Transitioning to Medicare

csimone

New Member
What should I be thinking about as I near 65? Did someone help you with this process?
 

I made my own decisions.

I would encourage you to read the Medicare manual that comes each year to understand what Medicare covers and then compare that to your own needs/situation. Then start reading the information about the various supplemental plans offered by insurers in your area.

I originally chose a no-frills Medicare advantage plan offered by a major insurer with a monthly premium of $35.00/month. The next year I went with the same insurer's zero-premium plan.

With the current plan, I have out-of-pocket expenses each year of a couple thousand dollars mostly for prescription medication co-pays mainly due to the high cost of my insulin.

These no-frills/no-premium plans work for me because I'm willing to accept in-network care and have enough savings to cover the possibility of high back-to-back annual deductibles if I get sick for an extended period of time. Choosing a more comprehensive plan with a higher monthly premium might be better for someone that would prefer to seek out of network care or was concerned about smoothing out their monthly expenses and reducing the possibility of high annual deductibles.

There is no one size fits all plan and the plan you start with may not continue to be the best plan as you age.

Do your homework each year as coverage and your personal situation changes.

Good luck with your decision.
 

Just remember to sign up within 6 mos. of your 65th BD, or you'll be penalized. If you already have insurance, make sure they send you the forms to change your plan so that Medicare is the first payor and the private insurer now becomes the second payor.

Signing up on the website is easy.

Our insurer was rather dilatory; we didn't get our forms until 5 weeks before the BD dates. But everything was processed in time so the transition was seamless.

Due to COVID and the USPS slow-down, I would complete the forms and mail them back ASAP after receipt, however.
 
Another thing I learned is once you get on advantage plan you cant from what ive read go to a a supplement plan.

Please be careful. There are pitfalls. I chose plan N and Im happy with it. I can go to any doctor i want without approval. I just changed my primary doctor. I also go to another doctor for my thyroid.
 
Have a question about Medigap...
During Age 65 initial Medicare enrollment, is it better to opt for Medigap instead of Advantage plan?

Heard additional approval process is involved for someone to switch from Advantage plan to Medigap.
 
Just remember to sign up within 6 mos. of your 65th BD, or you'll be penalized. If you already have insurance, make sure they send you the forms to change your plan so that Medicare is the first payor and the private insurer now becomes the second payor.

Signing up on the website is easy.

Our insurer was rather dilatory; we didn't get our forms until 5 weeks before the BD dates. But everything was processed in time so the transition was seamless.

Due to COVID and the USPS slow-down, I would complete the forms and mail them back ASAP after receipt, however.
I don’t understand this at all. My husband still works his private insurance through his employer is first. It can’t be made second as far as I know. Medicare is second. VA is third as far as I know.
 
The insurance forums using VBulletin can refer you to someone in your state who can sign you up and tell you all the details. You need to contact an expert. They work at no charge.
 


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