Medicare 2025 Discussion

[Hooper]

I went to a seminar about Medicare.

I learned some things.

Part A is hospitalization only and is free if you have a vetted work history of 10 years contributing to Medicare.

The Part B is $174.70 a month for everyone. ( and it usually goes up proportionately to any SS increase they decide upon in a given year.) Mine started out at $145.

A Part B IRMAA Income Related Adjustment Amount may be added for high income applicants in addition to the $174.70!!!!!

You can add Part D drug coverage. Usually $30 to $40 a month with a $2,000 out of pocket max cap.

Medigap plans are standardized and must follow federal and state insurance laws. They can offer A-D, F, G, and K-N.

All Medicare Supplemental Insurance plans offer the same basic benefits no matter where you live or which insurance company you buy from.

Medigap plans sold to people new to medicare are no longer allowed to cover Part B deductibles as of 2020.
Medigap plans cover copayments, coinsurance, and deductibles. Some offer insurance outside of the US if you travel.

They had info about COBRA but I didn't take notes because it didn't apply to us.

www.medicare.gov/medigap-supplemental-insurance-plans
www.medicare.gov/publications

There are two types of Advantage programs called Part C. They pay for about everything in network, in your state. Out of state, they suck.

They have a PPO program and an HMO program and in both of them, you have to deal with people deciding upon your health and welfare based upon the trends, statistics, and whims of others. They force you to use generic drugs which sometimes do not have all of the ingredients of the name brand.

(I wish I could find that yooootooob of the insurance agents at a convention asked if anyone would go the advantage route. No one said they would.)

The HMO is, "This is your network", AND THAT'S IT!

The PPO you can go outside of their network, but you will pay dearly for it.

Advantage Plans are a big moneymaker for insurance companies because they get a check for $1,000 every month to manage your health in Oklahoma. In the coastal states, they get $2,000. This is why they offer incentives such as hearing, dental, vision, local gym access, etc. Vision is usually a yearly eye exam and some cheap assed glasses for $100. Don't go getting astigmatism or double vision. You will pay. Don't get a root canal or a crown, and don't require $5,000 hearing aids.

You still have to pay the $174.70 every month so the Advantage plans that say there is no monthly payment is a lie.

If a doctor or hospital takes Medicare, they HAVE to take your supplement.


One good thing is the dreaded doughnut hole is going away in 2025.

I took good notes huh?

Ask your Doctor or any Doctor or any Hospital Admittance personnel, about the Advantage plan, from what I have heard it is pretty much a complete rip off. Everything has to be preapproved and you do not get a choice on the Doctor or Hospital you need. Everything is Networked. If you live in a rural area you are a screwed pooch.

 

[KOPBET]

For those that are new to Medicare, please note a few of things about Medicare Advantage.

It is NOT Medicare and it is NOT an Advantage.

Hospitals and doctors are more and more dropping MA from acceptance.

You still have to pay the Part B premiums.

 

[turkeyrun]

I know you hate walmart but if you're travelling that much, it's pretty smart to choose them. CVS and the others are very inconsistent.

CVS sux more than Spread Eagle

 

[SKATA]

This is interesting reading, I received my quotes for Part D for 2025. My Part D went from $6.30/month in 2024 to $0 in 2025 (I have 4 generic perscriptions). I will still have the $594 deductible to cover, and the elimination of the "donut hole" (which thankfully I don't reach). My Part B premiums will go from $174.70 to $185.00 and my Medigap Plan B premium will be about $150. That is my coverage only, my wife's is about the same. She's had more trouble with the pharmacy than she's had with the insurance company.

Yes your numbers are correct. There are about 15 part D plans available for me in Oklahoma. The Wellcare Value shows 0 deductible and 0 generic drug costs for me. How??? The plan I am looking at shows $7.90 monthly and generic tier costs $10. Probably what I will choose for 2025. Hope there are no hidden surprises.

 

[okcBob]

I went to a seminar about Medicare.

I learned some things.

Part A is hospitalization only and is free if you have a vetted work history of 10 years contributing to Medicare.

The Part B is $174.70 a month for everyone. ( and it usually goes up proportionately to any SS increase they decide upon in a given year.) Mine started out at $145.

A Part B IRMAA Income Related Adjustment Amount may be added for high income applicants in addition to the $174.70!!!!!

You can add Part D drug coverage. Usually $30 to $40 a month with a $2,000 out of pocket max cap.

Medigap plans are standardized and must follow federal and state insurance laws. They can offer A-D, F, G, and K-N.

All Medicare Supplemental Insurance plans offer the same basic benefits no matter where you live or which insurance company you buy from.

Medigap plans sold to people new to medicare are no longer allowed to cover Part B deductibles as of 2020.
Medigap plans cover copayments, coinsurance, and deductibles. Some offer insurance outside of the US if you travel.

They had info about COBRA but I didn't take notes because it didn't apply to us.

www.medicare.gov/medigap-supplemental-insurance-plans
www.medicare.gov/publications

There are two types of Advantage programs called Part C. They pay for about everything in network, in your state. Out of state, they suck.

They have a PPO program and an HMO program and in both of them, you have to deal with people deciding upon your health and welfare based upon the trends, statistics, and whims of others. They force you to use generic drugs which sometimes do not have all of the ingredients of the name brand.

(I wish I could find that yooootooob of the insurance agents at a convention asked if anyone would go the advantage route. No one said they would.)

The HMO is, "This is your network", AND THAT'S IT!

The PPO you can go outside of their network, but you will pay dearly for it.

Advantage Plans are a big moneymaker for insurance companies because they get a check for $1,000 every month to manage your health in Oklahoma. In the coastal states, they get $2,000. This is why they offer incentives such as hearing, dental, vision, local gym access, etc. Vision is usually a yearly eye exam and some cheap assed glasses for $100. Don't go getting astigmatism or double vision. You will pay. Don't get a root canal or a crown, and don't require $5,000 hearing aids.

You still have to pay the $174.70 every month so the Advantage plans that say there is no monthly payment is a lie.

If a doctor or hospital takes Medicare, they HAVE to take your supplement.


One good thing is the dreaded doughnut hole is going away in 2025.

I took good notes huh?

It’s true there are no monthly premiums for traditional MedA (unlike MedB), but hospitalization isn’t free under MedA
In 2024 you pay:

• Days 1–60: (of each benefit period): $0 after you meet your Part A deductible ($1,632).
• Days 61–90: (of each benefit period): $408 each day.
• After day 90: (of each benefit period): $816 each day for each
  lifetime reserve day
  (up to 60 days over your lifetime).
• After you use all of your lifetime reserve days, you pay all costs.

 

[Tinytim]

Why is your "gap" insurance $414? You should shop that out.

I traded mine in for United health, best insurance I’ve ever had.

 

[DRC458]

A classmate of ours, an M.D. who just retired, told us and anybody who would listen to him, to avoid the Medicare Advantage plans like the plague! This was before we retired and were even eligible for Medicare. If we stay with our current Part D coverage for next year, our premiums will more than double (from $24.90 to $59.90). My wife only has one or two prescription meds, but I have several. We have used the same insurance agent since we retired, and we send him a list of all of our meds every year. He compares all of our meds and all of the available Part D plans, and gives us a recommendation as to whether or no to change. We had changed Part D coverage every year except 2023 and 2024, when we stayed with the same one. I'm anxious to see what he comes up with this year.
BTW - Plan F is no longer available for new enrollees, unless you were eliglble for Medicare on or prior to January 1, 2020.

 

[crrcboatz]

For us retired folks. Time to bring up the 2025 increases in Medicare costs. Here is what I uncovered this week:

* My Medicare Part "D" costs are going from $19.90 per month to $59.90 per month. The tier 1 & 2 pricing doubled. I only have three generic prescriptions per month.
* My Medicare gap is going to increase $414.52 per year.
* Medicare Part "B" will increase $132 per year.
* SS will increase 2.5% for next year.

I will have to shop around for another Part "D" program. No much else I can change. I have already contacted Senator Langford and Congresswomen Bice offices.

Does the increases have anything to do with all the illegal invaders in our country getting free health care ???

Tks for the update. Needed this!

 

[crrcboatz]

A classmate of ours, an M.D. who just retired, told us and anybody who would listen to him, to avoid the Medicare Advantage plans like the plague! This was before we retired and were even eligible for Medicare. If we stay with our current Part D coverage for next year, our premiums will more than double (from $24.90 to $59.90). My wife only has one or two prescription meds, but I have several. We have used the same insurance agent since we retired, and we send him a list of all of our meds every year. He compares all of our meds and all of the available Part D plans, and gives us a recommendation as to whether or no to change. We had changed Part D coverage every year except 2023 and 2024, when we stayed with the same one. I'm anxious to see what he comes up with this year.
BTW - Plan F is no longer available for new enrollees, unless you were eliglble for Medicare on or prior to January 1, 2020.

Yeppers on the advantage thing according to m son in law who s a surgeon in OKC

 

[okcBob]

I think it depends on the patient. Advantage plans have no monthly premiums and offer extra benefits like vision & dental but they restrict your choice of providers and require preauthorization for some stuff. You won't have those problems with traditional Medicare with a supplemental plan, but you'll pay a lot more every month.
So, if you’re healthy & not on a lot of expensive meds, an advantage plan will be a LOT cheaper. If you have multiple health issues, then the traditional MCR would prob be better.
Biggest prob I’ve seen with advantage plans at work was getting our patients insurance auth for transfer to a SNF, or rehab hospital, or an LTACH. But, if I’m a patient trying to get into a SNF or LTACH, I’ve got a lot bigger problems than insurance to worry about.