Wednesday, October 15, 2014

Planned Seniorhood

Dear Dr. R.V. Shrink:
We retired early and took our Social Security at 62. We have been on the road full-time for four years. This year we both have to decide how to take Medicare. It is driving my husband crazy. He says it is more complicated than a corn maze. He has been online studying and stewing about it for two months now and still hasn’t come to a decision. Time is running out to make that decision and I can’t seem to get him to pull the trigger on one plan or another. Should I lock him in the trailer and refuse to let him out until he decides, or is that too harsh? He doesn’t appreciate my input because I haven’t studied it at all and have no idea how to proceed. I look to him to make this decision and I don’t know how to get him to jump.
--Medinuts in Medford

Dear Medinuts:
The way insurance works is simple. Most companies have a very uncomplicated business plan--Confuse and Conquer. Medicare works the same way. Instead of having basic coverage that just kicks in when you reach 65, they have multiple choice plans, with multiple choice plans within the plans. I can see how your husband is totally confused. The problem is, he has to make his choices.

Everyone has a different set of circumstances, so it takes a bit of homework to figure out which combination of options work best for you. It sounds like he has done his due diligence. Here is how I decided. This may not be your solution, but it may give you some guidance as to how to attack the problem. I found a copy of the Medicare guide book and read it a couple times. Then I called a local Medicare facility and asked questions on things I found totally confusing. Once things started to focus more, it was not all that confusing for me.

I am highly suspect of insurance companies. So when my mailbox started filling up with bazillions of offers to buy into a Medicare Advantage Plan I personally became suspicious. When I called about Medigap Plans I was always being routed to the Advantage cubical of sales people. This was another red flag for me. As a full-timer, I decided I did not want a network plan. With Original Medicare I can go anywhere I want that accepts it. I also found that with an Advantage Plan I would have to go see doctors A and B before I could see doctor C. If I want to go to doctor C, I would rather go direct. If you want to go with an Advantage Plan, pick one and get it over with, but read the fine print.

If you don't want to go with an Advantage Plan, and you stick with Original Medicare, here is a starting point for your husband. You get Medicare A, and Medicare B will come out of your Social Security. Easy so far, right? Now you hit Medicare Plan C. It has a whole alphabet full of sub-plans. You will notice that Plan F is the most expensive because it covers 100% of deductibles and co-pays. What many people miss is that Plan F has a high deductible option (HD). It is a very reasonable premium and tops your cost out at just over $2,100. Out of all the alphabet soup deals I studied, this looked like the best deal for the least dollars.

Then we get to Plan D, which stands for DRUGS. By this time you need drugs just to focus and make a decision. If you are in need of regular drugs, you are going to deal with the donut hole for several more years. It won’t matter if you are in an Advantage Plan or Original. Most communities have a Senior Help Center that will sit down with you and give you a step-by-step walk-through plan options. Another thought for Veterans is the VA can be part or all of your plan, if you so choose.

I wouldn’t lock your husband in the trailer unless you are in there with him. This decision will affect you as much as him. You should be studying this labyrinth of lunacy as hard as he is. Together you can help each other make the best decision that will cover your personal situations.
--Keep Smilin’, Dr. R.V. Shrink


Anonymous said...

I absolutely agree! It is a maze and I came to the same conclusions...Plan B is a must and runs a bit over $100 a MUST get a plan D or you'll pay through the nose later when you really need it...suggest the plans that include walmart $1 generics since they are available wherever you roam.
It seems like medicare advantage plans should be avoided in every case for RV'ers. And all the alphabet soup plans CAN be distilled down into Plan F or Highdeductible planF depending on what you can afford monthly. Both provide superior coverage. I took the no deductible plan for about $130 a plan A&B&F and D run about $265 a month for me as a single. Could knock that down to around $200 with the high deductible. Now all ya have to do is find a doctor who accepts new medicare patients on the road! (Other than DR. R.V. Shrink of course!)LOL

Penny said...

We originally went with the Suppplemental Plan F because we were on the road and didn't want to worry about having a co-pay when one of us might have to see a doctor. Unfortunately, the premium increased each year (it will with all plans, I think) until, to save some $$, I switched to a Plan G...which also pays everything EXCEPT the Medicare Plan B deductible. I still didn't have to pay any co-pays but somehow that deductible got paid. We will try and switch partner to that plan next year.

As far as the drug plan (Part D) goes, you will be penalized if you don't get a plan when you start Medicare so choose wisely. If you don't have a lot of expensive meds, get the cheapest plan you can get. I get my major (i.e. expensive) meds from overseas and just use my med plan for spur-of-the-moment needs (antibiotics, prescribed cough meds, other short term meds).

Unknown said...

I went through a similar process, and for like reasons settled on the plan F with high-deductible. The other thing you don't find out about until you use it, is the incomprehensible ACTUAL coverage (what they really pay) when bills go out. Bottom line is that Medicare F/HD is costing me very little, not even my deductible, due to the way Medicare sets limits on services. I still don't fully understand it all, but I'm not unhappy.

Anonymous said...

As I found out recently the VA is not an option for all veterans. The VA sent me an unsolicited package to apply for a VA card. I completed the form and submitted it. The VA then came back and told me that some veterans (like me) who happen to have a reasonable income and/or assets) will not be issued veteran's cards at this time due to their constraints( I assume funding and staffing). So, it appears that some veterans are considered to be less entitled than others.

Anonymous said...

To be eligible for VA you have to have served one day in a war zone and meet the income limits. For a couple it is $39,894 or less. To me that is high. Over that and a person should be able to afford their own medical insurance.

Unknown said...

I read about this issue all the time from all types of people all over the country. It seems all of you have missed one very important step (SHIP) which is run by your LOCAL office of the aging. All ship reps are private and will never tell you have to do anything but what the laws states, but what they will tell you is ALL the steps you need to take, and most important what insurance "you can and cannot get" Most people including me and my wife did not understand, If you go with regular Medicare and part D and supplement insurance "aarp or which every you choose" you only have a few BY YOUR ZIP CODE, In my county I had only 2 to choice from, so that made it easy. So go online or look through the Medicare book and look up you ship rep and that person will help you out with every step of this issue.