Medicare 2025 Discussion

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SKATA

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FWIW, you used to be able to put your formulary, or in your case, a lack of one, in the medicare website and it would shoot out several options cheapest to most expensive.
Yes can still do that step. Works by drugs/pharmacy/tier costs. My concern is when I change to a program for less cost, what's the unknown.
 
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FWIW, you used to be able to put your formulary, or in your case, a lack of one, in the medicare website and it would shoot out several options cheapest to most expensive.
We have an insurance company that is very knowledgeable in the part D field. They sent us a card today to come in for a comparison review with what we currently have. Every plan changes almost every year for the most part. It's good to get a review annually.
Our situation is different than most. I get 100% care and prescription from the VA.
BUT, we are on the road almost 7 months out of the year in the RV where there may not be VA care available.
There is the traveling Vet Program enacted by congress that nobody in the VA knows about that we can find, that keeps saying everything depends on your primary doctor. My primary has never seen any information about what that program is all about, so it's all on me.
Over the years, skip a day on meds occasionally so I'm about 100 days ahead of all prescriptions currently.
We keep the part D Medicare in case there is an emergency on the road with no VA capability to get care or pay for it.
Once again, go to an insurance agent to see what is available. It changes every year. It's rare that we have stayed with the same Part D company more than two years.
As much as I hate Walmart, I had to choose them as a prescription provider. They are everywhere.
I'll have to bite the bullet and get a script there if the earth is ending and there is no place else to go.
 

Snattlerake

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I went to a seminar about Medicare.

I learned some things.

Part A is hospitalization only and is free if you have a vetted work history of 10 years contributing to Medicare.

The Part B is $174.70 a month for everyone.
( and it usually goes up proportionately to any SS increase they decide upon in a given year.) Mine started out at $145.

A Part B IRMAA Income Related Adjustment Amount may be added for high income applicants in addition to the $174.70!!!!!

You can add Part D drug coverage. Usually $30 to $40 a month with a $2,000 out of pocket max cap.

Medigap plans are standardized and must follow federal and state insurance laws. They can offer A-D, F, G, and K-N.

All Medicare Supplemental Insurance plans offer the same basic benefits no matter where you live or which insurance company you buy from.

Medigap plans sold to people new to medicare are no longer allowed to cover Part B deductibles as of 2020.
Medigap plans cover copayments, coinsurance, and deductibles. Some offer insurance outside of the US if you travel.

They had info about COBRA but I didn't take notes because it didn't apply to us.

www.medicare.gov/medigap-supplemental-insurance-plans
www.medicare.gov/publications

There are two types of Advantage programs called Part C. They pay for about everything in network, in your state. Out of state, they suck.

They have a PPO program and an HMO program and in both of them, you have to deal with people deciding upon your health and welfare based upon the trends, statistics, and whims of others. They force you to use generic drugs which sometimes do not have all of the ingredients of the name brand.

(I wish I could find that yooootooob of the insurance agents at a convention asked if anyone would go the advantage route. No one said they would.)

The HMO is, "This is your network", AND THAT'S IT!

The PPO you can go outside of their network, but you will pay dearly for it.

Advantage Plans are a big moneymaker for insurance companies because they get a check for $1,000 every month to manage your health in Oklahoma. In the coastal states, they get $2,000. This is why they offer incentives such as hearing, dental, vision, local gym access, etc. Vision is usually a yearly eye exam and some cheap assed glasses for $100. Don't go getting astigmatism or double vision. You will pay. Don't get a root canal or a crown, and don't require $5,000 hearing aids.

You still have to pay the $174.70 every month so the Advantage plans that say there is no monthly payment is a lie.

If a doctor or hospital takes Medicare, they HAVE to take your supplement.


One good thing is the dreaded doughnut hole is going away in 2025.

I took good notes huh?
 

JD8

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I went to a seminar about Medicare.

I learned some things.

Part A is hospitalization only and is free if you have a vetted work history of 10 years contributing to Medicare.

The Part B is $174.70 a month for everyone.
( and it usually goes up proportionately to any SS increase they decide upon in a given year.) Mine started out at $145.

A Part B IRMAA Income Related Adjustment Amount may be added for high income applicants in addition to the $174.70!!!!!

You can add Part D drug coverage. Usually $30 to $40 a month with a $2,000 out of pocket max cap.

Medigap plans are standardized and must follow federal and state insurance laws. They can offer A-D, F, G, and K-N.

All Medicare Supplemental Insurance plans offer the same basic benefits no matter where you live or which insurance company you buy from.

Medigap plans sold to people new to medicare are no longer allowed to cover Part B deductibles as of 2020.
Medigap plans cover copayments, coinsurance, and deductibles. Some offer insurance outside of the US if you travel.

They had info about COBRA but I didn't take notes because it didn't apply to us.

www.medicare.gov/medigap-supplemental-insurance-plans
www.medicare.gov/publications

There are two types of Advantage programs called Part C. They pay for about everything in network, in your state. Out of state, they suck.

They have a PPO program and an HMO program and in both of them, you have to deal with people deciding upon your health and welfare based upon the trends, statistics, and whims of others. They force you to use generic drugs which sometimes do not have all of the ingredients of the name brand.

(I wish I could find that yooootooob of the insurance agents at a convention asked if anyone would go the advantage route. No one said they would.)

The HMO is, "This is your network", AND THAT'S IT!

The PPO you can go outside of their network, but you will pay dearly for it.

Advantage Plans are a big moneymaker for insurance companies because they get a check for $1,000 every month to manage your health in Oklahoma. In the coastal states, they get $2,000. This is why they offer incentives such as hearing, dental, vision, local gym access, etc. Vision is usually a yearly eye exam and some cheap assed glasses for $100. Don't go getting astigmatism or double vision. You will pay. Don't get a root canal or a crown, and don't require $5,000 hearing aids.

You still have to pay the $174.70 every month so the Advantage plans that say there is no monthly payment is a lie.

If a doctor or hospital takes Medicare, they HAVE to take your supplement.


One good thing is the dreaded doughnut hole is going away in 2025.

I took good notes huh?

You took excellent notes lol......


I've talked about some Advantage horror stories on here that I saw...... it's criminal they call it "Part C" because people think it's part of Medicare. Nope. By signing up you assign your rights away to an insurance company and it's usually EXTREMELY difficult to get out of it and back on regular Medicare.
 

JD8

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We have an insurance company that is very knowledgeable in the part D field. They sent us a card today to come in for a comparison review with what we currently have. Every plan changes almost every year for the most part. It's good to get a review annually.
Our situation is different than most. I get 100% care and prescription from the VA.
BUT, we are on the road almost 7 months out of the year in the RV where there may not be VA care available.
There is the traveling Vet Program enacted by congress that nobody in the VA knows about that we can find, that keeps saying everything depends on your primary doctor. My primary has never seen any information about what that program is all about, so it's all on me.
Over the years, skip a day on meds occasionally so I'm about 100 days ahead of all prescriptions currently.
We keep the part D Medicare in case there is an emergency on the road with no VA capability to get care or pay for it.
Once again, go to an insurance agent to see what is available. It changes every year. It's rare that we have stayed with the same Part D company more than two years.
As much as I hate Walmart, I had to choose them as a prescription provider. They are everywhere.
I'll have to bite the bullet and get a script there if the earth is ending and there is no place else to go.

I know you hate walmart but if you're travelling that much, it's pretty smart to choose them. CVS and the others are very inconsistent.
 
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This is interesting reading, I received my quotes for Part D for 2025. My Part D went from $6.30/month in 2024 to $0 in 2025 (I have 4 generic perscriptions). I will still have the $594 deductible to cover, and the elimination of the "donut hole" (which thankfully I don't reach). My Part B premiums will go from $174.70 to $185.00 and my Medigap Plan B premium will be about $150. That is my coverage only, my wife's is about the same. She's had more trouble with the pharmacy than she's had with the insurance company.
 

bas402

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For us retired folks. Time to bring up the 2025 increases in Medicare costs. Here is what I uncovered this week:

* My Medicare Part "D" costs are going from $19.90 per month to $59.90 per month. The tier 1 & 2 pricing doubled. I only have three generic prescriptions per month.
* My Medicare gap is going to increase $414.52 per year.
* Medicare Part "B" will increase $132 per year.
* SS will increase 2.5% for next year.

I will have to shop around for another Part "D" program. No much else I can change. I have already contacted Senator Langford and Congresswomen Bice offices.

Does the increases have anything to do with all the illegal invaders in our country getting free health care ???
Short answer…yes!
 

bas402

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I went to a seminar about Medicare.

I learned some things.

Part A is hospitalization only and is free if you have a vetted work history of 10 years contributing to Medicare.

The Part B is $174.70 a month for everyone.
( and it usually goes up proportionately to any SS increase they decide upon in a given year.) Mine started out at $145.

A Part B IRMAA Income Related Adjustment Amount may be added for high income applicants in addition to the $174.70!!!!!

You can add Part D drug coverage. Usually $30 to $40 a month with a $2,000 out of pocket max cap.

Medigap plans are standardized and must follow federal and state insurance laws. They can offer A-D, F, G, and K-N.

All Medicare Supplemental Insurance plans offer the same basic benefits no matter where you live or which insurance company you buy from.

Medigap plans sold to people new to medicare are no longer allowed to cover Part B deductibles as of 2020.
Medigap plans cover copayments, coinsurance, and deductibles. Some offer insurance outside of the US if you travel.

They had info about COBRA but I didn't take notes because it didn't apply to us.

www.medicare.gov/medigap-supplemental-insurance-plans
www.medicare.gov/publications

There are two types of Advantage programs called Part C. They pay for about everything in network, in your state. Out of state, they suck.

They have a PPO program and an HMO program and in both of them, you have to deal with people deciding upon your health and welfare based upon the trends, statistics, and whims of others. They force you to use generic drugs which sometimes do not have all of the ingredients of the name brand.

(I wish I could find that yooootooob of the insurance agents at a convention asked if anyone would go the advantage route. No one said they would.)

The HMO is, "This is your network", AND THAT'S IT!

The PPO you can go outside of their network, but you will pay dearly for it.

Advantage Plans are a big moneymaker for insurance companies because they get a check for $1,000 every month to manage your health in Oklahoma. In the coastal states, they get $2,000. This is why they offer incentives such as hearing, dental, vision, local gym access, etc. Vision is usually a yearly eye exam and some cheap assed glasses for $100. Don't go getting astigmatism or double vision. You will pay. Don't get a root canal or a crown, and don't require $5,000 hearing aids.

You still have to pay the $174.70 every month so the Advantage plans that say there is no monthly payment is a lie.

If a doctor or hospital takes Medicare, they HAVE to take your supplement.


One good thing is the dreaded doughnut hole is going away in 2025.

I took good notes huh?
Indeed you did and are spot on! Great post!
 

TerryMiller

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I know you hate walmart but if you're travelling that much, it's pretty smart to choose them. CVS and the others are very inconsistent.

Wife and I have the Summer job that takes us out on the road for anything from 3 months to 6 months. We've used Walmart's pharmacy a lot in the last six summers, and this year she found out that it is easier using their phone app to set up getting a prescription filled. In the past five years, every time she had to get a prescription, Walmart seemed to have to set up another profile for her, so she has something like 13 different profiles, which made it difficult to determine which one to use. This summer she used the app and it simplified it a bunch.

A side note with Medicare. In my case, I have regular Medicare and a Plan N supplement, and it basically covered all of my quarterly eye injections and all of the expenses for my partial knee replacements, which was back in January. The knee coverage was for the hospital, all doctors and anesthesiologists, home health care, and follow up checkups.
 

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