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So, I am not retired YET but about ready.  I'm 67 and trying to figure out whether traditional Medicare or advantage plans are best. What are your experiences with either or both?

I have the Medicare A card, but since I'm still working, I have insurance through my employer.

Horace

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Unless you can keep your other insurance, you will lose prescription coverage and some other benefits.  Advantage or Supplement plans are spotty as to what they will and won’t cover, so examine them closely to find one that best covers your particular health needs.

 

In certain limited cases, especially when you don’t need any expensive drugs, straight Medicare may be your best choice.

 

 I’d recommend that you see an agent that specializes Medicare insurance.

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1 hour ago, Blackwater 53393 said:

I’d recommend that you see an agent that specializes Medicare insurance.


THIS^^^^

 

Ask around there are people that specialize in navigating Medicare and Medicare Advantage plans. Many provide this service free of charge. 
 

If you plan on traveling a lot, keep in mind that many Advantage plans only cover a certain geographic area. If you leave their coverage area you are considered out of network. 

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Can't advise you what to do but can tell you what I did.  I enrolled in medicare when I turned 65 and this became my secondary health insurance and I'm glad I did because way before retiring I had to undergo another arterial stent placement and Medicare paid for what my primary had not which came up to 3K.  I retired at 73 and Medicare then became my primary but I retained my original insurance and this became my secondary.  Now both my wife and I ran up some hefty medical expenses but I have yet to pay any deductible.  It all depends on what your primary work insurance covers but I have become a firm believer.  Basically Medicare pays for 80 % or in some cases 100% of doctor's and hospital bills, my secondary pays for most of my medications and around 20% of what Medicare doesn't cover.  I'll give you a quick example:  In 2012 I was diagnosed with Chronic Myologenious Leukemia.  I've been on a medication called SPRYCEL since (and will be for life).  This is STUPIDLY EXPENSIVE!  My secondary insurance paid $43,000.00 for the SPRYCEL in 2021 while my share was $1,800.00 for the year.

Good luck, and what Sedalia Dave says.

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I have Medical Mutual which essentially takes over your Medicare. Lots of benefits and it costs nothing except a $5.00 co pay for a doctor visit. I don’t know if it’s in your state but check it out.

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Can't advise on insurance, straight Medicare wasn't bad.  If you take regular medication, visit with your Doc and get him to prescribe an inexpensive set to replace the expensive ones before you retire.  Saved me an absolute bundle.  I currently have a Medicare "replacement" , not much available where I live.  I got it because it covers hearing aids and I needed new ones.  The portion they covered is more than many years worth of their premiums.  Shop programs and read the fine print!  Good luck!

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Be aware that there are massive holes in nearly EVERY coverage plan! 
 

I was stunned when I reached what they call the “donut hole” in my prescription coverage. Two of my diabetic medications cost me $5,000.00 for a ninety day order and I hit the mark at the end of May.  There are NO GENERICS for these drugs!!!  I was fortunate to have healthcare providers that supplied me with samples of those medications to take up much of the slack.  It gets tough when you’re on a low to moderate fixed income.

 

This became REALLY frightening when, after seven years in a clinical trial for a cancer drug, Schoolmarm was informed that the study was complete and that the company that created and supplied the drug that saved her life and kept her alive would no longer be furnishing it and that a monthly prescription of the medication costs $20,000.00!! Her policy wouldn’t completely cover ONE MONTH’S dosage and our portion of the cost would be $16,000.00.  Again, there is no generic and isn’t likely to be one for at least five more years.

 

We have to apply for grants to offset some of the costs. It has to be done almost every other month.  These drug companies say in their advertising that if you can’t afford your medications, XXXX inc. can help.  That doesn’t go for people on Medicare or Medicare Advantage or Supplement insurance.  The people who probably need the help the most can’t get it!!  
 

I’m telling you all this so that those of you who are nearing retirement and destined for Medicare are informed. My family makes a couple thousand dollars more than the limit set to receive any assistance.  That means that because we make three or four thousand dollars more than their limit, we have to come up with another $207,000.00 a year to get the medical supplies that we need to stay alive.

 

Gettin’ old ain’t easy on the pocketbook!!

 

 

 

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I have the Senior Advantage program through Kaiser.
They take all of my Medicare, and each of us pays a $15 monthly premium.

In 2016, I had a full prostatectomy for cancer... retail cost was $43,000.
Last January, I had a heart attack and two stents installed... full cost not known.
In September, the stents failed, and I had a 4-way bypass... retail cost $200,000, co-pay was $1300.

We don't have vision (glasses) and I don't care... I get ours from Costco at 1/3 the price Kaiser charges.

Drugs are sold at significant discount from retail.
For example, Jardiance is $600 retail, costs me $90.

All HMO use incentivized medicine.
As part of the profit sharing plan, the doctor gets a percentage of my monthly premium NOT spent on tests or care.
I fired my last cardiologist who was useless as tits on a boar... the root cause of his ineptitude is not known to me.
He would have dragged his feet long enough to kill me, if I had not gone up the chain and over his head, and gotten the CABG bypass.
I figure I had about 2 more weeks before my LAD closed up a second time, and killed me outright.

 

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Thank you all for the great info.  I'm watching this thread quite intently.  I'm close to retirement but my Sjogrens is kicking my a$$.  It is difficult for me to work right now because of the inflammation and pain.  I'm at the point of trying to decide whether to go on a medical retirement, go down to work part time or ???? 

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12 minutes ago, Calamity Kris said:

Thank you all for the great info.  I'm watching this thread quite intently.  I'm close to retirement but my Sjogrens is kicking my a$$.  It is difficult for me to work right now because of the inflammation and pain.  I'm at the point of trying to decide whether to go on a medical retirement, go down to work part time or ???? 

 

Before you think about retirement, have your Dr put you on disability. This is especially advantageous if you have both short AND long term disability insurance. Get your Dr. to say that it has progressed to the point you cannot work. Then when your long term disability insurance runs out, apply for Social Security disability. The first time you apply SSA will likely deny your claim. Be persistent and keep after SSA till they approve your claim.  Find a good patient advocate that can help you with the SS application process.

 

The advantage to all this is by already being on disability you have more justification for the SSA disability application. Once the SSA approves your disability claim the monies you receive may be tax exempt.

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