Should You Get Medigap Supplemental Insurance with Your Medicare?

As I mentioned in a recent post, within three months before or after your 65th birthday, it is important that you contact the Social Security Administration to sign up for Medicare.  This is true even if you already have insurance through an employer or the military.

Once you have completed the paperwork for Medicare, the next thing you will need to decide is if you want to get a Medigap policy (Medicare Supplement Insurance) or a Medicare Advantage Plan.  In this post I will go over the Medigap Supplemental Insurance plans, like the one that my husband has selected.  You may also want to read "Should You Get a Medicare Advantage Plan with Your Medicare?" and "How to Sign Up for Medicare." These articles will help you consider all the options available to you.

Medigap Supplemental Insurance  

The reason why someone would want to have a Medigap policy is because Medicare doesn't pay for everything.  While regular Medicare will cover most of your medical expenses when you are over age 65, there are large deductibles and expenses that are not covered.  Medigap policies are designed to "fill the gap" by covering some of those expenses like copayments, coinsurance and deductibles, so that patients do not end up with a lot of large medical bills.   Some of the Medigap policies also cover things that Medicare does not include at all, such as emergencies during foreign travel, although each plan is different so you need to shop around to make sure you are getting the coverage that meets your needs the best.

You will have to pay a premium with a Medigap policy, in addition to the premiums you pay for Medicare.  You cannot have both a Medigap policy and a Medicare Advantage policy.  You have to choose one or the other.

One of the reasons that people sometimes choose a Medigap policy rather than a Medicare Advantage Plan is because they want to stay with their current doctors rather than be limited only to the doctors that are part of a Medicare Advantage HMO or PPO list of approved providers.   

For example, my husband has CKD (chronic kidney disease) and he was very happy with the doctors who were treating him prior to his 65th birthday.   He contacted all the physicians that he sees and discovered that all of them accepted both Medicare and Blue Shield.  As a result, he chose to buy a Blue Shield Medigap policy so he could stay with his favorite doctors. Conversely, I was not that attached to my physician so I chose a Kaiser Permanente Medicare Advantage plan.  My plan is substantially less expensive, but his plan allowed him to stay with his current physicians, which was important to him.

My husband also chose a Plan "F" Medigap insurance policy.  This is the most expensive Medigap plan.  He pays about $275 a month in addition to the $135 that Medicare currently takes out of his Social Security.  However, when he had a heart attack, we paid no deductible or co-pay.  On the other hand, as of 2019, when this article was updated, I only pay the standard $135 a month to Medicare, which is deducted from my Social Security, to cover the cost of my Kaiser Medicare Advantage plan.  However, spending the same amount of time in the hospital and having heart surgery would have cost me at least $1000 in deductibles and co-pays.  In other words, my husband pays an extra premium, but no co-pays and deductibles.  I do not pay an extra premium, but I do have co-pays and deductibles ... although they are quite reasonable.  

Whatever policy you choose, if you are unhappy with it, you should know that once a year in the fall  open enrollment period (between October 15 and December 7) you can select a different plan to use the following year.  However, if you have end stage renal failure (which means you are on dialysis), there are severe restrictions on switching plans.  This is one reason my husband wanted to keep his current doctors.  He did not want to change doctors, end up unhappy, and then be stuck with new doctors he did not like.

You can find a lot more information on the Medicare website.  In addition, as you approach age 65, you will be contacted by a number of Medigap and Medicare Advantage companies in your state.  You may want to attend their seminars and learn about the differences between what the various companies offer before you make a final decision.

Contact Information for Medicare:

http://medicare.gov/

1-800-MEDICARE  (1-800-633-4227)
TTY 1-877-486-2048

Questions about Eligibility for Medicare:

Social Security Administration:  1-800-772-1213

To Get Personalized Insurance Counseling:

Call the State Health Insurance Assistance Program which is also called SHIP.  The number is different for each state. The one for California is listed below:

California SHIP:  1-800-434-0222

Related Articles You May Want to Read:

Should You Get a Medicare Advantage Plan with Your Medicare? 
How to Sign Up for Medicare

Regardless of your circumstances, nearly everyone should contact Social Security within three months before or after their 65th birthday and decide what they need to do.  This is the first step you should take in the process.

If you are interested in learning more about preparing for retirement, you may want to check out the tabs at the top of this page.  They contain links to hundreds of articles on family relationships after retirement, where to retire in the United States or overseas, financial planning and medical issues.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credit: www.wikipedia.org/commons

How to Sign Up for Medicare

If you are approaching the age of 65, you need to make sure that you sign up for Medicare and select the medical plan that you prefer as soon as possible.  I have just gone through the process and thought that it was somewhat complicated, so I decided to help others understand what is involved in the process.

Contact the Social Security Administration

The first thing you will want to do is sign up for basic Medicare.  You can do this at the Social Security office nearest you or by going to Medicare.com.  Their website does a good job of helping you understand which parts of Medicare are the correct choices for you.  You have a seven month window in which you can sign up without paying a penalty later.  You can sign up during the three months before the month you turn 65, during the month of your birthday, and during the three months after your birthday month.

If you are already collecting Social Security or Railroad Retirement Board benefits, in most cases you will automatically get Medicare Parts A and B on the first day of the month that you turn 65.  The same is true if you are disabled and already collecting benefits, even if you were under 65 when you began to receive payments.

If you are approximately 65 but not yet collecting Social Security, you still need to sign up for Medicare.  If you think that you have signed up, but you do not receive your Medicare card a month or two before your 65th birthday, you should contact Social Security.  Your card will look similar to the one in the attached photo.

Special Circumstances Involving Medicare:

There are specific situations that complicate things for certain people, as you see below:

For example, whether you are already collecting your Social Security benefits or not, you need to contact the Social Security Administration within three months of your 65th birthday if you have end stage renal disease (on dialysis).  This is the one illness that affects your Medicare insurance choices.

In addition, if you are still working and you are covered by medical insurance through an employer, you may initially choose to only get Part A and delay signing up for Part B, without penalty.

On the other hand, if you are on a COBRA plan from a former employer, you should not wait until COBRA ends before you get Part B coverage.  You should sign up at the same time you enroll in Part A.

If you are active duty military at the age of 65, you must sign up for both Part A and Part B of Medicare in order to keep your TRICARE coverage.

As you can see, signing up for Medicare is very complicated and different rules apply to different groups.  Not only that, if you make a mistake and delay signing up for Part A and/or Part B when you should have, you may be required to pay a penalty which will permanently make your premiums higher.

There are a number of variables that can affect different groups of people ... those who are already on a group insurance plan at work, those who have end stage renal failure, those who are on COBRA, and other groups.

Should You Get a Medigap Policy or a Medicare Advantage Plan?

Once you have signed up for basic Medicare, you need to decide if you will want to supplement it with a Medigap policy, to cover things that are not covered by basic Medicare, or whether you want to have your coverage assigned to a Medicare Advantage plan.

At the bottom of this article, see the links to the articles I also wrote about Medigap insurance and Medicare Advantage plans.  Most people will want to have one or the other.

Meanwhile, if you are getting close to your 65th birthday, you need to contact Medicare to make sure you are signed up for the basic Medicare plan that is right for you.  Below, I have given you some contact numbers, as well as some information about how you can get free personalized assistance in making the right decisions for you.

Contact Information for Medicare:

http://medicare.gov/

1-800-MEDICARE  (1-800-633-4227
 TTY 1-877-486-2048

Questions about Eligibility for Medicare:

Social Security Administration:  1-800-772-1213

To Get Personalized Insurance Counseling:

Call the State Health Insurance Assistance Program which is also called SHIP.  The number is different for each state. The one for California is listed below:

California SHIP:  1-800-434-0222

Regardless of your circumstances, nearly everyone should contact Social Security within three months before or after their 65th birthday and decide what they need to do.  This is the first step you should take in the process.

Other Articles You May Want to Read:

Should You Get Medigap Supplemental Insurance with Your Medicare?
Should You Get a Medicare Advantage Plan with Your Medicare?

If you are interested in learning more about preparing for retirement, you may want to check out the tabs at the top of this page.  They contain links to hundreds of articles on family relationships after retirement, where to retire in the United States or overseas, financial planning and medical issues.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credit: www.wikipedia.org/commons
 

Retire to Robson Ranch near Dallas, TX

When I sold real estate in Dallas, Texas in the 1990's, there were a number of senior apartment complexes and assisted living facilities, but there were no age-restricted over-55 luxury retirement communities in the area.  Although there were many beautiful gated, golf communities where retirees often lived, they were not exclusively designed for seniors.  The nearest age-restricted development was Del Webb's Sun City Georgetown, Texas community near Austin.

Because of my knowledge of the area, I was delighted to hear that Robson Resort Communities, a premier builder of luxury retirement homes in Arizona, has now opened a lovely development just 35 miles north of the Dallas-Fort Worth area, near Denton.

Amenities at Robson Ranch, Texas

* Lovely gated community with a roving security patrol

* 17,500 sq. foot Wildhorse Clubhouse with a lovely ballroom, plus activity and meeting rooms

* Indoor and Outdoor Swimming Pools

* Sports center which, in addition to the pools, also has a fitness center, aerobics exercise room, massage and steam rooms, tennis courts, volleyball courts, pickleball courts, and a gymnasium.

* Creative Arts Center with studios and gallery

* Gorgeous outdoor areas including a dog park, walking trails, children's playground, and a fishing lake

* Championship 18-hole Golf Course


Activities at Robson Ranch

With so many high-quality amenities, no one could possibly participate in all the choices that are available to the residents of Robson Ranch, including the emeritus life-long learning classes sponsored by the nearby University of North Texas and held in the Wildhorse Clubhouse, as well as a number of club activities, charitable events, golf tournaments, art classes, dance classes, a choir, and a wide selection of fitness classes.  There are plenty of choices for anyone who wants to live a healthy, stimulating life after retirement.

Attractive, Modern Homes at Robson Ranch, Texas

The beautiful new, energy-efficient homes in this lovely community are luxurious, yet affordable.  Prices range from about $210,000 for a 1624 sq. foot two bedroom home, to approximately $335,000 for a 3228 square foot home, and $400,000 for a 3746 square foot home with three bedrooms and 4 1/2 bathrooms.  All of the homes have two-car garages.


More about Denton and the Dallas-Fort Worth Area

Nearby Denton, Texas is home to the University of North Texas and Texas Women's University.  Consequently, the residents at Robson Ranch have all the conveniences you would expect in a college town ... access to live performances as well as plenty of restaurants, bars, shopping centers and movie theaters.


If you wish to attend professional sporting events, enjoy the symphony, shop at Neiman-Marcus, or take the grandkids to Six Flags amusement park, all of those possibilities and more are easily available to you in the nearby cities of Dallas and Fort Worth.

If you are considering a move to Texas from another state, you will be interested to know that Texas does not have a state income tax, although property taxes are a bit higher than they are in other states.  You will have to weigh these two taxes against each other to decide whether or not you are better off.

Texas Weather 

As a former resident of Dallas for over 25 years, I did want to let people know about the infamous Texas weather.  Winters are typically mild and pleasant, with an occasional dusting of ice or snow.  Summers can be brutally hot, with temperatures shooting up to over 100 degrees during the afternoon.  Summer nights, however, are comfortably warm and perfect for an evening barbecue with the neighbors.  From spring through the fall, there will be periodic thunderstorms, which can spark an occasional tornado ... although it is relatively rare for anyone to be injured.


Source:

http://www.robson.com/communities/robson-ranch-texas

If you are looking for more places to retire, in the United States or overseas, or you are interested in learning more about other retirement related concerns, use the tabs at the top of this page to find links to hundreds of other articles.

You are reading form the blog:  http://www.baby-boomer-retirement.com

Photo credit:  Photo of Dallas skyline is courtesy of www.morguefile.com

Surviving a Brain Aneurysm

Until recently, brain aneurysms were not something that I ever thought about.  They are not one of the medical conditions that we regularly see featured on the news, and no one I know had ever suffered from one.

Last week, however, one of our daughters collapsed when an aneurysm burst in her brain.  She is 47, in good health, and she has not smoked or used alcohol (two of the risk factors), in over 20 years.  She was fortunate because, when she passed out, a paramedic happened to be nearby.  He got her to the hospital within a few minutes.  Over the next 36 hours, she was transported by helicopter to another hospital and had brain surgery.  She was one of the lucky ones.  Approximately 40% of the people who have a burst brain aneurysm die before they reach the hospital.  Another 20% reach the hospital too late to be treated.

After doing research on this shocking disorder, I learned that they are much more common than I had ever realized, and there is a reasonable possibility that they could affect you or someone in your family.

According to the Brain Aneurysm Foundation:

About 1 in 50 people have an unruptured brain aneurysm
In the United States, an aneurysm ruptures about every 18 minutes
When an aneurysm ruptures, about 40% of the patients will die immediately
Approximately 2/3 of the survivors suffer some permanent damage
There are usually no warning signs

As a result of these numbers, I felt that this was a topic that Baby Boomers and their families might find life saving.  In fact, many of you may wish to be screened to make sure that you do not have one of these hidden time-bombs inside your head right now.

What is an Aneurysm?

An aneurysm occurs when an artery wall becomes weak and bulges out in the shape of a balloon.  If this bulge begins to leak, the blood can damage and even destroy nearby cells.

Brain Aneurysm Risk Factors

There are a number of risk factors that may cause the initial damage to the artery wall or cause an aneurysm to form and/or start leaking:

Hardening of the arteries
High blood pressure
Heredity
Smoking
Head Injury
Alcohol use
Drug use, particularly cocaine

Once the artery wall has been damaged, it usually will not repair itself.  However, nothing may happen for a long time. An aneurysm can start to form years or even decades after the initial damage to the artery wall.  For example, you may be born with a damaged spot on your artery; or drug use and other behaviors in the early twenties can weaken the artery.  Years later, during a time of stress that causes a spike in blood pressure, an aneurysm can begin to form and start leaking.

Symptoms of a Brain Aneurysm

There is no way to know that you have a brain aneurysm unless it is revealed in a brain scan.  However, once it starts to leak, you may only have minutes before you lose consciousness.  If you are alone, you may not survive unless you get help quickly.  Therefore, it is important to recognize the symptoms, whether you or someone you love is the victim.  The quicker the patient gets treatment, the more likely they are to survive.  Here are the most common symptoms:

The most severe headache you have ever experienced
Nausea and vomiting
Neck stiffness
A brief blackout
Vision or speech problems
Confusion or sluggishness
Jerky movements
Clumsiness
Paralysis or weakness on one side of the body (similar to a stroke)

What Happens Once You Reach the Hospital

As frightening as all this sounds, once the patient reaches the hospital their outlook increases substantially.  The medical staff will do a CT Scan, an MRI, an arteriogram and/or a spinal tap.  These are used to diagnose the aneurysm and locate the bleeding.

Surgery Options

In the past, the primary type of surgery for a brain aneurysm involved opening the skull and clipping the bulge in the artery.  This surgery was very invasive and risky.

In the past seven years, however, surgeons have developed a process called cerebral coiling.  A catheter is threaded from the groin, up through the body and into the brain where a stint is placed inside the damaged artery and a tiny platinum coil is inserted into the aneurysm.  This coil causes a blood clot to form and seals it off, stopping the bleeding.

Post Surgery

After surgery, the amount of damage done by the aneurysm can vary widely from person to person.  Nearly every patient will be extremely tired, experience headaches and will be sensitive to bright lights, although these problems will eventually diminish.   Either their long-term or short-term memory could be affected.  They may have trouble with double-vision or their speech, and there could be weakness on one side of their body.

They may need physical therapy and other types of rehabilitation.

While the healing process may seem slow and even discouraging to the patient, it is important to remember that they are the lucky ones ... they survived.

At the time I am writing this, our daughter has spent nearly two weeks in ICU.  She has retained her motor skills and memory.   She still had headaches and is light-sensitive.  She will have a few restrictions for the next few months ... no roller coasters or other intense activities.  She will not be allowed to drive alone for a couple of weeks after she returns home.  However, the good news is that the brain damage she suffered was minimal and she is expected to recover fully.

My hope is that others will recognize the symptoms of an aneurysm as quickly as the paramedic recognized what was happening to our daughter.  Once more people are aware of this danger, outcomes will hopefully improve and lives will be saved.

Sources:

http://www.brainaneurysm.com/
http://www.bafound.org/brain-aneurysm-basics
http://www.bafound.org/brain-aneurysm-basics
http://www.kramesstaywell.com (Booklet #11271 "Brain Aneurysm Understanding, Care and Recovery")

If you are interested in learning about more medical issues and other retirement concerns that could affect you, use the tabs at the top of this page for links to hundreds of additional articles.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credit:  www.morguefile.com