3 ms·

Sorry for the lack of an immediate response. Yes, both of us are over 65. The insurance was a high end PPO with no lifetime max and $20 copay. My wife is a ca

Sorry for the lack of an immediate response. Yes, both of us are over 65. The insurance was a high end PPO with no lifetime max and $20 copay. My wife is a cancer survivor, and I take drugs to minimize my cancer risk. Additionally, the premium growth rate accelerated considerably after 65. We did not actually pay $85k for a year but that was going to be the price. We were told what the new premiums would be, and instead of paying the $85k (paid monthly in installments), I switched immediately to the MA plan and told my wife, let's see how this works out. She held on for six months, then ran into the stalling, and then it took her another six months before she could get on the same MA plan. The reason our MA plan works is that it's offered by the same medical center we happened to use 100% of the time on our previous insurance. So we didn't need to switch any physicians. Regarding predatory MA's, my wife's surgeon, who was trying to get the approval for her surgery, told her, "This isn't going anywhere, you're past the time to switch to medicare, get an MA. However, be sure you avoid these companies." Yes, we switched to medicare late, and we are reminded of that every month when we pay the penalty. (I should mention our current MA plan is a HMO, not a PPO -- my typo.)

landemva 4y ago
> I take drugs to minimize my cancer risk. What is this about? I take laetrile via raw bitter apricot seeds, and generally avoid sugar and avoid many carbohydrates.
- Blammar 4y ago
  Look up Barrett's Esophagus and the recommended treatment for it.
ceejayoz 4y ago
> Yes, we switched to medicare late, and we are reminded of that every month when we pay the penalty. Doesn't the high-end PPO count as creditable coverage to avoid the penalty?
- Blammar 4y ago
  Hmm. It wasn't that we didn't have coverage -- that's a separate penalty instilled by the ACA. It was that, after 65, you're supposed to be on Medicare. Period. And they way they enforce it is they charge you extra when you do finally get on it (presumably after your private insurance becomes just too expensive...) I'd be delighted to be proven wrong, but we were told repeatedly, including by Medicare itself, we Shall Be Penalized.
  - toomuchtodo 4y ago
    There is a late enrollment penalty, and it can be substantial (ie paid for the remainder of your lifetime). https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties https://www.medicare.gov/basics/costs/medicare-costs/avoid-p...
  - ceejayoz 4y ago
    > It was that, after 65, you're supposed to be on Medicare. Period. And they way they enforce it is they charge you extra when you do finally get on it (presumably after your private insurance becomes just too expensive...) https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties https://www.medicare.gov/basics/costs/medicare-costs/avoid-p... "It’s important to sign up for Medicare coverage during your Initial Enrollment Period, unless you have other coverage that’s similar in value to Medicare (like from an employer). If you don’t, you may have to pay an extra amount, called a late enrollment penalty." The penalty is intended to stop people from saving money by forgoing insurance entirely, then hopping on when they get sick. Ask your insurer if they can provide a certificate of creditable coverage for the period. I wonder if a quick consult with a lawyer with relevant experience would be of use.

landemva 4y ago

> I take drugs to minimize my cancer risk. What is this about? I take laetrile via raw bitter apricot seeds, and generally avoid sugar and avoid many carbohydrates.

Blammar 4y ago
Look up Barrett's Esophagus and the recommended treatment for it.

ceejayoz 4y ago

> Yes, we switched to medicare late, and we are reminded of that every month when we pay the penalty. Doesn't the high-end PPO count as creditable coverage to avoid the penalty?

Blammar 4y ago
Hmm. It wasn't that we didn't have coverage -- that's a separate penalty instilled by the ACA. It was that, after 65, you're supposed to be on Medicare. Period. And they way they enforce it is they charge you extra when you do finally get on it (presumably after your private insurance becomes just too expensive...) I'd be delighted to be proven wrong, but we were told repeatedly, including by Medicare itself, we Shall Be Penalized.
- toomuchtodo 4y ago
  There is a late enrollment penalty, and it can be substantial (ie paid for the remainder of your lifetime). https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties https://www.medicare.gov/basics/costs/medicare-costs/avoid-p...
- ceejayoz 4y ago
  > It was that, after 65, you're supposed to be on Medicare. Period. And they way they enforce it is they charge you extra when you do finally get on it (presumably after your private insurance becomes just too expensive...) https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties https://www.medicare.gov/basics/costs/medicare-costs/avoid-p... "It’s important to sign up for Medicare coverage during your Initial Enrollment Period, unless you have other coverage that’s similar in value to Medicare (like from an employer). If you don’t, you may have to pay an extra amount, called a late enrollment penalty." The penalty is intended to stop people from saving money by forgoing insurance entirely, then hopping on when they get sick. Ask your insurer if they can provide a certificate of creditable coverage for the period. I wonder if a quick consult with a lawyer with relevant experience would be of use.