Confused by Medicare? Join the club. My husband and I will both be signing up for Medicare this year. He has cancer that is incurable but hopefully manageable. He will be on oral chemo the rest of his life. Very EXPENSIVE oral chemo. That’s a whole story in and of itself. But I thought I’d start talking about Medicare in my blog by giving an overview. If it helps you, consider buying me a coffee!
Here is an ๐จ๐ฏ๐๐ซ๐ฏ๐ข๐๐ฐ ๐จ๐ ๐๐๐๐ข๐๐๐ซ๐. Donโt get the parts and plans confused. โPartsโ are the main components of Medicare. โPlansโ are the optional supplement plans. Both have letter names.
๐๐๐ซ๐ญ ๐ has no monthly charge. Itโs not free; itโs just that youโve already paid for it through your FICA taxes. Sign up for it. If you donโt, you wonโt get your social security benefits. Thatโs the law (unless youโre on Congress – they voted themselves exempt).
๐๐๐ซ๐ญ ๐ costs $148.50/mo for everyone. Itโs optional. You donโt have to sign up for it. You pay the federal government out of pocket until you get social security. At that point, your social security check is reduced by the cost of Part B, if you elected to sign up for it. Parts A & B are usually called โtraditionalโ or โoriginalโ Medicare.
๐๐๐ซ๐ญ ๐ is whatโs called Medicare Advantage. You cannot have Part A, B, and C. You get either Part A (and B, if you want) OR Part C. Medicare Advantage programs typically have low or no premiums but also many more co-pays, networks, and restrictions. Itโs a good option for some but not advised for my husbandโs cancer.
๐๐๐ซ๐ญ ๐ is the prescription drug plan. There are many options. It is optional. I think most people sign up for one. In our case, itโs not helpful because our three prescriptions are not adequately covered.
๐๐๐๐ข๐๐๐ซ๐ ๐๐ฎ๐ฉ๐ฉ๐ฅ๐๐ฆ๐๐ง๐ญ ๐๐ฅ๐๐ง๐ฌ (๐๐๐๐ข๐ ๐๐ฉ) can be purchased to supplement Parts A & B. Itโs optional. There are rules regarding whether it can be used with a Part C Advantage Plan. See this link:ย https://www.medicare.gov/…/medigap-medicare-advantage…ย . The supplement plans are named by letters: Plans A, B, C, D (not to be confused with Medicare PARTS A, B, C, D), F, G, K, L, M. Plans C and F are only available to purchase if you were eligible for Medicare before 2020 only. There are high-deductible plans and regular plans. There are three ways they are rated: Community rated, attained age rated, and age at issue rated. The supplements help cover what Medicare Parts A & B donโt cover. Prices vary depending on sex, location, company, smoker or not, and possibly other factors. You purchase through private insurance, not the government.
Did you follow all that? Thereโs more to it than that โ so many rules! But thatโs the basic explanation. We are getting Medicare Parts A, B, and D (least expensive one since none of them cover adequately what we need), and Supplement G (community rated, not high deductible), and staying on Samaritan Ministries. We have been members of Samaritan for many year, thankfully.
It will be very expensive for us. For many, it is a reduction of monthly costs. Our monthly healthcare costs will more than double once we’re on Medicare. I hope after a year I will have enough data for analysis to see what we might be able to drop or change. But since some of the decisions we make now are more or less permanent, Iโm going with the most comprehensive coverage. If I choose less expensive, less comprehensive options, some of those decisions cannot be reversed later without medical underwriting which Evan would never pass. So, weโll see!