Help me pick a supplemental insurance to cover 20% after Medicare

Start your paper trail with your General Practitioner and get a referral for a specialists. Do Physical Therapy and Injections, then get on Pain Management. That is enough paperwork to help justify you having a problem.

No. When someone is on Medicare there are three categories of Medicaid. With QMB Medicaid, for someone who earns roughly under $1,060 a month, that is true. For SLMB and QI Medicaid you're still on the hook for the 20% as well as the Part A deductible and a few other things. You can still go bankrupt from medical bills being on Medicare with an SLMB or QI attachment.

I have to wait til I am 55 and then my child support is no more and I get my US Steelworkers Pension of 500 plus dollars. Plus what I already get.

I am in the central part. howdy neighbor

Apply for medicare, QI-1 can pay for it.

thanks for this post, OP. bumping up, to read.

Yes, I’ve learned a lot from his videos

Here is an article that might help you...and yes, you can apply for MEDICARE now.

[link to medicare.com (secure)]

IF you obtain both Medicare AND Medicaid these private companies make available what I eluded to earlier....what are known as SNP-D policies, meaning "Special Needs Policies - Dual, meaning you have both basic plans.

The advantage in them can best be illustrated by my simply showing you one of them. The main advantage is they ADD benefits you may not have now.

Here are a couple from United;

[link to www.aarpmedicareplans.com (secure)]


You have these SNP policies for folks on both Medicare and Medicaid and then there are also SNP policies for certain with certain chronic conditions such as heart disease, diabetes, etc....

Again, apply for Medicare and then you will qualify for one of these...if you choose. Feel free to reach out to me if you have any more questions or need further help.

On the page for Mo Medicade, page 4, I am just over the Federal Poverty Level. I think that was $1050, I am at $1230.

Thank you Sir. I'll see if I can sort it out!

Yeah, see my fourth post from the bottom on page 3. $1230 would qualify you for SLMB Medicaid. But if you're turning 62 you should be on Medicaid until you turn 65.

Supplemental plans are fine for those who can afford them...most can't, which is why the Part C (Advantage Plans) are so important for everyone else.

Happy to help any way I can.

She could easily be approved for Medicaid. What is holding her up is over 2,000 in the bank. She needs to spend the extra money or very carefully hide it. Look into the rules for Medicaid spend down to do it legally. This would involve receipts for care providers, needed medical equipment, pre-pay for burial and other things. Medicaid does a look back period over 5 years at bank accounts but she doesn't have that much money to "hide". She could pull out several hundred a month and it probably wouldn't be noticed. You would be doing her a big favor by helping her get on Medicaid. In the future, God forbid, if she needs assisted living or a nursing home it would be covered 100 percent. For the most part secondary insurances other than Medicaid do not cover long term care.

Last Edited by akaSuzanne on 11/13/2019 04:02 PM

What do you think of the plans on this page?

/www.ehealthmedicareplans.com/?medicarecom=2&allid=Med40680&r​oundrobin=1&type=MA&forceV1=true#quote-plans/MA/65674/26190/C​EDAR/1/p1

What is the difference between HMO-POS, HMO, PPO, etc?

Again, I'm lost! I appear to be above the poverty line to continue to get Medicade....

She resides in New York State so assets are irrelevant. You are thinking of the pre-2014 rules for Medicaid eligibility. It's the first line in the article.

[link to obamacarefacts.com (secure)]

IF you can afford it, the way to go is a Medicare Supplement (the ones from AARP and Humana are the best generally) and they pay the 20% medicare part B doesn't pay, and they often pay for other things medicare doesn't even begin to cover. They start at about $150/mo and go up to over $300. It depends on your age when you sign up. Older you are at signup, the more it costs monthly. The kicker to this is that you MUST select and pay for a separate Medicare Part D plan, also. Drug coverage is NOT part of these medicare supplement plans.

The BENEFIT if you can afford it, is that you can see any doc that takes medicare patients, anywhere you are or travel to. Your RX coverage does not limit you to any particular pharmacy or a mail-order pharmacy, either. You can get your RX filled in the pricey little boutique pharmacy in the doctor's building or one of the big chains. It's up to you.

The other option is Medicare Part C plans. The groups offering these plans get a fixed dollar amount per year per patient in their plan. So they have a motivation to keep costs down. They get to keep what they don't spend at the end of the year. You may have to be stuck with a primary care doc you don't know or like or want. And that primary care doc acts as 'gatekeeper' to specialists. You may need a written referral to see a specialist. The 'specialists' like orthopedic surgeons or oncologists (cancer specialists) in these plans may or may not be of prime quality. The kicker is these plans offer the 'extra benefits' you see advertised on TV. They also include the prescription drug plan in the whole package. However, the drugs come with a co-pay at various types of drugs. The cheap generic stuff may only cost you a dollar or two or three. But the injectables, drugs that are brand name only, (usually the newest and best available meds - especially if you have a serious condition that demands constant care to avoid dying - will cost you up to 40-50% of the cost of the drug. Given a single RX for some meds can cost $5000/mo or more, these plans can be a killer for drug costs. Remember today, hospital stays are generally very short, surgery and recovery can get you new hips or knees and home in four or five days. The real high costs today (outside of an ICU stay) are the meds you need daily or may need in the future.

AARP offers free consultation that's not biased toward their own offerings. The Federal Government Medicare offers the same plan finding assistance. Just be sure you understnd the restrictions and potential costs on the plan you choose. The 150/mo plus part D plans for a straight medicare supplement seems high. Until you need a new heart or lung and anti-rejection drugs. Or more complex treatment of a long-term but potentially deadly disease over years. Believe me, the wrong plan can suck all the gold out of your 'golden years' and leave you with nothing. BE CAREFUL and KNOW WHAT YOU"RE BUYING EACH YEAR>

LOL...hang on an realize you have SEVERAL MILLION others out there with you on the "lost" part.

Didn't you say you already have Medicaid or did I misunderstand?

Basically the difference in a PPO vs HMO is going to be with an HMO your are more restricted in who you can go to for care....your health care provider has be be "in network', meaning they are a part the the HMO or you will be penalized for using someone outside of the network.

With a PPO, you can choose ANY doctor or provider as there are no networks...in other words, they give you more freedom, usually at a slightly higher monthly premium or higher deductibles or co-pays. Not always but usually.

Last Edited by FeedYourHead on 11/13/2019 04:17 PM

Yes, been on Medicaid since my heart attack and stent 1.5 years ago.

OK....you need to do the following;

1. THIS is literally the ONLY website you need to have to get accurate information...ALL the others are just insurance agencies or brokers, etc.

[link to www.medicare.gov (secure)]

You only have to register if you actually apply.

Of course, once you narrow your choices you will want to visit the insurance carriers site itself just to reinforce the info you get at the gov site.

2. On the website above you want to apply for MEDICARE...Part A and B This is the first step and until you apply and receive this coverage the rest is moot..

3. IF you qualify and once you choose to add Medicare Part A&B then (and only then) would you qualify for one of the SNP-Dual plans.

I hope that helps, at least a little. Now..one last thing, the Medicare.gov website has agents available to guide you as well...don't be afraid to ask them for help. NOT the others but the Medicare folks. What you want at this point is someone who can advise you, not someone trying to sell you something. I know this stuff is scary but give them a chance.

Last thing....nobody (including me) knows everything there is to know about this stuff so go easy, try not to get frustrated and reach out for help...

==========

thank you for responding... she had juvenile rheumatoid arthritis at age 5 and now how Rheumatoid arthritis as an adult. she has all the paperwork/history need...been on steroidal drugs since age 5.but she isnt receiving any benefits...l tried va as a veitnam vet 11b..69-70 [agent orange registered ] they said no.

Look into American Republic. It's great for the person I know that has it, although they're grandfathered into a plan that is no longer offered. It costs about 310 bucks a month. They also refund the premium for any overage you pay so, if your Medicare covers everything, you get a nice check when your yearly term is up.

Thank you for that link. Saved to bookmarks. I think I will call them tomorrow. Kinda already have brain overload from just today's info!
Again, thank you Sir!

I'm still unclear if Medicaid will continue now that I am on Social Security. Apparently I have about 3 weeks to figure it all out before enrollment ends in December.

I think it is odd that you cannot join at any time of the year, I find that really odd.

I'm here if you need me...just reach out

I might upgrade my account just so I can contact you by phone.

I'll try calling the people in that link tomorrow and see what I can figure out.

My biggest question so far is if my Medicaid will continue till I turn 65. 62 now. Then there is the income issue, I saw a link for Missouri (can't find it again) that showed me just above the income to continue Medicaid.

Hell I don't know!

You are welcome to call me...don't mind at all. We could go through various websites and your options that way.

Sounds as if you may need to converse with the actual folks at Medicaid though regarding your specific situation and if your Medicaid is going to continue. That would be top priority.

Last Edited by FeedYourHead on 11/13/2019 07:55 PM

If I retire at age 62 and start collecting Social Security, will I be eligible for Medicare at that time?
Answer is here:
[link to www.ehealthinsurance.com (secure)]

There's a Medicare Medical Savings Plan offered in my area, no premium, high deductible, that deposits $3,240 per year into an account to be used for medical expenses.

I'm relatively healthy right now, so I'm considering it, but don't know of anyone who's on it so I'm undecided. It sounds good! The deposit can be used for any medical expenses, so long as they're qualified medical expenses for income tax purposes, so the funds could be used for dental and vision care. If the funds aren't used, the yearly $3,240 deposit just gets added to the funds already in your account. The deductible is high, can be as high as over $8,000 per year, but with regular Medicare, there is NO limit to what your expenses can be, 20% of whatever. And then, should you happen to pass on, whatever remains in your account will be paid out to your beneficiary.

Anyone have any experience with a plan like that? It's supposed to be like a Health Savings Account except the funds keep building up in your account until you use them. In about 10 years, you'd have about $32,400 accumulated IF your health was good. Heck, I know of someone who just turned 90 with no serious health problems! He still does his own cooking, cleaning, yard work, etc.

[link to lassohealthcare.com (secure)]

Last month (December) Plan F is even available( if on it then can stay on it...grandfathered in).

Beginning January 2020 the best plan for supplemental Medicare is plan G since F no longer available.

No, not unless you have a disability.