Plus, it is not the way anyone in their right mind would set it up. Its not all that hard to figure out at 65-- but impossible to remember at 68, because it doesn't really make any sense.
We knew this would be your conclusion from the beginning. Medicare is simple. Turn 65, decide the route to go and enroll. There are no "gotchas", either a supplement or MA gives you great coverage and limits your out of pocket expenses. And the US spends a higher percentage of GDP on healthcare because of the employer plans the vast majority of the people in the US are enrolled in, not because of Medicare. Only 15% of the population is enrolled in Medicare. If you need any other information on Medicare, let me know.
And, given that you are paid by UHC and help it sell its Medicare products, we knew this would be your conclusion from the beginning. On a daily basis, my Facebook is flooded with ads for organizations wanting to explain Medicare to me - and just coincidentally I'm sure, sell me products. I'm sure they're not doing it from the kindness of their hearts. The structure of Medicare and its interaction with other disparate ways to access healthcare in the US is absolutely not straightforward. Nor are the gotchas those interactions create. It's sad you're in denial on this. It's a great system for the healthcare industry to make money off, though - over 20% of total US healthcare spending goes to it. "UnitedHealthcare is already the leader in Medicare Advantage. Its membership in that business line grew 8.5% year over year to 5.2 million, while revenue from that business rose 11.5% to $21.1 billion." https://www.modernhealthcare.com/in...e-grows-medicare-members-optumhealth-patients
I am an independent agent that is appointed by a bunch of different companies, UHC is just the biggest and best carrier I represent. That depends. I run two different kinds of events as allowed by CMS. One type is a formal sales event where I show the benefits of the UHC product line. The other type is a formal educational event where I am prohibited from stating anything about any carrier other than to note I am a licensed agent. I do both types of events knowing that the educational events CANNOT END IN A SALE OF ANY KIND. So yeah, kindness of my heart. Medicare doesn't "interact" with any other type of health insurance except for very limited cases. If you have anything other than Medicare Part A you cannot have any other coverage. I don't know how much more straightforward you can be. That's why I chose UHC to represent. If you understood Medicare compensation even a little bit you would see how UHC's MA plans are actually saving the government money. Having a discussion with someone that already has their mind made up isn't very fun. Have a nice night @M
Still in denial I see. It absolutely does interact with other types of access to healthcare. Hence the gotchas and inconsistencies I've outlined in various posts over the last few days. Simple example one more time:- employer coverage = creditable coverage; COBRA coverage from employer != creditable coverage. An inconsistency and gotcha if you're not aware of this. In part, by denying legitimate claims: https://www.nytimes.com/2018/10/13/us/politics/medicare-claims-private-plans.html Indeed. Time for you to stop being so defensive.
There are no gotchas. Very few people go from COBRA to Medicare. You think bringing up the exception disproves the rule. Also, I’m not in denial about anything, I just understand how the system works while you seem to be doing what you can to discredit a wildly popular program while not really understanding even the most basic parts of it.
Still in denial I see, even when presented with a very specific gotcha. "It's Dangerous to Keep COBRA When You're Eligible for Medicare". https://www.thestreet.com/investing...ra-when-you-re-eligible-for-medicare-14017568 Really hope your advice to potential Medicare users is more balanced than your postings on here.
May I step in here? I appreciate a good debate, but that ended a few posts ago. @stanger and I disagree on many things (and agree on a few), but he does know health insurance/Medicare inside and out. While many of us may believe a single payer (call it Medicare for all or not) is a better, more economical (all things considered), and way more efficient system, we have what we have... and @stanger knows that system. It is, literally, his business. I would suggest moving on at this point. It appears you are arguing at cross purposes now. @M, I like your posts and agree with much of what you write (including some in this thread), but it seems this discussion has run its course. Thanks.
Did you read the article or just look for something that supported your point in the headline? Seriously, read it and get back to me.
I was talking on the phone with my Jr. coworker and explaining him some stuff that I usually do, but that he will have to handle this week, since I will not be in the office until the 29th (staggered scheduling) and I could not help but think of the recent conversation about the US healthcare system and how somebody tried to explain it to a non-American. "Our system is pretty simple, you do A, then B and the outcome is C. Unless A is bigger than 65, then you have to apply for D, but remember that D needs to be supplemented with D1 or D2 or else instead of C, your outcome will be F. For people that is not 65 but cannot do A then B, you have to apply for X, unless you live in some states, where you basically go to Z. If you apply for X, than you have to make less than 4 times M, otherwise you're not covered, but you might be able to get some subsidies and get a cheaper rate, but if you live in a county with no W, then you end up paying P. If you can't qualify for A, D, X, W, then yeah, you go to the ER when you're about to die." Pretty simple, no?
If I was a Yank, thank God I'm not, I would be pissed I had to spend my retirement time trying to figure out what's the option to choose from to have a health care covering.
In our defense, if you have decent retirement and live in a big market, most likely you will be fine, with a better coverage than most people that has no coverage through either employment or another government program. Now, if you get a paltry check, and/or live in a market with few or no supplementary plans, each big illness would be like Russian roulette. In general terms, if you ignore the costs, most people in the US (85-90%) is covered one way or another, and in most cases the coverage will suffice, minus a few thousands dollars in premiums and/or out of packet copayments. The problem is when you don’t have coverage or for one reason or another you have big out of pocket costs. Obamacare tried to plug a lot of those holes via subsidies and expanding the coverage of existing programs (while increasing taxes for the wealthy a little bit), but Republicans have been trying to dismantle the law since before its implementation, without complete success, but enough to keep the coverage gap wide and their true constituents’ tax breaks intact.
@stanger I appreciated your time and patience in the last two pages, I am 58 and starting to think about these things a lot and you seemed to be presenting more educational information than promotional information. @M seems mad about the whole insurance thing and it is complicated as fuk. It aint Stangers fault... We (Americans) are getting royally screwed over in our healthcare, but I really do not think that is stanger's fault. The whole employer based crap and typical American greed seem to be at the root of the problem. Then we factor the fact that some think healthcare is a right and get confused between care and insurance. We end up talking past each other and corporate America keeps taking an outsize share of our labors. Sadly i suspect our current system is so inefficient that we could probably give everybody the health care they need without too many more total dollars than are being spent now. The biggest problem we have besides the will, is how do we transition to something like that without devastating financial markets, since the S&P is Americas impotent god that must be protected at all costs.
I'm not claiming anything is Stanger's fault. I am merely pointing out the gotchas and inconsistencies in the system. Stanger chooses to minimize or ignore them,, so I will point that out too.
Here's another piece of wonderful insurance nonsense. Not Medicare, but solely in COBRA . And solely in California. California extends the federal COBRA from 18 months to 36 months. Except... if your employer is self-insured, it doesn't. You only get the federal 18 months. Except... even if your employer is self-insured, if you were on certain HMO plans when employed (think Kaiser...) that are regulated by the state of California, you do get the 36 months. I mean. wtf?
And the gotchas keep on coming... this one on the interaction between Medicare and HSAs. "The big gotcha for older workers is Medicare’s six-month retroactive rule". https://www.investmentnews.com/medicare-and-health-savings-accounts-dont-mix-170877 "Although some individuals can effectively postpone HSA ineligibility, it is important to note that Medicare Part A coverage is retroactively effective for individuals who delay Medicare (or Social Security) benefits. If an individual does not enroll in Medicare when he/she is first eligible (and is not enrolled in Social Security), his/her later enrollment in Medicare Part A is retroactive for six months. Therefore, if an employee initially declines Social Security retirement benefits and Medicare coverage in order to contribute to the HSA and later elects to enroll in Medicare, the individual will be retroactively enrolled in Medicare Part A for the preceding six months, making his/her HSA ineligible for those six months." https://www.truckerhuss.com/2016/05...-eligibility-to-avoid-surprise-tax-penalties/ Oh and those HSA funds can be used for Advantage premiums and part B costs... but not for Medigap policies.... another inconsistency.
Not really. Very few people would opt to keep COBRA when eligible for Medicare considering there is normally a substantial difference in premium between the two. high earners like yourself are an exception. California is an odd case with just about everything. I'm not licensed in California so I can't speak to the rules there. You don't have an issue with Medicare in this example, your issue is with how the IRS looks at HSA's. HSA's were created to try to keep EGHP premiums lower by allowing you to buy a higher deductible plan through your employer. You are only eligible to have an HSA is you are in a high deductible plan because of the IRS allowing tax benefits for money you have held from your paycheck to fund it. The money you put into an HSA is able to be used on qualified Medicare expenses, you just can't contribute to it after you become eligible for Medicare. The only part of this that I would agree with you on as far as a "gotcha" is the following, which you sort of touched on, which is the 6 month backdating. There is a reason for this, as for all the rules, really, and I will quote AARP on the reasoning. https://www.aarp.org/health/medicare-insurance/info-04-2009/ask_ms_medicare_question_53.html Resources are available to help guide you through your specific situation, and although the above does start to get into some complicated maneuvering, the vast majority of people do not have any of these issues and Medicare is pretty straight forward. AARP, I will note is a sponsor of the UHC Medicare plans, is an excellent resource for your questions. I am neither minimizing nor ignoring anything. My job is to advise people on the best route to take for their individual situation. You have a very rare situation personally, if what you have been posting is true, and your experience is no where near the experience of 99% of people that enroll in Medicare. You are also looking for unique situations to try to prove me wrong for some reason I can't understand. Nothing you have posted about is normal for the vast majority of people. I hope you are using a professional to assist you.
I'm not even a "high earner" per se. I happened to sell my house in 2019 and the taxable portion of the gain is deemed income on which my 2021 Medicare part B is determined. My earned income was actually 0 when the house was sold. But, again, this COBRA situation is an example of a gotcha created by multiple disparate systems of healthcare access and the interactions between them. It's the largest state and is an example of how arcane rules can trip people up. Fortunately I discovered this one before it could impact me. Indeed, but so what? It's another example of how the complexity of healthcare access can trip people up. How about the inconsistency where you can't use HSA funds for a Medigap policy but can for an Advantage plan? They're too much into plugging UHC products as opposed to giving independent advice in my experience. I'm not "looking for" anything. I'm merely posting the inconsistencies and gotchas that I have run across in the last 15 months or so. Which says it all really... that I need a professional to assist. Really, how messed up is that? I mean, essentially you're correct. Both myself and my wife - will likely go from Employer group insurance -> COBRA -> ACA -> Medicare in less than 2 years with all the attendant inconsistencies that exist between those means of access.. Compare and contrast to every other western country... it's crazy. And I'm not convinced my situation is that unusual anyway. Many stop paid employment before the age of 65, so a transition involving at least 3 of the above must be quite common.
I did for a year. I was on a drug that BCBS approved and MC did not. Near as I could figure it was going to cost me an extra 2500 or so to shift over before the Cobra ran out. Turned out ir would have been more like 25000-- the price went through the roof before MC got around to it...
Not only your health care system sucks in comparison to the Dutch one, but also your tax system I notice. Over here profit on your house sale, as is the case with profits made on sales of stocks or options etc., arenot considered income. So no taxes on them. So if I had foreseen the covid disaster and the ensuing stockmarket collapse and I had made a billion on put options, I would pay litterally ZERO taxes on that. Man, you guys are stuck in the wrong country
Interesting. Was it a cancer medication? I don’t mean to pry, feel free to not answer. Most of the meds covered by Part B are extremely expensive. There are not a whole lot of meds covered under Part B so it would have been a cattier, not Medicare, that would do the approval unless it was a very specific med. Part D plans can change formulary once a year which is why I always advise my clients that are on sups to shop their drug plans every year.