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Old 02-12-2010, 06:50   #61
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have you run the numbers on high deductable plans?
If you need a lot of treatment every year, it's a bad deal. But if you only have a major issue once in 5 years then a high deductable is cheaper. Not CHEAP, but cheapER. We can get down to about $7000/year with BCBS.
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Old 02-12-2010, 07:31   #62
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have you run the numbers on high deductable plans?
If you need a lot of treatment every year, it's a bad deal. But if you only have a major issue once in 5 years then a high deductable is cheaper. Not CHEAP, but cheapER. We can get down to about $7000/year with BCBS.
That sounds about right. That's what I was paying for a high deductible plan before I cancelled it and went with I.M.I.S. last year at age 59. Over 5 years I paid around $30-35,000 and got zip in return, so its basically "catastrophic insurance" ... more peace of mind than anything.
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Old 02-12-2010, 08:38   #63
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Madwand - I would suggest you do some very serious research into Medicare. You will be shocked and angry at what you actually get and how much you must pay. It took me almost 6 months of going over and over the "fine print" and brochures and many, many advisors on what to get and how to do it. You have to put together a "package" of additional insurance that surrounds Medicare and fills in gaps
Ok, I just found out I am not eligible for Medicare since I don't pay Social Security. I do, however pay Medicare taxes on my paycheck, so I am actually paying for your Medicare coverage you are complaining about. Thank me. Isn't that great? I have also paid SS taxes at one point and currently pay MC taxes and will benefit from neither when I retire. Awesome plan. Yes, you were right, it does make me angry. Angry that I am paying for other ungrateful people's coverage.

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That is termination of your major medical coverage and you are being sent to Medicare - no choice. My company did the same and everybody I know with excellent medical coverage while working or where in the "gap" between retirement and age 65 were terminated from company medical plans at age 65.
Sorry, I don't know where you are getting this...I just checked with my human resources department. When you become eligible for MC, your primary employer medical coverage becomes SECONDARY, it does NOT terminate. Secondary is NOT termination of your major medical coverage. Your employer coverage will even continue to pay for drugs unless you opt for Part D drug coverage.

In my case, if I were eligible, my employer would require that I purchase Part B, obviously so that they would have a lesser burden when I make claims. But at the same time, they would also discount my current premium because of the Part B coverage. But my employer coverage never terminates at any time. Maybe your employer decided to terminate your coverage, but it has nothing to do with becoming Medicare eligible.

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- - Here's the hook - we were offered a "supplemental" to Medicare at very high prices. Supplementals cost money and there are numerous versions and many companies offering them. This is where the research comes in. Some of these "supplementals" are near scams and some are authentic and the costs are usually quite lower than your company's offered conversion to a "supplemental." So you have to do some serious shopping around.
Who offered you that? That has nothing to do with MC.

Quote:
- - The primary supplemental fills up the payments from Medicare's 80% to 100% - there are many versions of this to weed through to find the one best for your own circumstances.
Yes, that's what my primary employer coverage would do as it became secondary.

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Oh! no privileges involved, since the only choice is Medicare or nothing - or move out of the USA.
Again, that's not true. Maybe for you, but my insurance does not drop me if I become MC eligible.

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$30K in premiums - 20 years - Age?

- - You must be younger than 45 years old to pay that amount of money. I presume most, or at least a significant majority of cruisers and serious wannabe cruisers are about to be retired around age 55 to 65. So the "place-holder" premiums apply to the younger cruisers who are probably on a "sabbatical" cruise of a year or two or three before returning to the work place. Here is where the "place holder" premiums are important both in medical but also in automobile/vehicle insurance. As I mentioned, once you "drop out" getting back in can easily exceed the cost of "place holder" premiums.
I am 45 now. I retire in 9 yrs, 3 months at age 55 with 30 years. Maybe a little earlier if I sell some leave back. My current premium is $114 a month for $5,000,000 major medical coverage. $114 times 12 times 20 years is $27,360. I rounded it up, as it is 9 years three months in the future that I am talking about. I will be paying that amount of money as a place holder if I decide to keep the insurance and am gone for 20 years and then decide to come back. During that time, I will also need to have some method to actually pay for medical care if I need it. I am guessing out of pocket will do in most places.

The only question is do I keep the $30,000 placeholder policy while I travel.
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Old 02-12-2010, 08:58   #64
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That sounds about right. That's what I was paying for a high deductible plan before I cancelled it and went with I.M.I.S. last year at age 59. Over 5 years I paid around $30-35,000 and got zip in return, so its basically "catastrophic insurance" ... more peace of mind than anything.
When I searched for International Medical Insurance, I.M.I.S. has 3 or 4 different companies they represented. I got other companies by doing a web search for international medical insurance and eliminated the "Travel Insurance" folks as their policies are for a limited time like one or 2 months.
- - Each company has about 3 or 4 versions, sometimes more - so I had to make a spreadsheet and list which one did what for how much.
- - Be very careful to read everything, as quite a few had "waiting periods" of up to one year after you started paying before they would cover you. Some didn't have the waiting period, so I went with one of those - I.M.G.
- - Remember, insurance is nothing more than a "gamble/bet" you are betting you are going to get sick and the company is betting you will not get sick.
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Old 02-12-2010, 09:06   #65
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I would definately keep the policy. My parents ages 82 and 79 were able to continue their insurance through their company after retirement and use it as secondary after medicare. Between the two they have almost no out of pocket medical expenses. They do have to pay $7000 in premiums but with multiple heart surgeries and other ailments that have required hospital stays over the years it is probally the only reason that they are still able to be financially independent. Many of us do not have that option.
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Old 02-12-2010, 09:09   #66
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The only way you'll ever receive Social security/Medicare is if you have FICA tax deducted from your paycheck or you pay when fileing your Federal Income Tax.

After you've turned 50, go to WWW.SSA.GOV, enter your SSN and see what your benefits will be, and then plan for the conditions that will confront you on retirement.

Employer paid Group Insurance is written by so many different Insurance Companies, tailoring their plans to each employer, that trying to compare one to the other is impossible.
I have a nephew whose two year old daughter has lukemia, and everyone within that Employer paid Insurance Group has had their premiums increased and their coverage decreased, and he is a Doctor in a Medical Center.
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Old 02-12-2010, 09:35   #67
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Madwand - two things, the money you are paying in your withholding is not for Medicare, it is for a program for national health insurance for poor people. The Fed's instituted the collection of the premiums from all of us, but never instituted the national health insurance for the poor people. Another of the great deals from your friendly folks in Wash.,D.C.
- - As to when at age 65, your company terminates your normal health insurance and converts it to "supplemental" - the difference is that the coverage limits and conditions of your current medical terminate and you are now under the coverage and conditions of Medicare. That is what is terminated. In my case the company medical coverage I had was very broad and extensive - virtually unlimited. It was a negotiated benefit plan that evolved over many decades into a "golden" benefit. When the various financial crunches came we were willing to give up pay/salary in lieu of any cuts in the medical benefits.
- - Your human resources people are usually not really as well versed as you think they are - for something as important as medical benefits you need to really dig out the details yourself. Remember they are not working for you, they are working for the "company/firm."
- - The whole subject is like the Federal Tax Code - convoluted and full of "gotcha's" along with more than a few "screw you's" mixed in. As mentioned by another poster, HSA's may or may not cover medical service outside the country. Many good doctors and surgeons also know how to "game" the system to assist you in getting as much payment as possible for your actual medical situation. That is why I mentioned the aspirin/Advil - the more you dig into the actual benefits and conditions and schedules of payments, etc. the more your brain cells rebel and start frying themselves. What one "expert" tells you another will tell you the opposite.
- - As a "government" worker, outside the Fed requirements for SSA coverage, there are ways you can "game" the system to get qualified for SSA and Medicare. Normally, however, those outside the Fed Medicare system usually have far superior medical coverage terms and conditions than those of us in the "vast unwashed" who have only Medicare. My mother worked for NY State as a teacher and her NY State coverage was superior to what she would have had under Medicare. But that was 20 years ago, things always change and not always for the better.
- - Maintaining eligibility for the superior coverage available from a State/Local government system might just be worth the "place-holder" costs especially when you consider that some doctors/hospitals/providers do not accept Medicare patients.
- - Like the cruising lifestyle where you and only you are in charge of your existence and maybe, demise - this medical insurance morass can only be decided by yourself after some due diligence. Your health history, family medical history, environmental conditions and future plans are all unique to you - so "one size fits all" simply doesn't work.
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Old 02-12-2010, 09:51   #68
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Madwand - two things, the money you are paying in your withholding is not for Medicare, it is for a program for national health insurance for poor people. The Fed's instituted the collection of the premiums from all of us, but never instituted the national health insurance for the poor people. Another of the great deals from your friendly folks in Wash.,D.C.
Maybe that's all it is. I'm not a fan of welfare though, so I really don't appreciate having to pay this.

Quote:
- - As to when at age 65, your company terminates your normal health insurance and converts it to "supplemental" - the difference is that the coverage limits and conditions of your current medical terminate and you are now under the coverage and conditions of Medicare. That is what is terminated. In my case the company medical coverage I had was very broad and extensive - virtually unlimited. It was a negotiated benefit plan that evolved over many decades into a "golden" benefit. When the various financial crunches came we were willing to give up pay/salary in lieu of any cuts in the medical benefits.
I see what you are saying now. It's still not terminated, but if you like calling it that, that's fine. It just becomes secondary. In my case, it would even become cheaper if I got MC.

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- - Your human resources people are usually not really as well versed as you think they are - for something as important as medical benefits you need to really dig out the details yourself. Remember they are not working for you, they are working for the "company/firm."
Could be, but I mean it comes down to am I gonna get MC or not? If you must be SS eligible, then I will not. Pretty clear. Probly better off without it. At least they can't make me pay for Part B.

Quote:
- - As a "government" worker, outside the Fed requirements for SSA coverage, there are ways you can "game" the system to get qualified for SSA and Medicare. Normally, however, those outside the Fed Medicare system usually have far superior medical coverage terms and conditions than those of us in the "vast unwashed" who have only Medicare. My mother worked for NY State as a teacher and her NY State coverage was superior to what she would have had under Medicare. But that was 20 years ago, things always change and not always for the better.
Yes, I am a government employee. We fight pretty hard to keep our benefits. But I always take issue with people who say they have no retirement. Everyone has the option to put money away in their own retirement account. Just because they choose to squander their pay instead of living at a lesser standard does not mean that the citizens should be taxed to pay for their retirement. It really amazes me that most people in this country pay no mind to the fact that they will work till the day they die because they don't fund a retirement account.

Quote:
- - Maintaining eligibility for the superior coverage available from a State/Local government system might just be worth the "place-holder" costs especially when you consider that some doctors/hospitals/providers do not accept Medicare patients.
- - Like the cruising lifestyle where you and only you are in charge of your existence and maybe, demise - this medical insurance morass can only be decided by yourself after some due diligence. Your health history, family medical history, environmental conditions and future plans are all unique to you - so "one size fits all" simply doesn't work.
You are right, it will depend on my health in the next 10 yrs. I will probably keep the coverage for the first year, just to see how the whole cruising/health thing works out. My guess is health will improve due to cruising and make insurance a moot point.
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Old 02-12-2010, 09:57   #69
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The only way you'll ever receive Social security/Medicare is if you have FICA tax deducted from your paycheck or you pay when fileing your Federal Income Tax.
Right, I don't pay, but did in a previous lifetime. I don't benefit from all the money I put into the system back then. I hear there's some stipulation that you have to have contributed within a certain time close to retirement. Also, because I am a municipal or government employee, even if I did qualify, my payments would be severely limited because I don't "need" the money as much as Johnny Ditchdigger who can't be bothered to save for retirement.

BTW, the government job I have, if anyone is interested, is as a police officer and firefighter for the local airport. I don't get paid a lot. Schoolteachers have a higher median pay than me. The difference is, I don't complain about it, I don't go on strike. I know I'll have enough for a nice boat when the time comes.
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Old 02-12-2010, 10:55   #70
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Best not have a heart attack. My last heart cath ran 26K for the doctor and 78K for the hospital. That was 19 hours total- time in to time home. The hospital price has come down just a bit, my first and second ones cost just over 85K each. Be aware my doc ended up with just over 5K of his 26K bill. Still not bad for a hours work. He did 4 other heart caths that day. 5X5= a good day. Ken
Jeepers!

100K for 19 hours!

It doesn't seem moral to charge such enormous fees.

I used Medex Insurance when I was travelling, buying the annual plan was the best deal. International Travel Insurance, Medical & Security Evacuation - MEDEX
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Old 02-12-2010, 11:38   #71
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I used Medex Insurance when I was travelling, buying the annual plan was the best deal. International Travel Insurance, Medical & Security Evacuation - MEDEX
Funny, it's only good for one year if you ever use it:
This insurance cannot be renewed. However, another policy may be purchased. If a new policy is issued, any claims incurred under the previous policy will be considered a pre-existing condition and therefore not covered under the new policy.
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Old 02-12-2010, 11:56   #72
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Speaking of how much Health Care Cost, reminded me of my experience working in IT for hospitals.

In the 80's I was a cobol programmer doing maintance on a hospital billing system written by IBM in the late 60's early 70's (SHAS). It was written to handle multiple hospitals on an average sized mainframe computer (64k).
The system didn't have space to record or save a room charge over $999.99 nor did it allocate a field size for a total bill over $99,999.99.
But then the date routine ran out of space on Sept. 8, 1985, and the caliculation went to a negitive number, so the system was trashed.
Times change!
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Old 02-12-2010, 13:11   #73
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If you worked in any job that paid social security taxes anything during your life for a total of "x" years (credits) you are eligible to receive SS payments and Medicare at your appropriate SS benefit age.
From SS/gov website:
How do you qualify for retirement benefits?
When you work and pay Social Security taxes, you earn “credits” toward Social Security benefits.
The number of credits you need to get retirement benefits depends on when you were born. If you were born in 1929 or later, you need 40 credits (10 years of work).
If you stop working before you have enough credits to qualify for benefits, the credits will remain on your Social Security record. If you return to work later on, you can add more credits so that you qualify. No retirement benefits can be paid until you have the required number of credits.

- - However, any other retirement income or wages can make your SS benefits taxable. The formula is in the IRS 1040 instructions worksheet for SS benefits.

- - As to having both Medicare and a State medical program, it varies with the State. From the web, it seems that Ohio requires their retirees who are eligible for SS benefits to enroll in Medicare "A" and the State medical apparently becomes the supplemental.
- - You cannot "double dip" or choose one system over the other as all the systems talk to each other and require you to disclose all your sources of medical benefits.

- - Just to boost the sales of aspirin/Advil, it seems that some States are changing their retiree medical benefits to shift part of their financial burden onto Medicare. Since State employees are not generally covered by Federal Laws protecting retirements and benefits - The States Rights thing - you can add to your anxiety the possibility that your State benefits will be altered/reduced to reduce the State's financial deficits.

- - For all those on CF who live in "other" countries that have National medical, maybe you should go outside and consider kissing your country's earth for not having to deal with the chaotic USA medical system.
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Old 02-12-2010, 13:29   #74
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avb3 - Doesn't most parts of Canada now have a requirement that you must be in country up to 6 mos/year? I see that in other threads on the subject quite often.
My understanding is each province is different, with the majority having the requirement you point out.

The reality is that there is no way anyone knows how long you are out or in the province. Even the U.S. Customs and Border only record when you enter the United States, but have no record of when you leave, so they cannot realistically enforce the 183 day restriction.

I would not hold my breath though that things in this regard with the U.S. Customs and Border will not change in the future... I would expect them to utilize technology of some sort to close that gap.

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- - To Canadians CF members - can you pay a "premium" to Canada's health system to stay covered if you stay out of Canada longer than the required "in country" requirement?
Not sure of that, but a great question to ask travel insurance companies.
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Old 02-12-2010, 15:30   #75
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Funny, it's only good for one year if you ever use it:
This insurance cannot be renewed. However, another policy may be purchased. If a new policy is issued, any claims incurred under the previous policy will be considered a pre-existing condition and therefore not covered under the new policy.
And that is reflected in the cost (200 per annum when I last took it). I repeated every year for about 5 years. Its not meant to cover medical/dental doctors precaustionary check up visits, or palliative care etc. Merely to cover unforseen misfortune.
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