Alas, it is time to enter the Medicare Maze. Joy, joy, I have reached the magic age and you enter the gate three months before your actual birthday. For years my plan was to go into the Medicare office in person and sign up. I just wanted to go and ensure I was making the right decision since I am working and I do not need to sign up for Part B yet, due to insurance at work.
Medicare is not set up to help folks make decisions. Even as I filled out the form, had I not done my research, I would have been scared into picking Part B. I get lots of crazy emails, Facebook ads, and ads in the mail and if I relied on this information alone, I would be ill informed.
The Basics
Medicare, for most folks, kicks in on your 65th birthday. You need to apply for it three months ahead. It takes about two months to get set up. Basic Medicare is free, that is Part A. Part B is not free, it costs about 144.00 and keeps going up overtime. However, this does not cover all your expenses. You have to then pick between two major options: Pick a Gap plan + Part D + eye insurance + dental insurance Or pick Medicare Advantage, which includes drugs plan, Dental and eye benefits and most include a free gym membership, but do not be fooled by free. I may be wrong that Part D is included in Advantage plans. And for years I thought when I got Medicare it was going to be free, silly me.
The Gap Plans
You can no longer get F plan. If you are on F plan, beware, no new folks means your costs are going to go very high. I was warned by my agent not to take it for Wally, had we signed him up. I missed the cut off as I was not old enough to even sign up. However, the G plan is basically the same, except for the annual 198.00 fee. Plan G is a gap plan meaning it covers what Part A and Part B do not cover, which could bankrupt you if you got very ill. The beauty of this plan is you can pay monthly an extra 73.00 or more depending on your plan and have no co-pays and no deductibles. To this plan you will need to add Part D for drugs and add dental and eye plans. You will have the options to use this insurance anyplace and pick a top cancer center, options the Advantage plan does not offer.
The (DIS) Advantage Plans
Remember the saying, you get what you pay for? Well, that holds true for these plans. If you have endless funds in the bank and can afford to pay the 7,000.00 deductibles and co-pays you are golden. Advantage plans sometimes even pay you to take them, sounds great, right? They pay some dental and eye care, they sponsor Silver Sneakers and it costs you nothing per month except for your co pays, and annual deductibles. But, did you know, it works like a HMO. It only allows certain doctors and takes away your choice to go to a cancer specialty center, like MD Anderson, which in my great state of Texas, only shows up on one Advantage plan and only in the Houston, TX area. You also cannot use it out of your geographic area. Still sounding good? I do not think so. You also have co-pays and that monster deductable, if you ever get ill.
My Decision
Wally and I are working. We have insurance at work that is decent. We could opt in for Medicare, but that would mean we would need to pre-pay quarterly, which is ok, but I would need to get organzied and get it set up, or leave it as is. It would remove our annual deducatables and co-pays. So while I would pay about 100 more per month, it would remove every surprise cost should either of us be hospitalized. If our joint salaries two years ago were under 174,000.00, then there would be no extra fee added, is we made more than that we would pay about 50 more dollars per month. We still would need Part D and keep our dental and eye plan...I am lazy.
Signing Up
I decided today to sign up for Part A. Should be easy enough right? I wish! I called the local Medicare office and asked a myriad of questions. She told me the next step was to go to Medicare.gov. Sounded easy enough.
I went to Medicare.gov and started to fill out the form and stop when it asked me for my Medicare number. It said if I did not have one, I had to get it off the SSI web page. Great. Now I needed to remember my SSI log in. That was a fail, even though I was using the correct Username and Password. I called. 30 minutes on hold. The call was 1970 scratchy quality and the girl was sort of a snot. I asked for help and told her my log in issues and that the Medicare lady told me to go to Medicare.gov and Medicare.gov told me to go to the SSI website and she said two things that confused me. She said I could not sign up on the SSI site but that I could. BLINK. What she should have said was that you get to the Medicare application on the splash page for SSI, which apparently is not connected to the regular SSI page. I had asked her once I logged in what do I look for, should be easy, right? Wrong. She again gave me bad directions. She said to log in, go to the first page, use the Menu > Benefits > Medicare application. Well, there was no such options once you log into the regular SSI page. There is no link to take you out to the proper page, info was sparse and my blood pressure was rising.
Then I do a Google search for "How do I apply for Medicare?" and I landed back on the first SSI page (before you log in) and I found the option. And I know my way around the Internet and web pages and I was ready to blow a gasket. My logic of logging in and then finding the right option was wrong.
The form itself was easy enough but you need to pay attention to the questions. You need to have a working log in to SSI site, so do set that up before you even try this. For a working person like me with good health insurance from my company I only wanted Part A, no Part B and I was not signing up to take my SSI at this time. Seems simple enough. You need to know that if you are not insured at this time and you omit part B you will be penalized. If you currently have an HSA, you cannot sign up for A or B. If you do, you get a penalty. They will find out at the end. When you do retire someday, you have to show proof of insurance. One paper is filled out by your employer and another form you fill out. You gather both forms and submit to Medicare. You would need to do this two months prior to retirement so your benefits do not lapse.
As I filled out the forms and chose not to take Part B, very scary Red text popped up and indicated I may get a penalty and some other scary sounding text. Had I not known better I would have selected this. Other than that, it was pretty easy. You electronically sign it and submit and I guess after a while it goes through and then you get your card.
By the way, if you do not sign up for SSI at the same time and you take both Part A and B, it does require pre-payment quarterly as your medicare costs typically are paid out of your SSI payment. If there is no SSI coming in, they pre-bill you. I do not understand why they cannot be paid monthly out of a bank account, but whatever. I guess they want you to take SSI earlier than later, but Wally and I are holding out for the MAX payment.
The maze is deep and wide. You need to do your homework. Do not go down a rat hole and figure out too late you picked the wrong option. While you can sometimes go from a Gap plan to an Advantage Plan, it does not usually work the other way, especially if you get cancer. Once you pick one of these plans you need to be prepared to stay with it.
The drug plans are also Russian Roulette, as they need to be reevaluated annually. The med that cost nothing this year can go sky high the next. The independent agents offer plans to do that work for you, for a fee.
I am not an agent, nor an expert, but this is roughly the ins and outs of Medicare. There are lots of ways to go wrong. Do not enter this maze without knowing where you want to go.