Bureaucracy drives me nuts (and its a short drive). The Social Security/Medicare paperwork-industrial complex is probably the ultimate bureaucracy. The root of all evil. The “Mordor” that all hobbits must travel to. With many orcs and evil wizards you have to get past along the way. Chances are you’ll fall into the Crack of Doom and be consumed by fire.
Thank God retirement has come in stages that began 5 years ago. Eating an elephant one bite at a time as it were (just a metaphor I love elephants and would never eat one). I’m a year out from being signed up for Medicare and Sunday afternoon I figured out I better start the learning journey. Over the last few years I’d heard snippets of talk referring to Medicare “part A, B, C & D” and all I knew was that part A referred to hospitalization and part D had to do with prescription drugs.
So after maybe 3 hours of YouTube videos on the subject and maybe another hour of reading articles online, I have a fair understanding of the subject I could now explain to someone with 5 minutes and a White Board. Part A is hospitalization, Part B is outpatient doctor visits. When you turn 65 you will enroll in one of 4 options:
1.) Medicare Part A & B (‘traditional’ $170.14 out of your SSA check, run by the government)
2.) Advantage Plan (“Part C” $170.14 – like the traditional, only run by a private company + bennies)
3.) Supplemental (“D” – traditional A+B from above $170.14 plus D more ins. $40 – $200 more)
4.) Advantage Plan plus Supplemental (Part C $170.14 & D $40 – $250)
That’s all. 4 options. You are either going to pay $170.14 a month, or you are going to pay $170.14 plus added insurance ($40 – $250). What’d that take? 2 minutes? Fleshing it out a little, “spitballing” it if you were, you are either going to pay a lot each month, or you are going to pay when you get sick or need drugs. Like all insurance. Pay me now or pay me later. I remember years ago when I found out me and my employer paid about $10,000 a year for Blue Cross Blue Shield insurance. I thought good lord! I don’t use anywhere near that! With inflation the magic number, whether you are employed, or whether its Medicare, is $12,000. That’s the Magic Number that the politicians and the lobbyists have worked out for the ‘grift’.
What’s really insulting is when you pay a godawful amount like $12,000 a year for insurance now, is when you still get billed for a co-pay! So like I say they are going to take out $170.14 the month I turn 65 next year for Medicare Part A & B (last year it was $163). So whether I keep the “traditional Medicare“, or go the private company route (SSA/Medicare gives the private company $12,000) with an Advantage Plan, $170.14 is coming out of my SSA check either way. With traditional Medicare, the healthcare provider knows the game that has been worked out over the last 60 years.
With an Advantage Plan (Part C), that private company supposedly has the same ,operating parameters that Medicare does, but they are trying to make money, so they are going to say you don’t need that MRI or chemotherapy. And if they don’t authorize the treatment, you don’t get it. So they are walking a fine line, if they kill you by denying treatment, you’re dead and they no longer get paid. But another guy just enrolled, so they don’t care if you are dead or not. Advantage Plans generally have $0 monthly fee (you already pay for it with the $170.14 coming out of your Social Security check). An Advantage Plan is just the traditional Medicare Parts A & B run by a private company and called Part C.
With an Advantage Plan you are supposed to get added benefits like partially paid for dental care, eyeglasses, weightloss blah blah blah. They all try to compete so that you will choose their Advantage Plan. That’s Part C. You are no longer ‘in’ Medicare, a private company now controls your healthcare. You can just leave it at that, or add Part D, a Supplemental Plan. Insurance upon insurance. Your basic Part D plans ($40 ish a month) just help with your prescription drug costs. Your more extravagant plans ($200 ish a month) pretty much eliminate any drug co-pay or any other co-pay (doctor visit inpatient).
Since I am in pretty good health (cholesterol medication) I think I’m just going to go the “traditional route”. Although I do need dental and eyeglasses, so that does make looking into an Advantage Plan a good idea. The bottom line is no one will give you any definitive answers. They will not use any real numbers. Its all couched in the “may, could, possibly, might” world where they act like someone is going to sue them if they gave a real answer.
Because what I started to see in all this is the hypochondriac type who always has to be “over insuranced” like they are going to die if they have to pay a $30 dollar co-pay for an office visit. Or pay $400 dollars every 3 years for glasses. Get over it. Save the money you are not spending on all the added insurance and use it to pay the co-pay, use it to pay for your $20 a month prescription of Pravastatin. When I was working I went through a period where I bought dental/vision insurance. It took me about 5 years before I figured out (back then) that dental didn’t pay anything routine, and vision you paid for it every year, but only got glasses about every 3 years. I was paying way more for the insurance than if I had just paid for the glasses or the tooth filling.
If you bought the most extravagant Supplemental Plan Part D say $250 a month, on top of the $170.14 a month, you would essentially pay nothing through out the year, but you’d also be paying $5,040 a year in insurance. With Advantage Plans, your maximum out of pocket is $8,300. Some are a lot less, generally those are the ones with a monthly premium. With a Supplemental Plan Part D, if you just get a basic one for say $40 a month, your maximum out of pocket can still be quite high. But once you go above $40 a month your maximum out of pocket for the year jobs way down often around $226 a year.
Iowa life 