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 Post subject: Medicare advice
Post Posted: Oct 15, 2017 1:57 pm 
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We have a very good friend who is about to be eligible for Medicare and is looking for some local advice on the details and the process of selecting supplemental, etc. Does anyone know anyone?? Thank you so much if you can help. Post here or PM and we will get the word to our friend.
BGRs

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 Post subject: Re: Medicare advice
Post Posted: Oct 15, 2017 2:35 pm 
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 Post subject: Re: Medicare advice
Post Posted: Oct 15, 2017 7:13 pm 
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Everyones' medical and life situation is different.

I found it to be rather complicated. What was best for me was VERY different than what was best for my partner. We wanted to have the same plan but that wasn't smart for us.

I recommend attending a workshop and ask a lot of questions. They gave me information that was not explained in the handbook nor online.

Various organizations provide workshops. Check with the local senior resource centers.
Here's another option.
https://www.senioranswers.org/programs/medicare-monday/


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 Post subject: Re: Medicare advice
Post Posted: Oct 15, 2017 7:36 pm 
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I agree with CW, go to a workshop. Even if you have to drive down to Denver. After the workshop you will know exactly what is best for your situation and which companies have the best prices.

I wanted Plan G or F and they gave me a spreadsheet of all the companies in the US that offered those plans including all the costs. What a time saver!!! And my cost is much less than what a friend pays who has the same plan but with a different company.


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 Post subject: Re: Medicare advice
Post Posted: Oct 15, 2017 9:21 pm 
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I am rapidly approaching the same set of decisions, and there are books that provide a world of help. The one I started with was "Medicare for Dummies" ... yeah, I know, but I am a dummy when it comes to health care and the book was extremely helpful to me in getting a high-level view before I dip into the bowels of the system (it was written by Patricia Barry, who is "Ms Medicare" for AARP). The two lessons it drums repeatedly: Use the Medicare Plan Finder at http://www.medicare.gov site to research all your options, and pay no attention whatever to solicitations and ads by Medicare providers. I have not used that online tool yet, but will doing so at some point in the next few months.

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 Post subject: Re: Medicare advice
Post Posted: Oct 17, 2017 12:32 pm 
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My husband retired at the end of September and chose a Medicare Advantage program. He goes to the doc about twice a year; once for a physical and once for a meds review. He takes few prescription meds. It's really the best choice for us since he's not a heavy user of the healthcare system.

One caveat though, and it's a big one. He's a patient at Conifer Medical and chose his plan (thru United Health Care) based upon the fact that he wanted to keep his doctor there at Conifer. When he got his new card he found that they had set him up with a PCP in Denver! We have subsequently learned that UHC has some sort of problem (sounds like a software bug to me) that precludes them from setting him up with his doctor as an existing patient, and since Conifer is currently not taking new patients they can't work around that bug. He's been hassling with this for nearly a month now, as have the poor folks at Conifer Medical's insurance department. It's VERY frustrating!


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 Post subject: Re: Medicare advice
Post Posted: Oct 17, 2017 1:56 pm 
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Medicare is very complicated! And it's very, very hard to get information from them. I know as I've spent hours on the phone with Medicare.

Whatever your friend does, s/he should either have a good supplemental insurance or go with a Medicare Advantage program. That 20% co-pay of Part B can really, really add up. I met a poor woman whose husband chose to "save money" by not having a supplemental and when he got sick and the 20% co-pay added up to thousands of dollars, she had to go back to work to pay off their debts.

Medicare has a major flaw - we the patient do not have to OK or approve any payment to a doctor or medical institution. So it's up to us when we get the Medicare claims statement to make sure we received the services that is being billed - sometimes very difficult as the statements come out every 3 months. A long time if you have had a lot of medical visits.

Several things your friend should watch out for if s/he goes with original Medicate and a supplemental:

1. Not every medical facility or doctor takes Medicare, sometimes only one does. You have to ask.

2. A facility cannot say the cost was x, medicare paid y, and you owe them z (what Medicare did not pay). That is, when a facility accepts Medicare, they agree to accept just what Medicare pays, the patient cannot be billed for the difference. Swedish tried to do this to my husband.

3. A facility must let you know if there is a chance Medicare will not pay for a service or device. Your friend will sign a waiver to this effect. If s/he does not sign a waiver and Medicare refuses to pay for the service or device and thinks the facility should know this, then s/he is not responsible for the cost, the facility is.

4. If you try to report fraud to Medicare, they really do not care unless the amount is huge. My husband was billed for oxygen he had never received and therefore did not have. It took me a YEAR to get Medicare to do something about this, after I was told I must contact the company which I did every other month to no avail.

5. Some doctors do not take "assignment", the Medicare default payment amount but charge 15% above the assignment amount. A supplemental policy should cover this expense as it can really add up.

6. And it's not "free" as many people think. Part A is if s/he is eligible but there's a premium for Part B, for Part D (drug coverage) and the supplement.

And we have NO choice but to go on Medicare if we seniors want medical coverage and don't have Union or government coverage. This really bugs me when I get into a tussle with Medicare or try to read and understand their legalese letters. There's no competition and therefore no real service. But that's just my opinion, sorry to be so negative here.

Just for thought - my husband and I both choose original Medicare with a supplemental so we could go to the Mayo Clinic in Rochester MN or any national facility that takes Medicare. We do no have to stay within Colorado or with a certain list of providers or doctors.


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 Post subject: Re: Medicare advice
Post Posted: Oct 17, 2017 2:03 pm 
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This is very good advice and thank you to everyone! We, too, will be going through this next year and want to get all the advice that we can!

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 Post subject: Re: Medicare advice
Post Posted: Oct 17, 2017 4:04 pm 
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Great article in this month's AARP monthly Bulletin explains very well how to make Medicare work for you.

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 Post subject: Re: Medicare advice
Post Posted: Oct 17, 2017 4:25 pm 
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pm'd you:)


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 Post subject: Re: Medicare advice
Post Posted: Oct 17, 2017 5:22 pm 
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If anyone has any Medicare questions feel free to call or text, my name is Andrew and Medicare is my main occupation.
Andrew 720-256-3030


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 Post subject: Re: Medicare advice
Post Posted: Oct 17, 2017 6:49 pm 
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Thank you all. I am passing all our your wonderful advice forward.
Keep sharing, please.
Mrs. BGR

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