Retirement Health Planning - Medicare .

Retirement Health Planning - Medicare    Last Update Jnauary 16, 2020

      This is my Homepage for Health Planning in Retirement. While I will ultimately add my own ideas and suggestions, the initial focus is to create a reference site based on my extensive research into this topic. Like my study of Cancer and it's treatments, Genealogy, and my years in Project Management and Business Process Engineering, it's another subject that is much more complex than the casual observer, or non-involved participants, believe. That's primarily due to the difficulty in organizing the huge amount of information available, and constantly changing and being updated, related to the topic, into a framework for understanding by those not immersed in the details. However, unlike Genealogy, Project Management and Process Engineering, decisions made in relationship to Medicare and how you structure your health management process and affilitations, will have a direct impact on the rest of your life related to health, wealth and longevity.

      As a temporary placeholder, I will initiate this effort by sharing my pesonal introduction (all after this paragraph) to my friends and associates that are, or are soon to be, involved in this subject. My objective, as you will see expertly demonstrated if you follow the below recommendations, is to help others in this very complicated topic. Ultimately I hope to form a Local Discussion Group to maintain and update this communication based on changes in the law (which I'm sure are coming), and to help others to implement the needed continuous education to address the subject on an annual basis. This will become increasingly difficult for us all as we pass through this last phase of our life. I will be adding my own You Tubes, probably after the first of the year, covering how to access, organize and evaluate the information that is on the web in the many government sites, based on their relevance to the decisions that you make. Each decision will eliminate much of the remaining information from the area of relevance to your needs, but add additional topics for more detailed review. Like the below links, if I can find the quality work that has already been done, then I won't need to spend my time reinventing the wheel. We can all just roll on. Please feel free, after reviewing the referenced links, to use the below as a message to your friends and family that might find this information useful, or send them the link to my page. I will be updating it routinely going forward. The Initial Message:

      If you are older than 64 years, it is imperative to have an understanding of Medicare, and it's related insurance products, that are available to you (unless you are very wealthy, of course!). If you rely on the sales people that will constantly call and email you, or give you a presentation over a free lunch or dinner, to give you the best deal, for you; you will not get it! These decisions will impact your cost, and more importantly, will impact the treatment and care you get (or don't get) through retirement. Some of the decisions that you need to consider are best made six months prior to your 65th birthday. Many decisions made at that time will effect your health services, and cost, for the duration of your life. It's a complicated subject, and will require your annual knowledge update.

      I highly recommend that you start by watching these three You Tube videos. They may not answer all your questions, and may expose more questions than answers; but will provide a foundational basis, in order to pursue your understanding and decision making. The YouTube presenters are not selling anything. At this point, I have never met or talked to either one of them. You will see, especially after all the calls you are now getting, and will continue to get every Open Enrollment Period, that these guys are using the deep knowledge they have on this subject, to provide a free, non-biased educational service. All of their videos (and there are 30+ done by each of them so far) are strictly aimed at providing you the EDUCATION YOU NEED TO MAKE AN INFORMED DECISION. These decisions WILL IMPACT YOU AND YOUR FAMILY FOR THE REST OF YOUR LIFE!

      You may need to watch these videos more than once to fully understand what is being said about the basic plans, their benefits to you, their differences, and the forces that are leaning on these plans every year. It will provide an understanding of why you need to thoroughly understand your options in order to make your decisions. Everyone else is pushing an agenda, and your well-being is not even included in their list of objectives. Please watch these, more than once, and forward this list to anyone you know already approaching or beyond the age of 64. That is when they need to start this educational process to make the decisions that will affect the rest of their life.

      I will be expanding the below site as I expand my understanding of the topic, first with like links (only 10 of the 60+ by these two most impressive educators have been reviewed so far) and others that I stumble upon, through this webpage Retirement Health Planning - Medicare at http://www.GallaghersInGA.com/Medicae/RetirementHealthPlanning.html

Medicare Supplement - Medigap Plans For Those with Original Medicare Part A & B - for Doctors and Other Out-patient Services
       The Medicare Supplement Plans can only be utilized by those enrolled in the Medicare Part A and Part B Plans. Also known as Medi-Gap Coverage, these insurance policies cover much of the cost for Doctor's services provided inside and outside of the hospital. There are Policy Types (F, G, N, ...) defined by Medicare, and all of the Insurance Companies administerting their own Plans within these Policy types, must include at minimum, the basic services defined by Medicare for the Policy Types. The costs, however, vary greatly from company to company, and within individual policies from the same company, that may be offered within your county. This topic will be expanded at a later time, but for now I'l include the basic, high level considerations, or rules, as I understand them. If I have mistated anything here, please let me know as I have spent much less time in this section so far.
  1. You must be covered under Original Medicare in order to qualify for a Supplement, or Medi-Gap Coverage Plan.
  2. You can choose "Origianal Medicare" when you enroll in Medicare. Be aware that many large employers may put you into a Medicare "Advantage Plan" without fully informing you about the differences. They are just "different versions of Medicare". DO NOT START MEDICARE IN AN ADVANTAGE PLAN UNTIL YOU UNDERSTAND THE MEDICAL AND FINANCIAL RISKS YOU ARE ASSUMING!
  3. You can subscribe to a Supplement when you are 64 1/2 years old. It won't become active until you reach age 65 and have subscribed to Medicare. There are other circumstances to delay this beyond your 65th birthday if you are working or have other medical insurance (TBD).
  4. The Medicare Supplement (or Medi-Gap) Plan is additional coverage to the basic (or Original) Medicare Policy. Your primary coverage is provided by Medicare, you and your Doctor determine your treatments, Medicare pays most of the bills, and your Supplement pays much if not all of the balance of the bills.
  5. When you initially subscribe to a Supplemental Plan, you are guaranteed acceptance by that plan. There are no medical questions or considerations.
  6. If you decide at a later date to change your Supplemental Plan to a new policy (within the same insurance company or a different company), your acceptance is dependent upon a review of your medical history, and the provider can reject your application and deny acceptance. This would indicate that if you start having medical issues, you may not be able to change your policy in order to avoid higher monthly premiums. Since the individual policy premiums continue to change every year, you want to be in the best plan available to you, as each year starts, in case you get stuck in that specific insurance company\plan due to new medical needs. This is the reason you need to review your plan annually and make a conscience decision about which policy is best going forward. You can't know what problems or issues you may experience, but you can determine when you are paying more than you need to, for what you are getting.
  7. Medical Supplement Plans can be changed at any time during the year; they are not limited to the "Open Enrollment Period" between October 15th and December 7th. After your initial policy, they are subject to "underwriting", which means your medical history will be considered.
More to come - stay tuned!
Medicare Part D Drug Plan Evaluation For Those with Original Medicare Part A & B - for Drugs
       The Part D Medicare Plans can only be utilized by those enrolled in the Medicare Part A and Part B Plans. The Part D Plans cover Drugs. They can only be started when you initially join Medicare, or joined or changed during the annual October 15 to December 7 Open Enrollment Period. Each includes a monthly premium which is $13.20 - $84.20 for the 21 plans available in Hall County, Georgia for 2020. That's $158.40 to $1,010.40 of fixed cost. So the first determinate of your drug costs is what county you are in. All of them may (and most do) also incude a co-pay for each time you get each drug, based on several things: Where you get them - specifically (which drug store or mail order); How many days supply you get; What tier that drug is in for that plan (the tier can be 1-5 for the same drug, between plans; even plans within the same company). This combination of factors makes it frustrating and challenging just to figure out what you will actually have to pay to continue your current prescriptions. Some of the sites are better than others to start to evaluate this. The Medicare.gov site, if you select to look at Plan D options, provides for you to enter your drugs, dosages, where you want to get them and gives you access to the 21 plans. The comparison function leaves much to be desired. All of the costs are given (select Plan Details tab) so that you can compare the costs. You get a much better comparison at the EHealthCare.com site (see example on right). You can also go to StartPartD.com; create an account (optional) so it remembers your drugs; select the pickup points, including mail in 90 day supply, and it will provide a side by side comparison. On this site you can enroll after you figure out how to see the comparison. Medicare is supposed to automatically cancel your existing Part D provider automoatically if you change Policies. This site is associated with the Chris Westfall oganization from the introduction videos, and you can contact his group for assistance for the enrollment, and going forward for all your Medicare needs. He has an awesome organization, as you will find out.

       This is the basis for determining your cost for your drugs next year. It says and provides no compartive information to access whether the Plan, or the Company, has a competent staff, has on-line ordering for renewals, has a 90 day mail order process; sends a renewal notice when they think you are running out of a drug; provides the ability to enter a new prescription on-line and they simply contact the Doctor for Approval and send the drug, which you receive in two days. If you read reviews all over the web, you find out that the company doesn't answer the phone, the help line attendants don't speak understandable English, or the billing departments keep claiming your not paying your premium being automatically deducted from your credit card or bank account. As I find sources for that missing information, I will add it here. If you want to understand the basic difference between the plans having to do with potential changes in your drug needs, like cancer, chemotherapy, Heart Disease, or others, you could call the Insurance Company and ask for an explanation about what the primary differences are between the three plans from the same company in your county? Good luck with that. Don't bother during the only period you can actually make the change, they are too busy to answer the phone. Thre's nothing wrong with our health care system, is there?

Corrections, suggestions, contributions, problems or recommendations are always welcome. Please email: CIMpleBS@gmail.com
Please direct your questions about Medicare to one of the Referenced gentlemen or their sites.