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Medicare Health Plans
#31
not everyone that is eligible for social security is eligible for medigap. Not all medicare advantage plans are HMO's. Mine isn't.
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#32
(10-22-2014, 08:06 PM)surferdude2 Wrote: I use Plan F - high deductible for my Medicare supplemental coverage. The premium costs me 83$/mo. I pay the first $2110 as the deductible. After the deductible is met, plan F pays 100% of all charges that I incur after Medicare pays their part..

I could avoid the deductible by getting plan F standard version but the premium is $254/mo. That would cost me $3048/yr whether I used it or not. It pays 100% of all costs from the get go.

I figure I don't need insurance unless I get some terrible disease and even then I'll only be out the $2110 deductible plus 12 X $83 for the premium = $996. The total cost for a year could never exceed $2110 + $996 = $3106. That would be the worse case. If I am reasonably healthy, I'll pay the usual Medicare annual deductible of $147 and the plan F-high deductible premium of $996 for a total of $1143 for the year. That's a good saving over the standard plan F cost of $3048.

I consider what I have as catastrophic coverage and I'll gladly pay for the small stuff and hope it is ever so.

edit: I consider the Prescription plan D as nearly worthless but I keep it anyway.

just curious. I was told that with straight medicare if you go in the hospital for a medical condition that one has to pay a deductible and if that same person has to go into the hospital 91 days later for the same condition they have to pay the deductible again. Not for sure if it is 91 days but I am sure that the person has to pay a deductible EVERYTIME they go into the hospital UNLESS it is for the same illness and not longer than the time period specified by medicare (I can't recall if it is 30, 60 or 90 days but if one exceeds the time period, they must pay another deductible). Is this Plan F?
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#33
Plan F is one of the optional insurance policies (A,B,C etc), the highest cost, and the best, that you can add to your medicare coverage. It will pay all the deductibles and charges that medicare does not pay.
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#34
I have a Medicare Advantage plan and its not an HMO. Its a PPO. Anywhere its accepted out of network which is anywhere that accepts medicare it pays exactly the same as in network on anything.

Most of stuff is out of network even my cpap and no hitches at all. Prescriptions run about 3 bucks a fill for about anything in a generic or a brand name if its preauthorized as medically necessacary by my doc.
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#35
(10-22-2014, 09:03 PM)me50 Wrote: I am not sure that is the case if the person is eligible for LIS. Just something to check into.
What is LIS?
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#36
(10-23-2014, 05:03 AM)justMongo Wrote:
(10-22-2014, 09:03 PM)me50 Wrote: I am not sure that is the case if the person is eligible for LIS. Just something to check into.
What is LIS? Low Income Subsidy?

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#37
(10-22-2014, 08:06 PM)surferdude2 Wrote: I use Plan F - high deductible for my Medicare supplemental coverage. The premium costs me 83$/mo. I pay the first $2110 as the deductible. After the deductible is met, plan F pays 100% of all charges that I incur after Medicare pays their part..

I could avoid the deductible by getting plan F standard version but the premium is $254/mo. That would cost me $3048/yr whether I used it or not. It pays 100% of all costs from the get go.

I figure I don't need insurance unless I get some terrible disease and even then I'll only be out the $2110 deductible plus 12 X $83 for the premium = $996. The total cost for a year could never exceed $2110 + $996 = $3106. That would be the worse case. If I am reasonably healthy, I'll pay the usual Medicare annual deductible of $147 and the plan F-high deductible premium of $996 for a total of $1143 for the year. That's a good saving over the standard plan F cost of $3048.

I consider what I have as catastrophic coverage and I'll gladly pay for the small stuff and hope it is ever so.

edit: I consider the Prescription plan D as nearly worthless but I keep it anyway.

Thanks for some real-world data. So in my financial spreadsheet I keep that models my cash burn as a retiree, I can probably plug $4K in for health care and not expect to exceed that?

I think I have a pretty good handle on everything else for retirement. I've purposely tried to structure my life to minimize my cash burn when the "miracle of direct deposit" stops. It's really tough to obtain accurate Medicare information.
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#38
(10-23-2014, 08:25 AM)GeoffD Wrote: Thanks for some real-world data. So in my financial spreadsheet I keep that models my cash burn as a retiree, I can probably plug $4K in for health care and not expect to exceed that?

I think I have a pretty good handle on everything else for retirement. I've purposely tried to structure my life to minimize my cash burn when the "miracle of direct deposit" stops. It's really tough to obtain accurate Medicare information.

Medicare with the plan F (either the high deductable or the standard) will cover all your medical expenses except for pharmacy, eye care, most dental care.

The add-on prescription plan is necessary because although flawed, it does provide some protection. Also, if you do get hit with some terrible charges eventually the plan will cover them.
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#39
(10-23-2014, 05:03 AM)justMongo Wrote:
(10-22-2014, 09:03 PM)me50 Wrote: I am not sure that is the case if the person is eligible for LIS. Just something to check into.
What is LIS?

I think it stands for low income subsidy so if someone makes below a certain amount, they get their scripts at a discounted rate
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#40
I'm just saying.. when dumped out of retiree healthcare into Medicare, pick wisely.
If you start with a regular plan F, you can downgrade all the way to A.
But, going from A to F requires medical underwriting where they look at your records and can deny or charge a super high premium if you're not in top shape.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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