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Switching over to the big M ...
#1
... as in Medicare.  Come along about February or March, our household will switch from group employer health insurance to Medicare plus a supplemental policy.  We're shopping supplementals right now, mainly looking at the diffs between BCBS of K, and United Healthcare through the AARPers.  Not a whole lot of diffs, age range costs are about the same, plans & rates are pretty much equal except one thing jumped out.  On the popular Plan F policies, through Blue Cross, we can save about $90 a month if we agree to their preferred network of providers.  LMH isn't in that group.  Supposedly, what that boils down to is any in-house major surgery has to happen in Topeka at St Franny or Storefront Veil.  We're trying to decide if saving a thousand dollars a year in premiums is worth that.

We'll probably purchase/rollover the Delta Dental coverage that we currently have through employer group insurance & we'll probably end up without vision insurance.

Here's why this is in Soapbox.  Right now, like everybody else with insurance & not yet on medicare, our health coverage is responsible for the lion's share of our medical expenses, or, for this exercise, let's say virtually all of it.  It pays the whole freight on the medical bills (minus our deductibles & co-pays & such).  Once we transition to medicare, the insurance companies are responsible for only 20%.  I realize the frequency of use most likely will increase, but they're paying 80% less than they previously did while I, on the other hand, will be paying more each month for my health insurance when you consider all the components:

   monthly medicare premium deducted from social security
+ monthly supplemental premium
+ dental premium           
= more money than currently paying & there's no vision insurance

I'm paying more & receiving less.  And that's not even factoring the prescription drug part of the equation.  Nobody in our household takes any prescriptions (knock on wood), but we know the safe bet is we will in the future.  We're thinking about skipping the part D coverage for a few years.  It's my understanding there is a penalty for late enrollment, but I'm told it's not horrible.  In the meantime, there's a very good chance we won't need any 'scripts for years to come & I don't wanna pay during that time something like $3k to $5k in part D premiums.  Hmm.  I should think on that some more.  That's probably bad strategy.  

Anyway, it wangs my dang doodle that my total costs go up while the insurance gets an 80% break.
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#2
It's a heck of a transition, and things are much too complex, but I'm surprised that you think you'll be paying more for less coverage.

The Medicare supplement plans are supposed to pick up virtually everything that's not covered by traditional Medicare, as I understand it.

And my guess is that combined, we'd wind up paying about the same or very possibly less than group coverage costs through an employer. A quick back of the envelope glance would be about $100-200 for Medicare, the same for supplemental, and about $50 for vision+dental, which winds up being about $450/month total at the high end.
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#3
Yah, the supplemental picks up the 20% but the cost of the medicare premiums plus the supplemental premiums plus the dental premiums is going to cost more than I'm currently paying.  And that doesn't even include Part D or any vision coverage.  So, yah, I'm paying more & getting less which is a heckuva thing for a system that's intended to provide affordable health coverage for seniors.
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#4
eewwwww! this is old peep shirt.

insurance only pays for 20%?!?!?!

wtf. that's absolutely reverse of my current plan. why, that's ruinous!!  gotta be an R thing to stick it to the Ds.

I'm surprised that BCBS of KS? does not cover LMH, or is that only in Plan F?
No replies to subterranean posters for 1 days and counting
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#5
(10-31-2017, 06:08 PM)rockchalker52 Wrote: Yah, the supplemental picks up the 20% but the cost of the medicare premiums plus the supplemental premiums plus the dental premiums is going to cost more than I'm currently paying.  And that doesn't even include Part D or any vision coverage.  So, yah, I'm paying more & getting less which is a heckuva thing for a system that's intended to provide affordable health coverage for seniors.

You must have very cheap premiums then - $450/month is pretty good, even for group coverage.
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#6
Have you looked at a BCBS Advantage plan? A PPO is the one you want.
May you build a ladder to the stars
And climb on every rung
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#7
I've got the supplemental thing and the prescription thingy and I'm here to tell ya that RC's initial thread post brought back nightmares from a year ago when I went through it all. My healthcare costs are waay too frigging high in my opinion. I'm going to review them and something is gonna get dumped, probably the supplemental.
Yes, you have all heard me grouse about me paying high healthcare costs when I have ZERO health problems and never have, really. All the money I've spent on this crap have been a giant waste of money for me. I've had a knee scoped and an eardrum patched in my adult life and that's all. I should've dropped the healthcrap crap and paid cash and I'd be miles ahead. I've got an annual (anal?) physical scheduled for Thursday and if it's like all the others, screw it, I'm making a change. I've had enough of this goddamn healthcare sheeiit.

{Flecks of spittle on monitor and keyboard, wipe off with tissue. Pour another whiskey}
You are the wind beneath my wings, otherwise known as turbulence.
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#8
um. that is why it is called insurance. Ya just never know ... but I feel your need there.
No replies to subterranean posters for 1 days and counting
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#9
(10-31-2017, 06:09 PM)susnus Wrote: eewwwww! this is old peep shirt.

insurance only pays for 20%?!?!?!

wtf. that's absolutely reverse of my current plan. why, that's ruinous!!  gotta be an R thing to stick it to the Ds.

I'm surprised that BCBS of KS? does not cover LMH, or is that only in Plan F?

BCBS does include LMH on Plan F but not on the Plan F program that offers discounted rates for using their network of providers.
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#10
It's much too complicated.

There should be a simpler, easier way to structure Medicare, I would think.

And, yes, insurance is weird, in that if you pay for it and don't use it, it seems like a waste of money, but if you don't have it and need it, that's almost certainly worse.

I used to think it was an obviously better choice to get a MA plan, for those of use that like simplicity, but then I read about some downsides of those (can't remember them right now), so it's not that clear to me anymore. They are simpler, in that you only need one plan, instead of 3 or 4, and they're often not as expensive as the regular Medicare+supplemental plans.

http://www.investopedia.com/articles/per...-plans.asp
http://www.reuters.com/article/us-column...GS20141016
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