Yes, aren't the Medicare Supplements wonderful? I keep advising my friends who are about to embark on it to get a supplement plan and avoid Advantage if at all possible.
John B
As musicians and singers grow older, this stuff is very important; but it's also important for younger musicians and singers, as well.
In my case, the local State Farm Agent explained everything and provided excellent advice on the
smart strategy, which is to get the best coverage for
everything in the "traditional" Medicare way of doing things--no Medicare Advantage sneaky weaseling.
I think the rules continue to be the same as 10 or so years ago, when the rule was there is a grace period of "no underwriting" beginning one month before you turn 65 years-old and then continuing for another month or so, where "no underwriting" means insurance companies by law must presume you are in the best possible health and cannot ask questions about anything, which maps to the lowest possible prices for Medicare Part D and Medicare Supplemental Insurance, which also in a different way maps to Medicare Part B, for which you are enrolled automatically but if you are trying to save money must request not to be enrolled (
very stupid).
If you decide to wait on all the good coverage, then after the "no underwriting" grace period, insurance companies can deny you coverage or charge high rates. Medicare will let you enroll in Medicare Part B later, but if you opted out of it initially, then there is a penalty each month which continues forever.
The
smart strategy is to get the best of the additional coverage during the "no underwriting" grace period.
The thing about Medicare Advantage is that it's basically a sneaky way for insurance companies to make money by being able to deny coverage for expensive procedures and treatment.
They offer all sorts of things that sound "wonderful", like "free" dental, food allowance, transportation allowance, glasses, and other stuff; but when you need expensive treatment, they can and will either (a) deny to cover it or (b) agree to cover it but take a long time and make physicians jump through hoops to get treatment approved. Medicare Advantage is like socialized Canadian Health Care and British Healthcare, where there are long wait times and folks are denied healthcare for so long they die before it's approved, which is one of the reasons folks come to America and pay for American healthcare out of pocket.
The primary reason for Medicare Part A, Part B, Part D Prescription Drug Plan, and Medicare Supplemental Insurance is that all the healthcare providers who take Medicare are required to do what Medicare tells them to do, which basically maps to the being paid without question whatever Medicare pays--no seeking prior approval or having to "prove" necessity and all the sneaky weaseling that occurs with Medicare Advantage plans.
Full Medicare (A, B, D, and Supplemental) costs more initially and continues to cost more than a Medicare Advantage plan; but it's basically carte blanche when you need healthcare that is very expensive--no questioning, no prior approvals, and all that stuff, just full coverage and the healthcare providers have agreed to accept whatever Medicare pays them, hence you get treatment and have no co-pays or out of pocket expenses other than co-pays for Part D Prescription Drugs, if there are any co-pays.
On the Part D side, I take Mounjaro, which at retail with no insurance is approximately$1,500 per month, but the co-pay for my Part D Plan is $50 a month and then after a few months becomes no co-pay.
I have State Farm for Part D and Supplemental, and it's expensive; but it saves me approximately $17,000 per year just for the Mounjaro; and as noted earlier, having the TAVR procedure plus one-month of rehab at a Skilled Nursing Facility cost me nothing and as a bonus, since I have a State Farm Hospital Indemnity Plan, I was paid cash for each day in the hospital and for each day in rehab, where for me the "rehab" aspect was focused on getting me off supplemental oxygen and rebuilding my physical strength, where I no longer needed supplemental oxygen after about two weeks and by the end of the four weeks, I could walk for a long time without needing a walker or cane, and after the first week or so did
not need to be in a wheelchair. I was approved for up to 180 days of rehab, but after the third week I could walk without a walker or cane for long enough that the rehab folks basically said I was rehabbed and there was no need for more rehab.
It's not inexpensive and overall costs somewhere in the vicinity of $750 a month (Medicare A, B, D, Supplemental, Hospital Indemnity, Life Insurance, and Part D co-pays); but it's the best possible healthcare coverage; and I only have co-pays for prescription drugs--no pre-approvals, no questioning what physicians determine, and generally getting the best healthcare at no cost other than the co-pays for certain prescription drugs.
When prescription drugs at cash prices (no insurance) are over $20,000 a year, that puts the $750 a month for everything into practical perspective and makes having full coverage
smart.
