Medicare Plan G

[Tinhack]

If you on straight Medicare, you paid 20% of the total charge. Medicare only pays 80% and unless you have a supplement , you are responsible for the other 20%

Having said that, I have a Humana supplement N plan. I've been pleased with it. $96.00 per mo where I live

I pay 20% of the allowed charges. My 11 days in a premium hospital, including 3 days of intensive care, correction of an ulcerated stomach (internal bleeding) that started my heart attack and the replacement of my aortic valve by the best-known surgeon in the San Antonio area cost me about $3500. It was my choice to go there, and I had to sign a release in the ambulance for them to take me there because they thought I'd die on the way. I told them turn up the oxygen and don't spare the horses. That was in July of 2018. By the way, my chest scar is only about 3 1/2" long. I've heard of OHS* folks being split from throat to belly button.

You? You'd be lucky to get an English-speaking doctor from the US at a satellite first aid station. That's how the group insurers work. Good luck if you really need a doctor quick.

I have RA appointments for which I pay $23. Sometimes they'll be twice a year, sometimes monthly for a few months when I have a flair-up. My cardiologist wants to see me annually. That's usually about the same.

The deductible went up this year--I think it went up to $250/year.

I could see it being hard on someone living paycheck to paycheck (SS), but I stay ahead. But I live in Texas and it's easier to do down here.

*OHS - Open Heart Surgery

 

[ultrarunner]

Plan G basically replaced the plan F. There's very little difference in the two.

Why is Medicare Plan F no longer an option for most people? In short, Medicare Plan F is being phased out because of the first dollar coverage that made it so popular. As federal lawmakers saw it, that kind of coverage has the potential to be overused at the expense of the Medicare program.

 

[Tinhack]

Oh yeah, I forgot about the two months of in-home care after my surgery. I didn't pay anything for that.

Edit: Within 5 minutes of me arriving at the hospital ER and transferred to a gurney in the ER, the ER doctor and three assistants were hand-forcing 4 pints of whole blood through both arms. That's what saved my life. You wouldn't get that at a satellite hospital or aid station.

 

[LouNY]

I have the "G" option it is certainly not inexpensive at $226 a month on top of the Medicare then $31 month for a drug plan. The G is what replaces the F, and it has a $240 a yr deductible.

 

[ultrarunner]

Mom 24 years of plan F and the last 18 months is the only time with hospitalization...

At age 89 the premiums
took a big chunk of the monthly social security and for decades the plan was little used.

Stats show for many it's the end of life when the lions share of medical expense incurred.

 

[ponytug]

Mom 24 years of plan F and the last 18 months is the only time with hospitalization...

At age 89 the premiums
took a big chunk of the monthly social security and for decades the plan was little used.

Stats show for many it's the end of life when the lions share of medical expense incurred.

5% of Medicare beneficiaries cost the system 15% of its spending in their last year of life according to this report;

The True Cost Of End-Of-Life Medical Care

It's a well-known fact that we spend a lot of money on the healthcare of those who are dying, especially during the last 12 months of life. But is that "wasted" money a bad thing?

www.acsh.org

A more recent report suggests that it might be as high as 8.5%, pretty typical of most countries. (Taiwan was 11.2%)

https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0174

The countries included were Denmark, England, France, Germany, Japan, the Netherlands, Taiwan, the United States, and the Canadian province of Quebec.

If you consider the average life expectancy in the US of 75-78, and that Medicare for most folks starts at 65, those numbers are not that far out of the average cost per year. In other words, no, we don't spend a proportionally enormous amount of money on healthcare in our last year of life.

All the best,

Peter

 

[kenmac]

I have the "G" option it is certainly not inexpensive at $226 a month on top of the Medicare then $31 month for a drug plan. The G is what replaces the F, and it has a $240 a yr deductible.

I believe it depends on your zip code and other things such as no underwriting for coverage, etc,.
A plan G for my would have been $150 per mo so I opted for the N @ $96 per mo. and will self insure for the small deductible, etc,. Went to the dermatologist today and it cost me $20 for my visit

 

[KennyG]

I have a theory on why Plan F is no longer available for new enrollees but G is (and why D is available but C isn't). The only differences in these plans is that the old ones (C and F) covered 100% of Part B deductible and the new ones (D and G) do not. It's human behavior. If you don't have any liability you tend to overuse and abuse the system. I have N because it has a lower cost because it doesn't cover "excess charges". I'm in an area that doesn't really have an issue with those.

 

[Tinhack]

...spending in their last year of life...

I certainly hope that was determined after the fact. I wouldn't want some bean-counter determining my end of life. I plan to make it another 30 years. That will make me 103 years old.

 

[ponytug]

I certainly hope that was determined after the fact. I wouldn't want some bean-counter determining my end of life. I plan to make it another 30 years. That will make me 103 years old.

The analysis is all after the fact, not by the insurers.

I do think that the important takeaway is that on average the spending is about the same year to year, regardless of whether it was the the person's last year or not.

Best of luck in your goal, and being both healthy and active (mentally and physically) when you get there.

All the best,

Peter

 

[3Ts]

Plan F also includes a limited amount of coverage for out of country accidents requiring medical care. Not sure how that works though.

 

[KennyG]

C, D, F, G, M and N cover 80% of "Foreign Travel Emergency". As I understand that is for care until you can safely return to the US.

 

[Sprinkler Fitter]

My wife will start getting Medicare in stop September, I’m younger than her, from what I read she will automatically get A & B because she is getting social security already. We don’t have to get any extra’s though do we?

 

[KennyG]

You don't have to get any extras. However, consider the long term needs. There are a lot of limitations to basic Medicare that a supplemental (Medigap) plan will take care of and if you don't pick up a supplemental plan when you are first enrolled, you may not be able to add it later. Also, Part D covers medication. You can add it later, but you will pay a significant premium penalty if you don't get it initially.

 

[Sprinkler Fitter]

You don't have to get any extras. However, consider the long term needs. There are a lot of limitations to basic Medicare that a supplemental (Medigap) plan will take care of and if you don't pick up a supplemental plan when you are first enrolled, you may not be able to add it later. Also, Part D covers medication. You can add it later, but you will pay a significant premium penalty if you don't get it initially.

What is the cost on some of the supplements? I still have my insurance from my job when I retired in 2020.

 

[KennyG]

What is the cost on some of the supplements? I still have my insurance from my job when I retired in 2020.

You will need to check for your area and the various options. I pay about $110 per month for Plan N. For Part D I pay more because of a late enrollment penalty and a high income penalty so it is about $60/month

 

[mjonesnh]

What is the cost on some of the supplements? I still have my insurance from my job when I retired in 2020.

Plan G runs 118/month, Part D is 50 cents /month. Was paying 31.00/month going to 56.00/month. Shopped around, talked with my agent and changed companies for part D. Same drug store, same medicines. Just different plan. Pays to run the numbers at open enrollment. All my current meds are zero copay.

 

[LouNY]

My wife will start getting Medicare in stop September, I’m younger than her, from what I read she will automatically get A & B because she is getting social security already. We don’t have to get any extra’s though do we?

The various medigap or advantage plans vary in cost considerably depending on your location. The Part "A" is called no cost, as it's paid for while working. Part "B" has a cost the basic is $174 per month. Then the various medigap policy's my "G" is $266 a month and my part "D" $31 month. But others on here are much less for the same coverage because of their location.

 

[Sprinkler Fitter]

Plan G runs 118/month, Part D is 50 cents /month. Was paying 31.00/month going to 56.00/month. Shopped around, talked with my agent and changed companies for part D. Same drug store, same medicines. Just different plan. Pays to run the numbers at open enrollment. All my current meds are zero copay.

The various medigap or advantage plans vary in cost considerably depending on your location. The Part "A" is called no cost, as it's paid for while working. Part "B" has a cost the basic is $174 per month. Then the various medigap policy's my "G" is $266 a month and my part "D" $31 month. But others on here are much less for the same coverage because of their location.

Thanks. I forget the exact price but I pay $500 a month now for the same insurance I had while working and I think they said it goes down to $250 when I get on Medicare.

 

[ultrarunner]

Not in the know but several co workers past 65 have not done anything with any of the "Plans" as they are gainfully employed with comprehensive employer coverage here at the hospital.

One told me penalties don't apply as long as you have employer coverage with no gaps.

Also said COBRA doesn't count?