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  • #31
    Re: Medicare

    Originally posted by matapule View Post
    [...]
    Yes, most everyone on Medicare pays $96.40 per month. If you chose to participate in a Medicare Suplemental program there is an additional charge per month. TuTu, I think you have purchased a Supplemental program and pay an additional premium per month.
    I pay one $96.40 payment per month. It's deducted from my social security check. I'm not near my file but I'll check to see exactly what that charge is for. FWIW...if I'd switched to HMSA 65C (it's Medicare supplemental program), I would've ended up paying almost the same premium every month as I was paying for my private, HMSA small business plan...which was approx. $325./mo.
    Originally posted by matapule View Post
    [...]
    Oh Tutu, matapule can fix sleep disorder, liki, liki!

    You put the lime in the coconut (with rum)
    and drink it all up
    You put the lime in the coconut (with rum)
    And drink it all up
    You silly womans

    Then you listen to matapule talk story hour after hour
    You be sleep in no time wit snoring!
    No moa problems!

    It work for matapule's uaifi.
    *sigh* Been there, done that. Oh wait, I haven't tried your endless talk story, tho'!!! Seriously, I have no problem going to sleep. Staying asleep is the problem due to the PLMD. The treatment is a little more hard core than a pina colada! Alcohol actually exacerbates the problem.

    Comment


    • #32
      Re: Medicare

      Originally posted by tutusue View Post
      I pay one $96.40 payment per month. It's deducted from my social security check. I'm not near my file but I'll check to see exactly what that charge is for.[...]
      Okey dokey...got to that very large file today and...and...the only difference between you and me, matapule, is you have C (which, for you, incorporates A, B & D and is an HMO) and I have A, B & D (which is a PPO)!!! And, you're with Kaiser and I'm with Secure Horizons! Yes, there are differences in our coverages and as you've already pointed out, different regions allow for different coverage. That's true for Secure Horizons also. And, we both pay $96.40/mo.

      I wish I'd found this site a few months ago:
      When considering your Medicare options, it is easy to get confused and overwhelmed.
      What an understatement!

      Comment


      • #33
        Re: Medicare

        Originally posted by tutusue View Post
        And, you're with Kaiser and I'm with Secure Horizons! !
        Tutu you must have a Secure Horizons, no cost (other than your mandated 96.40 per month), supplemental plan. If you were on straight Medicare, Secure Horizons would not be in the picture.

        Secure Horizons is sponsored by AARP (I have a love/hate relationship with them). AARP is reported to be the largest lobbying organization in DC. Secure Horizons gives AARP a kickback for sponsoring them.

        I researched Kaiser, Secure Horizons, Aetna, etc. when I signed up for Senior Advantage part C. Kaiser was by far the best deal in my region. Secure Horizons came in second. The big problem with Secure Horizons is that they had no annual stop loss like Kaiser had.

        I have friends/neighbors (in their 80's) in Cabo who have Secure Horizons in Seattle. They are very happy with their plan. They had medical treatment in Mexico and Secure Horizons reimbursed them 100%.

        Tutu, I disagree with you about the site you recommend. It is a sponsored site. The best place to get information about Medicare is medicare.gov If you want to compare various plans, go here and follow the instructions.
        Last edited by matapule; October 12, 2009, 05:41 AM.
        Peace, Love, and Local Grindz

        People who form FIRM opinions with so little knowledge only pretend to be open-minded. They select their facts like food from a buffet. David R. Dow

        Comment


        • #34
          Re: Medicare

          Tutusue, thank you so much for this thread. I'm 64, drawing Social Security, & am with Kaiser, so I had many questions re Medicare. Most have been answered by this thread, especially by those links from Matapule and you.

          Complication: Lockheed is contemplating removing Kaiser from our choices in Northern California for 2010 (for calendar year 2011). So, I and my fellow retirees know nothing about what's going to happen. We're hoping for a grandfather clause for those over 65, which I will be by 2011.

          My prescription co-pays have been running around $10.50 for 100 pills (blood pressure / cholesterol); my dental (chlorohexidine) prescription is around $20. So, you won't hear me complaining.

          Salamat po.
          Born in Hawaii, too - Truss me

          Comment


          • #35
            Re: Medicare

            Originally posted by matapule View Post
            Tutu you must have a Secure Horizons, no cost (other than your mandated 96.40 per month), supplemental plan. If you were on straight Medicare, Secure Horizons would not be in the picture.
            Exactly. Is "straight Medicare" also known as Original Medicare?
            Originally posted by matapule View Post
            Secure Horizons is sponsored by AARP (I have a love/hate relationship with them). AARP is reported to be the largest lobbying organization in DC. Secure Horizons gives AARP a kickback for sponsoring them.
            My SH rep disclosed that.
            Originally posted by matapule View Post
            I researched Kaiser, Secure Horizons, Aetna, etc. when I signed up for Senior Advantage part C. Kaiser was by far the best deal in my region. Secure Horizons came in second. The big problem with Secure Horizons is that they had no annual stop loss like Kaiser had.
            I believe SH refers to this as "out of pocket limit". I'm reasonably sure I have that; one amount for "in network"; another amount for "out of network". As you know, networks apply to PPOs.
            Originally posted by matapule View Post
            I have friends/neighbors (in their 80's) in Cabo who have Secure Horizons in Seattle. They are very happy with their plan. They had medical treatment in Mexico and Secure Horizons reimbursed them 100%.
            I have a family member who lives in Cali and has Secure Horizons. He loves it, too. Our coverages are different, tho', because we live in different states.
            Originally posted by matapule View Post
            Tutu, I disagree with you about the site you recommend. It is a sponsored site.
            Yes, I'm aware of that. But it offers somewhat of an understandable, condensed explanation of the various Parts.
            Originally posted by matapule View Post
            The best place to get information about Medicare is medicare.gov If you want to compare various plans, go here and follow the instructions.
            Oh, I've been there...many times! Hence, my confusion!!!
            Originally posted by Palama Kid View Post
            Tutusue, thank you so much for this thread. I'm 64, drawing Social Security, & am with Kaiser, so I had many questions re Medicare. Most have been answered by this thread, especially by those links from Matapule and you.
            Cool...that's what this thread is for. This dialogue is also good for me because we're coming up on open enrollment next month. No matter which insurer I chose a few months ago, it would've been out of frustration and confusion. Secure Horizons seemed like a safe, short term choice. I'm still researching whether it's a good, longer term choice. This thread is helping with that!
            Originally posted by Palama Kid View Post
            Complication: Lockheed is contemplating removing Kaiser from our choices in Northern California for 2010 (for calendar year 2011). So, I and my fellow retirees know nothing about what's going to happen. We're hoping for a grandfather clause for those over 65, which I will be by 2011.
            Maybe Matapule can answer this question...Can any 65 year old in California opt for Kaiser's Plan C or does one have to already be a subscriber to Kaiser? IOW, if Lockheed drops Kaiser as an option for it's retirees, can PK apply for Kaiser on his own when he's 65? PK, when you hit 65, can you drop your employer coverage altogether in favor of Medicare plan C (Kaiser)?
            Originally posted by Palama Kid View Post
            My prescription co-pays have been running around $10.50 for 100 pills (blood pressure / cholesterol); my dental (chlorohexidine) prescription is around $20. So, you won't hear me complaining.
            Have you checked medicare.gov to see if 1) they're on the drug formulary and, if so, 2) what they will cost you when you're on Medicare?

            No matter how many questions this thread answers, PK, it's still best to research plans in your area and take advantage of free seminars. This thread will hopefully arm you with important questions to ask when you get to that point within the next year.

            Comment


            • #36
              Re: Medicare

              Just wanted to add one thing about ESRD patients (those on dialysis). They DO have opportunities to get Medicare supplement policies within so many days after first being eligible for Medicare (can't remember offhand the number of days) as well as within so many days after turning 65. I've had several dialysis patients obtain AARP supplement policies this way. (HMSA 65C+ sucks for dialysis patients however....they have to pay $22 copays for EACH treatment....times 3 treatments a week times 4 weeks a month...well...you get the picture. It's a lot for most people to pay out of pocket every month.)

              Comment


              • #37
                Re: Medicare

                Originally posted by tutusue View Post
                Is "straight Medicare" also known as Original Medicare?
                Yes

                I believe SH refers to this as "out of pocket limit". I'm reasonably sure I have that; one amount for "in network"; another amount for "out of network". As you know, networks apply to PPOs.
                Secure Horizon has no out-of-pocket (stop loss) feature in the SoCal region. Each region can be different.

                This dialogue is also good for me because we're coming up on open enrollment next month. No matter which insurer I chose a few months ago,
                That is correct. Open enrollment runs from Nov 15 to Dec 31 each year. You can change plans each year during that time period with no penalties. You can even change back to a plan you dropped a couple of years ago. I like the flexibility of the whole system and the optrions that are available to me. That is why I support a national public health option for health care.

                Can any 65 year old in California opt for Kaiser's Plan C or does one have to already be a subscriber to Kaiser?
                The answer is yes. You do not need to be a current Kaiser subscriber to join Kaiser Medicare Supplemental or Kaiser Senior Advantage. For example matapule's uaifi just signed up for Kaiser Senior Advantage without being a current member of Kaiser.

                if Lockheed drops Kaiser as an option for it's retirees, can PK apply for Kaiser on his own when he's 65?
                Lockheed has nothing to say about who a retiree selects for their Medicare coverage. PK can pick anyone they want for Medicare coverage (change their mind every year too) regardless of who their current carrier is through Lockheed.

                PK, when you hit 65, can you drop your employer coverage altogether in favor of Medicare plan C (Kaiser)?
                That will be a choice that PK will need to make. If PK chooses to work at Lockheed past age 65, they can contnue to particpate in Lockheed's company plan (whoever the carrier might be at that time) and I believe that the $96.40 will NOT be deducted. However PK can elect to drop his Lockheed coverage and go on Medicare coverage (for which $96.40 will be deducted) but lockheed will probably give PK a rebate on the company insurance he is not using.

                PK, it's still best to research plans in your area and take advantage of free seminars. This thread will hopefully arm you with important questions to ask when you get to that point within the next year.
                Kouia, Agreed.
                Peace, Love, and Local Grindz

                People who form FIRM opinions with so little knowledge only pretend to be open-minded. They select their facts like food from a buffet. David R. Dow

                Comment


                • #38
                  Re: Medicare

                  Tutusue & Matapule, thank you. This entire thread has helped tremendously.

                  Next year, Kaiser's Senior Advantage looks like my best choice @ a much lower cost per month. BTW I retired in 2000 @ 55.
                  Born in Hawaii, too - Truss me

                  Comment


                  • #39
                    Re: Medicare

                    Originally posted by matapule View Post
                    [...]
                    Secure Horizon has no out-of-pocket (stop loss) feature in the SoCal region. Each region can be different.
                    Here's what I'm reading in my "Summary of Benefits", "Premium and other important information" for Part B:
                    General
                    $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                    In-Network
                    $2500 in-network out-of-pocket limit. Not all plan services are covered under the out-of-pocket limit. Contact plan for a detailed list of non-covered services.
                    Out-of-Network
                    $3750 out-of-network out-of-pocket limit. Not all plan services are covered under the out-of-pocket limit. Contact plan for a detailed list of non-covered services.
                    I will definitely contact my plan!
                    Originally posted by Palama Kid View Post
                    Tutusue & Matapule, thank you. This entire thread has helped tremendously.
                    For me, too, PK!
                    Originally posted by Palama Kid View Post
                    Next year, Kaiser's Senior Advantage looks like my best choice @ a much lower cost per month.[...]
                    Very cool! Rates and coverage can change from year to year so be sure to check that plan again prior to signing up.

                    Comment


                    • #40
                      Re: Medicare

                      Originally posted by tutusue View Post
                      Here's what I'm reading in my "Summary of Benefits", "Premium and other important information" for Part B:

                      I will definitely contact my plan!
                      It's all in the details, never assume anything.

                      Very cool! Rates and coverage can change from year to year so be sure to check that plan again prior to signing up.
                      Kaiser Senior Advantage is going to remain essentially the same for 2010. I'm sticking with it.
                      Peace, Love, and Local Grindz

                      People who form FIRM opinions with so little knowledge only pretend to be open-minded. They select their facts like food from a buffet. David R. Dow

                      Comment


                      • #41
                        Re: Medicare

                        It was announced this morning that the premium for Medicare part B will remain the same in 2010 at $96.40 per month. However, the premium for part D (prescriptions) will increase in 2010. The amount of the increase was not announced.

                        Since I have part C Medicare, this should not affect me.
                        Peace, Love, and Local Grindz

                        People who form FIRM opinions with so little knowledge only pretend to be open-minded. They select their facts like food from a buffet. David R. Dow

                        Comment


                        • #42
                          Re: Medicare

                          Originally posted by matapule View Post
                          It was announced this morning that the premium for Medicare part B will remain the same in 2010 at $96.40 per month. However, the premium for part D (prescriptions) will increase in 2010. The amount of the increase was not announced.

                          Since I have part C Medicare, this should not affect me.
                          It'll be interesting to see if my premium increases as Secure Horizons charges nothing beyond the standard $96.40. There's no separate charge for D.

                          Comment


                          • #43
                            Re: Medicare

                            So, let's see if I have this right. Plan C would replace having Plans A + B.

                            Yes? OK, then, anyone know what the options are (in Hawaii) for Plan C, besides Kaiser?
                            Now run along and play, but don’t get into trouble.

                            Comment


                            • #44
                              Re: Medicare

                              Amati, you'll need to go to medicare.gov and do a search using criteria specific to the (would be) recipient. A quick search using my criteria shows a couple of others...AlohaCare and Ohana...but I don't know what their limitations are.

                              ETA: Matapule's Kaiser part C replaces A, B & D. I don't know if other Advantage plans also replace D by including drug coverage in C.
                              Last edited by tutusue; October 15, 2009, 03:58 PM.

                              Comment


                              • #45
                                Re: Medicare

                                Originally posted by tutusue View Post
                                Amati, you'll need to go to medicare.gov and do a search using criteria specific to the (would be) recipient. A quick search using my criteria shows a couple of others...AlohaCare and Ohana...but I don't know what their limitations are.
                                Since Tutu has Secure Horizons, they are available in Hawaii too. On Medicare.gov, you search by your zip code.

                                ETA: Matapule's Kaiser part C replaces A, B & D. I don't know if other Advantage plans also replace D by including drug coverage in C.
                                Part C (the HMO all inclusive plan) includes part A, B, & D. Check plans carefully, they all can vary to a great extent. Kaiser was the best deal in my area.

                                I went to Kaiser yesterday with a stabbing pain in my left shoulder that I have had for several months off and on. The Kaiser doctor said his specialty is sports medicine and he knew exactly what I had.....bursitis. He gave me a painless injection of cortisone in the shoulder joint and matapule mo bettah, lik gnu, ya betcha. My cost? $15 for everything.
                                Peace, Love, and Local Grindz

                                People who form FIRM opinions with so little knowledge only pretend to be open-minded. They select their facts like food from a buffet. David R. Dow

                                Comment

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