Medicare Dos and Donts

[lakngulf]

I am now 64 and headed toward Medicare the first of next year. Am interested in experiences you have had dealing with enrolling, selecting options, drug benefits, etc for Medicare. I am not sure whether I should be doing anything now or not. I am on my wife's state government health insurance, and keep thinking they will send me so info, but nothing so far. They will cover something of a supplement.

Any help in how I get started will be appreciated. Thanks.

 

[Bird]

I think you need to go to your nearest Social Security Administration office to apply for Medicare and take your birth certificate or other proof of age. Of course, I retired from the city and if a retired city employee was not eligible for Social Security (and I was not), then the city paid the Part A premiums and I had to pay the Part B premiums. It only took me about a month and a half of visiting the Social Security office, making lots of phone calls, visiting the city hall, etc. I started in early October and turned 65 in January, so I was glad I started early. Of course that was all nearly 10 years ago.

I hope you have an easier time of it, and if you are going to be applying for Social Security also, it will be much easier. Once my wife turned 65 and applied for her Social Security, then I qualified for the Part A under her benefits instead of the city paying for it. My pension system holds out the Part B premium from my pension and pays it.

 

[smstonypoint]

I retired from a state university in SC, and so I am covered by SC's state employee/retiree insurance program. I have a neighbor in NC who is a NC state retiree and based on my conversations with him, our insurance plans differ in many respects. The upshot is that my experience in SC and the experiences of those from other states may not be relevant to yours in Alabama.

That being said, Medicare became my primary insurer and my state plan became my secondary (supplemental) insurer when I turned 65. My monthly state insurance premium did not change. My research and that of my colleagues before me indicated that obtaining the same level of supplemental coverage outside the state system would be much more expensive. I cover my wife through my state insurance plan. She will turn 65 in December and she will then have Medicare as her primary insurer and the state plan as her secondary insurer. The premium I pay for her state insurance will not change.

All in all, I have been satisfied with my state insurance plan, both before and after retirement. If Alabama doesn't have a good plan for its employees/retirees, it may pay to look around. I am sure that your wife can obtain useful advice from the HR folks at her agency.

BTW, if you have yet to start receiving any offers from companies offering supplemental insurance, be prepared for a deluge. You might want to check to make sure that your mailbox can handle a ton of mail.

Good luck.

Steve

Edit -- My experience differed from Bird's. I was covered by SS, so I didn't have to visit the SS office for Medicare coverage. Everything was handled by mail.

 

[bobmisi]

I didn't have to do anything. At about 3 -5 months prior to turning 65 my card came in the mail, and all I had to do was send it back if I did not want part B, and the sent me a new card without it, as I'm on my Wife's policy. You should not have to go anywhere, but you could call your local SS office and inquire.

 

[MarkF48]

I'm on Medicare with a supplemental Advantage plan administered through BCBS (my former company foots most of the bill for the supplemental coverage). When I signed up for Medicare I did the entire process online at Medicare.gov: the official U.S. government site for Medicare and created an account with a password. I don't recall if I ever did call them for anything. Your user account will have information about your health and drug plans, as well as other information once you get signed up. It's been a while, but I sort of recall during the signup process the site stated I may need to submit certain documents such as birth certificate and such, but that never happened and they evidently had enough information. If you do need a birth certificate make sure it's an "official" one from the town you were born in. I had a problem with getting a passport a while ago that my birth certificate was from my town of birth, but was of an older "version" that the government wouldn't accept. I called the town and had them reissue a new one for a small fee. The online process was fairly easy. As I went through each page of the signup I printed pages I thought were important that I might want a record of and so I remembered what I put in as information.

As far as coverage, it's pretty much outlined in the this PDF book http://www.medicare.gov/Pubs/pdf/10116.pdf which I think you will get in the mail at some time prior to your sign up date. If you opt to have a supplemental coverage what you get will likely vary depending on the particular plan you sign up for. My supplemental coverage is through BCBS and they administer my health coverage and I do not contact Medicare for anything. You do however need to sign up for Medicare even if you have supplemental coverage.

As smstonypoint mentioned he was already covered by SS. I was also, so I don't know if this will make a difference in the process. I also signed up for SS online and did not visit an office. I'm not sure how many offices are actually still operational. I had read somewhere a lot of them were closing in preference to either using the phone or internet to access them.

This may be of interest also http://www.medicare.gov/pubs/pdf/02110.pdf

 

[lakngulf]

Appreciate the good info so far, and the links. Keep 'em coming. I do expect the State health plan to cover something of a supplement, and I am already on SS, so they should have the info needed. I will check out the sites, and the publications.

What about selecting drug plan? I remember helping my Mom pick one a few years back. Does the State supplement plan come into play with the Drug plan?

 

[smstonypoint]

What about selecting drug plan? I remember helping my Mom pick one a few years back. Does the State supplement plan come into play with the Drug plan?

Drug prescriptions are handled through my state health plan supplement to Medicare -- I didn't need to obtain separate Part D coverage. It may be different in Alabama.

Steve

 

[zzvyb6]

I took on Social Security at age 62 as part of my early retirement selection. I did the SS enrollment online. At 65 I was automatically enrolled in Medicare and Medicaid. If you want out, its also able to be done online. I selected a Humana Prescription Drug coverage deal and also Humana Supplementary coverage (Plan "F").

After being on these plans 5 months I needed prostate cancer surgery and follow-up care (total bill is now over $121,000). I have paid NOTHING for this and the amount due after 2 months is still ZERO.

Since I took a lump sum buyout instead of a pension, my only 'income' is the Social Security. Since its below a specified yearly amount, many drug companies let you claim poverty, allowing you to get non-covered medicines for FREE (As in Viagra for example). This low income status provides pathways for other benefits fo us po peoples, too.

 

[dave1949]

If you are drawing SS now, you should get the card in the mail that bibmisi described. That's my experience too.

Before Sharon retired I was on her Maine state public employee health care coverage. After she retired the benefit was very expensive to carry a spouse, her rate was fine, but to keep me on it was astronomical. I don't think they wanted me. :laughing:

It pays to shop around. I have Medicare A & B, plus an extension to B which includes D. The extension plus D cost is $54/month and provides the coverage I need. What you need may differ of course. This is from Martin's Point, a small Maine-New Hampshire company I didn't know much about but they checked out. The cost is well below any AARP sponsored plan or other big-name insurers.

Did it all on-line too, and all the medical people associated with our local hospital are preferred providers. The only thing different I did was move my prescriptions from Rite Aid to the grocery store because that grocery chain is their preferred pharmacy in Maine and the co-pays are lower. Plus I stopped paying Anthem ~$300 per month for an individual policy with a $15K deductible.

In any case, every year Oct to mid-December you can make changes to your selected carrier and coverage if you are on Medicare. So, it isn't as if you are making a decision you have to live (or die ) with forever with private insurers. The state plans may not be so flexible in that regard. I think you need to begin by completely understanding the state plan and go from there.

 

[grnspot110]

Just be sure to sign up for part "D", prescription plan, even if you don't need it now! I write the checks for my mother's bills, she hadn't signed up for part "D" & at her age, the monthly penalty for not signing up is more than the Humana plan payment. ~~ Lowell

 

[radioman]

Here are my tips... If you are on SS for any reason wheather its retirement or disability, you are elgible for part A no matter what for free. You DON'T need to pay B or C to get D as long you are covered by someone else like your wife. BUT here is the catch as I found out last year. SSA will try to penalize you for not having part B or C for EACH month you dont have insurance and it adds up to thousands. To combat the penalties is to prove you HAD insurance somewhere else and that starts with documentation. You need to print/keep all records of your spouse covering you with your name and SS and her name and SS on the paperwork. Dont rely on the SSA form to send to her company to fill out and send back to you. The SSA has a publication saying you dont need them to sign the forms, just showing proof of insurance is all you need , but the SSA offices will act like no - its not possible until you show them their OWN publication stating that. I'm filing mine away to keep forever. I had no insurance for almost a year due to this BS and sought help and answers till I found it. I will not bore you with the issues trying to get documentation - but I can tell you this - its important to do it NOW as you have access NOW and you WILL NOT have easy access later. trust me. been there. done that.

 

[lakngulf]

Just be sure to sign up for part "D", prescription plan, even if you don't need it now! I write the checks for my mother's bills, she hadn't signed up for part "D" & at her age, the monthly penalty for not signing up is more than the Humana plan payment. ~~ Lowell

Will do. I have researched the State policies a bit, and I think the drug plan happens there. But not sure.

 

[smstonypoint]

I am now 64 and headed toward Medicare the first of next year. Am interested in experiences you have had dealing with enrolling, selecting options, drug benefits, etc for Medicare. I am not sure whether I should be doing anything now or not. I am on my wife's state government health insurance, and keep thinking they will send me so info, but nothing so far. They will cover something of a supplement.

Any help in how I get started will be appreciated. Thanks.

My wife turns 65 on 12/20 of this year. She is already on SS, so her experience may not be relevant for those who are not yet drawing.

She received her first Medicare-related communication from the SSA on Saturday. It was a form that was to be completed and returned to the SSA by those wishing to apply for financial assistance in obtaining Part D coverage. It looks like you need minimal assets to qualify. I don't remember receiving the form back in 2012 when I turned 65, so this assistance may be via the ACA.

She received her Medicaid card today (8/11) and her coverage begins on 12/1. Her card indicates that she has both Hospital and Medical Insurance. The accompanying material says that she doesn't have to do anything unless she wants to decline Medical Insurance. She doesn't , but if she did, she would have to mail in a form indicating that was the case. The SSA would then issue her a new card saying that she had only Hospital Insurance through Medicaid.

Steve

 

[QRTRHRS]

I took on Social Security at age 62 as part of my early retirement selection. I did the SS enrollment online. At 65 I was automatically enrolled in Medicare and Medicaid. If you want out, its also able to be done online. I selected a Humana Prescription Drug coverage deal and also Humana Supplementary coverage (Plan "F").

After being on these plans 5 months I needed prostate cancer surgery and follow-up care (total bill is now over $121,000). I have paid NOTHING for this and the amount due after 2 months is still ZERO.

Since I took a lump sum buyout instead of a pension, my only 'income' is the Social Security. Since its below a specified yearly amount, many drug companies let you claim poverty, allowing you to get non-covered medicines for FREE (As in Viagra for example). This low income status provides pathways for other benefits fo us po peoples, too.

My wife is also on an "F" plan. She doctors quite a bit and her deductables were running 2-3 grand a year. While the Advantage plans run what 40-50 a month with co-pays, the 130/month for the F plan with no co-pays are a no brainer. She was in ER seven times between Xmas and New Years a few years back. Not one cent out of pocket.

I still have 15 months to go before I get on Medicare. Being pretty healthy, I will probably just go with an Advantage plan.

If I understand correctly, the government dictates what each plan offers no matter the insurance company you choose to buy from. The cost is not fixed however. Someone correct me if I am wrong. It's been awhile since I helped my wife wade through the paperwork.

 

[MacLawn]

Whew, great post! Navigating this SS mess is not easy. I've been studying it for a few years before I turned 65 last January. Went to my local office and got on Medicare and the hospital part, forgot wha' it's called. All this B, C, D, F mess, reminds me when I was in high school!

Anyway, just last night, I submitted my SS retirement form online to begin getting my gubmint checks starting 2/15. Does anybody know if that means I'll start receiving checks in February or when? My guess is it'll be March 1.

Let's hang in boys, we're gonna make it. I think.

 

[lakngulf]

Whew, great post! Navigating this SS mess is not easy. I've been studying it for a few years before I turned 65 last January. Went to my local office and got on Medicare and the hospital part, forgot wha' it's called. All this B, C, D, F mess, reminds me when I was in high school!

Anyway, just last night, I submitted my SS retirement form online to begin getting my gubmint checks starting 2/15. Does anybody know if that means I'll start receiving checks in February or when? My guess is it'll be March 1.

Let's hang in boys, we're gonna make it. I think.

I think they will let you know when to expect first payment. After that it depends on your birthday to determine the time each month that the money will hit your account.

 

[randy41]

i applied and asked for it to start in january. they say they will start paying me back the money they borrowed over the past decades in the middle of february. don't know a thing about medicare except that they say it is too soon to apply and i should wait until next year. i turn 65 in 5/15.