Medicare for us

[Drwine]

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Reaching out to both working physicians 65 and older. Obviously signing up for Medicare part A is an easy decision. If you re working do you keep the same insurance? Or did you sign up for the other parts of Medicare and buy a Medigap supplement? Or did you sign up for a Medicare Advantage plan? Thoughts on the pros and cons of each choice?

 

[Saddleshoes]

The process of signing up for medicare is easy.
However, the choices one must make are complicated.
I started researching my options a year in advance.
Medicare Advantage is like buying a new car. Too many different brands and models with different options within each model. (Many are rip-offs)
In my case I was a retiree from state employment. (An earlier gig) My state retirement system had negotiated a group plan that was outstanding.
---Moral of the Story: Start early and do your research!

 

[tartesos]

The process of signing up for medicare is easy.
However, the choices one must make are complicated.
I started researching my options a year in advance.
Medicare Advantage is like buying a new car. Too many different brands and models with different options within each model. (Many are rip-offs)
In my case I was a retiree from state employment. (An earlier gig) My state retirement system had negotiated a group plan that was outstanding.
---Moral of the Story: Start early and do your research!

20 years early or is it too early? 😬

Glad it worked well for you.

One thing I hear a lot is not to use an advantage plan if you can help it.

 

[gutonc]

20 years early or is it too early? 😬

Glad it worked well for you.

One thing I hear a lot is not to use an advantage plan if you can help it.

Medicare Advantage plans are super helpful when you're generally healthy and a complete disaster if something actually goes wrong.

Get secondary coverage and Part D.

 

[wysdoc]

My advice: DO NOT sign up for a Medicare advantage plan for 3 main reasons:
1. You are only allowed to see a small panel of doctors. If you need medical attention while traveling, it's ALL out of network.
Traditional Medicare allows you to choose your own doctor/stay with the doctor you had before Medicare.
2. There is a lot more gatekeeping and denial of claims/requirements for prior approval with Medicare Advantage plans.
3. I agree with getting supplementary coverage (Part B) and Part D for prescriptions. Shop carefully on the Medicare site to see which pharmacies in your area will cover the medications you take. You can even list your meds & see how much the copays would be.

@Drwine my spouse is still working and it was better for him to switch to Medicare than to keep his private insurance policy through work.
The cost and expense sharing to the practice is much less than when they subsidized his BC/BS plan. He cares about that because he is the practice owner LOL. Total cost now to have Medicare + Part B and Part D is about $290 a month.

 

[Dusn]

I can only speak to my own specialty but if you go with Medicare “advantage” and get macular degeneration, they’ll make us use the cheapest off-label medication option with step therapy, and if that option isn’t working, they’ll make us keep using it until you’re permanently blind. Then maybe we can switch and gradually go up the steps and by the time we get to a stronger option, you’ll be permanently blind and it won’t help anyway.

Choose straight Medicare + medigap.

 

[RangerBob]

I can only speak to my own specialty but if you go with Medicare “advantage” and get macular degeneration, they’ll make us use the cheapest off-label medication option with step therapy, and if that option isn’t working, they’ll make us keep using it until you’re permanently blind. Then maybe we can switch and gradually go up the steps and by the time we get to a stronger option, you’ll be permanently blind and it won’t help anyway.

Choose straight Medicare + medigap.

And if you have a STEMI, get a CABGx4 with ongoing post-op A fib with RVR, severe anemia, multiple electrolyte imbalances that are still persisting, moderate B/L pneumothoraces, Medicare Advantage will deem you "not medically complex enough." The IM medical director said she was medically stable enough for a SNF and denied the appeal.

Apparently they also refused it for my Guillain Barre patient (w/c bound due to LE weakness), but at least that got overturned on appeal.

Those are bread-and-butter inpatient rehab diagnoses, but yet Medicare Advantage plans will deny them.

Choose straight Medicare + medigap (lets make it a slogan)