Aldeer.com Forums Alabama Deer Talk Aldeer General Forum Question for our members already on Medicare

I swear it wasn’t me Irishguy. I’m in the business and I get texts too.

Eligibility period aging in is 3 months prior to 65th birthday, month of your birthday and 3 months after your 65th birthday or 7 months. After that if you sign up for B or D, with some exceptions like keeping employer coverage if you’re still working, you will pay a lifetime penalty based on how late from eligibility you signed up. My uncle waited 2 years to sign up for part D after eligible and pays a small fortune in lifetime penalty each month. That’s why I’ll get the cheapest part D when I age in and change if needed during AEP. And definitely go to CMS website for basic information on parts A B C D and supplement plans.

I didn't know that

I know some of you will disagree but I took the Medicare advantage route which saves me about 200 dollars a month. I have been in this plan for three years and it has covered almost everything including three surgeries. I also have plenty of doctors and hospitals to choose from. My wife starts on advantage in six weeks. I can’t wait!

Medicare consult in Huntsville

A friend says this is a free service. I will call this morning and see. If so, I plan on scheduling an appointment.

Will report back here ...

Can’t emphasize enough about what MW2015 stated about penalties for late enrollment, they are FOR EVER, make sure you have some type of B and D coverage.
I have A,B, D(WellCare) and Inovative Plan G with Physican Mutual(gap insurance)

That’s another good ,and innovative like the name, supplement if you can have a higher deductible for the first few years. I work with Physicians Mutual too.

As far as part D, my uncle never got it because he didn’t take prescription drugs. Then he had a blood clot and diabetes as he aged and had to take prescription drugs. That’s when he signed up 2 or 3 years late and got stuck with lifetime penalty. When he aged in he could have signed up for the cheapest part D an available and changed to another plan during AEP if needed. Another thing to consider with part D is the plans don’t cover every drug. All part D plans have a formulary which is approved by CMS and a list of drugs the plan covers. CMS has requirements for insurance companies in putting formularies together. Formularies have drug tiers of 5 or 6 levels like generic, etc. There are limited exceptions to formularies that you can apply for with your physician in certain medically necessary reasons. There are also step programs where you may have to try a less expensive drug first to see if you can use it without side effects before another drug is approved. It really can get complex but these are things folks forget about when the drug they need isn’t on a plan’s formulary. Check the formulary to see if the plan has your drug on it. Many times some of the drugs may be in the formulary of a plan but some may not. Check before you sign up. CMS list all the part D plans in your area and you can find the information on the CMS website.

Question:
If you sign up for cheap D rx plan then decide you need a better plan during AEP, are these plans rates set or are they based on your current rx history? Obviously, this could make a huge difference.

When I got my D coverage I was talking/working with a fellow that was in the business, gave him my meds only 2 BP/ acid pill, both were covered under my plan $0.99 it has gone up a couple of dollars now, what I have always been told was you can change anything during AEP, just make sure your plan will cover your medication

MW2015, I am in my last year of the high deductible

Personally, I felt like a medicare advantage plan was best for me, been on it for almost 14 years. Never had a doctor that wasn't in their system. I've been through extensive cancer treatment, 2 knee replacements, a hip replacement, etc. No problems with coverage. The hip replacement cost me $375, the bill was like $18k, plus copay for rehab at $25/session. Primary care doc is $0 copay, specialists are $25 copay. Generic meds are $0 copay. Also has $1000/yr dental coverage. They've paid over $2-300k on my behalf, and i pay $185/mo deducted from my social security payment. Win/win for me

Not based on individual. Rates and formularies for each plan are approved by CMS. Plans and premiums tend to change and everything must be approved by CMS. . You would look at what plans and premiums are offered each year and what drugs are covered by the plan. All of that information is available during AEP on CMS website. You can put in the prescription drugs and see what plans cover it and your cost share. Even some of the insurance carrier websites will let you put in your individual prescription drugs and it will show which plans cover them and what the plan premiums and cost share are. But the best resource is CMS website.

What if you turn 65 and aren’t taking SS yet? Will they still take it out of your SS

Not based on individual. Rates and formularies for each plan are approved by CMS. Plans and premiums tend to change and everything must be approved by CMS. . You would look at what plans and premiums are offered each year and what drugs are covered by the plan. All of that information is available during AEP on CMS website. You can put in the prescription drugs and see what plans cover it and your cost share. Even some of the insurance carrier websites will let you put in your individual prescription drugs and it will show which plans cover them and what the plan premiums and cost share are. But the best resource is CMS website.


If you stick with a certain rx D plan for several years, will the rates stay at a lower level than someone who signs on for the same plan a few years later? Basically, do rates stay lower on a plan you stay with or do rates go up every year equally for current participants and new participants? Hope that makes sense??

No. Doesn’t matter how long you stick with it. Premiums are for plan not person in part D. Doesn’t matter whether new or in it for several years. May go up or down or stay the same but how long you are in it doesn’t impact premiums.

Definitely get a consultant. My new humana plan reimburses the part b copay. That's about $350/month for me and wife.

Probably an MAPD giveback plan. Get part B back usually in exchange for higher deductible, copays, and other things you may give up compared to normal MAPD version. Some folks love them especially if in good health and rarely visit doctor but 1-2 times a year. Much more than that and they typically spend the savings from giveback on higher copays.

This was another one of my questions as my wife is younger than myself and I was considering going two more years as my employer pays for all my family coverage

Nothing but federal income tax will be withheld from your SS as long as you are only signed up for regular Medicare, called Part A. After you begin taking your SS, unless you sign up for an Advantage Plan, Part B, Part D or a supplement plan, nothing will be deducted except federal income tax and you have optional percentages on the SS website for that.

I signed up for Part B to become effective October 1, 2025 even though I didn't retire until December 5. I wish I had signed up earlier because Part B paid for everything that my employer insurance didn't between Oct 1 and Dec 31 when my employer coverage ended. I never knew that it would do that and I'm not sure that it was supposed to do so but it did. It became my secondary coverage behind my employer provided Cigna Plan. Had I signed up mid year 2025 it may have saved me over $3K in medical bills. This my personal experience.