Medicare supplement vs. Merrill Lynch retirement health plan vs. COBRA

If you were happy with the ML coverage while you were working and can afford the premiums, you would probably be best off going with COBRA.  That would be the same insurance as active employees.  But, be sure about the premiums because you would no longer get the company contribution.  However, with your complex situation and a very short time to make a decision, I suggest you call the local Area Agency on Aging (phone book, govt pages) and ask the counselors there for help.

As you are over 65, COBRA should be considered out of the question.  Failure to enroll in Medicare will bring on future penalties, and COBRA is not an acceptible substitute.  The best of the Medicare Supplement plans is Standardized plan "F", and it is available from most companies.  You can shop online for the company with the best price.  Plans are standardized, and therefore Identical.  As far as prescription drugs go, deadline for applying is 12/31.  Wait an extra day, and you will need to wait until next year, and will need to be penalized for the rest of your life should you enroll in the future.  Best shopping is go to www.Medicare.gov.  Enter your drugs, and then select the plan which is best for your needs.  Even if you use no medication, you will want to gewt a plan to avoid penalty in the future.

Thanks very much, Harry. 

My application for Medicare as well as my wife's may have been made a bit too late for our enrollment to begin by January 1.  Social Security sent us each a form to be forwarded to my former employer (which has provided health insurance for both of us), on which the employer certifies that our coverage ends on 12/31/2008).  That process didn't occur as fast as it might have; we only now have the forms back from the employer and are ready to bring them to our local Social Security office on Monday.  In the event that Social Security, on receiving the forms, tells us that our Medicare enrollment cannot begin on January 1, it seems to me we have no alternative to enrolling in COBRA until such time as our Medicare coverage begins.  (A person I spoke to at Social Security about one week ago said something about a 7-day window for returning the form in question, with a 7-day grace period, for a total of 14 days.  I'm unclear about this rule but expect to find out more on Monday.)

On the other hand, if Social Security does not provide a definitive answer as to our start date, I would hold off on COBRA enrollment until (A) we need it because we have incurred medical expenses or (B) our window for COBRA enrollment is about to close (that will occur on March 3rd) and Medicare has still not enrolled us.  I suspect you will be offered a 2/1/09 effective date.  There is a "Special Enrollment Period" (SEP) which allows you to come off the group plan without waiting until the Annual Enrollment Period (AEP) which is Jan 1 - Mar 31 with an effective date ofd 7/1.

As for Mediare Part D, I believe--please tell me if you're convinced I'm wrong--that as long as I can demonstrate that my prescription drug coverage to date has been what Medicare calls creditable, meaning that it has been as good as or better than what Medicare offers under Part D, then I will not be penalized by being charged a higher premium.  This is correct.  A letter from prior plan is all you need.  Also, as you are just coming on to Medicare, this also would waive the penalty. I former employer has provided that certification, which applies up to 12/31 of this year.  If I choose to enroll in the employer's retiree medical plan, then I believe that the same logic will continue to apply.  So I ought to be able to switch to Medicare Part D without penalty whenever I want to, as long as the switch occurs in an open enrollment period.  Again, if you think I've misunderstood the rules, I'd be grateful for your thoughts.

Like you, I find supplement plan F to be best for our needs, though it seems to me that the high-deductible version of the plan could save us money without adding to the risk. The hi-deductible is fine, as long as you are aware that if you ever want to go to the regular "F" plan, you will need to Medicaally qualify.  Most people are very happy with the hi-ded plan UNTIL they get sick.  The deductible will increase every year, and could get very costly in later years, when you really need the insurance.  I came to that conclusion when I found that the money saved in premiums with the high-deductible version is approximately equal to the extra deductible amount.  So with the H.D. version of plan F, it would be like having plan F but paying the additional premium only if we had medical expenses. 

I may opt to get supplemental plan F (or H.D. F) and Medicare Part D coverage only for my wife, who currently takes no medicine, while myself taking my former employer's retiree medical plan, which has a better prescription drug coverage than that offered by Medicare.  The retiree plan provides secondary insurance, which, while lacking in some of the features of supplemental plan F, would nevertheless provide catastrophic coverage (any costs after $6,500 out-of-pocket), which, for me, is the most important feature. Sounds logical.  See if the WellCare Classic plan is available in your state.  It has a $295 deductible, which is waived for generic drugs.  Also a $0 co-pay for generics.  Should be in the mid $20 premium range.

The premium of the retiree plan is somewhat less than sum of the premiums of the cheapest supplemental plan H.D. F and the cheapest Part D; the difference is not big enough for that alone to be the deciding factor.

Thanks again for your reply.

Best regards,

Alan

Feel free to contact me at harrythal@aol.com.  Happy New Year

Harry

     What ever you do be careful of any group acting as though they are looking out for seniors. Maybe they are, but, sometimes they are not educated enough to know what they are talking about.  They think all insurance agents just want a commission, and are all bad. These groups some times might have the word aging in there title. They give out inaccurate information, and know just enough about medicare to be dangerous. They call themselves "real people" not sales people.  If you want fair advise find the State section in your phone book, then insurance, then senior insurance. Call them and ask them to mail you the consumer guide to medicare supplements and medicare advantage plans. The book should be free. You don't even need a insurance agent there at that point. Take your time and read threw the prices of medicare supplements and get the cheapest plan F you can find, it's that easy. If you want a real cheap plan look at medicare advantage plans, but expect to pay around $20 for a doctors visit, and maybe around $200 a day for the first 5 to 10 days if admitted to the hospital. $50 for emergency room.

     I have written in some counties medicare advantage plans that covered doctor visits for $10, and, hospital for $100 per day,  days 1-5, and, covered medicare part D drugs, all that in one plan for a 0 premium. All you would have had to pay was the 96.40 a month for your medicare part B all the rest was free.  I think there are still some 0 premium medicare advantage plans out there but higher co pays.  Maybe now $30 a month for advantage plans. Remember read the consumer book put out by the State you live in that's your best bet, well usually.

     Do the math in 2008 if one recieves medicare part B The average income folks will pay 96.40 a month out of there SSi check. You have to pay that to get any medicare related insurance.  From there you can get a plan F (which pays every thing medicare approves 100% no co pays no deductables full coverage.) but no medicare part D drugs. If you are 65 figure $96.40 + around $80 for your plan F medicare suppement (if you're lucky and female, they are cheaper figure around $90 a month for a man) plus say $35 a month if you want medicare part D drug plan

Obama's health care proposal is, in effect, the repeal of the Medicare program as we know it.  The elderly will go from being the group with the most access to free medical care to the one with the least access.    Indeed, the principal impact of the Obama health care program will be to reduce sharply the medical services the elderly can use.  No longer will their every medical need be met, their every medication prescribed, their every need to improve their quality of life answered.

It is so ironic that the elderly - who were so vigilant when Bush proposed to change Social Security - are so relaxed about the Obama health care proposals.  Bush's Social Security plan, which did not cut their benefits at all, aroused the strongest opposition among the elderly.  But Obama's plan, which will totally gut Medicare and replace it with government-managed care and rationing, has elicited little more than a yawn from most senior citizens.


It's time for the elderly to wake up before it is too late!

In our new book, Catastrophe, we explain - in detail and in depth - the consequences the elderly of Canada are feeling from just this kind of program.  Limited colonoscopies have led to a 25% higher rate of colon cancer and a ban on the use of the two best chemotherapies are part of the reason why 42% of Canadians with colon cancer die while 31% of Americans, who have access to these two medications, survive the disease.

Overall, the death rate from cancer in Canada is 16% higher than in the United States and the heart disease mortality rate is 6% above ours'.
Under Obama's program, there will be a government health insurance company that gets huge subsidies of tax money.  It will compete with private insurance plans.  But the subsidies will let it undercut the private plans and drive them out of business, leaving only the government plan - a single payer - in effect.

Today, 800,000 doctors struggle to treat adequately the 250 million Americans who have insurance.  Obama will add 50 million more to their caseload with no expansion in the number of doctors or nurses.  Indeed, his plan will likely reduce their number by lowering reimbursement rates and imposing bureaucrats above them who will force medical decisions down their throats.   Fewer doctors will have to treat more patients.  The inevitable result will be rationing.

And it is the elderly who rationing will most effect.  Who should get a knee replacement a 40 year old or a 70 year old?  Who should get a new hip, a young person or an old person?  Who should have priority in the operating room a seventy year old diabetic who needs bypass surgery or a younger person?  Obviously, it is the elderly who will get short shrift under his proposal.

But the interest groups that usually speak up for the elderly, particularly AARP, are in Obama's pocket, hoping to profit from his program by becoming one of its vendors.  Just as they backed Bush's prescription drug plan because they anticipating profiting from it, so they are now helping Obama gut the medical care of their constituents.

It is high time that the elderly of America realized what the stakes are in this vital fight to preserve Medicare as we know it and keep medical care open, accessible, and free to those over 65.  It is truly a battle for their very lives.