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forkids2 forkids2 is online now
 
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Medicare/Medicare Advantage
Old 01-28-2020, 10:19 AM
 
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I just wanted to post this in case anyone else that is close to turning 65 is unaware of it like I was. I retired last June and in my school system you get to keep your insurance coverage with the same subsidy as when you were an active employee, which is great.

I'm turning 65 in March and they will be switching me to their Medicare Advantage plan. I was surprised to learn that you still have to apply for and pay the premium for regular Medicare in addition to the premium for your Medicare Advantage plan. Maybe everyone else knows this, but I didn't and was surprised to learn my insurance would actually cost me an additional $144 a month(the premium for original medicare).

Just wanted to help anyone who might not realize it when they are planning their retirement - that they may be getting $144 less per month than expected when turning 65 so they can plan accordingly.

I do love retirement, tho!


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Old 01-28-2020, 10:24 AM
 
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For me, that $144 is automatically deducted from my Social Security.

I am assuming you are not yet getting SS yet.
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Old 01-28-2020, 10:58 AM
 
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I am getting social security and the $144 will be deducted from it when my Medicare starts in March. I just wasn't expecting it. I thought Medicare Advantage would take the place of Medicare - I didn't know I would be paying for both. When I was planning my retirement, I thought I would have $144 a month more than I will actually have. I didn't want that to be a surprise to anyone else when figuring what their retirement income will be.
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You may want to consider
Old 01-28-2020, 01:21 PM
 
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check around and see if a supplemental medicare insurance might provide better coverage, more benefits for your needs, or smaller premiums.

I was guided to have a list of my medications and conditions when checking with various companies. A friend has supplemental plan that does the best coverage for her very expensive medication for which the local advantage plan does little.

The advantage plan I have is an individual plan rather than a group plan. They have various tiers of coverage ranging from no additional premium over medicare to one with over $100 in addition to the medicare premium. My plan costs an extra $45/month over medicare.

You do not have to go with the district's plan, unless it is in your best interest.
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And...
Old 01-28-2020, 01:26 PM
 
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If your income is over $85,000 as of two years earlier than your retirement date, ( they do a 2 year income tax lookback), you will pay more than that. I pay over $200 for what I was told would be free medical benefits in my state due to the dates of my years of service. I am not on SS yet, and the state is supposed to refund that extra VAT tax after they send letters asking for proof of payments this spring , but I had never heard of that before I retired and had to apply for Medicare last July. Once I apply for SS this summer, the basic Medicare payment will come out of SS and be added back into my pension. When I see my accountant this year, I am hoping that my income in 2018 was less than 85,000 so I can go to my SS office and get that tax taken off. Before I was old enough for Medicare, I was in the state plan and paid nothing but a small co-pay for doctorís visit. But when you turn 65, most people have to enroll in Medicare.


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Old 01-28-2020, 03:16 PM
 
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My district has the same type of coverage and I found out that the district would charge me $150 for medicare advantage (in addition to the $135 paid to medicare) I found that the exact same medical advantage program was zero additional cost if I got it directly.

Check with the advantage plan you want directly. Most of them in my area are free except for your medicare payment.
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Medicare
Old 01-28-2020, 03:52 PM
 
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Basic Medicare cost is now $144.00. Just went up by $10 for everyone. My DH paid $189.00 because of the two year look back but now he is paying $144.00. His supplement plan costs $0 and is awesome. I am not 65 yet but I will be using the $0 plan too. It is blue cross too.
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Medicare Advantage
Old 01-28-2020, 05:22 PM
 
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Because we are so rural and travel out of state for much health care, It was recommended that we NOT go with Medicare Advantage plans. It was our understanding that Advantage limits us a bit geographically speaking. DH has a Medicare plan, just not Advantage.
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Old 01-28-2020, 07:27 PM
 
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I just started Medicare in December. I pay the $144 for Medicare B and then an additional $110/month for my district's Medicare Advantage plan. I have no deductibles and pay nothing for doctor appts and tests. I pay $2 for a 3 month supply of each generic drug (I take a lot!) and $5/10/20 if I needed some name-brand ones.

Do you think I could find a better plan?
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Old 01-29-2020, 05:52 AM
 
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Medicare has open enrollment for supplements and advantage plans each year. In 2020 it is from October 15 to December 7. Unless one has a qualifying event, this is the time you can change.

On thing to remember if you get your supplement/advantage plan through your district is that if you leave the district plan, you may not be able to get back on it. It may not allow reenrollment. (District based plans have different enrollment rules than market plans.) So be very careful in comparing plans. Be sure the plan is actually better than the district plan.


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Blue cross
Old 01-29-2020, 11:04 AM
 
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For blue cross, you cannot go backwards. If you start with the 0 dollar plan you can always go up. If you start with the $200 plan, you can only go up but not down to a cheaper plan. My DH takes no drugs and has no issues so we are sticking with the 0 plan. It pays for his gym, $200 towards sneakers and $75 per quarter at cvs. I am 64 so I pay for my own plan. Which stinks!
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Old 01-29-2020, 11:14 AM
 
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There is an appeal for medicare premiums assigned.

"Appealing your IRMAA
If your financial circumstances have changed since you filed the tax return used to determine your IRMAA, you can attempt to appeal that surcharge. You may be eligible to appeal if you:

Got married or divorced.
Experienced the death of a spouse.

Lost out on a major source of income (like your job, or an income-producing property).

Think the Social Security Administration has the wrong tax information for you on file.
Keep in mind that your IRMAA will affect your Medicare Part D premiums as well, so if you have reason to believe you shouldn't be subject to a surcharge, get moving in filing an appeal."

https://www.fool.com/retirement/2019...dicare-pa.aspx

I'm guessing that retirement equals losing a major source of income. It might be worth investigating.
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Medicare advantage
Old 01-29-2020, 01:48 PM
 
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Before retirement in June 2019, I was asked each year by my district after being 65 if I wanted to use our negotiated health benefits or Medicare. I chose our school benefits and they notified Medicare.

In preparation for retirement we joined Medicare b and paid for it for 2 months. My school benefits ended 30 days after retirement. Then we were ready to have Medicare advantage through NJ state health benefits for retirees with 25 years of service.

So, we have Aetna Medicare advantage which includes parts A, B, D
Cost of partB is deducted from our social security checks and reimbursed in my pension check (for me and hubby).
So far, we are happy with the small copay for dr visits and we donít need referrals to see specialists.
Meds are affordable too, especially ones we can get by mail every 90 days.

It appears that your state and negotiated contract while employed can differ significantly from someone elseís.
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Old 01-29-2020, 04:23 PM
 
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Could you help me with the two year look back? Are you always paying for Medicare based on what your income was two years prior? In other words, if our income falls below the cut off of $170,000 this year, do we still have to pay the penalty because our income was higher than that two years ago? I actually just retired, but my husband is still working 2 days, so we may exceed $170,000. It's going to be close.
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Yes Nancy lee
Old 01-29-2020, 05:42 PM
 
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We had to pay 189.00 for two years after my husband retired. Now we pay $144.
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Old 01-30-2020, 04:43 AM
 
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Thanks Juliet. That doesn't seem fair does it?
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Old 01-30-2020, 06:08 AM
 
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Well, he did make more than the $170,000.00 cut off while working. We were confused about paying so much but the local office explained the look back feature. This year, the look back is over. We are just careful not to have DH take too much out of IRA. He did not start collecting SS until age 69 so he gets 4 8% bumps. And if something happens to him, I will get that check. Worth it to wait a few years if possible.
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Nancy Lee
Old 01-30-2020, 09:02 AM
 
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I'm guessing the look back of 2 years considers people who file taxes late, enter appeals, etc.

Given the publicized precarious state of social security and medicare (yes, because the feds have been raiding the funds for years without paying them back), they are trying to have the better paid help supplement the poorer folks.

I suggest you check out the appeal process I indicated in a previous post on this thread. They specifically include a change in employment as a cause for adjustment. You may be able to have your fees lowered since your income this year may well be less.
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Old 01-30-2020, 03:08 PM
 
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Yes, a person at Social Security told me about the appeal where you can avoid the two year lookback if your income has fallen significantly. Like I said, though, with my husband still working 2 days I think we may be right at about $170,000 -- very close, so I think I might just let sleeping dogs lie and if we wind up making less than $170,000 I think I can get a refund of the extra surcharge I paid. Thank you!
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Wanted to clarify that the
Old 02-01-2020, 09:16 PM
 
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$144.00 is the premium to purchase Part B of Medicare and those who do not qualify for Social Security pay that separately. Medicare Advantage plans do vary from state to state and premiums vary as well and it behooves teachers to do research on what their plan offers in their location. Thanks to the OP for posting this to educate readers to make informed decisions.
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