Medicare questions

[nisryus]

So now that i got my 401k questions squared away, its time for health coverage.

I haev started looking for work, but in the mean time, ex company is offering COBRA.

Questions are:
1. My wife is on SSDI (but she is below age 65), so she is enrolled in Medicare Part A already. I checked Medicare site and she can get Part C (Medicare Advantage) with drug coverage. If we are to enroll her in Part C, will there be penalty if I find a job and offer better insurance, and she has to cancel her Part C coverage?
2. Why is Medicare so.. cheap? I see so many different plans being offered but they are generally much cheaper than private insurance...
3. Is it wise to get her coverage under COBRA, while enrolled in Part C, I saw some people say its better to get extra coverages, just to be safe.. is that reasoning valid?

TIA

 

[Torn Mind]

Is she dual eligible?

Does she actually use medical services?

Avoid UHC if she actually uses services because out of the garbage companies, they're likely in first place for being pieces of shit. Every single transaction might be a rejection initially, followed up by an appeal. So many providers don't even take them and those that do might do just the bare minimum.

 

[BoomerD]

No reason she would have to cancel her Part C coverage just because YOU get a job. Keep it, use it as her primary and yours as secondary to cover any deductibles and/or co-pays.

I've had two different Med Advantage plans. First one was with Humana. If it was available where I now live, I'd STILL have Humana. I now have Regence Blue Shield. It's OK, but much more costly than Humana was. (higher premiums, higher co-pays/deductibles, and prescriptions are a bit more expensive.

 

[Captante]

If you go with any "Advantage" plan be 100% certain to read ALL the fine-print.... per Consumer Reports there are numerous potential "gotchas" to look out for.

Bear in mind those plans are not actually "Medicare" at all except in name.

 

[PowerEngineer]

If you go with any "Advantage" plan be 100% certain to read ALL the fine-print.... per Consumer Reports there are numerous potential "gotchas" to look out for.

Bear in mind those plans are not actually "Medicare" at all except in name.

Yes, I also suggest that OP be very careful with Part C Medicare plans. I would also be a bit worried about how preexisting conditions might be handled if you subsequently decide to switch Medicare plans. FWIW I've had no problems with UHC Plan F Medi-gap coverage.

 

[nisryus]

To answer Torn Mind, she is not dual eligible. She has asthma, anxiety disorder (very light), and probably heart disease (her grand father and her father both have it), so she does sees specialists more than a few times a year.

When we called Medicares numbers and spoke to one of the agent, since she has SSDI, she is qualified for Part C. The hard part is to chose a plan.

UHC i think is United Health Care, right? I saw the cheapest plans are AARP xxx, but looks like they are all plana insured by UHC. I kind of remember NPR had a few articles on health care with patients complains on UHC too...

We are in Central Texas, so several other choices we have are Blue Cross, Humana, and Baylor Scoot & White.

First time we have to deal with Medicare, so I just borrowed the Medicare 2023 booklet from my neighbor and going to read through it.

 

[Torn Mind]

To answer Torn Mind, she is not dual eligible. She has asthma, anxiety disorder (very light), and probably heart disease (her grand father and her father both have it), so she does sees specialists more than a few times a year.

When we called Medicares numbers and spoke to one of the agent, since she has SSDI, she is qualified for Part C. The hard part is to chose a plan.

UHC i think is United Health Care, right? I saw the cheapest plans are AARP xxx, but looks like they are all plana insured by UHC. I kind of remember NPR had a few articles on health care with patients complains on UHC too...

We are in Central Texas, so several other choices we have are Blue Cross, Humana, and Baylor Scoot & White.

First time we have to deal with Medicare, so I just borrowed the Medicare 2023 booklet from my neighbor and going to read through it.

Yes, United Healthcare.

I have plenty of personal experience with it; both myself and my mother.

Now, I didn't have to suffer consequences because Medicaid cover doctor's visit, but the fist inkling of their "culture" was:
1. the denial of a second doc's claim which the doc appeal.
2. In addition, I couldn't find any specialist willing to take the insurance.

In my mother's case they were so brazen as to deny a covered drug and basically render an appeal as pointless due to the timing.

They'll deny claims at every opportunity. This in turn turns doctors away from accepting the insurance.

Their directory is false representation of who actually takes patients, in part due to the above.

They tempt people with rewards and benefits like OTC. My mom is "dual eligible" due to income. But those benefits are best left to strictly healthy seniors.

You could just stick with Original Medicare(which is to not pick any part C plan). I think with part C, you have to pick a primary and depend on them for referral. With original Medicare, you have much more flexibility and can basically see any specialist you want.

As for heart disease, I'll say that the end result of hoping the system will help, regardless of insurance, is that they'll likely first start with a three year course of statins. Changing diet will help a lot. Cutting out both amount and frequency of refined carbohydrates would be a start if you haven't done so already.

 

[Geekbabe]

I went with traditional Medicare, I have part A & B, I also have a medigap plan via Harvard Pilgrim & a drug plan via Cigna. My situation is different, I have stage IV cancer & pretty severe COPD. I also live in Massachusetts which is one of 3 states that have different rules. COBRA would have cost me over $700 a month but only for 6 months, it would then have skyrocketed to almost $1,500 a month to cover myself and my husband.

I have applied for SSDI & am still waiting, my Medicare costs close to $350 a month plus a $280 yearly deductible & a $505 deductible for my drug plan. Expensive but that’s it, no copays, no extra charges & I can see any Doctor that accepts Medicare. With the number of scans & tests I get this is a good thing.

I would stay far,far away from the Medicare advantage plans, many of them won’t cover a dime till you spend 6-7K.