You said you already made your choice, but wanted to hear what others have/had. Mine is a bit complicated, because I changed from one plan to another. Also, because I worked for Medicare for several years (as a nurse in their fraud department, a partnership with the DOJ/Dept of Justice), I am well versed in Medicare, so I did include information on all the options. If you don’t want to read this part, just skip it.
I originally had traditional Medicare A & B plus a second plan thru my partner that covered what traditional Medicare did not cover (20% of all charges) and all my prescriptions. I didn’t really need B at the time, since my partner’s plan would have covered it, but there is a penalty if you do not sign up when you are 1st eligible or cancel B and want to restart. See below.
From Medicare website: “If you didn’t get Part B when you’re first eligible, your monthly premium may go up 10% for each 12-month period you could’ve had Part B, but didn’t sign up. In most cases, you’ll have to pay this penalty each time you pay your premiums, for as long as you have Part B.”
When I came off my partner’s insurance, these were my choices:
- Stay on traditional Medicare A and/or B (Medicare pays 80%, you pay 20% of all costs - after you pay deductibles) & if wanted, pay a monthly fee for Part D (medications - also has a deductible and copays) and/or a monthly fee for a Medigap plan (Medicare supplemental insurance that covers some or all of your responsibility), or
- Temporarily turn my Medicare benefits over to a managed care Medicare Advantage Plan called Part C (this includes coverage for A & B, though there are still deductibles, copays/coinsurance, and usually medications, again w/ ded and copays).
You can make changes to your choices once a year during open enrollment Oct to Dec for the following year. There is also an open enrollment January 1–March 31 when you can switch from 1 Medicare Advantage Plan to another or switch back to traditional Medicare.
Personally, I always choose to carry Part B. It covers physician visits, outpatient therapies, and DME (medical equipment). Specialist costs are often very expensive and some include facility charges too, such as if you have a minor procedure in the office or outpatient surgery center. There is always a deductible and copays, but out-of-costs for services covered by Part B can be very expensive. Since the monthly fee for B comes out of my SS monthly deposit, I don’t make a separate payment, so I think of it as my Medicare payment.
My actual preference would be to switch from my managed care plan back to traditional Medicare. Traditional Medicare generally does not require prior authorization or many of the challenges that come with a managed care plan. I would carry:
- Part A (no monthly cost, but requires a 20% responsibility after deductibles),
- Part B (currently $170.10/month + $233 deductible and copays),
- Part D drug plan (various plans w/ different costs/month plus deductibles & copays) and,
- A Medigap plan. ( As noted above, Medigap insurance “…provides coverage for many of the co-pays and some of the co-insurance related to hospital, skilled nursing facility, home health care, ambulance, durable medical equipment, and doctor charges.” Medigap plans average $150/month).
That sounds like a lot of money (and it is for people on a fixed income), but A only covers hospitalizations and surgeries, skilled nursing facility care, home health care, and hospice care, plus lab tests and it is really not free. There are still deductibles and copays for every other item noted. Also Part A does not include medications (even if taken in the hospital if you lready take the drug at home).
I have not done the above (yet) because I am under age 65 and have Medicare because I qualify as disabled. Because of this, the cost of a Medigap plan in my state would be $400 plus dollars/month instead of the average $150/month. And, it would stay the same even after I turn 65. This is another one of those “penalties”, in this case, buying a Medigap plan before turning 65.
One other important note is that a managed care Medicare Advantage plan cost more when traveling out of your area. My current plan only covers services at the 2 hospitals in my city. If I go outside the network, they only pay 50% of costs. For those who travel full-time in a van or other vehicle, this makes quite a difference. Unfortunately, there are no plans that pay the full amount in all 50 states. Another reason for staying with traditional Medicare if you can afford it. It pays for charges at any facility that co
Some vanlife blogs mention catastrophic medical plans and travel insurance. Catastrophic plans only pay for medical emergencies and have a high deductible in order to keep the monthly rate at a reasonable cost. Some full-time nomads carry travel insurance. I am unsure how either of these would work with Medicare.