Over-65 Major Medical -vs- Medicare Bundle.

AllenChicago

Guru
5000 Post Club
8,448
Requesting Feedback From My Colleagues..

I'm still getting used to the reality that a 100 year old person with no health insurance can now enroll in a regular Major Medical, just like a 50 year old. In fact, the premium for a 65 year old and a 100 year old is the same! I ran a quote at HC.gov last night for a 96 year old with $18,000 in income. His monthly premium is just $26, for a $500-DED / $2500-OOP BCBS Silver policy.

This brings up the question...COULD it be more beneficial for someone nearing age 65 to forgo enrolling in Medicare, and obtain an ObamaCare Major Medical plan instead?... Especially if their projected income qualifies for a good APTC $$ amount?

Approximately how much does it cost per month right now for a Senior who has Medicare A&B + MedSupplement + Part-D Rx coverage?

-Allen
 
Requesting Feedback From My Colleagues..

I'm still getting used to the reality that a 100 year old person with no health insurance can now enroll in a regular Major Medical, just like a 50 year old. In fact, the premium for a 65 year old and a 100 year old is the same! I ran a quote at HC.gov last night for a 96 year old with $18,000 in income. His monthly premium is just $26, for a $500-DED / $2500-OOP BCBS Silver policy.

This brings up the question...COULD it be more beneficial for someone nearing age 65 to forgo enrolling in Medicare, and obtain an ObamaCare Major Medical plan instead?... Especially if their projected income qualifies for a good APTC $$ amount?

Approximately how much does it cost per month right now for a Senior who has Medicare A&B + MedSupplement + Part-D Rx coverage?

-Allen

Dallas quote...

$105 for Part B
$137 for Plan G
$25 for Part D

But...there are way too many variables. I would say 99% of the time, its better to go Medicare.

1. Part B is income based. If they are significantly over $85K (single) or $170K (joint) that may make a difference.
2. They are going to come out ahead on medical
3. If they hit the donut hole, but not the max...then maybe. If they are some injectable. Maybe
4. There is penalty for not going on B when eligible. I don't think indy qualifies to make you NOT a late enrollee ( I need some help on the late enrollee rules. Somarco...HELP!)
 
Requesting Feedback From My Colleagues..

I'm still getting used to the reality that a 100 year old person with no health insurance can now enroll in a regular Major Medical, just like a 50 year old. In fact, the premium for a 65 year old and a 100 year old is the same! I ran a quote at HC.gov last night for a 96 year old with $18,000 in income. His monthly premium is just $26, for a $500-DED / $2500-OOP BCBS Silver policy.

This brings up the question...COULD it be more beneficial for someone nearing age 65 to forgo enrolling in Medicare, and obtain an ObamaCare Major Medical plan instead?... Especially if their projected income qualifies for a good APTC $$ amount?

Approximately how much does it cost per month right now for a Senior who has Medicare A&B + MedSupplement + Part-D Rx coverage?

-Allen


For downstate:

Female NS 65...$104.90 + $108.80(Oxford Plan F) + $15.70(Humana Walmart) =$229.40 per month.

Male NS 65......$104.90 + $122.90(Oxford Plan F) + $15.70(Humana Walmart) = $243.50 per month.


Different Plans would reduce premiums and the Medicare Supplement premiums increase each year. Plan F is the best coverage, but not the best bargain...that would be Plan N, which would run about $35-40 less per month. The Walmart plan is the cheapest Part D plan and the best buy, but won't be the best for everyone depending on their meds. Also, if they're high income the Part B premium will be higher.
 
Allen, my understanding and just looked it up you cannot qualify for a subsidy even if your are eligible for Medicare, doesn't matter if you take it or not.

If you’re eligible for government-sponsored health insurance like Medicare, Medicaid or Tricare, you won’t qualify for a subsidy. This is true even if you’re not actually enrolled in the government-sponsored health insurance. It’s your eligibility that disqualifies you for a subsidy.

----------

I had a case within the past 12 months that a couple where the wife turned 65 and immediately lost the subsidy. She was po'd because she opted out of Medicare so they could retain the very low premium's they were enjoying.
 
This brings up the question...COULD it be more beneficial for someone nearing age 65 to forgo enrolling in Medicare, and obtain an ObamaCare Major Medical plan instead?...

I seem to remember from my ACA training that you can't enroll someone into a ACA plan that's Medicare illegible.
 
Well then, it looks like my question is answered. If eligible for Medicare, you have to take it, or go uninsured. Can't even get a Limited Benefit plan as of 2015. Thanks everyone for your detailed feedback and responses!
:) -Allen
 
Back
Top