Should You Get a Medicare Advantage Plan with Your Medicare?

As you approach the age of 65, your first step in obtaining Medicare is to contact the Social Security Administration and sign up.  The ideal time to do this is within three months before you turn 65, during the month you turn 65, or during the three month period afterwards.  You can sign up at a later age, but you will pay more, in most circumstances.

You can read more about how to complete this process by reading my article "How to Sign Up for Medicare."

Once you have signed up for Medicare, your next step is to decide if you want to get a Medigap policy (Medicare Supplement Insurance) or a Medicare Advantage Plan.  In this post I will discuss Medicare Advantage plans, similar to the one I have selected.  You may also want to read my article  "Should You Get a Medigap Supplemental Policy with Your Medicare?"  

Medicare Advantage Plans

When you select a Medicare Advantage Plan you are still using Medicare.  You get your Part A and Part B services directly through your Medicare Advantage Plan.  Your healthcare providers are required to provide you with everything that original Medicare offers except hospice care and research studies.  You will still receive those services; Medicare just covers them directly.

The benefit of getting a Medicare Advantage Plan is that they usually offer extra services in addition to those you would get only from straight Medicare.  Depending on the insurer, these extra services could include vision, hearing, dental and wellness programs.  Some Medicare Advantage Plans charge no premium above what everyone must pay for basic Medicare; others charge a small additional premium.

For example, I have chosen to use Kaiser Permanente in California as my Medicare Advantage provider.  The only additional fee they have is an optional $20 a month for their Plus plan, which includes dental and extra vision benefits.  You need to understand your plan, however, because the fees and services vary from company to company.

All Medicare Advantage Plans must follow Medicare's rules and provide you with the basic services.  However, they can charge different out-of-pocket fees and they may have their own rules about their services, such as requiring you to get a referral from a primary care doctor in order to see a specialist.

Different Types of Medicare Advantage Plans 

There are a wide variety of Medicare Advantage Plans available and choices vary from state to state.  You can choose an HMO, a PPO, a Private Fee-for-Service plan, Special Needs Plans, HMO Point-of-Service plans and Medical Savings Account Plans.

A few months before your 65th birthday, most of the providers in your area will start mailing you brochures about their plans and some will have seminars to explain how their plans work.  Hospitals and senior centers in your community may also sponsor informational meetings.  Selecting the right program for you can be very confusing, so I highly suggest that you talk to your friends who are already on Medicare.  Ask them about the type of plan they are using, what they like about it and what they would change.  It is recommended that you discuss your choices with an agent who represents a variety of insurance companies and types of policies.

You may also need to take costs into consideration.  One of the factors which helped me make up my mind to use Kaiser was the fact that the optional premium was only $20 above the cost of basic Medicare and my out-of-pocket costs were very low ... for example, $10 to $15 for office visits.

On the other hand, the disadvantage was that, when I decided to switch from my prior insurance to Kaiser, I had to change all my doctors.  Some people are so attached to their current doctors that they don't want to make such a drastic change.  My husband was one of those, which is why he chose to use a Medigap Supplemental insurance policy rather than a Medicare Advantage Plan.  Since I am quite healthy and never saw my physician except for an annual medical exam, I did not mind making the change.
 
There is a lot more information that you need to know about Medicare Advantage plans.  In addition to reading brochures, attending seminars, and speaking with an agent, you can learn more by contacting Medicare directly.  I have included the contact information below. 

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.

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, the best places to retire in the United States and overseas, financial planning and medical issues.

You may also be interested in reading:

How to Sign Up for Medicare
Should You Get Medigap Supplemental Insurance with Your Medicare?

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

Photo credit:  www.wikipedia.com/commons
 

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