Medicare - General Questions

I'm about to be 64 so I am a year away from coverage but realize I understand very little about how Medicare works and it's time to learn. I know I need to sign up 3 months before reaching 65 and I know there are different parts to Medicare. Which parts should I consider?

I am still working and will be for two or three years at my own business which does not provide health care.

I have good health care coverage (Blue Cross) through my wife's plan which requires sizable employee contributions. My wife is about three years younger than me and will probably stop working a year or two before reaching 65 and she would pay to maintain her present employer's plan after retiring till she reaches 65.

In the long term I know I need a supplemental plan. But how to decide on what coverages and what plans?

In the short term I'll be 65 and I will be on Medicare for my primary coverage while my wife is still working and she is on her employer's plan. During that period do I evaluate the relative costs and benefits of my buying supplemental coverage vs. having my wife's plan still cover me for supplementary coverage? Not sure of the add'l contributions now required for my wife's plan to cover me in addition to her.

And if anyone can recommend a book or guide for me to educate myself that would be great.

You have to sign up for part A, which is hospital coverage, 3 months before or after your birthday. You can do it online.
Part B is what I guess we used to call Major Medical. The base premium is currently $134, but there are surcharges based on income if yours is over $85,000, and it can go as high as $428, if your income is over $428,000 (joint)

The first thing I'd do is compare what your premium would be to what you are paying for yourself under your wife's coverage. If you are happy with your coverage, and the premium is lower with your wife's coverage, it's a now brainer, just take part A. You'll also want part D, unless your wife's employer provides drug coverage

As far as supplemental coverage goes, if you take part B, yeah you'll need it. The coverage is the same across all insurers, I believe. You can choose from plans A through F, with F being the most comprehensive. I've heard, but don't know for a fact, that plan G is just about as good, but lower cost.

My coverage for supplemental has no in network/out of network, as long as Medicare paid a claim, they will pay the rest. So you need to stick with providers who are Medicare participating.

Hope this helps

“Medicare for Dummies” is on Amazon for $15.17. I used an earlier version several years ago and it was easy to use and helped.

+1 on the Medicare for Dummies book. Well worth the $.

The first decision is to determine whether it’s cheaper to stay on your wife’s insurance or whether to go fully on Medicare with either a Medicare supplemental plan or A Medicare advantage plan.

A big difference (for me) in going with a Supplemental plan was that there are no “network” restrictions. Your coverage is the same anywhere in the country. When I retired could have gone on COBRA for 18 months but the combination of the part B and Supplemental premiums was significantly less than the COBRA premium. I went with Plan F which is the most expensive Part B Supplemental plan.

I originally thought that having all the premium payments (if any) wrapped up in an Advantage plan vs having a separate Medicare part B coverage would be an advantage but I have found the Supplement Plan is hassel free.

Thanks, all.

I have a lot to learn. Getting the Medicare For Dummies book looks like a no brainer.

Unless the difference between that and a supplemental coverage is substantial I would lean towards staying on my wife's plan till she retires, which won't be very long after I turn 65 anyway.

At that point I'll have to figure it out. My wife and I value the freedom to see the doctor we want, regardless of in/out network. Our Blue Cross fully covered my PCa treatment. But my wife had an orthopedic surgery last year and after doing her research and meeting providers she decided on a surgeon out of our network and we covered an out of network cost to Blue Cross.