Retirement, Medicare, drugs, supplemental insurance general discussion

Oldstick

Senior Member
Everyone's situation is different and everyone's needs for coverage are different. With that being said, it is more efficient to talk to somebody one on one and assess their particular situation to help them decide their best route. I am an independent Broker and represent multiple different companies that offer medicare advantage and medicare supplemental plans, i will be more than happy to answer and help any of my fellow woody's members with their plans. Pm me for any additional questions that you may have.

That is very good advice, it took me months of digging and reading before I had even weak grasp of how all that stuff worked.

Someone asked about the general price of the supplement plans and seems most of them charge according to your age. The older, the higher of course. And you don't automatically qualify, depending on your health history. They offer several different ranges of coverage and the prices we found for a 78 year old were $120 to $300 or so a month, according to what coverage.
 

KyDawg

Gone But Not Forgotten
I signed up for long term healt care about 4 years before started receiving SS. If you do it early enough the cost is very low. I would suggest that you talk to several providers of medicare supplements and develop a better understanding of what you are paying for.
 

Jim Baker

Moderator
Staff member
So was the amount blue cross paid more consistent with them being primary coverage? (80%)

No. BCBS paid 100% of the Doctor and Lab Charges less $40 copay after MC paid the $7.39. Wife keeps all those records. I will try to remember to get her to pull them out.

I do remember the $7.39 because it was an odd amount. Didn't correlate to 20% of anything.

Like I said it confused me and I just put it aside. In the end everything was paid so I didn't worry with it anymore. Which is part of the healthcare insurance problem.
 

Milkman

Deer Farmer Moderator
Staff member
No. BCBS paid 100% of the Doctor and Lab Charges less $40 copay after MC paid the $7.39. Wife keeps all those records. I will try to remember to get her to pull them out.

I do remember the $7.39 because it was an odd amount. Didn't correlate to 20% of anything.

Like I said it confused me and I just put it aside. In the end everything was paid so I didn't worry with it anymore. Which is part of the healthcare insurance problem.

Sounds like your coverage is like my buddy mentioned above. Your wife's coverage is primary and medicare is secondary.
 

Milkman

Deer Farmer Moderator
Staff member
Ok
Let’s see what anyone has to add to this subject.
 

Jim Baker

Moderator
Staff member
Since my last post here I spent 4 days in the hospital. I recieved a explanation of payment from MC that was for the first 2 days. A week or so later I received another for the last 2 days. Seems their "periods" ended during my stay so my MC payments were in two different time periods.

After trying to understand the "explanations" of payment I filed them away. Now I don't even bother to open them up. They are hazardous to your health.

Everyone gives BCBS a bad rap, but I have say they have paid every dime Medicare didn't.
 

KyDawg

Gone But Not Forgotten
We have medicare and the supplement. We also got a long term health care policy to cover nursing home expenses. I hear people say they they will never go into a nursing home, but some times that decision can be out of your hands. We have one that the premium stays the same, but coverage is increased every year we don't use it. Does not take long in some of those places can wipe out a lot of money. I am not necessarily talking about spending the rest of your life in one, because a good one can do a good job of rehab, to the point you can return pretty much to a normal lifestyle. If so you do not want to do that, way down on money due to nursing home bills.
 

Oldstick

Senior Member
I will add that my father-in-law has come out ahead of the game with a Medicare supplement plan. He signed up with a supplement type F plan from Mutual of Omaha, beginning last January, for $198 a month. He has to have a type of chemo treatments for a blood marrow disorder every week. His portion, after Medicare pays, is at least $300+ a month.

The only way he qualified for the supplement plan, due to his pre-existing health, was the Medicare rules that require them to cover you when one of the "Medicare Advantage" plans drops coverage in your area.

So my advice to anyone who's not in the super wealthy classification, is to get a Medicare Supplement plan while you are able, unless you already have an employer or retiree plan available that can act as the supplement.

Medicare Advantage plans are not the same as Medicare Supplement plans, as he found out the hard way, thanks to some help from the phone salesman at "AARP Advantage".
 

BassRaider

Senior Member
Retired 8 yrs ago(57). Medical went from $300 mo to $1600 mo ('16). On top was meds and deductibles to the tune of $22k yr. Last year we both turned 65 and our yearly medical was $12k. This year estimates to be $6k + meds and co-pays.
We had to make drastic changes:
I went with Kaiser for $91 mo (doctor $5, specialist $33 + meds) I am more than satisfied with the care the provide.
My wife went with United Health ($192 mo/$89 mo for Rx). She wanted her same doctors.
We each have $134 deducted from SS for Medicare.
 

Oldstick

Senior Member
As a heads up, my Mom has discovered a flaw in the system for those with both Medicare and supplement plan. It shows up when you go to a pharmacy to get "medical equipment" such as diabetic test strips or needles, etc.

Medicare covers equipment under Part B, instead of Part D (prescription drugs). And for some reason the pharmacies say they cannot file with the supplement plans, so they charge you the coinsurance that part B doesn't pay. But then evidently, Medicare automatically forwards the claim to your supplement plan which also pays the same coinsurance amount to the pharmacy.

The pharmacy never contacts you or issues you an automatic refund. She has had this happen both with local pharmacies and with the big chains. The supervising pharmacist at Wal Mart told her it was a known problem in the system and supposedly a fix is being worked. In the meantime, she has to make a second visit with her receipts and insurance statements to get her refunds.

Why a double payment like this is not automatically flagged in anyone's accounting systems, is beyond me.
 
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