Tom, we've had Humana for several years and been satisfied with them. We have no problem finding doctors that are covered by the plan and even when we've gone out of the network, it hasn't been that expensive. And since our meds are all available in generic form there have been 0 costs for them when we get them through RightSource, the Humana pharmacy.
Medicare insurance & supplemental plans
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Tom
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Thanks Ned. I was thinking of Humana only for prescription coverage. Blue Shield hasn't said anything about the supplemental coverage. Unfortunately, only one of my meds is available as generic, so I look at the deductibles and coverage in the donut hole. Reminds me, I need to check Humana's formulary.
Plan C is Algodones or a Canadian pharmacy.
Plan C is Algodones or a Canadian pharmacy.
Rancher Will
Well-known member
Just be thankful that you all are only having to consider your personal plan.
As an Employer, even my Accounting Firm is having a hard time destermining how and what I will need to do to comply with the new Federal Health Insurance Regulations under the new laws and still be profitable for our business.
As it stand now, we are leaning toward dropping all of our Insurance plans that I have provided for our employees and informing the employees for them to sign up for their individual options.
The decision is not yet made since by dropping our Employees Group Policy that I have always paid, I could save, up front, almost $250,000, less any penalty to the government which could be up to $2,000 per employee, based on our preliminary figures. This would save me about $200,000, Net, after paying the penalty on the surface. However, in order to be fair with my employees, I intend to make up as much of the difference as possible by adjusting the employees total compensation, if possible, so that they do not take a bad hit fiancially.
My accounting firm is still working it out and we hope to make a decision as soon as possible. We also do not want to make a decision that we will be locked into if the regulations and law changes, which we hope, after the next election in November.
If it was only my own personal insurance it would be simple.
By the way, we have already been notified that our 2013 group premiums will be raised about 15 percent from 2012.
As an Employer, even my Accounting Firm is having a hard time destermining how and what I will need to do to comply with the new Federal Health Insurance Regulations under the new laws and still be profitable for our business.
As it stand now, we are leaning toward dropping all of our Insurance plans that I have provided for our employees and informing the employees for them to sign up for their individual options.
The decision is not yet made since by dropping our Employees Group Policy that I have always paid, I could save, up front, almost $250,000, less any penalty to the government which could be up to $2,000 per employee, based on our preliminary figures. This would save me about $200,000, Net, after paying the penalty on the surface. However, in order to be fair with my employees, I intend to make up as much of the difference as possible by adjusting the employees total compensation, if possible, so that they do not take a bad hit fiancially.
My accounting firm is still working it out and we hope to make a decision as soon as possible. We also do not want to make a decision that we will be locked into if the regulations and law changes, which we hope, after the next election in November.
If it was only my own personal insurance it would be simple.
By the way, we have already been notified that our 2013 group premiums will be raised about 15 percent from 2012.
Jim Godward
Well-known member
Pat's medical insurance was going to convert everyone to the Medicare supplement of their choice and pay them $200/month each for them and their spouse. That whole thing is on hold for another year because of all the changes.
The good news is we keep what we have and only pay $200 total for better coverage than a supplemental plan would provide - at least the ones we looked at, Plan F, etc.
The good news is we keep what we have and only pay $200 total for better coverage than a supplemental plan would provide - at least the ones we looked at, Plan F, etc.
BernieD
Well-known member
I just received our Statement of Benefits and Changes in Coverage from our Medicare Advantage provider. Other than a merger with Blue Cross/Blue Shield of Arizona, which may explain the one increase explained next, everything stayed the same or improved except for an increase in the daily/total hospital copay. The improvements were due to the Obamacare required services and the prescription formulary was expanded. Everything that I take is a $12 copay for 90 day supply.
Rancher Will
Well-known member
I hesitate to write this for the reason that I doubt that it is typical. However, I believe it may illustrate the cost of the Political complications of a government medical program, specifically Medicare and Obmacare. Perhaps others may be able to use some ideas.
My wife and I have a Medical Savings Account for our health insurance. It is a savings account that I initiated, through our accounting department, starting in 1961. I pay no insurance premiums.
This year my wife underwent knee replacement. Prior to the surgery and recovery, I visited the doctor, hospital and ReHab Center to discuss our payment system, informing them that since my wife was not covered under Medicare (she is in her 70's) and since we were prepared to pay cash for all costs, I wanted to negotiate the involved costs.
In our discussions it was pointed out that in our situation neither the doctor's staff, nor the hospital staff, or ReHab staff would be required to be involved in Medicare techicalities, Insurance Company requirements, or any government paperwork. Only a statement of amount would be provided to me at each step in the procedure and would pay upon receipt of the bill.
Two weeks ago I visited the Doctor and the hospital finance manager. My wife has completed all of her Rehab visits and all bills were paid by me. Both the Doctor and Hospital person informed me that by my paying cash for all costs, both doctor and hospital received more net income than they would have received had Medicare been involved. And, both informed me that the amount that I paid was less than most Supplement Insurance with Medicare premiums would have cost me. The difference, the amount discounted for cash, was that costs that the doctor and hospital did not have to endure with the details required with Medicare/Insurance.
It was just much simpler and cost effective for the doctor and hospital to just bill me personally rather complete all the record/paper work for complications. And they received payment without the delay at each step of the process. I just wrote the checks at each step at checkout with no delay for payment.
Actually this worked out just about like other purchases that I make for my business. By negotiating a cash price in advance, I usually save costs.
I do believe that even while we hear many complaints about insurance companies, if Health Insurance was permitted to be competitive, perhaps more like property, casualty, auto and other insurance, Medical Providers, Health Insurance Companies, and customers, all would realize savings and the system would be much more simple. I have always believed in the Principle, "KISS".
My wife and I have a Medical Savings Account for our health insurance. It is a savings account that I initiated, through our accounting department, starting in 1961. I pay no insurance premiums.
This year my wife underwent knee replacement. Prior to the surgery and recovery, I visited the doctor, hospital and ReHab Center to discuss our payment system, informing them that since my wife was not covered under Medicare (she is in her 70's) and since we were prepared to pay cash for all costs, I wanted to negotiate the involved costs.
In our discussions it was pointed out that in our situation neither the doctor's staff, nor the hospital staff, or ReHab staff would be required to be involved in Medicare techicalities, Insurance Company requirements, or any government paperwork. Only a statement of amount would be provided to me at each step in the procedure and would pay upon receipt of the bill.
Two weeks ago I visited the Doctor and the hospital finance manager. My wife has completed all of her Rehab visits and all bills were paid by me. Both the Doctor and Hospital person informed me that by my paying cash for all costs, both doctor and hospital received more net income than they would have received had Medicare been involved. And, both informed me that the amount that I paid was less than most Supplement Insurance with Medicare premiums would have cost me. The difference, the amount discounted for cash, was that costs that the doctor and hospital did not have to endure with the details required with Medicare/Insurance.
It was just much simpler and cost effective for the doctor and hospital to just bill me personally rather complete all the record/paper work for complications. And they received payment without the delay at each step of the process. I just wrote the checks at each step at checkout with no delay for payment.
Actually this worked out just about like other purchases that I make for my business. By negotiating a cash price in advance, I usually save costs.
I do believe that even while we hear many complaints about insurance companies, if Health Insurance was permitted to be competitive, perhaps more like property, casualty, auto and other insurance, Medical Providers, Health Insurance Companies, and customers, all would realize savings and the system would be much more simple. I have always believed in the Principle, "KISS".
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Tom
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Interesting Will.
I had relatively simple surgery during a period when I had no insurance and was not eligible for Medicare. The hospital required that I pay up front, which I did. Actually, they gave me the option of a payment plan or cash up front, and I chose cash.
Just for clarification ... Medicare and Supplemental currrently cost me a little over $200/ month, approx $2,500/year, and it would have taken several years of premiums to equal what I paid the hospital. How many months/years of premiums did you save?
I had relatively simple surgery during a period when I had no insurance and was not eligible for Medicare. The hospital required that I pay up front, which I did. Actually, they gave me the option of a payment plan or cash up front, and I chose cash.
Just for clarification ... Medicare and Supplemental currrently cost me a little over $200/ month, approx $2,500/year, and it would have taken several years of premiums to equal what I paid the hospital. How many months/years of premiums did you save?
garyb1st
Well-known member
Will, Don't know much about Medical Savings Accounts, but suspect the fact that you were able to establish one in 1961 goes along way toward explaining its current benefit to you. My guess is the vast majority of workers who were not covered by a group health insurance policy probably didn't have the cash to put into a MSA. The few that could, may not have known of their existence. Even if they did, they may not have had your foresight and perseverance to put money in the bank and forego some of the many tempting opportunities life has to offer. Like being able to drive a new car, or simply take another vacation in the Bahamas.
Regardless, I doubt the current state of the health care industry would be much different if they were. I believe the major cost drivers of the health care industry are salaries, corporate profits, over testing due to a fear of misdiagnosed illness/disease and the resultant expensive litigation that frequently follows. Then there's one that doesn't get a lot of attention. Procurement.
Personally I believe our procurement process is so out of whack that it may be beyond repair. And I'm not only talking about health care but big business and government. There's simply not enough oversight and accountability. It's been that way for a long time. The government tries to address it with something called Fraud, Waste and Abuse. It doesn't work. Too many layers. Too many people with the pen. I retired from a Fortune 100 company. Before that I worked for the largest insurance broker in the world. It doesn't work there either.
Will, I really don't know anything about you or how many employees you have. But obviously you've been successful. Do you think you would have been as successful if you turned over the pen to your employees who have no interest in the viability and longevity of your ranch?
Now let me finish by way of a few example:
In 2008 a nurse in the California prison system made $331,346. That included $211,257 in overtime because the state had no budget for more nurses. She wasn't alone. A total of 42 state nurses made more than $1 million in a six year period. I know, where do I sing up.
Then there's the guy who paid him self more than $1,000,000 as city manager of one of the poorer cities in the L.A. area. He and 7 of his buddies are looking at some serious prison time. They shouldn't. They should have been booted from office long before that happened.
Another example of out of control administrators are the morons who allowed the city to construct a high school that cost $578 million to build. It's the Robert F. Kennedy Community Schools. Actually is a complex of public schools. The AP dubbed it the Taj Mahal. This all occurring while thousands of teachers were being laid off.
These are just a few examples of how extravagant, creative and ineffective people can be when spending someone else's money.
Regardless, I doubt the current state of the health care industry would be much different if they were. I believe the major cost drivers of the health care industry are salaries, corporate profits, over testing due to a fear of misdiagnosed illness/disease and the resultant expensive litigation that frequently follows. Then there's one that doesn't get a lot of attention. Procurement.
Personally I believe our procurement process is so out of whack that it may be beyond repair. And I'm not only talking about health care but big business and government. There's simply not enough oversight and accountability. It's been that way for a long time. The government tries to address it with something called Fraud, Waste and Abuse. It doesn't work. Too many layers. Too many people with the pen. I retired from a Fortune 100 company. Before that I worked for the largest insurance broker in the world. It doesn't work there either.
Will, I really don't know anything about you or how many employees you have. But obviously you've been successful. Do you think you would have been as successful if you turned over the pen to your employees who have no interest in the viability and longevity of your ranch?
Now let me finish by way of a few example:
In 2008 a nurse in the California prison system made $331,346. That included $211,257 in overtime because the state had no budget for more nurses. She wasn't alone. A total of 42 state nurses made more than $1 million in a six year period. I know, where do I sing up.
Then there's the guy who paid him self more than $1,000,000 as city manager of one of the poorer cities in the L.A. area. He and 7 of his buddies are looking at some serious prison time. They shouldn't. They should have been booted from office long before that happened.
Another example of out of control administrators are the morons who allowed the city to construct a high school that cost $578 million to build. It's the Robert F. Kennedy Community Schools. Actually is a complex of public schools. The AP dubbed it the Taj Mahal. This all occurring while thousands of teachers were being laid off.
These are just a few examples of how extravagant, creative and ineffective people can be when spending someone else's money.
Jim Godward
Well-known member
To go along with Gary's story, a friend of mine needed a MRI, he is self insured and started asking prices at the local hospital and Imaging center. After hearing the prices, he started looking elsewhere. Now remember he is paying cash. One of the places about 150 miles way blew him out the door with a quote of $900. This compare with the $2400 locally. It costs about $100 roundtrip for gas and meals, guess what he did.
Arrogance and we have a captive customer base enters into the equation as well.
Arrogance and we have a captive customer base enters into the equation as well.
Ernie Ekberg
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So, here I am, going to be 65 next month. Received my notice from SS stating they will be taking $98 out of my SS check each month for Medicare. I don't take any medication, and have no prescriptions. I guess, since I'm still working like a dog, I'm still healthy. Do I need this supplement for something I don't need?
garyb1st
Well-known member
Ernie, my DW was out jogging in March. As she was heading back to the house, quite exhausted, she tripped on a sidewalk that was uplifted by large roots. Long story short. She fell and broke her shoulder. Lots of pain and two surgeries to fix the shoulder and remove the metal plate and screws and she's still going to therapy. She's younger than you. Lots younger. Pay the $98.00.
Ernie Ekberg said:
No Ernie, you don't need it for something you don't need. You need it for things that you don't know of, that you might need. Also, since you don't take any meds, you might be tempted to NOT pay for Part-D (prescription coverage). Remember that if you don't elect Part-D when first eligible, you will pay a higher premium later when you do/may need it. Also, remember that under "Obama Care" the currently popular and affordable "Medicare Advantage" programs will be discontinued, and your only option to improve on Medicare care, will be the more costly 'Medicare supplements'.
Growing old has been a blast, being old sucks......
Rancher Will
Well-known member
Tom, as I mentioned, after I settled the final payment, the Hospital employee in the finance office informed me of what I mentioned. Her statement to me was based on her belief that anyone on Medicare would have had about $1200 premiums paid by deduction from that person's Social Security check over the past year. By way of a round number, the same person told me that she pays "over $300 per month for her share of her group medical insurance provided by her employer (the hospital)" deducted from her salary. Obviously, I didn't ask her what coverage she had for her medical insurance.
My total cost for my wife's knees replacement, 2 days in the hospital, 4 days in the recovery/rehab center, and 8 weeks rehab for 3 days per week, was $2,285. I paid one payment to the Orthopedic Center for the Surgery, another payment for 2 days in the hospital after the surgery, another payment after the 4 days in the recovery/rehab center to that center, and one payment each week of the last 8 weeks of rehab in the Orthopedic Center. So altogether I wrote 11 checks in payment for the whole bill. As I mentioned, I had negotiated the rate prior to the surgery based on anticipated expenses and payment by cash payment at completion of service.
I did not mention, but to be accurate, I did also purchase "walker", a cane, an exercise ball, and some ice packs at the Walgeens Drug store for my wife use after the surgery. The cost of these was only a few dollars, less than $125.
As rancher and trucking business owner my accounting firm steered me onto a Medical Savings account. I had never heard of such a thing before that time. Since my ranching business receives income basically once per year, when we sell feeder calves, I have always deposited what I could afford into that account each year. Since the account is invested with an investment firm in Denver, over the past number of years, the earnings from that investment has also added to the Medical Saving Account so that it is now sizeable. Over the past few years the investment earnings have deposited more earnings than I have deposited from my Ranch/trucking business.
My total cost for my wife's knees replacement, 2 days in the hospital, 4 days in the recovery/rehab center, and 8 weeks rehab for 3 days per week, was $2,285. I paid one payment to the Orthopedic Center for the Surgery, another payment for 2 days in the hospital after the surgery, another payment after the 4 days in the recovery/rehab center to that center, and one payment each week of the last 8 weeks of rehab in the Orthopedic Center. So altogether I wrote 11 checks in payment for the whole bill. As I mentioned, I had negotiated the rate prior to the surgery based on anticipated expenses and payment by cash payment at completion of service.
I did not mention, but to be accurate, I did also purchase "walker", a cane, an exercise ball, and some ice packs at the Walgeens Drug store for my wife use after the surgery. The cost of these was only a few dollars, less than $125.
As rancher and trucking business owner my accounting firm steered me onto a Medical Savings account. I had never heard of such a thing before that time. Since my ranching business receives income basically once per year, when we sell feeder calves, I have always deposited what I could afford into that account each year. Since the account is invested with an investment firm in Denver, over the past number of years, the earnings from that investment has also added to the Medical Saving Account so that it is now sizeable. Over the past few years the investment earnings have deposited more earnings than I have deposited from my Ranch/trucking business.
Rancher Will
Well-known member
Garyb1st, I have 9 full time truck drivers, one full time mechanic, one office manager, and on my two ranches I have One Ranch Manager on each plus 8 full time ranch employees. Until two years ago I also employed 6 part-time ranch employees. Economic times convinced me to stop employing part time employees and I adjusted our work schedules and some machinery changes to save costs. I also employ an accounting firm in Denver.
This past year I have changed my marketing system to make use of Superior Video Auctions for most of our cattle sales. My Semi Trucks are all contracted to haul products of three different businesses.
This past year I have changed my marketing system to make use of Superior Video Auctions for most of our cattle sales. My Semi Trucks are all contracted to haul products of three different businesses.
Tom and Margi
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Ernie Ekberg said:
My Medicare kicked in at age 65 while we were in Alabama working and exactly three days later I had a stroke. It was mild. That "mildness" was determined after many, many expensive tests and walking with a cane for a short time. Medicare doesn't even begin to cover everything you might need in an emergency.
My answer to your question would be: Yes. Unless you're independently wealthy, you do need a supplement for those times when things that have always happened to other people suddenly happen to you.
The Medicare "D" drug coverage is another issue completely and should be addressed separately.
Margi
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Tom
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Thanks for the explanation Will.
I recall the option to participate in medical savings plans at various employers, but they seemed to work different from yours. As a result, I didn't participate in any of them.
I recall the option to participate in medical savings plans at various employers, but they seemed to work different from yours. As a result, I didn't participate in any of them.
P
PatrioticStabilist
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I got on medicare for about 6 months while Tom was between projects, my premiums were over $330 a month so soon as he went back to work I picked up his insurance again. They had carried him between jobs, we kept asking and no answer so were trying to find out if we had to get COBRA. Sometimes they carry him sometimes they don't, such consistency! I checked with medicare to make sure my premiums wouldn't be jacked up annually. Long as I produce a letter of credible coverage that we have been continually covered they won't. Our problem is for the last year he works we will be means tested as to his salary the prior year. Once we can show that our income is reduced the premiums will come down. I never realized they even had this when I applied. And I took the supplement and part D.
Our premiums for his insurance is $197 a month with a $3k deductible and its good anywhere in the world, its called BUPA, but in the US United Healthcare. Really really lowered the premiums that way and well woman and other things are covered and not subject to the $3k part. So far so good. I hope it all works out when we transition over to medicare.
Our premiums for his insurance is $197 a month with a $3k deductible and its good anywhere in the world, its called BUPA, but in the US United Healthcare. Really really lowered the premiums that way and well woman and other things are covered and not subject to the $3k part. So far so good. I hope it all works out when we transition over to medicare.
The window between my COBRA coverage and Medicare was 12 months for me and 24 for Sue. During that time we had a $10,000 deductible that we didn't come close to meeting. The first time we paid for care with cash assuming that we would accumulate the deductible receipts in case we met the deductible.
When I checked with the Insurance company they recommended running all claims through them to get their discounts. We did that and the cost for almost all care dropped 40%. You cannot afford to self insure.
When I checked with the Insurance company they recommended running all claims through them to get their discounts. We did that and the cost for almost all care dropped 40%. You cannot afford to self insure.
BernieD
Well-known member
Ernie Ekberg said:
Ernie
I believe that if you don't sign up for Medicare when you turn 65, the monthly premium will increase for each year you wait until you do unless you are covered by an equivalent plan during the interim. You don't wait to take out car insurance until you have an accident.
Not A Clue
Well-known member
BernieD said:
I will be 65 next year also. I believe that three months before you are 65 you are supposed to sign up for Medicare, but if you are still working full time, as I will be, you just sign up for Part A. Part A doesn't have a deductible. I will not be drawing SS yet. I am not planning on retiring until I am 68, but starting to draw SS at 66, full retirement, and at that time I will add the necessary coverage. If I am off base here, please let me know.
