Community Chat

[BoopOMatic]

I wish I knew about Medicare. I know they take $ out of my SS for it, but that's all I know. I have health insurance through my husband's work. I don't know if I even need Medicare or not. I tried to drop it but evidently it's very complicated to do so.

I tried to find out info last open enrollment but I never could find out anything. I even spoke to an insurance agent. It's just so complicated I gave up.

[Carmie]

@BoopOMatic   When you are 65 and receiving SS, you are entitled to Medicare Part A ( inpatient hospital insurance ) at no cost to you.

Medicare Part B ( outpatient hospital and professional provider services) must be purchased and the money is taken from you SS chexk before you receive it.

Medicare does not pay everything at 100%, so if you have insurance through your husband's work, that insurance is paying what Medicare does not.

It sounds like you have what is needed.  There is no need to change anything until your husband retires.

[Cakers3]

---

@Kachina624 wrote:

---

@Cakers3 wrote:

---

@Kachina624 wrote:

I don't know what you're talking about as I've been on Medicare a number of years, have had major surgery and visit my doctor and specialists numerous times a year but have never paid a penny out of pocket. 

---

@Kachina624   I don't know to whom you are talking to but I have a question for you-Medicare has a deductible so do you have some type of supplemental insurance?

I've never heard of Medicare paying for everything with nothing out of pocket to the patient.

---

@Cakers3   Of course I have supplemental insurance and I have no deductible or co-pays. 

---

@Kachina624   Well you didn't say you also had supplemental insurance.  That is why I asked the question.

You only said that you've been on Medicare for years and never paid a penny for surgery, specialists, etc.

Your post indicated you only had Medicare and it never cost you $$.

[Carmie]

@Cakers3   

Some people who have Advantage  Medicare Plans pay zero premiums, have no deductible or copays.

They get covered services paid at 100%.

The only thing they pay out of pocket is the Medicare  Part B Premium which  is taken from their SS payments each month.

[BoopOMatic]

@Carmie  Thank you

[teganslaw]

---

@Carmie wrote:

@Cakers3   

Some people who have Advantage  Medicare Plans pay zero premiums, have no deductible or copays.

They get covered services paid at 100%.

The only thing they pay out of pocket is the Medicare  Part B Premium which  is taken from their SS payments each month.

---

That must depend on the state. I have never heard of  a Medicare Advantage Plan with all those perks.The Advantage plans I checked out had no premiums or copays but high deductibles. Nothing is free, so the people on Advantage plans probably pay something that is in fine print.

[proudlyfromNJ]

---

@teganslaw wrote:

---

@Carmie wrote:

@Cakers3   

Some people who have Advantage  Medicare Plans pay zero premiums, have no deductible or copays.

They get covered services paid at 100%.

The only thing they pay out of pocket is the Medicare  Part B Premium which  is taken from their SS payments each month.

---

That must depend on the state. I have never heard of  a Medicare Advantage Plan with all those perks.The Advantage plans I checked out had no premiums or copays but high deductibles. Nothing is free, so the people on Advantage plans probably pay something that is in fine print.

---

@teganslaw  I have Medicare Advantage Plan PPO in NY. My Dr. visits used to be ten dollars but in the last two years it is now zero dollars. I see Dr. every three months, she insists to review the three meds I take. I've only paid some for mammo and thyroid test that had to be taken in a special place. My Dr. gives cardio tests, stress test, all the usual. Never pay. Now I haven't been in the hospital so can't speak for that.

[Carmie]

@teganslaw   You are correct.  It depends on where you live as to what Advantage Plans are available.

They are different in each state and in each county within that state.

You should get a booklet entitled " Medicare and You" during the open enrollment period.  The back section of the book should list what is available for you in your area.

The zero preminum, no deductible, no copayments do exist in some areas.  In addition, some people can get Advantage Plans through their retiree benefits or through organizations they belong to that are quite comprehensive.

I myself have an Advantage plan that costs $61 a month.  Everything is paid 100%.  There are no deductibles or copayments and I can go to any provider of my choosing.

I do have copays on RX drugs, but I very seldom use drugs. This year I paid a total of $8 towards RX drugs.

I also get $25 or $50 for each service I receive for routine services like mammograms, colonoscopies and well exams.  It is sent via a gift card once a year.

[JeanLouiseFinch]

The entire topic of Medicare is confusing to me, which plan to choose, then the add ons, go with Advantage, stay far away from Advantage. It makes my head spin. 🤪.  Any advice with be appreciated.  

[Carmie]

@JeanLouiseFinch   I worked in health insurance for 25 years doing customer service.  I understand Medicare very well.

Ask me anything  and I will try to help. There is no one plan fits all and all states are different.

Traditional Medicare Part A and B is a constant...pretty much the same in all 50 states.  
Advantage Medicare is all over the place as far as prices and benefits are concerned.