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Because they need you to buy into the plan while your NOT taking drugs so that you can keep the plan stable for those that take TONS of medications. If you're "lucky" you'll end up needing lots of expensive drugs so you get back what you paid in. This how these types of programs work and exist.
Half right. If you are LUCKY you will never need all kinds of expensive drugs. Health is priceless. And yes, this is how insurance works - private or public.
You have home owners insurance, I presume. Do you home your house burns to the ground so you can "get your money's worth"?
Half right. If you are LUCKY you will never need all kinds of expensive drugs. Health is priceless. And yes, this is how insurance works - private or public.
You have home owners insurance, I presume. Do you home your house burns to the ground so you can "get your money's worth"?
I was being sarcastic, which is why I put "lucky" in quotes. Guess I should have put the /sarcasm word in for those that are literal. Sheesh.
10-years into retirement, my wife and I still take very little in the way of prescription drugs - OTOH, we are taking more now than 5-10-years ago, plus prescription drug price increases are outrageous! Without her Medicare RX supplemental plan and my Medicare Advantage RX plan, we could be paying much more. (I'm not taking anything now, but, in the past, my tier 1/2 prescriptions have even been "free.")
So, even though we still don't take many prescriptions, I'm hanging onto the coverage we've got. For the same reasons, I'm also keeping our LTC insurance, Life insurance, Homeowner's Insurance, Auto Insurance, etc. ... even though we've barely collected anything on any of them.
So which part D plan to choose for someone who doesn’t take Rx drugs now? The cheap plan that covers common drugs but not the expensive stuff needed for cancer or transplants, or the Cadillac plan that covers everything at a much higher premium?
Others tell me it’s OK to roll the dice and get a cheap plan, then upgrade as needed once a year. Some cancer chemo is around $30K/session, and that could really hurt financially if the need arose between enrollment periods.
If you dont take meds now, pick a plan with a high deductible. That should be the cheapest. If/when you need expensive drugs, you only pay up to the deductible amount. The next year, get a better plan with a lower deductible.
Addressing several questions and (mis)information in this thread:
For 2020, The HIGHEST deductible allowed for Part D is $435 per year. The national average Part D deductible is $308. Yes, you can find zero deductible plans, but I'd guess the higher premiums would not make that a better financial decision.
Anyone who really needs/desires a zero deductible should consider a Medicare Advantage program.
The penalty for late enrollment in Part D The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage. Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($32.74 in 2020) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium. (Imho it's nuts not to get the Part D as soon as you lack other coverage - like an employer plan.)
If SS is taking your Part D premiums out of your SS check, YOU voluntarily elected to do that. You should call them and have it fixed. (An exception may exists if your tax return shows a high income - very high - and you fall into IRRMA.) I'm suspicious that the deduction your seeing is actually your Part B premium.
Last edited by Jkgourmet; 01-04-2020 at 06:26 AM..
If SS is taking your Part D premiums out of your SS check, YOU voluntarily elected to do that. You should call them and have it fixed. (An exception may exists if your tax return shows a high income - very high - and you fall into IRRMA.) I'm suspicious that the deduction your seeing is actually your Part B premium.
One caveat on this: in addition to convenience, there's another advantage to having premiums taken out of your SS payment. In years when the increase in premiums is greater than your SS COLA increase, the "hold harmless" provision (I hate that term because it has another meaning in legal circles but that's what it's called) means that your net SS check will not decrease. If, for example, your B and Prescription plan premiums increase by $50/month and your SS COLA increase is $30/month your SS payment net of insurance premiums will stay level. It won't decrease by $20.
This provision does not apply if your pay your B and Prescription plans separately or if you're subject to IRMAA.
And, another answer to the OP: it's to keep people from gaming the system by not buying coverage till they get an expensive prescription. It would be far more expensive if only people with expensive prescriptions bought coverage. It's the same reason you can't buy windstorm insurance when a hurricane is headed for your Zip code!
It's insurance, just like homeowner's, or fire, or renters insurance that you buy in case there is a need. You have to pay into a policy in order to get a benefit when needed.
Just like you can't get fire insurance after the house is on fire.
Excellent analogy.
Quote:
Originally Posted by orngkat
The one we went with is very inexpensive but still feels like ransom when you don't need it - yet.
Your argument is inane. Reread the above post from reed. Another example would be you wanting to wait until you were actually involved in a car accident before purchasing auto insurance.
Quote:
Originally Posted by organic_donna
I think part B pays for chemotherapy.
It depends on the setting. Part B covers chemo if you have it infused as an outpatient. However, if you are an inpatient in a hospital (as I was when I had my six 24hr/day week-long infusions), then Part A covers the cost of the chemo.
The one we went with is very inexpensive but still feels like ransom when you don't need it - yet. Plus, they are taking it out of SS without our permission which seems illegal.
This feeling of ransom is something you made up in your mind. All insurance is based on the same concept. Why get bent out of shape for a safety net you may need one day. Just get over it.
And then they should consider what might happen if they become seriously ill and the Advantage program puts them on step therapy.
The guy I'm dating works the state hotline for Medicare beneficiaries. He gets a lot of calls from people wanting to get out of Medicare Advantage. It's worked well for a few people I know but when my Dad signed up for it after aggressive selling by some agent, he was unhappy almost immediately. Fortunately it was early in 2019 and he was able to switch back to traditional Medicare.
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