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Well, I will be 65 in December.


I understand I can sign up for Medicare beginning in September, but how is the transition from an Obamacare individual health insurance policy to Medicare supposed to be made?


Seattle Pioneer
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Seattle your transition will be very clean and very simple. The fact your current insurance has been purchased through an exchange will not change any part of the transition as compared to transferring from a healthcare plan through an employer.

I personally worried and fretted about this - that was unnecessary. You can sign up for Medicare Parts A & B at Medicare.gov

A few comments beyond your question -

Think carefully and long about getting a Supplemental (aka Medigap) policy. There are two basic choices.

One is an Advantage type plan. These were created in the Bush administration. Currently these plans get a subsidy paid by traditional Medicare recipients. That changes annually, I believe it in the $700 to $900 per year range. The capitation allows Advantage plans be be profitable with either lower premiums or at similar premiums offer additional coverage(s). You may recall during the ObamaCare fights each party accused the the other of taking money form Medicare in the amount of roughly $700 Billion - that money was an elimination of the capitation. The Ryan Health plan did and an original ACA legislation did that. I am not aware of any pending change in the capitation, but as medical costs for the government continue to increase that is low hanging fruit.

The second option is traditional Medicare with a Medigap policy (There is no requirement for the Medigap policy, but 20% of the costs for any major illness or injury is not small. ICU fees start at $10K per day here in Atlanta.)

One way or another under current law you are required to either have Drug coverage or sustain a life long cost increase penalty of 1% per month. So skip 2 years of Part D coverage. Say you sign up your premium, not matter what policy you select will be 124% of the stated rate. The penalty is permanent and intend to force people into coverage at younger ages when they needs are less.

Everyone has opinions - I have tried several choices and I think it is best to have all of one's medical premiums deducted from a social security payment. From time to time I change my Part D policy. The switch is much cleaner via Social Security. If you change banks, you do not have mess with moving the insurance payments - a process I have found always takes more than 1 monthly billing cycle.

You have to watch your Part D plans (If you go that way as opposed to say an Advantage plan most of which satisfy the Drug coverage requirement.) Companies offer broad formularies one year maybe with competitive prices. Then sometime slowly sometimes quickly they ax the formulary, jack up copays or maybe raise premiums. Each year I feel a person needs to examine options at Medicare.gov (I screwed up one year by accidentally comparing 2013 premiums for some plans with 2012 premiums for other plans. When you go to Medicare.gov in the fall, both prices sets are present.)

The Medicare.gov system for comparing PartD plans is excellent. If you sign up for ABC's plan and decide to change to the XYZ plan it is simple. You will be include in the last plan you signed up for. The process of signing up for any plan automatically cancels existing or previously selected plans.

In you choose a traditional Medigap policy the coverages for each of the government described plans is the same. There are very few coverage differences between insurance providers. I know there are significant difference in the quality of customer service. Do your research. You only are guaranteed one bite at this apple - generally speaking. Yes I could switch my insurance company - I am in good health and any company would like me. But we had a friend who had a stroke and no one would take her. Three years after her stroke, her company existed the health insurance business. That event is the one exception which guarantees a second bite at the apple. One should the selection of an insurance company for Medigap coverage as a lifetime commitment, unlike Part D which can be changed annually.
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don't worry

Your mailbox will be beseigned with mail starting 90 days ahead of your 65th birthday

You'll get letters from dozens of plans wanting to sign you up for supplements or for 'all in one' care.

you probably will sign up for a supplement plan. I think it is plan F that most people get.

On the other hand, you might elect a 'all in one' type HMO deal where they do the Medicare, Supplement and drug plan - but your choices of docs are limited to their network....

I got straight Medicare - since I travel a lot..... and don't want restrictions on coverage area...which usually come with the 'all in one' deals.

I got Walmart/Humana drug plan.....about as cheap a you can get since I only take one generic med.

And I got a supplement plan, now through New Era....that covers the 20% that Medicare does't in some cases.

You get a Medicare card. You go to your doc and he takes it (and your supplement card which you don't need for doc visits)...that's it....

simple.

In 3 months your mailbox will be overflowing with ads saying 'sign up with me'!.....plus you might get some phone calls...


t.
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Yeah....you do have to sign up , but a call to the SS office should probably do it. or you can probably do it on line.....

For Medigap, if you go that way.....choose one of the larger plans...not some smaller niche player.....


t.
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GWPotter writes,

The second option is traditional Medicare with a Medigap policy (There is no requirement for the Medigap policy, but 20% of the costs for any major illness or injury is not small. ICU fees start at $10K per day here in Atlanta.)

</snip>


Is that what the hospital bills, or Medicare's reimbursement?

You are only responsible for 20% of the Medicare rate, not the price-gouging "regular" hospital charge.

http://blogs.marketwatch.com/encore/2013/02/21/brill-make-he...

Brill then offers several real-life examples demonstrating the huge spread between the Medicare reimbursement rates and the rates that hospitals and doctors try to charge to private insurers and patients paying out-of-pocket. A blood-protein test that Medicare reimburses at $13.94 gets billed at $199.50 to an uninsured 64-year-old; a stress test for the same patient gets marked up from the $554 Medicare rate to almost $8,000. Three CT scans for a slip-and-fall victim? Medicare would have paid about $825 in total; but a Connecticut hospital billed the patient $6,538.

</snip>


20% of the Medicare rate is going to feel like leaving a tip for the waitress after a meal.

intercst
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I have original Medicare and a supplement Plan F from Mutual of Omaha. My $80K billed knee replacement and 2 months of PT.....not a bill, nada, zip, zilch. In fact, in close to 5 years now, I've never had a billing problem or questions about bills.

I have changed my Part D plan due to some an expensive drug, and will be looking for another new plan this year. I discovered what the donut hole looked like (there was no raspberry jelly in that donut hole either) just a drug that went for $116/90 days to $877/90 days.

I have now resorted to calling the cardio office every month for another 4 weeks of the drug. Was recently told to call a week before I need it so the lady can get it in for me.
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GWPotter,
This is an excellent explanation.
I went on Medicare last year and I agree that medicare.gov is an excellent website. I compared the plans in our area and went with the best policy that I could get. I think it had a 4-5 star rating.
I have not been disappointed. I fell and broke my arm four months ago and other than a charge of less than $200 for the ambulance (after insurance paid most of it) the rest of the nearly $4,000 bill was taken care of by Medicare. This was an ER visit and I was in the hospital less than two hours.
So far so good.
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Good info here. When I was first eligible for Medicare, and got stacks of mail from every provider in the Medicare Supplemental business, I first eliminated any that did not include my primary care physician in their list of preferred providers. I ended up signing up for a Medicare Advantage plan that included drug coverage and an option to self refer to out of network providers at a higher co-pay. I've found that coverage is virtually the same as the last employer provided health plan I had and is a much lower premium than any individual plan I've ever seen.
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Well, I will be 65 in December.


I understand I can sign up for Medicare beginning in September, but how is the transition from an Obamacare individual health insurance policy to Medicare supposed to be made?

Seattle Pioneer



If you have ever been bothered because no one remembered your birthday, fear not. I started receiving mail from insurance companies 5 or 6 months before my 65th birthday.

You need to sign up for Medicare 3 months early. Your birthday is in December, so your effective date (if you sign up early enough) will be December 1. The first date you can enroll is September 1. If you do not sign up in September, your effective date will be delayed. Sign up in October and you effective date will be January 1.

So, be prepared (where have I heard that motto before?). If you are signing up for traditional Medicare only, that's not too difficult. If you want a Medigap, Medicare Advantage, and/or Prescription Plan, you'll have to do some research and that will take some time on a computer at medicare.gov.

Karen
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Does the Obamacare policy cancel Dec. 1, the first month of eligibility for Medicare?
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I understand I can sign up for Medicare beginning in September, but how is the transition from an Obamacare individual health insurance policy to Medicare supposed to be made?


Seattle Pioneer


If you are currently collecting Social Security the transition will be automatic. 3 months before your 65th birthday you will be notified by Medicare.
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<<If you have ever been bothered because no one remembered your birthday, fear not.>>


Heh, heh!


Thanks for all the good comments!

<<You need to sign up for Medicare 3 months early. Your birthday is in December, so your effective date (if you sign up early enough) will be December 1. >>



This appears to answer the question I was interested in most immediately.

So Medicare for me would begin December 1st, since my 65th birthday is in December ----if I sign up in time, which I will.

Does that mean I should cancel my for profit (as intercst would say) individual health insurance plan as of the end of November?



Seattle Pioneer
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So Medicare for me would begin December 1st, since my 65th birthday is in December ----if I sign up in time, which I will.

Does that mean I should cancel my for profit (as intercst would say) individual health insurance plan as of the end of November?

Seattle Pioneer



Yes, you should cancel your individual plan as of the end of November. I called BCBS in very early June and requested that my policy be cancelled at the end of the month. I had set up an automatic payment with my bank and I cancelled that immediately after my June payment was sent. And I sent a payment for my Medicare in late June.

You could cancel by letter, of course. If you mail in payments monthly, you could include a letter requesting termination of the policy at the end of November. I would recommend calling anyway, just in case your letter gets lost in the payments received department.

Karen
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I've found that coverage is virtually the same as the last employer provided health plan I had and is a much lower premium than any individual plan I've ever seen.



I agree. My husband worked for a very large bank in NY city and we thought their coverage was excellent but at the same time we were also paying hundreds of dollars a month for a plan that was being subsidized by his company.
Just the other day my husband said that our Medicare plan was better than what his previous employer was providing and for the both of us we are paying just about $300 a month total.
I do miss my dental coverage though as now I need several thousand dollars worth of work.
Oh why didn't this come up a year ago when I still had dental coverage??
Can't win 'em all.
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I do miss my dental coverage though as now I need several thousand dollars worth of work.


This happened to my dad, who went to Tufts Dental School to have the work done very cheaply and very well. A bit scary IMO having a kid with his hands in your mouth with sharp instruments, but we are not so sure about how good our current dentist is who has been in practice for probably too long.

IP
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Medicare - Frequently Asked Questions

https://questions.medicare.gov/
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This happened to my dad, who went to Tufts Dental School to have the work done very cheaply and very well. A bit scary IMO having a kid with his hands in your mouth with sharp instruments, but we are not so sure about how good our current dentist is who has been in practice for probably too long.


I actually did some research on Harvard Dental School and Tufts Dental Schools. I was thinking about going there but then I remembered that I had dental work done about 35 years ago at a local mall. I went to them because they took my insurance. They really messed me up. I should have sued them for what they did. Again, there was a senior dentist on staff but he was working with someone who was, IMHO, a child. I said "no way" is that kid touching my mouth. Well, once they knock you out how would you know who did what to you while you were in the dental chair.
Long story short, the local dentist will do my crown. She went to Tufts and she comes highly recommended. Both my husband and myself had cleanings and they were very thorough - took an hour and a half. Explained everything that was wrong and might need attention.
We were very impressed. This dentist took over from a dentist who had been at that location for 35 years. He wanted to preserve his reputation when he sold his practice.
Finding a new dentist is scary!
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Finding a new dentist is scary!

For sure not looking forward to this aspect of moving to our retirement home. I really hate changing doctors.

IP
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For sure not looking forward to this aspect of moving to our retirement home. I really hate changing doctors.



I know. We moved from NY to MA last year and I had to give up my internist who really knew my health history. Also, I liked my dentist.
I think I like the dentist that I saw recently in our new town. She seemed very competent. I also recently saw a periodontist who is also a local resident of the town but practices in another town. He saved my tooth, a tooth that has been giving me problems for years. The only other alternative was an implant and I could not bear the thought of that.
Yesterday I had an appointment with the orthopedic surgeon with regard to my fracture humerus, from the fall I took in April. I am not fond of him at all. Had he done his job, I'd be further along in my progress. Now I have to go back to another physical therapist for a different kind of therapy. He told me the only other alternative was surgery. I told him that I had had TWO blood clots, one in each leg and he looked at me in shock and said "I guess you don't want surgery then".
What's with these doctors? Doesn't anyone have my medical records? DVT's are very dangerous and he had no idea that I had two?
Now that's scary.
Good luck finding new doctors. Don't listen to friends or relatives. Do research on the internet before making any decisions.
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Don't listen to friends or relatives. Do research on the internet before making any decisions.

I think listening to those you care about is a good starting place for names to further research on line. It's similar to what I do here with financial advice, firmly vetting the idea I get from the faceless boards with data.

I do miss Boston, even having moved away 3 decades ago! Still a Sox and Pats fan though. I don't think that can ever be extracted.

IP
not missing the Boston cost of living
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I think listening to those you care about is a good starting place for names to further research on line.



You are right! Always do further research online.
I moved from NY to MA last year and I do not miss the high prices in Manhattan. Believe it or not, the cost of living here in a coastal town is much much lower than it was in Brooklyn Heights which is right across the East River from downtown Manhattan.
We found a supermarket called Market Basket whose prices are for the most part 50% lower than in the local Brooklyn grocery store.
Even the local gourmet market is less expensive than where we used to shop.
Utilities are also less expensive and plays in Boston are a steal compared to Broadway plays.
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...What's with these doctors? Doesn't anyone have my medical records?...

TIME. Time needed for paperwork!!!

Good luck.

TB
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do miss my dental coverage though as now I need several thousand dollars worth of work.

Not having dental coverage was an issue for me, but I did the math and figured out that I would have just been trading dollars. The annual premium was very close to the maximum annual benefit, so I chose not to do it.

The premiums I didn't pay over the last 7 years would go a long way toward paying the cost of the work I've had done in the last 2 years.
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My experience is that Dentist costs can be minimized by careful at home flossing and brushing.

Also, my experience is that the only really expensive dentist is the one who does procedures you don't need.


Seattle Pioneer
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My experience is that Dentist costs can be minimized by careful at home flossing and brushing.




Half of my front tooth was knocked out when I was 12. Crowns last an average of 10 years or so. The crown on the front tooth is now 11 years and it has shifted. I am afraid it will fall out. So, I need another crown. They are expensive.
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