Health insurance for seniors

debo_2006March 14, 2013

My 77 YO mother has a COBRA health insurance plan from when her DH passed many years ago from the steamfitter's union. Her month payment is going up to $545 per month. Apparently, she wants to keep this insurance because it covers everything and it's easy. She never has to pay a single penny for anything so she says.

She is a BC survior, has controllable lukemia, back issues which she does nothing about, a pacemaker, and there always seems to be some kind of health issue pop up regularly.

Though she is not well-off, she gets a decent income from DH's pension, SS, and 401K withdrawals so she can afford to pay that amount, but.....

I'm just curious if there are other resources out there where the insurance is less. $545 for a senior seems incredible high to me, but then it does cover EVERYTHING...including dental and eyes too. Maybe I'm off base and she's lucky to have great insurance for that kind of $, but she is not one to research such issues should there be other alternatives out there for her.

Other than looking at the .gov website, not sure where to start.

Thoughts? Thanks.

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sushipup1

Is she eligible for Medicare?

    Bookmark   March 14, 2013 at 1:36PM
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debo_2006

Yes

    Bookmark   March 14, 2013 at 1:42PM
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sushipup1

Call your local Area Agency on Aging office for the SHIP or HICAP program in your area. They will give the best step-by-step counseling for senior insurance.

Just insert your state into the search.

Here is a link that might be useful: SHIP/HICAP programs

    Bookmark   March 14, 2013 at 3:07PM
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debo_2006

SHIP is for long term care which she won't qualify for nor will she buy it since her premium would be astronomical at her age. HICAP is in California. She's in PA. I'm looking for medical insurance alternatives not long term care.Thanks though.

    Bookmark   March 14, 2013 at 3:46PM
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sushipup1

OK, different names in different states, but this is a federally mandated program under the Older Americans Act of 1965.

Here is a link that might be useful: Pennsylvania program

    Bookmark   March 14, 2013 at 3:59PM
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debo_2006

I guess what I really am asking is about a medical insurance company such as Blue X, Aetna, or the like that I may compare rates to the COBRA plan she already has. Those bigger companies that I mentioned are probably not for individuals but for corporations, I suppose, but an example. Not sure what's out there for seniors. The linked site are mostly for LTC or Medicare. Perhaps there isn't anything out there BUT Medicare for seniors in terms of covering doctor visits, hospital visits, dental, eye, etc.

Thanks.

    Bookmark   March 14, 2013 at 4:33PM
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sushipup1

Medicare is an excellent program and will probably save her money. No, dental isn't covered, and neither are vision checks/glasses. I guess I am not sure why you are rejecting Medicare.

Sit down with someone from your local APPRISE program and at least run a dollar-for-dollar assessment. The counseling is free, so your mother has nothing to lose.

    Bookmark   March 14, 2013 at 4:40PM
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emma

Please try to get medicare it is great. I have to pay $200 a month for BCBS supplemental because of my age, but is worth every penny. I pay nothing but premiums, not even deductibles.

    Bookmark   March 16, 2013 at 9:29AM
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sushipup1

Emma, don't forget that you pay a premium for your Medicare Part B, that's deducted from your social security check. It shows up on your annual SS statement. And there's also a Part D premium.

    Bookmark   March 16, 2013 at 1:04PM
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emma

Sushipup, I just gave my tax papers to my accountant so it's fresh in my mind. Like I said I pay nothing but premiums. I did have to pay for a tetanus shot when a wasp stung me. A whole $10.

    Bookmark   March 16, 2013 at 7:40PM
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aekekk

Just a shout out to you regarding the health insurance: My father-in-law was a retired union steamfitter: passed away last July. I know the benefits he received before retirement were comprehensive and excellent. During his retirement, he was receiving Medicare coverage and subscribing to Part D thru United Health Care. He had several health ailments and he paid significant $$ out of pocket, not reimbursed, for prescriptions. If your Mom's plan covers prescriptions and given her health issues, maybe she would be better off keeping the plan she has? My husband and I pay for our own health plan and it costs us about 1350.00/month for 2 of us and we pay co-pays of 25.00--does not include dental/vision and we pay co-pays for prescriptions. We are self-employed.

    Bookmark   March 17, 2013 at 4:31PM
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aekekk

Just a shout out to you regarding the health insurance: My father-in-law was a retired union steamfitter: passed away last July. I know the benefits he received before retirement were comprehensive and excellent. During his retirement, he was receiving Medicare coverage and subscribing to Part D thru United Health Care. He had several health ailments and he paid significant $$ out of pocket, not reimbursed, for prescriptions. If your Mom's plan covers prescriptions and given her health issues, maybe she would be better off keeping the plan she has? My husband and I pay for our own health plan and it costs us about 1350.00/month for 2 of us and we pay co-pays of 25.00--does not include dental/vision and we pay co-pays for prescriptions. We are self-employed.

    Bookmark   March 17, 2013 at 4:36PM
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Nunyabiz1

Yep as most have stated you cant do better than Medicare with a part D.
Which is what ALL OF US from cradle to grave should have.

    Bookmark   March 19, 2013 at 10:13PM
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sushipup1

You also need a Medicare supplement to avoid a lot of out-of-pocket costs, but most are pretty reasonable.

    Bookmark   March 19, 2013 at 11:56PM
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maifleur01

You mom probably will have to pay extra to join Medicare now but it is worth it. If you can find a Medicare plan based on an HMO the drugs may be included in the plan. I am surprised that your parents were not required by their insurance company to sign up for Medicare.

    Bookmark   March 21, 2013 at 12:03AM
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sushipup1

If you are covered under a qualifying company insurance plan, you will not be penalized to join Medicare after age 65. And companies (over a certain number of employees) cannot discriminate by age against an employee by requiring them to shift to Medicare.

    Bookmark   March 21, 2013 at 12:07AM
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bruceingram1958

There are several resources on the internet that compare various health insurance policies. However, it is better also to consult a financial advisor to be informed about such matters and to arrive at an optimal decision.

    Bookmark   March 21, 2013 at 10:54PM
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debo_2006

After discussing with my mom, she does have Medicare as her primary with Cobra as secondary which covers the dental and eyes as stated in original post. She pays $104 out of SS for Medicare and $545 for the other. That's a lot per month at $650. But, as she said, she very rarely ever pays out of pocket for anything, but does have a very small deductible for her prescriptions which is generally met in the first month. No deductible or copay for her medical which is probably why the monthly payment is so high. She seems content ever though I told her to shop and do some research.

    Bookmark   March 24, 2013 at 2:16PM
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sushipup1

Just remember that there are free insurance counseling services in every community thru your local Area Agency on Aging.

    Bookmark   March 29, 2013 at 10:24AM
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emma

I don't have insurance for dental or for eyes and I don't need it. My teeth are in good shape because I go to the dentist every year and the cost for cleaning is a lot cheaper than insurance premiums. I had to have fillings put in along the gum line and it was $400, one time not every month or even every year. If your teeth are in bad shape and need extensive work, then you probably with need it.

As far as eye care goes I go once a year at a cost of maybe $200 and that is only because my eyes are changing rapidly, I have cataracts. I use my frames for at least 5 years and I don't buy designer frames or any options for the lenses, so they aren't to expensive anyway. Anything medical like cataract removal is paid by the insurance company.

    Bookmark   March 29, 2013 at 6:21PM
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kellygreen216

EmmaR are you on well water? If so you need some fluoride to prevent those gum line cavities. The new Listerine purple color mouth wash has fluoride in it and will help with gum line cavities. My dental hygienist recommended I use it for that. I use it twice a day.

    Bookmark   July 2, 2013 at 8:20AM
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Ray1000

Regardless of age and health issues she is paying entirely too much. Go to an insurance agent that sells Medicare Supplements and Medicare Part D (prescription drugs). The Insurance company cannot refuse to enroll her the first time for any reason. Also, check with an agent for dental coverage.

I am 69 and pay about $30 per month with Aetna for dental and $120 (Plan G) for the Medicare Supplement that pays the balance after Conventional Medicare Part A and B (80%).

Depending on age the Medicare Supplement, Plan F that pays all claim amounts (if Medicare pays for the procedure) with no copay or deductible should cost about $100 per month. Likely, you will find that aetna currently has the lowest price. Regardless of the company, all providers in her state must offer identical coverage with the premium being the only variable. Plan G will even be a lower price than Plan F with the only difference being she will pay an annual Medicare deductible for 2013 of $147.

Medicare part D pricing will vary but Medicare has an excellent website where you can enter the drugs taken and you will find the out of pocket pricing. I now pay about $30 per month with First Health and pay nothing for Tier 1 generic drugs. I have changed providers now 3 times due to lower prices offered by another provider. I shop every year! The Part D prescription various amounts depending on the provider and plan chosen. In general, it covers about 40% of drug costs unless it is a tier 1 generic drug. Be careful that you do the research because one can be screwed.

So, with the Medicare Supplement, Medicare Part D and dental insurance, the monthly cost should be about $160. Keep in mind that she can pay much more if she falls in love with an insurance company as she already has. She is likely paying a 3% administrative fee to her past employer for Cobra. Cobra should only be a temporary alternative until one is 65 and qualifies for Medicare.

    Bookmark   August 31, 2013 at 10:41AM
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patty_cakes

If I subscribe to Medicare Part D, does it go into effect immediately or what is the time frame? TIA

    Bookmark   October 1, 2013 at 5:15PM
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sushipup1

Patty Cakes, please contact your local Area Agency on Aging office and ask. There are lots of variables. If you turn 65 on October 15th and sign up for Medicare (all parts) before Oct 1, your coverage startes the first of October. If you've not signed up for Part D before, I think you can only sign up at certain times of the year. And there is an open enrollment period every fall for changing your Part D plan.

Call the AAA and ask for a consultation. Your situation might be different.

    Bookmark   October 1, 2013 at 7:55PM
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patty_cakes

Thank you Sushipup. Just received my Medicare 2014 'guidebook' in the mail today, so will read up and find out what I need to know. If I don't understand will make that phone call. ; o)

    Bookmark   October 2, 2013 at 12:48AM
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emma

The gum line problems are cause by gritting my teeth all the time. I have had two dentist tell me that and even watched a video on it. Since then I have broken the habit during the day and the night time solution is the take out my upper denture.

    Bookmark   January 2, 2014 at 3:55AM
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