEAN.
Your message reminded me that my own passage to Medicare came when I was thanking my lucky star for the passage of Obamacare and my good judgement in living in a lefty state that had managed to elect a doctor as governor and pass the Oregon Health Plan even before Democrats seized total control of the government. My body had apparently responded with extra stress to the election of Trump and I had a TIA--a sudden inability to process written English--that was thankfully very "T" indeed, but led to the discovery of Atrial Fibrillation, which then led to the discovery of coronary artery crisis spots so by the time I passed my 65th birthday I was recovering from quadruple bypass surgery. Despite my dire poverty I was, thanks to the combination of OHP and ACA, not only fully covered for all the preliminaries, but when the doctor went out to find out which of the blood thinners on offer was covered, came back a bit surprised to learn that I could indeed get the good stuff. The ACA provision bringing all the standards up to the "standard" had eliminated the second-tier status I had previously "enjoyed."
After Medicare my health prescription costs did rise from zero to nominal, but that was a small price indeed for the reassurance that I would no longer need to remain utterly poor to qualify for medical coverage.
Anyway, welcome to the club. It does sound like you've signed up for one of those Medicare Advantage Plans (as did I a few years ago) which, besides allowing healthcare providers to profiteer from looser rules than the "regular" coverage requires you to check in every year to make sure they haven't done a bait and switch and dropped all the sweet enticements they used to attract you.
Speaking of attraction, the sexy nurse photo certainly lives up to the billing. Of course you were naked the first time I saw you live (Lupin) a setting which partly explains why I also understand and heartily concur with the comment about older women looking better naked than clothed. I remember your written comment once upon a time about a delightful woman you met on a nude cruise who looked like Granny Clampett when clothed. I don't expect the decade since I last saw you at Powell's to produce and such effect next time you're in town, but our Hippie Hot Tubs and historic nude beaches are always on hand to provide the antidote.
What a saga, David. Yeah, timing sometimes is EVERYTHING. I’m so glad you’re okay, and I’m touched you recall our old days at Lupin!
No, I’m not on Medicare Advantage, nope. Well known scam. But I do have “Plan G,” also called Medigap, which a little extra I pay to cover the slice A and B don’t cover if something really goes sideways. It throws in some vision, hearing, and OTC drug fun. I have A, B, D, and G! Haha. I want a letter named after me, the “S” plan.
Dunno if Silver Sneakers cover the climbing gym (we do have all the normal gym stuff there!) but I would freaking love to climb with you if that appeals. xoxo
Medicare is so freakin’ great! Since you already signed up with a gym, I’ll add they sent Leah a free Fitbit. She’s finding it more accurate then the iPhone’s free iHeart app and it gives her a nice little zap when she crosses 10,000 steps. Oh, and her cataract surgery — which went very well!—dropped in cost from many thousands of dollars to hundreds once she crossed the invisible border. Medicare4all, right?
Amazing. I want Medicare Water Ballet and I want it now.
Congrats on joining medicare! As a state of Cal employee, I had excellent health insurance, and now that I'm retired, I have excellent supplimentary care for all the little things medicare doesn't cover. Like heating aides. Dental care. One weird thing about medicare is that it covers a yearly medical check in that is not supposed to be a medical exam. Most docs will push the limit by claiming they suspect a heart condition so they can listen to your heart, etc. It's still a game!
Oh man. Let the Parcheesi begin!
From what I understand, it’s super important to get your supplemental coverage secured and keep it up if you have any assets at all. The uncovered 20% can be huge.
I’m happy with my ACA coverage from Kaiser, but I’m really looking forward to Medicare in 14 years!
Please explain how the uncovered 20% can be huge - I’m not convinced yet, but I’m open. The only thing I’ve found so far that could be huge is a longer-than-30-day hospital stay (which is pretty much unheard of these days). What else?
Well, I am not as expert as the broker I consulted. But I have been bowled over by Emergency bills from the past. I’m conservative about it. And, this is important, the Medigap policy I got (in my region) is so cheap, it’s like “why not?” I just laughed at all the numbers, they seemed like pocket change. Maybe I’ll change it next year, I don’t know.
Starting my 4th year on Medicare. Beware of Medicare advantage plans. They will sell you on the low cost monthly premiums and inclusive RX coverage and then hit you with out of pocket costs depending on the care you need. I got the best supplemental plan I could afford and have had no out of pocket costs for my care which includes monthly infusions to offset unwanted chemo effects from lymphoma treatments 10 years ago (how’s that for a pre-existing condition?) and cataract surgery (I did pay out of pocket for specialized lenses to cure my astigmatism and extreme near-sightedness). No eye glasses needed after 60 years! Welcome to Medicare!
First of all, stay away, stay very far away from Medicare Advantage plans. They are private insurers pigging out at the Medicare trough. They promise ‘extras’ (eye, dental etc) and make up for it in big coverage loopholes. They’re a ripoff. Stick with “original Medicare”.
There’s a legit question of whether to get supplemental coverage, and given you’ve been without for a while and have some pent up demand, I would say go ahead and get it (a ‘reasonable’ plan) for a year and see if you use it much. They pay for the 20% of non-hospital fees that Med doesn’t cover and and other non-covered things. I took it for the first couple of years and then dropped it because I realized I was paying more in premiums than I was using. I may regret that — but other than covering hospital stays after 30 days (Medicare’s limit) I couldn’t get anyone to tell me what I needed it for. Not a recommendation cuz I’m sort of waiting for the other shoe to fall, but so far I have saved many thousands.
Beyond that, the manual (available online and hard copy) is decent. Read carefully through the various plan comparisons — it’s ridiculously complicated but if you are patient and take a few days to get used to all the terms etc., it finally makes sense. I couldn’t find any friends who were expert and I’m certainly not. You can change/adjust plans once a year, so you are better off playing it safe at first (it's better to get too much coverage and drop it later than to deal with penalties for signing up later).
The good news is that it's been a few years, but I found that the people on the other end of the official Medicare help line were actually kind, patient, friendly and knowledgable — all of them. Makes it so much easier to call.
Read hcare blog for cautionary summary on Advantage with links: https://albertwoodward.wordpress.com/
This is really excellent - thanks!
I wish to add to those warning you about insurance that should not include medicare in the name.
There are bills in congress to prohibit this deceptive practice.
I am 76 years old, and I have experience with Medicare.
It sounds like you did not sign up for Medicare, but for private health insurance. Medicare _DIS_Advantage. The clue was the "free" gym membership.
Under disadvantage, your choice of medical provider is limited. Your choice of care is subject to approval by a private insurance accountant.
You can be thrown off, just like other private health insurance, and may not be able to sign up for a Medicare supplement plan.
The lower premium is a false economy.
Please look into your options more carefully. You may want to change.
Elegantly done, as always. FYI, the argument for/against Advantage plans should go state-by-state - MA allows switching yearly.
Hey, thank you for all these “been there, done that” perspectives. I love it.
Here’s my initial take on the grift and horror of the predatory “Advantage” program — *everyone* know it’s dangerous crap, anyone who reads.
*Why is it still legal?* Seriously!
The Advantage-mongers are literally preying on the illiterate, the ill, people with no media access or social support.
I am appalled at all the con artist mail I’ve gotten at my doorstep about Medicare, that wasn’t remotely legit. I mean, I’m a high-info person, I wasn’t fooled, but I was furious! I would like to protest it, on the policy level.
As everyone pointed out, there’s a lot of paperwork to sign up, a lot of “alphabet” plans. It’s appalling that there isn’t ONE PLAN that covers EVERYTHING and that it’s a shell game to torture seniors. Fuck that!
But, thank goodness, I knew I could call a (state-licensed) independent broker in my region, who did ALL the hard parts. She does not have any vested interest in the various companies, she will work with them all. She knows who is offering the best deal at the best moment, etc, it’s her GIG. She cut to the chase about the major decisions and comparisons and listening to what mattered to me.
Believe me, I know seniors who stayed up all night reading ten thousand documents with a magnifying glass, but that was not me! The pros with a fiduciary duty are a GODSEND. Next year I’ll call her again and we’ll see how things have changed.
So, the details in my case: I am signed up for Plan A, like everyone, and Plan B. I got my Plan D for drugs, and my Plan G (Medigap) which covers everything A&B don’t quite meet! LIke I said, my total costs have plummeted to comically small.
Today, I got a full eye exam — covered. My lens and frames will be — covered. My prescription was so out of date! No wonder I have eye pain.
Then I went to the gym and joined this “Silver Sneakers” thing — covered. They allow you to use their huge facility during the afternoons, which is fine with me. The sun was pouring through the windows and the barn doors. They have a “Sneaker” class twice a week I’m going to try — I need to do weight-bearing exercise, on the CHILLED PUNK GRANNY end of the scale. Maybe if I get stronger I’ll get more ambitious, but this will be a good start.
What I really want is a very shocking “silver” lame outfit to wear to the “Silver Sneaker” sessions. I had to sign a promise I would dress appropriately, but HEY what does that MEAN.
Nothing more soothing than the knowledge of my Medicare
Your message reminded me that my own passage to Medicare came when I was thanking my lucky star for the passage of Obamacare and my good judgement in living in a lefty state that had managed to elect a doctor as governor and pass the Oregon Health Plan even before Democrats seized total control of the government. My body had apparently responded with extra stress to the election of Trump and I had a TIA--a sudden inability to process written English--that was thankfully very "T" indeed, but led to the discovery of Atrial Fibrillation, which then led to the discovery of coronary artery crisis spots so by the time I passed my 65th birthday I was recovering from quadruple bypass surgery. Despite my dire poverty I was, thanks to the combination of OHP and ACA, not only fully covered for all the preliminaries, but when the doctor went out to find out which of the blood thinners on offer was covered, came back a bit surprised to learn that I could indeed get the good stuff. The ACA provision bringing all the standards up to the "standard" had eliminated the second-tier status I had previously "enjoyed."
After Medicare my health prescription costs did rise from zero to nominal, but that was a small price indeed for the reassurance that I would no longer need to remain utterly poor to qualify for medical coverage.
Anyway, welcome to the club. It does sound like you've signed up for one of those Medicare Advantage Plans (as did I a few years ago) which, besides allowing healthcare providers to profiteer from looser rules than the "regular" coverage requires you to check in every year to make sure they haven't done a bait and switch and dropped all the sweet enticements they used to attract you.
Speaking of attraction, the sexy nurse photo certainly lives up to the billing. Of course you were naked the first time I saw you live (Lupin) a setting which partly explains why I also understand and heartily concur with the comment about older women looking better naked than clothed. I remember your written comment once upon a time about a delightful woman you met on a nude cruise who looked like Granny Clampett when clothed. I don't expect the decade since I last saw you at Powell's to produce and such effect next time you're in town, but our Hippie Hot Tubs and historic nude beaches are always on hand to provide the antidote.
What a saga, David. Yeah, timing sometimes is EVERYTHING. I’m so glad you’re okay, and I’m touched you recall our old days at Lupin!
No, I’m not on Medicare Advantage, nope. Well known scam. But I do have “Plan G,” also called Medigap, which a little extra I pay to cover the slice A and B don’t cover if something really goes sideways. It throws in some vision, hearing, and OTC drug fun. I have A, B, D, and G! Haha. I want a letter named after me, the “S” plan.
I realized all of the long comment below is useless because you're already enrolled. Duh
No biggie. PEople who read comments love it!
Dunno if Silver Sneakers cover the climbing gym (we do have all the normal gym stuff there!) but I would freaking love to climb with you if that appeals. xoxo