Can an indiviual opt out of Medicare, and, what would comparable coverage cost on the "free"market?

[MissMarple]

Do insurance companies even offer coverage for people over 65?

[grytpype]

1. To get Medicare you have to sign up for it and virtually everyone does.

[MissMarple]

4. Right, and I understand there are windows of opportunity in which you can change options.

But can you return to the private sector? Dick Armey seems to think he can't.

[Individualist]

2. Medicare is not mandatory, and insurance companies do offer coverage.

Some doctors don't accept Medicare.

[SmileyRose]

11. I'd like to know who does.

Everyone I know who had private insurance was told by their insurance carrier near their 65th birthday their coverage would either be changed to a supplement to Medicare or in the case of an HMO they would be required to Join Medicare C for that HMO's Senior Advantage program. I don't know of any medical insurance company in Georgia or in Michigan who offer straight up private, non subsidized insurance to seniors.

If you have the info I'd appreciate it. A couple I know is wealthy enough to afford private coverage but not wealthy enough to pay cash for everything and they want to stay out of the Medicare all together. They just feel they are wealthy enough the government should not have to subsidize their medical care -- but so far finding an insurance carrier has been a challenge.

Thanks in advance.

[laughingliberal]

3. People can opt not to sign up for Medicare

Comparable coverage, if you could even get it, for that age group with that type of unlimited coverage would surely go over $2000 per month.

[MissMarple]

5. I guess "existing conditions" would probably limit coverage opportunities.

[FarCenter]

6. Medicare Part C (aka Medicare Advantage) is essentially an opt out

of Parts A and B in order to get subsidized insurance coverage.

Because of Medicare Part C, Medicare is not strictly a "single payer" plan.

You can opt out of Medicare Part D, but you can't opt in again without paying a penalty unless you have carried private insurancet that provided credible coverage.

http://www.ssa.gov/pubs/10043.html

[FarCenter]

9. When you turn 65, the insurance companies innundate you with Medicare Advantage brochures

as well as Medicare equivalent drug plans and supplemental plans to cover things Medicare doesn't and fill the Part D "donut hole".

Stay well - otherwise figuring out health insurance will displace all other retirement hobbies.

[Warpy]

7. Rich old ex CEOs who made a killing

typically opt out of Medicare in favor of concierge physicians. People on Medicare might find themselves having to see specialists who don't accept Medicare as payment from time to time.

No one absolutely forces everyone over 65 to accept Medicare if they're wealthy enough to afford the alternatives.

However, even the rich old dudes with the concierge doctors will allow Medicare to pay their part of the bill if they have to go to the hospital.

[footinmouth]

8. I think Part A is automatic

I have the Medicare booklet right in front of me.

"If you are already getting Social Security retirement or disability benefits or railroad retirement checks, you will be contacted a few months before you become eligible and given the information you need. You will be enrolled in Medicare Parts A and B automatically. However, because you must pay a premium for Part B coverage, you have the option of turning it down."

There were a couple of situations where Medicare becomes mandatory.

"If you have coverage under a program from the Department of Defense, The Indian Health Service, Dept of Veterans Affairs or a state medical assistance program"

If he is covered under any of the above, it may be mandatory for him.

[FarCenter]

10. Not if you delay drawing Social Security until age 66 (currently "full retirement" age)

You need to sign up for Medicare about 3 months prior to turning 65 if you are not already drawing your Social Security retirement.

[footinmouth]

15. I find the whole thing rather confusing

My husband just had his appointment with SS to find out what's going on. That's why we're both reading the Medicare booklet. I'm still 5 years out so I bet it will be all changed before I enroll.

I am retired (age 60) and I'm paying my former employer for my individual coverage. I have lifetime Cobra. At 65 I will automatically be switched over to Medicare but I will be able to purchase the medigap insurance through them. I don't think I will have a choice of plans. I will be eligible to purchase whatever they offer the rest of the retirees.

My husband is sticking it out till age 63 1/2 so he can continue his plan through the 18 months of Cobra. Then the Medicare will kick in for him at age 65.

We are still confused.

[JimWis]

16. You got that right. Confusing. I turn 65 next spring. I have received

a booklet to explain Medicare. I have read it twice. I am a fairly intelligent person, an accountant by trade, and I still don't have a clue. I am trying to understand the part D, etc., how a medicare supplemental plays into it, drug coverage, arrrgg. I wonder if I can buy a book called "Medicare for Dummies".

[FarCenter]

17. It's complicated and confusing

I'm not sure about "lifetime Cobra".

But typically for early retirement with a pension and health plan, the employer will pay for part of the health insurance and the employee will pay for part via a deduction from the pension check. Maybe in your case, there is no pension, so you are paying the employer (or employer's insurance carrier) directly for the health plan.

When the retiree turns 65, the employer will assume that the retiree signs up for Medicare A&B and maybe C. At that point, the employer's health plan becomes "secondary" to Medicare. In other words, your doctor or hospital will submit claims to Medicare first since Medicare is the primary insurance. When Medicare pays only part, or denies the claim, then the doctor or hospital will submit the claim to your employer's health plan to see what more they will pay, if anything. Then the doctor or hospital bills you for the rest, (unless they have an agreement to accept the insurance carrier's payment as full payment, in which case, they adjust out the rest of the unpaid balance).

The good news, is that the cost of the employer's health plan for retirees over 65 is considerably less, since Medicare is picking up most of the bill.

If you do not apply for your Social Security retirement payments before age 65, then you need to apply for Medicare 3 months prior to reaching age 65. You will get lots of info in the mail from various insurer, etc., most of it very confusing.

Odds are you want to keep your employer's over '65 plan, but depending on how much you are paying, either another supplemental plan or a Medicare Advantage plan can be a better choice. One issue is that if you drop your COBRA, you probably can't get it back.

You also need to coordinate with your husband's medical insurance. If he only gets enough insurance to reach 65, then you may need to see whether he is covered by your employer's health plan via the 1+1 family option?

You also need to figure out the same considerations for Medicare Part D, which covers drugs.

Deciding on the age to start drawing your SS pension is another complex problem, and the optimum depends on your age, your husband's age, each of your pensions as determined by your earnings, and your spousal pension if greater than your own.

Good luck.

[footinmouth]

18. In m y case,

"lifetime" Cobra means as long as I pay my premiums I cannot be dumped. Once I fail to pay the premium or leave voluntarily, I'm on my own. I will remain part of that large group of employees and get a much better rate than I could get on my own.

I'm a former government employee. I enjoyed a fully paid family policy for the 20 years I worked there. It's a good policy, reasonable copays and 0 deductibles. Once I retired I had the option to either go onto my husband's plan or stay on my own. My former employer no longer contributes to my premiums. When I turn 65 I will be eligible for the Medicap policy issued through the same insurance company we have now.

1) Going on my husband's plan would have definitely been cheaper, however if he were to lose his job they are under no obligation to keep me insured, even if I pay.

2) Keeping my husband on my plan would have been horribly expensive and if I died, he would be out of luck.

We each opted to maintain single coverage, he, through his employer and I, through my retirement cobra.

Listening to the vocal right wing seniors out there, I guess I should be very afraid, but I'm not. What will be will be. If I need to give up anything so somebody else can be covered I'm happy to do so. I almost feel guilty having a fully paid policy for 20 years, on the taxpayers dime. It's just never been an even playing field out there, so I sure hope we can make it right.

[MissMarple]

13. In the book "Nudge", the authors say if you don't choose you are placed randomly in a plan.

There are many options but overall suitability is not taken into account In other words, there is no intelligently planned "default" plan that might cover most people more or less adequately. Then you are stuck until the next "window" to change plans.

[elleng]

14. I've changed addresses recently, and haven't yet informed SocSec.

Wonder whether they'll be able to find me!

[hedgehog]

12. My mother was a Federal employee - she was a nurse for the Veteren's

Administration. She is still covered by her Postal Worker's policy instead of Medicare. I'm not sure if my Dad is covered by her insurance or is he is on Medicare.