Medicare Information

Disclaimer:

This information is provided to assist someone seeking information on Medicare options.  It does not provide specific recommendations.  It is important that each person investigate the various plans, options, prices, etc. and make a personal decision as to which plan that is best for you.  This site will not display any prices as they will change and become out of date and maybe subject to personal situations.

Contents 

1. An Overview

2. Information on General Resources

3. Information on the Veterans Drug Program

4. Some Specific Retiree Experiences

Overview:

When one is approaching 65 or 65+ depending on your full retirement age per Social Security, it is important that one starting investigating Medicare and its options several months before that key date.  Some of the plans and options have specific signup periods and they do not necessarily tie to your full social security date, but in some cases to the standard calendar year.  There are a number of options generally available depending on the state and area where one lives.

These options are normally provided by Medicare, an insurance company, a Health Maintenance Organization (HMO), or by other private healthcare organizations.  Since each type plan is different, it is important that the capabilities and prices of each be investigated and reviewed to determine which type of plan is best for you.

Selection of Medicare options will depend on individual situations, features, doctor and hospital preferences, and in the end, probably costs all other things being equal.

Before making any cancellations or changes, one should verify that there desired new plan will accept you and that your doctors and hospitals will accept the new plan and its rates.

Basic Medicare education and overview information can be obtained at http://www.medicare.gov/Choices/Overview.asp and at Medicare & You 2003.

After one chooses a medicare plan, there may be a need to select a supplemental coverage plan.  These supplemental plans are also referred to as Medigap.  See Choosing a Medigap Policy  (http://www.medicare.gov/Publications/Pubs/pdf/guide.pdf) to learn about Medigap policies.  Medigap appears to only apply if one chooses “The Original Medicare Plan (sometimes called fee-for-service)”.

Inside the “Choosing a Medigap Policy” the various features of plans A-J are described (about page 14) and also the Basic Benefits of each are described on the prior page.  Some of the plans (F and J) have high deductibles at over $1600.  All the plans are not supported in every state and within that, individual insurance companies may support only selected plans.

It has been suggested that one can check with their current doctors or hospitals about carriers of Medigap insurance with whom they have experience.  Also check with local senior centers or organizations.  It may be possible to obtain a list of Medigap insurance carriers in your state from the state insurance agency.

It is also recommended that one obtain the details of various plans, what they pay, what they expect you to pay, and the costs.  Final analysis of total out of pocket costs (premiums, deductibles, co-pay, etc.) and reputation/staying power of the companies should help make a final choice.  Also important to understand if initial rates are ‘discounted’ to attract new clients i.e. they will increase after first year automatically (someone thought that AARP’s prices might be that way).

General resources:

http://www.medicare.gov/

This is the official U.S. Government Site for People with Medicare.  All the links above are on this site.  Phone number is 800-482-4045 (reported that the best to call to be is Thursday or Friday).

http://www.ssa.gov/pubs/10043.html

This is a Social Security document that describes medicare.  It is somewhat similar to those on the medicare site.

http://www.aarp.org/hcchoices/

This is the AARP “educated health care choices” webpage that has links to various pages that provide explanations on Medicare.

http://www.aarphealthcare.com

This is the AARP insurance information site.  Here you can get info and quotes on AARP supplemental and Medicare Supplemental Insurance.  Phone number is 800-523-5800.

https://netbenefits.fidelity.com/

Fidelity Netbenefits Sign on website.  Sign on, select the Health and Insurance tab.  There is information available – see the REFERENCE library.  Remember that the plan you retired under or switches to the Unisys PPO are your ONLY choices.

http://www.bcbsm.com/

Blue Cross/Blue Shield of Michigan website.  Specific Medigap insurance info can be located at http://www.bcbsm.com/members/pg_mes.shtml.  Phone number is 800-848-5101

Veterans Drug Program

A federal law entitles all veterans (National Guard is not considered a veteran) to purchase prescription drugs at significantly reduced prices. Each 30-day or less supply of medication for non-service connected prescription costs only $7.

Veterans receiving medication for treatment of a service-connected condition, veterans rated 50 percent or more service-connected, and veterans receiving VA pensions or whose income is at or below the maximum VA pension rate are exempt from co-payments for medications altogether.

To take advantage of this, you will need to do two things:

• Enroll in the VA Health Care System at http://www.va.gov/elig/ .  All veterans should do this now even if you don't currently need benefits.  There is no cost and being enrolled will save a couple of months if you ever need benefits.  No need to fill out the income section if you agree to pay their co-pays.
• Tell them you want "Co-Managed Care", ask for a Primary Care appointment ($15 co-pay) and take enough medical records and/or prescriptions from your own doctor with you to show what medications you need.
• In most cases, they will supply 6 months of your medications (the generic version, or sometimes a lower cost but supposedly equivalent drug) from their pharmacy for $7 per months supply, for each drug.
• They will set you up for another Primary Care appointment 6 months down the road to set up the next six months.

Specific Retiree Experiences (info provided for anyone who want to contact them for more info):

Terry Griner investigated several companies, narrowed it down to AARP and Michigan Blue Cross as he figured they had the political clout to stay in business.  He selected Michigan Blue Cross in the end due to price.  His wife is still in Care Choices (not 65 yet).

Ron Mack had an individual contract with Care Choices HMO.  When reached 65, he investigated several insurance companies, compared features and rates, he elected to defer (decline) Medicare Part B and has stayed in Care Choices.  He felt that AARP has the closest feature set to Care Choices, but even with a slightly higher cost with Care Choices, it was worth staying with Care Choices to not have the billing hassles (Medicare or the doctors/hospitals) he experienced when his wife went on Medicare B and supplement/Medigap.  Note: His individual Care Choices contract does not provide prescription drugs.

Ron also warned that one should make sure you will be accepted by Care choices (independent contract) and that their signup period should be verified (reported to be a very small window each year and he advised to call them in late 3Q/early 4Q to find out when the signup period will be).

Chuck Miller and wife, Joan, choose a Medicare + Choice plan which is the HAP Senior Plus plan available in this area.

Dave Sutton also selected Michigan Blue Cross for his supplemental insurance along with Medicare Plan B.