BS: Medicare enrollment question

Subject: BS: Medicare enrollment question
From: GUEST,leeneia
Date: 21 Nov 11 - 02:44 PM

Next year will be my second year on Medicare. I've received lots of info, and I've pored over web pages, and there's nothing that says clearly that if all I want is Medicare A and B, then I don't have to do anything.

I realize that I could call an 800 number and wait 30 minutes to talk to a human, but I'd be happy if a number of 'catters who are older than 66 told me that I don't have to sign up every year.

Don't they want to know that I'm still alive, still in the country, still retired, still want the coverage? It seems incredible.

(FAQ doesn't answer it and Live Chat doesn't work.)

Subject: RE: BS: Medicare enrollment question
From: Jack the Sailor
Date: 21 Nov 11 - 02:55 PM

I'm 53. I've seen ads and TV stories saying that you have to sign up every year for the drug benefit. Given the myriad of choices, it might be the logical thing to do.

Subject: RE: BS: Medicare enrollment question
From: ChanteyLass
Date: 21 Nov 11 - 05:20 PM

I think the drug benefit is Part D, and I think the longer you hold off getting it the more it will cost you when you do get it. I have a couple of years left figure it all out, but I take meds for chronic conditions and will want it from the very beginning.

Subject: RE: BS: Medicare enrollment question
From: Greg F.
Date: 21 Nov 11 - 05:30 PM

Suggestion: Call the 800 number and talk to a human. Or check the Medicare website- it's all laid out there quite clearly.

Subject: RE: BS: Medicare enrollment question
From: Jack the Sailor
Date: 21 Nov 11 - 06:42 PM

DougR probably knows.

Subject: RE: BS: Medicare enrollment question
From: Jack the Sailor
Date: 21 Nov 11 - 06:44 PM

I just saw an ad saying "Medicare Open Enrollment" ends Dec 7.

There was an "877" number and medicare.gov as contact addresses.

Subject: RE: BS: Medicare enrollment question
From: Bill D
Date: 21 Nov 11 - 07:35 PM

If medicare is all you have, it might pay to study the options for enrollment. If you are adding it to an HMO, it is much simpler. We do nothing each year,,,,we just ignore the ads.

(We are members of KaiserPermanente as an add-on... and have 92% good things to say about their plan)

Subject: RE: BS: Medicare enrollment question
From: Janie
Date: 21 Nov 11 - 08:07 PM

Can't seem to get the link maker page to come up.

http://www.ehow.com/how_7573404_opt-out-medicare-part-d.html

Subject: RE: BS: Medicare enrollment question
From: GUEST,leeneia
Date: 21 Nov 11 - 09:22 PM

So nobody's 67 or more and has been through this?

I have a private drug plan. They sent me a letter that clearly stated, "If you wish to continue, there's nothing you need to do." What a relief.

Subject: RE: BS: Medicare enrollment question
From: Janie
Date: 21 Nov 11 - 11:37 PM

Glad you found your answer.

Subject: RE: BS: Medicare enrollment question
From: dick greenhaus
Date: 22 Nov 11 - 12:02 AM

I called AARP today to check. The had an alternate plan to the one they're providing which costs nothing, but sticks you with a modest copay for a primary care physician's visit and a much stiffer copay for each visit to a specialist. Yhey were very helpful in working out the math with me.

Subject: RE: BS: Medicare enrollment question
From: JohnInKansas
Date: 22 Nov 11 - 12:12 AM

Medicare Part A covers Hospitalizations, and Part B covers most other medical care, but when your expense for the year reaches "point A" the coverage stops and your expenses escalate (you pay it all) until your expenses reach "point B," at which time a slightly different coverage applies to any further expenses.

The range of expenses between point A and point B is refered to as "the gap," sometimes also called the "MediGap."

If you receive Social Security payments, enrollment in Part A and Part B are automatic and mandatory unless you specifically opt out of it by showing that you have another qualified policy. Few people opt out of the A & B coverage.

Most people will want a "supplemental policy" from a private insurer to cover expenses "in the gap," and in some cases to cover amounts in excess of what Medicare pays for covered items. (Prescriptions have a large impact for most people.) The supplemental policy must be "Medicare approved" and there are lots of different plans.

You can change policies only during the annual "enrolment period" except in a very few special cases. Any "Supplemental Policy Provider" should provide you with clear instructions about the limits and conditions that might permit you to make a midyear change, but for most people those conditions will be unlikely to occur. The "exceptions" are fairly consistent; but there may be slight variations between policies, so you might want to look at what they offer as explanations.

If you have an option to participate in a "retiree insurance" plan with a prior employer, it will usually be to your benefit to use that policy for your supplemental coverage, because most such plans are "bundled" with large insurers who are able to impose limits on what medical providers can charge for the various procedures/medications you might use (in place of, or in addition to the Medicare limits). Smaller insurers have lesser ability to impose such limits, so that even a policy that pays a "higher percent" or has a "lower deductible" may still leave you to pay a little more. That's one of the factors that makes choosing a supplemental provider much more complicated.

Most insurers will automatically continue the prior year election unless you choose to make a change, and after you've fretted over it for a couple of years you'll just look for the "If you wish to continue, there's nothing you need to do" notation in the annual notice and file it away - if you got what you want when you signed up the first time.

If you have only Part A and Part B coverage, you really should look at adding a "Medigap" policy, especially if you have - or expect - relatively high prescription expenses; but once you've made the decision for one year it should be continued without action in subsequent years.

The basic Medicare "information" for supplemental policies is "CFR42 Part 410 SUPPL MEDICAL INSURANCE (SMI) BENEFITS" which you can download from the Medicare website as PDFs; but if you want to look at the whole thing it's currently 79 separate PDFS (one per "chapter") with a total of 3.59 MB. There are a couple of smaller FAQs and "Information for new subscribers" pamphlets, but I wouldn't know which one(s) to suggest as a simpler starting point.

You should have received a small booklet called "Welcome to Medicare" that actually is fairly informative, and also a booklet titled "Medicare and You." Most of the explanations you should need probably are in those two, but you'll need to read them carefully to extract the information in terms that mean something for your own case. If you don't have them, you may be able to download PDFs from the Medicare website.

John

Subject: RE: BS: Medicare enrollment question
From: GUEST,Eb
Date: 22 Nov 11 - 03:19 AM

"I called AARP today to check. The had an alternate plan to the one they're providing which costs nothing, but sticks you with a modest copay for a primary care physician's visit and a much stiffer copay for each visit to a specialist."

AARP is a reputable organization but even then it's a good idea to check AARP-approved medigap offers.

A few years ago I chose one of them. It cost me $84 per month. And then I had some minor surgery; Medicare of course did not cover it all, leaving me with a couple of hundred dollars to pay.

My Medigap plan contributed $8.00.

Subject: RE: BS: Medicare enrollment question
From: GUEST,leeneia
Date: 22 Nov 11 - 09:52 AM

Thank you, John and Eb.

For the record, here's what the Medicare & You booklet says. p 13

"If you join a private Medicare health or prescription drug plan, your plan can change how much it costs and what it covers each year...Review your plan each year...If you're satisfied that your current plan will meet your needs for next year, you don't need to do anything."

That's it. Notice the first words - "If you join a PRIVATE Medicare plan..."

Well, I'm not joining a private plan! They never answer the simple question, do I need to do anything if I'm sticking with the government's Medicare A and B.

They don't answer it in the booklet, and they don't address it on the website.

Subject: RE: BS: Medicare enrollment question
From: artbrooks
Date: 22 Nov 11 - 11:18 AM

All of the discussions at www.medicare.gov about changing focus on "Medicare Advantage" and Part D (drug) plans, so I'd say that Parts A and B are excepted by omission. I have good drug coverage elsewhere, but it is good to have a Part D plan if you don't (and there is no prescription coverage in A & B) and have medications you take regularly. In my area, at least, they cost between $15 and $25 per month. There is a penalty for late enrollment - right now, it is $.30 times the number of months between eligibility and signup, and I expect it will go up over time. The drug plans are what you need to scrutinize carefully during "open season", since they have a reputation for changing what they cover from one year to the next.

Subject: RE: BS: Medicare enrollment question
From: GUEST,leeneia
Date: 29 Nov 11 - 10:50 AM

I got the answer to my question from the recording at the 800 number. I had gone through three menus, entered my number twice, asked for an agent, and heard "If you are satisfied with your current plans, you may do nothing."

Finally!

Subject: RE: BS: Medicare enrollment question
From: IvanB
Date: 29 Nov 11 - 11:11 PM

I just ran across this thread tonight. As regards your prescription coverage plan, the letter you received probably contained verbiage that the plan "meets the requirements of Medicare Part D" (or words to the same effect). If so, you should save the letter, as it's proof, if your private plan ever ceases to exist, that you're eligible to enroll in Part D without penalty.

BTW, I'm 71, have prescription coverage under my pension plan and have never contacted SS except to apply for my initial benefits. Everything has continued to work just fine.

Subject: RE: BS: Medicare enrollment question
From: Allan C.
Date: 30 Nov 11 - 06:06 AM

I think it is horribly unfair that, at a time in one's life when least able to make sense of gobbledygook, the explanations of the various Medicare/Medicaid system intricacies should be so (deliberately?) obtuse.

Subject: RE: BS: Medicare enrollment question
From: GUEST,leeneia
Date: 30 Nov 11 - 10:09 AM

Ivan, thanks. You are the first person to actually answer my question exactly on point.

To be fair, Allan, the info isn't obtuse in style. It just doesn't answer the question I have in my mind.

I strongly suspect that a good many of the questions directed to an agent at the 800 number were the same as mine, and so they put the answer on the recording to save time.

You'd think that by now they would have this figured out.