Should I take Part B?

[Jess from VA]

Yes, it is time to make my elections for Medicare. (actually I'm a day late and they already enrolled me, but I can still drop it)

Yes, I have put this decision off like all other decisions on subjects that give me heartburn.

I have good (but bargain) Blue Cross BS Basic with my Federal retirement.  Once I have Medicare A (and I do, next month), it becomes my primary, and BC becomes secondary.

Except for a few oddball things B gives me that my Federal BC plan doesn't, B is largely a duplicate of my Federal plan.  

I have never had any major health issues my whole life, and may have seen a Dr twice in the last 10 years, briefly.  And I have never been one to carry extra insurance just because on ANYTHING (and never once been sorry either).

Given my default position of never seeing Drs, there is obviously the opportunity to have something sneak up on me that gets expensive quickly.  So there's that.

If I get B, Blue Cross tells me all or most of my office co pays will be waived (I have no deductibles); so that might have saved me $40 in ten years; big deal.  BC now will reimburse me up to $600 of my annual premiums with them, if I have B, which shows me they understand I am paying for double coverage (mostly, not completely).

B will run me $136 a month, $1608 a year (deducted from my social security retirement).  Less the $600 reimbursement from BC, B will run me $1000 a year for (mostly) duplicate coverage.  If I take it, I will not probably notice the loss of income, I live a simple life.  But my conservatism in all things, hates buying insurance I don't need.  

If I elect against B now, but my health changes to the point I feel I need it, if I enroll later, I will be penalized 10% extra for all the years I didn't have it.  That does not worry me, financially.

I am absolutely not getting Medicare D for prescriptions, and I have decent coverage for that with my BC.  (I take no ongoing dope for anything, and never have)

Any thoughts or advice is welcome.


(PS;  I realize that compared to many of my VRCC brothers, these figures are thousands and thousands of dollars cheaper than they have to deal with.  I am sorry for that, but it's not my fault. I retired from military and federal service at took the benefits they gave me.) 

[bassman]

If I elect against B now, but my health changes to the point I feel I need it, if I enroll later, I will be penalized 10% extra for all the years I didn't have it.  That does not worry me, financially.


Jess....is the 10% based on just for the $1608 annual total ($160.80) or is it on top of all the monthly premiums you might have to pay back from the time you became eligible to when you might actually sign up for Part B....i.e,  if you decide to sign up two years from today, would the penalty be $160.80 + 160.80 = $321.60 OR $1608 + 1608 + 331.60 = $3247.60?

[John Schmidt]

Jess, don't make the mistake of comparing medical history to what you might expect in the future. Generally speaking, your health in the next 20+ years won't be the same as the last 20. Make your decision accordingly.

[DDT (12)]

Jess,

How much is a 'quiet night's sleep' worth? How much can you actually afford? Your description of yourself didn't differ much from what mine was at that stage... However, I thought like John, and based upon family history, I knew it was only a matter of time before my circumstance would likely change (and it wouldn't be an improvement!)... Although I could afford the difference in cost, like you I didn't want to just flush money away either. Avoiding some modicum of risk now and a future 'fiscal hit' convinced me to take the whole enchilada... Just my thoughts... good luck with your choice!

DDT

[Alpha Dog]

Tell them you want C.  That would be the plan congress gets.  If it's good enough for them, then it should be good enough for you.

[Hacked Valk]

I rejected part B because I had secondary coverage under my former employer.  Found out too late that after retirement the secondary insurance became secondary to part B, not the main Medicare coverage. They paid nothing without having part B. Long since rectified.  To be safe you might confirm that situation does not apply to you. 

[solo1]

Jess, I'm with John . Don't think that your good health will continue.  Hopefully it will but the odds are it won't

I had a friend at work, who ran 5 miles every other day, was within his suggested weight , and had no bad habits, never went to a doctor. After he retired he had a stroke, left side, and it was unexpected.

Stay with all the medical coverage financially possible, you might need it later.

At 90, I speak from experience.

[Jess from VA]

If I elect against B now, but my health changes to the point I feel I need it, if I enroll later, I will be penalized 10% extra for all the years I didn't have it.  That does not worry me, financially.


Jess....is the 10% based on just for the $1608 annual total ($160.80) or is it on top of all the monthly premiums you might have to pay back from the time you became eligible to when you might actually sign up for Part B....i.e,  if you decide to sign up two years from today, would the penalty be $160.80 + 160.80 = $321.60 OR $1608 + 1608 + 331.60 = $3247.60?

Bassman, I'm the one asking the questions.  

Here's what my little booklet from the G says:  If you waited 2 full years to sign up for Part B, and didn't have other coverage, you'll have to pay a 20% late enrollment penalty (10 percent for each 12 mo period that you could have been enrolled, plus your std Part B monthly premiums).

So at last years rate of $134 a mo plus 20% at $26.80, your permanent rate would be $160.80.  This penalty appears to never go away, even if you reached a point where all past missed premiums had been recouped by the penalty.

There are something called special enrollment periods, where special exceptions to the rule are applied.  But if you don't qualify for one of those, you can only change your election to add Part B every year between 1 Jan to 31 March (open season), and you still get no actual coverage until 1 July of that year.  So if you need part B and rejected it, it could be some 18 months before you could get it, even though you had been paying for it from Jan-June of that year.  

I am not clear on what having other coverage means;  I have a federal retirement health plan, which is largely a duplicate of Part B, but I am not clear on if I reject Part B now but change my mind later, this means I don't get the penalty because I had other coverage.

EDIT:  OK, I discovered that even if you have other group health insurance (I do), the only way to avoid the penalty is if you are still working... or apply to add Part B before 8 months after you quit working.  I stopped working in 2010 (for actual wages), so I'd get the penalty.

[Jess from VA]

Yeah guys, I'm certain I can't count on no medical problems ever lasting right up to my last breath.

Short of riding under a semi on my way to Roanoke. 

There's a happy thought.   

[3fan4life]

Yeah guys, I'm certain I can't count on no medical problems ever lasting right up to my last breath.

Short of riding under a semi on my way to Roanoke. 

There's a happy thought.   

If you take the BRP you considerably reduce the possibility of that happening. 

[Jess from VA]

Yeah guys, I'm certain I can't count on no medical problems ever lasting right up to my last breath.

Short of riding under a semi on my way to Roanoke. 

There's a happy thought.   

If you take the BRP you considerably reduce the possibility of that happening. 

So instead, I ride into Bambi. 

[Jess from VA]

So, it seems to me I do not need Part B, now or in the immediate or reasonable future.

If I have it (based on all current medical history), almost any out of pocket expenses I would have will disappear.  But I've had none to speak of for many years (beyond a few office co-pays).

HACKED VALK:  My federal health plan does not require B to continue providing all it's benefits (I called BC direct to talk about that... and I thank you for your input on it).

If I reject it now, and want it later, I get the penalty (and wait up to 18 months for the actual coverage to start).

However, if I have a catastrophic event, either a big disease, extended hospitalization, or big injury (ride under that semi and actually survive), I'll wish I had B.

Having never carried a nickel more of insurance than I thought was necessary my whole life, I think I better carry Part B.  (But it gives me a bad taste in my mouth.  Ptouyyy.)

I haven't made up my mind yet and still have some reading to do, but....

[cookiedough]

tough call, sounds like 1K out of your pocket extra per year for insurance not needed.  But, if you think you can afford it,  am sure your health next 10+ years will get worse so ONLY one semi-major event will pay for itself if you look at it that way.

Glad you checked since my moms insurance with BCBS of Michigan follows Medicare paying first.   Whatever Medicare does not pay then goes then and ONLY then to BCBS. 

I cringe on the past 25+ years on how much we have paid into health insurance and ONLY time I have EVER used it to any degree of dollar amounts is a knee surgery.  Even then, I could be 50K easily ahead MONEY IN MY POCKET. 

[Atl-Jerry]

Jess,

I'm a retired GI too and I turned 65 about 3 weeks ago.  I had TRICARE prime for the past 24 years but when I went on medicare I had to switch to TRICARE for Life.  In order to keep Tricare fo life as a secondary coverage you must take medicare part B.  Otherwise you will forfiet your Tricare coverage.  My wife doesn't turn 65 until July and she remaines on Tricare Prime until then, but we'll pay the single rate until then.  Call Tricare and discuss it with them.

[..]

Yeah guys, I'm certain I can't count on no medical problems ever lasting right up to my last breath.

Short of riding under a semi on my way to Roanoke. 

There's a happy thought.   

If you take the BRP you considerably reduce the possibility of that happening. 

So instead, I ride into Bambi. 

Or a frickin Bear!

[..]

I too had to make the choice.

I was amazed at the amount of mail solicitations I received.

Hmmmmm there must be some money in this Medicare stuff?

Reading the Medicare handbook, which arrived just one week before my decision had to be made and had already been made. Typical Govt crap efficiency.

I digress. Reading the handbook makes me realize that putting the Fed Govt in control of a single payer system will be the biggest cluster for a loooooong time.

I was on Obamacare - Ha-Ha. So I had an easy decision. Switch to the partner company of the plan I was on and take Part B.

My monthly premiums for health have now doubled. WTF is up with that.

[Jess from VA]

Jess,

I'm a retired GI too and I turned 65 about 3 weeks ago.  I had TRICARE prime for the past 24 years but when I went on medicare I had to switch to TRICARE for Life.  In order to keep Tricare fo life as a secondary coverage you must take medicare part B.  Otherwise you will forfiet your Tricare coverage.  My wife doesn't turn 65 until July and she remaines on Tricare Prime until then, but we'll pay the single rate until then.  Call Tricare and discuss it with them.

Jerry, that sounds very similar (or identical, I don't know) to what happened to Hacked Valk (see his post above).  Being required to take B to keep your existing coverage.  

I specifically checked that with Fed BC/BS, and that's not the case for me.  I can reject B, and keep all my BC.  Most everyone gets A, and its coverage.  With B, B takes over as primary on all B coverage (like maybe 80%), and BC picks up the rest, that they would otherwise cover.  And with B, any and all copays and some other incidentals I would have to pay out of pocket under my BC disappear for good (that has not been much at all for me).

My BC Basic is a cheaper and lower (total) coverage Federal plan I chose, since neither of us has ever had much of any medical problems or expense.  I can change to any other federal plan each annual open season (if I want), but having a bargain plan makes me feel better about having to ante up the extra for B, for a lot of duplicate coverage.  The two together add up to really great coverage if I need a bazillion dollars to stay alive at some point.  (Though surviving that may be a mistake)

Alternatively, rejecting B, and then trading up to a best coverage Federal health plan instead would be more expensive (I think a lot more expensive).  But I need to look at that a bit closer.

And BTW, I guess we are both now official members of the geezer Varsity Club.  And for all that money, they don't give us a jacket or even a ball cap.        (just a crummy wallet card)

[Jess from VA]

I too had to make the choice.

I was amazed at the amount of mail solicitations I received.

Hmmmmm there must be some money in this Medicare stuff?

Reading the Medicare handbook, which arrived just one week before my decision had to be made and had already been made. Typical Govt crap efficiency.

I digress. Reading the handbook makes me realize that putting the Fed Govt in control of a single payer system will be the biggest cluster for a loooooong time.

I was on Obamacare - Ha-Ha. So I had an easy decision. Switch to the partner company of the plan I was on and take Part B.

My monthly premiums for health have now doubled. WTF is up with that.

As if I don't get enough junk mail, I too started getting all kinds of solicitations and offers.  And a lot of it was packaged sort of officially, looking like government notices that better be opened (instead of thrown in the can I now keep right next to the mailbox). 

I'd like a list of things the G operates that are bright and shining examples of efficiency and intelligence.

Well, my total cost (just for me) will double too, adding B.  But at least BC will give me $600 a year back, assuming I don't cost them anything (or much), and I haven't cost them more than a maybe a few hundred dollars in the last 8 years.  While our coverage has improved for odds and ends and copays or deductibles (and certainly for catastrophic care), it really hasn't doubled if you don't usually need much medical care.  I suppose the only way to get our money's worth is to get cancer or need a kidney, or ride under a truck. 

Insurance, the only game where you are gambling with your money that bad things will happen to you, and you hope to hell you lose the bet... your whole lifetime.   

[MarkT]

Jess, don't make the mistake of comparing medical history to what you might expect in the future. Generally speaking, your health in the next 20+ years won't be the same as the last 20. Make your decision accordingly.

Spot on, John.  Absolutely.

[0leman]

Jess, I am retiree from Fed Gov also.  Retired nearly 10 years.   Feds said I could keep my Fed health insurance forever (if I stopped it could not re-start it).  It was good insurance so I kept it.   

When I turned 65, I took a good look a the A/B options.  Fed pays for part A, hospitalization and really can't turn it down.   I felt the part B was not as good as the Fed insurance I had and I would have to get something else to get the same coverage, So told SS I didn't want part B.   I got at least 5 letters telling me letting me know that I would have to pay a penalty  if I didn't take it and want to enroll later in life.  I couldn't see paying another $100 plus a month (it has gone up several $$ since then)  for the same or less coverage.   Plus I have never had a Doc turn down my  existing insurance. 

My DW, when she turned 65, did take the part B.  I figured she would last longer than me, and was not sure whether Fed insurance would continue for her when I was gone. 

Not sure my decision is good for everyone, but it is working for me.   And since the Fed insurance I have is a large group insurance, we do get pretty good rates and low deductibles.

[Jess from VA]

Oleman, thanks for your input.   

I think I am in the same (exact) boat you are/were in.

Whatever my choices might be, I will never abandon my Federal retirement health insurance (once you do, it is gone forever: no changing you mind)  As in, OK, I'll take B, and abandon my federal plan.  That is not a reasonable option.  Those federal plans beat the pants off ALL other plans, period.

Part B is largely a duplicate of my Federal health insurance plan, and doubles my monthly cost.  Yes it provides a few extras having both (well it should, shouldn't it?), but the main benefit of having both is if you end up needing bazillion dollar catastrophic coverage, which my bargain Federal plan does not give me.

That is why I started this thread and asked everyone what they thought of B.

No one weighing in provided a solid reason or logic to keep both my federal plan AND B together, other than the quite logical risk of needing bazillion dollar catastrophic coverage, which can certainly be a part of becoming an old man (despite a lifelong history of good to excellent heath). 

When I said above I never carried a nickel more insurance than I needed, that was not really true.  That statement is true for all insurance OTHER than healthcare.  I never had health insurance until age 40 when I left the military.  The military takes care of you, but you don't have to pay premiums for it (unless you consider low pay and free health a package deal). 

But the day I transitioned to Federal civil service, I picked up a family health plan for me and the wife, like any reasonable man would, but in 20/20 hindsight, the both of us together would have come out ahead to have paid cash for all our health care, but pocketed the next 20 years of premiums.  Way ahead, I think. 

But with the ridiculous costs of healthcare, and the risks of human frailty, who in their right mind makes that choice?  One bad disease or injury at any time could bankrupt you, and make you homeless.  You might risk that alone, but with a family?  Now I always chose bargain Federal plans, as that was good risk management for two people with excellent health histories, but of course I was always overinsured considering we rarely used the insurance, with a few minor exceptions.

So you elected against B, like I feel like doing myself.  But I can afford the B premium (and my bargain federal plan, together) without really affecting my lifestyle.  So why will I take B?  FEAR, plain and simple.  Fear of the unknown.  Fear of catastrophic disease (much more than catastrophic injury, which I have managed to avoid all my life).  I suppose that is what essentially drives all insurance decisions, but uninsured health care costs can easily be more than what your house is worth, and certainly more than your cars and bikes are worth, and as for liability risks, I've never had a single at-fault accident since my early 20s, and even then, I was the only one hurt in that accident (cut knees only).  Not only have I never hurt myself seriously, I've never hurt anyone else or their property either.

It pains me to make a decision based on fear.  But is not an irrational fear, as it is entirely possible that the day is coming a doctor will give me some bad news about my health that will cost a lot of money.  I fear that day too. 

BTW, if you carried a Federal health plan into retirement, and have had your wife on it the whole time, she is certainly entitled to carry it on in her own name after you die.  I am not 100% on details of costs for her to do so after you die, and that is worth looking into, but they can't take it away just because you die.

   

[bassman]

Consumer Reports take....

https://www.consumerreports.org/cro/news/2011/06/which-is-better-a-federal-retiree-plan-or-medicare-part-b/index.htm

[Jess from VA]

Interesting.  While accurate as far as it goes, that is a rather more simple analysis than I have made.

It does support my decision to stay in my best bargain federal plan, and add B to it.  If I had a Cadillac federal plan and wanted to take B, I would definitely wait for Federal open season, and switch to a bargain federal plan (which I already have).

However, I am not sure the statement near the end, suggesting that you can quit your federal health plan, and then later go back and get another is true.  It is my understanding that once you sever any attachment to any federal health plan, you are out for good.  Maybe they will let you back in if you went with a medicare advantage plan in the interim, I don't know.

[bassman]

Totally agree your assessment of the last statement in the article.  It has been my understanding that to suspend the health plan you had to be going into TRICARE or CHAMPVA.  Those were the only two options I had when I retired and did not have access to either.  I wanted to suspend my FEHB to go on my wifes state health plan to try it out but was not allowed.  Ended up dropping FEHB (I know - I can NEVER go back) in favor of going on hers - so far NO regrets.  I did have a few restless nights of sleep when I first dropped but ended up doing fine in the long run.  I use Medicare A & B as primary and state BCBS as secondary.  I believe that was a requirement of the State that I had to have both A&B but I can't remember for certain - it's been about 10-11 years.

[Jess from VA]

Well, if I had a spouse with a bang up plan, or a good enough plan that I thought was a better deal than my Federal plan(s), I'd certainly consider it. 

(Long before Zerocare) My wife's private employment plan was an expensive take it or leave it package health-dental-eye-life insurance-disability blow job of a plan at thousands of dollars (a year) beyond what it was worth.  So she never took it and stayed on my federal plan.... and got a $6K pay raise (with no actual pay raise).  Unfortunately, almost none of her coworkers had that option, and because of the type of work involved (guns and security clearances), having no insurance meant instant termination of employment.  So take it or get fired (if you can't get it elsewhere).

I cannot know, but always believed that that plan paid kickbacks to the company, right out of their employees pockets.  Years ago, I got invited to a company Christmas party (with her), and after I had some (polite but pointed) words with leadership about some of their policies, I was never invited again. The feeling was mutual, and really the wife insisted I not attend any of their functions after that. 

There is always a right to silence, but I often lack the ability to remain silent.  Which is surprising to no one.    

[0leman]

Jess, almost 20 years ago, my DW developed mouth cancer.  At that time the School district she worked for had good insurance that was for her only.  I was also carrying her on my insurance (also the kids - Family plan).   Both insurances did cover almost 95% of the cost (it was like $90K).  It was well worth the cost of two plans. 

Right now we have a Me plus One coverage on the Fed insurance.  The insurance company created it several years ago to cover folks like us, lot cheaper than the Family plan.

We did/do have the monthly income coming in that I could have selected the Part B along with the Fed plan.   Just don't like spending money on something that duplicated what I have.  Especially giving it to Medicare.   Just saying. 

[Jess from VA]

Yeah, my propensity to throw mail away unopened or unread, caused me to miss last year's new self plus one, in lieu of family rates for Federal health plans.  But I got on it this year.

It always pissed me off that I had to pay the same for me and the missus, that someone with a missus and 7 kids had to pay.  More creeping socialism.  

But I think it only saved me about $22 a month, or something like that.

I'm with you on giving extra money to the G (for anything).  But despite a lifetime of good health and not too serious of injuries, I just don't want to worry about losing all my savings (and maybe house) to the healthcare industry.  Though if I get that bad..... I should probably just be taken to the vet and put down like a good old doggy.  

[C908]

I'm 2 years away from Medicare so I'm starting to pay attention on things I need to know. In my opinion Health care is nothing more than a legalized form of extortion. At the present time my wife and are forced to have our health insurance through Ambetter. I'm retired and my wife's employer does not offer health insurance. We have no choice but to get our insurance through the marketplace. In the county we live in the only choice is Ambetter, this company has a horrible track record. Before this year we have always had BCBS of KC but they pulled out of the marketplace. Our deductible is $6800.00 on each of us and you must see an in-network physician or they pay ZERO. This is where the problem comes in to play, there are very few in network physicians in our area. I feel like Ambetter's policy sets you up to fail which has been proven by the hundreds of reviews I have read. Out of desperation I called other insurance companies to see if I could possibly get coverage. The answer was NO, not a single one will write an ACL compliant policy in the county we live in. The only thing that can be purchased is a short term policy with pre existing conditions held against you, that means sky high rates and exclusions. So I look forward to Medicare in 2 years, unfortunately my wife doesn't qualify for almost 8 years.   

[Jess from VA]

Many older people, including professionals, have been known to seek ANY federal job they can get.  Not only can they then get a federal health plan, but after five years employment, they are then eligible to quit and keep that plan from there on out.  Course, out in the world of middle America, those jobs can be hard to come by.