Health Insurance for Old People

Logan52

Well-known member
Joined
Feb 27, 2018
Messages
648
Location
central Kentucky
Just a note to let you know dropping your Medicare part A and B can come back to haunt you.
My 90 year old Mom did that a couple of months ago. She came down with a mild Covid that went into pneumonia. This escalated into other problems.
For over a month, amid numerous snow storms at the height of my calving season, my wife and I were nearly totally occupied seeing to her needs. She ended up in need of the care she could only get in a nursing home. Her new supplemental insurance was a disaster for helping her get this type of care and we have been nearly pulling our hair out dealing with it. I finally had to hire an Elder Care attorney as the process was driving us crazy.
She is now in a local nursing home and much better.
 
Do people know that if you have Medicare part A and B you are also required to have Medicare Prescription Drug Coverage? In 2019 when I got social Security I did not sign up for it because my 2 prescriptions cost $10 each for three months worth at Walmart. Well, the government caught up with me and now I have to pay a penalty of $25 a moth for the rest of my life, deducted from my SS check.

I hope I get killed falling off my horse at full gallop on a fine day instead of going into a nursing home. Sorry this has happend Logan. Nursing home insurance is a separate thing. I think Medicare pays for a few days hospital care, some home care and short caretaker respites in nursing homes but it's not much. I'm glad your mom is getting 24/7 care she needs.
 
Last edited:
Do people know that if you have Medicare part A and B you are also required to have Medicare Prescription Drug Coverage?
That's not exactly true. You don't 'have' to enroll in Pt D when you sign up for Pt A & Pt B and you won't ever have to pay the penalties UNLESS, for some reason, you decide to enroll in Pt D later on. It's signing up later that results in "the govt catching up with ya". The penalty is a specific % of some base cost and you only pay the penalty for as long as you have a prescription plan.
 
I got a new insurance company after Regent BCBS decided to drop all the Medicaid clients in the whole county. Geezers too expensive I guess. The company that offered Medicare was the only one in the county so I had to sign up for it.

When I got a new insurance apparently they had made me sign up for part D. Now the government wants all the money they think I should have paid for 66 months of not having part D. My new insurance company said they did not turn me in, the government just found out about it. They also said I had to have part D, I can't just drop part D because the gov. won't allow it. I filled an appeal but of course was turned down.
 
Medicare Part D has some mysteries for sure. When I signed up for Medicare, there were many Part D plans in my area. With a wide range of prices. I started out paying about $10 or 12 per month. Next year I think it was about $15. Then last year, the premium was $0.50 per month. That's $6 per year. Then, this year, the premium is $0.00 per month. I pay no premium. I take 3 prescriptions that are very common drugs for old people. I can have them mailed to me or picked up at various drug stores. I pay zero for those 3 drugs that I take daily. When I or my wife are prescribed a drug when we are sick, the amount I pay is very reasonable. Mystery to me is how I get pills mailed to me and they cost me zero - no copay and no premium. This is a part D standalone plan, not a part of a medicare advantage plan. It is from Wellcare.

My father retired way back in the old days with a retirement plan that included medical benefits for him and my mother. Years later the company he had worked for went bankrupt. Some money was set aside in a trust fund to fund to continue those benefits for the retirees. My mother had medicare A&B as primary with the trust fund benefits as secondary. But no part D since that trust fund covered the drugs. When she was 88 years old, the trust fund money for prescriptions was depleted. I enrolled her in a Part D plan for the first time at 88. Then at 90, the money for medical benefits ran out and I enrolled her in a supplement plan. Just needed a statement of credible coverage from the trust fund administrator showing that she had been covered by a plan previously.
 
I am like @simme ... I have not paid a premium for my prescription plan the last 2 years now...

When I talked to our "ins lady" at work when getting ready to start Medicare, back 6-7 years ago....she explained about the penalty thing with the prescription plan.. since I did not take any prescriptions, she told me the best couple to look into... cheapest, so that I did not have to ever pay the penalty... It was like @simme said... $120 a year or $10 month or something... then it was $0 the last year. It is also Wellcare and is a stand alone policy...
Yes, if you had prescription with someone else, and then had to get it like at an advanced age... all you need is the proof of previous coverage...like simme's mom's plan
Sorry your original contact did not emphasize the possibility of penalties down the road... I don't know if there is any kind of recourse for you @TexasJerseyMilker .
Sometimes you play their game by their rules, and get what you really don't need, so that it does not come back to bite you later on...
 
I didn't have a previous contract. When I signed up Medicare sent me the form and I just checked the box part A part B.
"Previous CONTACT" not contract... I meant that when you were getting ready to sign up for medicare originally, it was a shame that they did not mention the possibilities of penalties in the future. Our county offers "medicare classes" every fall, Like adult ed classes...for people getting close to age and for others that might want to change type of plans...... and there are insurance agents that specialize in only Medicare plans and all the ins and outs. I went to 2 "information classes" was more confused than ever; talked to the ins lady from work when I was getting close to age... she guided me after asking questions of my personal health situation etc... It is NOT something to attempt to navigate on your own...

For ANYONE that is getting close to Medicare age... GET HELP navigating it as it has more twists and turns than a Louisiana swamp..... I think I am fairly smart enough to understand alot of things... I was TEA TOTALLY out of my league with figuring this out.
 
I suggest people read this book 2 years prior to medicare age.

Edit to add: I don't know why it says that "As an amazon associate thing". I just pasted a link. I don't earn any money. But it is a good book with a lot of info. If you have an HSA that you are contributing to prior to starting medicare, there is an important rule. IF you sign up for medicare after you are first eligible at 65 (maybe because you are still working with employer provided health insurance), then the official medicare start date is NOT when you sign up, but up to 6 months prior to your signup date. SO, you need to stop the HSA contributions well prior to your signup date. Or you will be "in trouble" with hsa contributions overlapping medicare coverage. Yeah, don't make sense. Welcome to medicare. It's covered in the book, I think.

 
Last edited:
As an Amazon Associate we earn from qualifying purchases.
That's not exactly true. You don't 'have' to enroll in Pt D when you sign up for Pt A & Pt B and you won't ever have to pay the penalties UNLESS, for some reason, you decide to enroll in Pt D later on. It's signing up later that results in "the govt catching up with ya". The penalty is a specific % of some base cost and you only pay the penalty for as long as you have a prescription plan.
Thanks! A good thing to know if I live that long.
 
What are the Advantage plans about? They advertise free dental coverage and other benefits.
keep in mind I am a hippy. Advantage plans are scams by private insurance taking funds from medicare. they are hmo type plans that can have limits and tell you what doctors to see. they skim enough to be able to offer all sorts of "free" stuff but when they end your coverage because you cost them too much or won't let you go to a specialist, that free stuff isn't going to do you any good. regular medicare A and B (and D) and a supplemental policy may cost a bit more but you will never be kicked off. the supplemental can be a high deductable if you think you will remain fairly healthy (and you can also just not get a supplemental plan but you will pay a percentage of bills) or a higher premium with nothing but the mandatory (I forget, less than $200) on the medicare itself. one or two of the supplementals even cover international travel.

Social Security and medicare are two of the best anti poverty programs our country has ever created. caring for the welfare of citizens is IN THE CONSTITUTION, nothing wrong with spending money to keep people healthy and with a minimum bit of income when they are old and/or disabled. And most of us put that money in place for that very reason all our working lives.
 
keep in mind I am a hippy. Advantage plans are scams by private insurance taking funds from medicare. they are hmo type plans that can have limits and tell you what doctors to see. they skim enough to be able to offer all sorts of "free" stuff but when they end your coverage because you cost them too much or won't let you go to a specialist, that free stuff isn't going to do you any good. regular medicare A and B (and D) and a supplemental policy may cost a bit more but you will never be kicked off. the supplemental can be a high deductable if you think you will remain fairly healthy (and you can also just not get a supplemental plan but you will pay a percentage of bills) or a higher premium with nothing but the mandatory (I forget, less than $200) on the medicare itself. one or two of the supplementals even cover international travel.

Social Security and medicare are two of the best anti poverty programs our country has ever created. caring for the welfare of citizens is IN THE CONSTITUTION, nothing wrong with spending money to keep people healthy and with a minimum bit of income when they are old and/or disabled. And most of us put that money in place for that very reason all our working lives.
Ya get what you pay for...and their are other plans other than HMO's. At least in Texas.
 
What are the Advantage plans about? They advertise free dental coverage and other benefits.

I will say up front that my knowledge is limited, but it seems like the "advantage" is to the insurance company. My mother signed up for that, but when she fell and had to spend an extended time in the nursing/rehab home the insurance company was about to stop paying for it. The people there recommended switching her over to conventional Medicare.
 
They're paying me too much. I just can't make myself retire. Keeping my day job, sold the big farm and most of the cows too. Just have a little place now and freezer beef.

But damn my phone rings off the wall with spam folks wanting me to sign up for medicaids. I'm still fully insured thru work.

When the time finally comes that I decide to walk away, I'm going to need yall's advice.
 
Just to throw my 2 cents in here. I am 71.... when I was coming onto 65, I talked to my ins advisor at work... I was going to lose my full time status at work, turn 65, and looking at SS signup also. We talked about my health condition... no issues, no medications regularly, no high blood pressure or diabetes or anything... BUT.... I was looking at some joint replacements...and my work ins had a 6500 deductible and other limitations so hadn't done it...
She told me to NOT consider any of the "advantage plans" there were too many "loop holes" and it would cost me dearly down the road... she said, this is what I put my husband on when he retired last year, he has had a knee replacement and it cost us $250 out of pocket...at that time.
I said fine, that is what I want... I went on Medicare A & B, got a supplement policy I think it is plan F or G... best they had... and took a prescription policy... cheapest we could find.. Wellcare... because I do not take any prescription regularly.
Medicare comes out of SS which is fine... my supplement was $78 the first year, has regularly gone up every year and is now $155... auto deduct out of my ckg acct once a month. Wellcare prescription plan was minimal, $12/mo... then $10/mo and last 2 years is no charge...
IF you do not get a prescription plan, there is a formula that will cause you to pay a penalty down the road when you do sign up.... as @TexasJerseyMilker has mentioned... UNLESS you have a prescription plan through work which then you can sign up with no penalty at any age. MUCH cheaper to sign up, pay a minimum and not get penalized down the road... like car ins and not needing it , until you do need it...

All of that said... My ankle replacement in Feb 2020, both knees in late 2021...... I paid a total out of pocket no more than $325 each year... ONCE for each year. I was in rehab... nursing home type care... for 17 days after each replacement... no one home to take care of me that first 2 weeks.... and I was in rehab/physical therapy for the ankle during covid disaster... for about 6-7 months after... for the knees I was in PT for a year plus due to some problems... and paid NOTHING except that "deductible" of $325 .... the first time it was $275, and has gone up a little and was $325 this past year. EVERYTHING was PAID FOR.......
I go to the dr if I need to, can make an appt with any specialist I want... had consultation on my shoulder and had x-rays, then an MRI and other things to determine the condition... I paid just the $325 last year... comes as a bill in the mail... I never get a dr bill... just a statement that tells what the dr appt or tests were and what medicare paid etc... and let's face it... one trip to a dr office and an x-ray will be more than the $325... so once you pay it... you do not pay anything for the rest of the year.
As far as the drugs go, I had to take some antibiotics and such... and there was a minimal cost for them... don't know how that would work for people that take anything regularly...

I don't know if I wanted to change from some other plan to what I started with, if I could afford it... so the best thing is to get on the very best plan right from the get go....

I can change to a "lesser plan" with other co-pays... I pay NO CO-PAYS..... once that $325 current deductible is met for the year... I pay nothing else.

I worked... and continue to work part-time... for 55+ years...Paid in... and continue to pay, SS and all, that out of the paycheck.... I did not have health ins for many years... I don't feel the slightest bit guilty for taking advantage of the benefits at this stage of the game

Hope this helps someone... Get someone you trust to give you guidance... the "seminars" I have gone to have only confused me... If you are contemplating something like a joint replacement get the BEST plan to start with... you can downgrade later if you never need it...

A friend of mine went from conventional Medicare to an advantage plan...2 or 3 years ago.... she has never used A & B since she started it... is now 79 and continues to work part-time... and said it was the best savings she ever made... gets all sorts of things like dental and eyeglasses and over the counter things like aspirin and all that for next to nothing... But what works for her would not have worked for me.... and maybe when I hit 80 I will switch.... as long as I have joint issues, I will stick with what I have... The $155/mo I pay is less than $2000 a year for the complete coverage I have... That is less than I paid for my part of ins through work.... when I was full time... and that ins had 80/20 after the deductible of $6500.....

Yes, Medicare is about $135/mo directly out of my ss check.... so I am actually paying a total of about 3600/yr between the Medicare deduction and the supplement... still less than the deductible I had .... Still a "deal" in my book...
 
Last edited:
Good information from Farmerjan above. I will add a little more about the Medicare supplement (also called Medigap) plans, especially Plan G. When it is time to "sign up, go to the Medicare.gov website and enter your zip code and sex and ALL plans offered in your state/county will be presented to you. In my area, there are 47 Plan G choices with varying premiums (G is just one of 8 plan choices). Lowest cost is $96/month. ALL of the Plan G choices are required to offer the same benefits. Those are set by Medicare. So, if all 47 of those choices offer the same benefits, why not just go with the lowest premium? There is a good reason. The lower premium choices are lower costs when you are younger, but the premiums increase as you age. Don't all the 47 choices have increasing premiums as you get older. Yes, they do. But the higher premium choices at signup will have premium increases due to inflation and cost of medical care. The lower premium choices will have those increases but will also increase due to your age. Those lower premiums choices at signup will end up being among the highest premiums as you get older - independent of inflation and cost of medical care. So, a person in poor health might select those low premiums at signup thinking they won't see much increase due to an expected shorter time on medicare. But a person in good health should probably choose a slightly higher premium at signup and avoid those age related premium increases.

Can't you change plans every year if you want to? Yes, you can. But I think you forfeit those "no premium increases due to age" when you change plans or carriers. There may also be issues with pre-existing conditions.

What is this Plan "G"? Plan G is the most comprehensive coverage. There are also Plans A, B, D, G, K, L, M, and N. With various levels of coverage. Lots of choices in plans, carriers and premiums. Buy the book "Medicare for dummies" and start reading 2 years before signup. The choices you make at signup are big decisions.
 

Latest posts

Back
Top