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To: Kirk © who wrote (115177)8/19/2021 12:30:16 AM
From: Rarebird
   of 116213
 
I am 5'9", 152 pounds. I use to eat a chocolate chip cookie, hershey bar and ice cream every day, along with lots of pizza, steak, potatoes and ribs. Then when I went to the doctor and found out my blood pressure was 185/110 with a heart rate of 125, I cut it all out for good.

I did a Google search for heart healthy foods and those were the foods I decided to eat for now on. I haven't cheated even once in ten years.

I work out with 12 pound dumbbells. That's a far cry from the 50 pound and 25 pound dumbbells I use to work out with in my 40s and 50s. But considering I have a torn rotator cuff ( 90%) on my right side and some neck issues ( C3 and C4 touch a bit), I can't complain. My exercises in those areas have me almost 100% free of pain and discomfit.

I am 68. Medicare is great. I chose original medicare because I like the freedom to choose the doctor I see fit and get second and third opinions without consulting with a primary care physician. Plus, we travel around and original medicare is good all over the USA. The Medicare supplement plan pays for the other 20%. I am on Plan G, which is cheaper than Plan F, and covers everything Plan F does except for the $208 deductible. It is cheaper because the monthly premium is considerably less than Plan F.

I am allergic to lots of medications so I chose a cheap generic drug plan ( Plan D) for $23 a month.

I developed a few issues since I went on Medicare, which, in a way, is good, since it saved me a lot of money.

I mention this because you say you are 64 and I take it you have given this some thought. Original medicare is more expensive than many of the 0 premium insurance plans, but well worth it if you can afford it since it provides the most freedom.

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To: Rarebird who wrote (115178)8/19/2021 10:27:02 AM
From: Kirk ©
   of 116213
 
Thanks. I put that Medicare summary into my decision file.

We have Stanford Hospital Group close by... I could walk if pushed or take the 22 bus down El Camino if too old to drive and too cheap to pay for an Uber. Hopefully I/we have a self driving car by then...

Stanford is rated I believe #12 overall in the US and they have given outstanding care to my GF's mother accepting whatever Medicare pays. We both plan to switch once on Medicare from our more affordable ACA plans.

I like the idea of having it all in one place and having a "case manager" who knows me.

I find the high deductible plans now are bad because I skip going to the Dr for "minor" things that could become worse at the worst case since why would I want to pay thousands for an MRI just to be told "RICE" is the best way to treat your minor torn rotator cuff tear or tendonitis? I will probably lean towards the HMO type plan that my GF has that leaves her free to go to the Dr for any ailment since it is just a copayment. My plan is to decide by the end of the year so I can sign up in January for my April 2022 eligibility.

So far, I don't take any prescription meds but some of my cardiologist friends say taking a low dose, generic cholesterol pill might be a good idea anyway... I think one said he takes it without having high cholesterol.

I've been negligent with COVID to do my Tue/Thur 25# dumbell curls and now my RSI wrist issues have returns so I'll have to get back at it and have started with 15# to make it less painful... I'm still old school of "no pain no gain" but I think I'm getting wiser now... like walking, it doesn't have to be painful to be beneficial.

Thanks again!

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To: Kirk © who wrote (115179)8/19/2021 2:04:07 PM
From: John Koligman
2 Recommendations   of 116213
 
Just another comment on Medicare - what Rarebird says makes sense, but my wife and I have a Humana Advantage plan. We live right outside Chicago and the plan we have includes the largest medical group in the state, which we used and liked prior to Medicare. It has a zero dollar monthly cost, and the kicker is that the plan's out of pocket max is $2650, so even if you were really sick and hit the max you still would be saving money over the $200/month for a supplemental. They also throw in 2k of yearly dental benefits, $300 for glasses, and a membership at a very nice local gym (which we enjoyed and have not used lately, for obvious reasons). So, I think it boils down to access and how many docs are in your area and are 'in network'. There are copays, you can see your primary at no cost, but a specialist visit is $25. I recently had a stress test and echocardiogram, both were $25 each out of pocket (you don't want to know what the provider billed though <ng>).

If the Biden plan passes they are talking about adding the dental/vision/hearing benefits to regular medicare, so that would be a plus, but my assumption is that perhaps the Advantage plans would then increase them.

Also, there are a whole range of Advantage plans out there, the HMO types generally are low/no cost with lower out of pocket max amounts, and the PPO types are more expensive with higher out of pocket max amounts.

John

Edit - One VERY important thing I forgot to mention is you need to carefully research the ability to switch from regular Medicare to an Advantage plan and vice versa in your state. The general rule is you have a year to pick a type of plan and then switch from one type of Medicare to another. After that, you might be subject to 'pre-existing' condition checks by an issuer of a Medicare supplemental plan if you decide to switch from an Advantage plan back to regular Medicare.

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To: John Koligman who wrote (115180)8/19/2021 2:33:31 PM
From: Kirk ©
   of 116213
 
Thanks for the info. I like having the added funds for health clubs, dentist and vision. I think it is because those "all in one" plans save a lot of costs to overhead so they entice us with extras that help keep us even more healthy. My list of questions for my decision include can I get the insurance for my current dentist who won't take my $100 per year Costco plan any more as they lose too much money on me... and can I get $ for swimming at the Elks Club and yoga classes at my local 24hr fitness when I'm up for returning to indoor workouts without masks.

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To: Kirk © who wrote (115181)8/19/2021 2:55:35 PM
From: John Koligman
1 Recommendation   of 116213
 
The other thing I noticed is that some groups are 'transitioning' their primary care physicians to patients with Advantage plans only. They claim the care will take more time and be more 'comprehensive', hence the change. My cynical side says maybe it is also due to money/reimbursement advantages, but thought I'd mention it. Here is part of a letter our group sent my wife, as her primary care physician is included in the move.


"Our New, Com­pre­hen­sive Pri­ma­ry Care Ini­tia­tive for Medicare Advan­tage PatientsAt DuPage Med­ical Group our physi­cians and asso­ciates are com­mit­ted to pro­vid­ing our patients with the high­est qual­i­ty health care. We con­tin­u­ous­ly seek new ways in which we can enhance patient care and their over­all patient expe­ri­ence. DuPage Med­ical Group is excit­ed to announce our new – Com­pre­hen­sive Pri­ma­ry Care Ini­tia­tive for Medicare Advan­tage patients.

This Ini­tia­tive will allow a select num­ber of DMG Pri­ma­ry Care Physi­cians (list­ed below) to tran­si­tion their Medicare (Age 65+) prac­tices to the more com­pre­hen­sive patient and well­ness focused care mod­els pro­mot­ed by cer­tain Medicare Advan­tage plans. Effec­tive Jan­u­ary 1, 2021, and due to the addi­tion­al demands on their time that this Ini­tia­tive will require, those select Physi­cians will only con­tin­ue to serve as a pri­ma­ry care physi­cian to those Medicare-eli­gi­ble patients which are enrolled in the Medicare Advan­tage plans they par­tic­i­pate in. They will no longer con­tin­ue see­ing pri­ma­ry care patients with tra­di­tion­al Medicare insurance.

Medicare Advan­tage plans typ­i­cal­ly pro­vide addi­tion­al ben­e­fits not avail­able under tra­di­tion­al Medicare. These plans may also pro­vide ben­e­fits that address patients’ social and envi­ron­men­tal needs as well. Patients impact­ed by this change should have received a let­ter from their pri­ma­ry care physi­cian advis­ing of this change and spec­i­fy­ing the Medicare Advan­tage plans they par­tic­i­pate in. More infor­ma­tion as to par­tic­u­lar plan ben­e­fits may be obtained by con­tact­ing a licensed and inde­pen­dent insur­ance agent, if you do not have an agent we have part­nered with agents who can help. They can be reached at 855-429-1086 for a no oblig­a­tion Medicare ben­e­fit plan review. Their goal is to help our patients find the best plan that fits their indi­vid­ual health­care needs.

All physi­cians will con­tin­ue to accept patients with Com­mer­cial insur­ance plans that are cur­rent­ly accept­ed by DMG. Please refer to the Insur­ance infor­ma­tion page in the Resources sec­tion of our site for a list of DMG accept­ed Insur­ance Plans."

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To: John Koligman who wrote (115182)8/19/2021 3:28:08 PM
From: Kirk ©
   of 116213
 
I think your cynical side is correct but if you have the MA plans, then it is good news since they won't have to spend as much time on insurance issues.

I long thought Medicare should change to a "whole health per person" deal where the government pays a certain amount per subscriber (Medicare adult) then it is up to the hospital to figure out how to care for the person then prevent them from all merging so you have choices to keep them competing for RESULTS.

But it really needs this as a single payer system that starts when you turn 18 and spends the money up front to keep people healthy so they are not already basket cases by the time they reach 65.

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To: John Koligman who wrote (115180)8/20/2021 4:21:30 PM
From: Rarebird
   of 116213
 
My supplemental Plan G plan with Aetna costs me $143 a month. The problem with these plans are that there are 8-10% rate increases per year. I was with Cigna Plan G for 3 years and switched out to Aetna Plan to save $50 per month. Same benefits for both. So, in a way, it is like trading.

What I don't like about the Medicare advantage plans is that G-d forbid you get unexpectedly sick and are out of your home area, you better be careful what hospital or doctor you see because if it is not in network, you will get charged a fortune.

If you plan on staying put in your home area, then medicare advantage is worth it if your network is composed of top doctors and hospitals.

I understand in cases of emergency the extra fees are waived. But that can be a debatable point outside of sudden heart attacks and epileptic seizures.

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To: Kirk © who wrote (115181)8/20/2021 4:31:16 PM
From: Rarebird
   of 116213
 
The Dental insurance I have in my Plan G supplemental Plan is basic and does not include periodontal cleanings, which I need and have seperate insurance for.

As for gym memberships, that is a bit overrated as it only costs $10 a month for a good gym membership in Las Vegas. I had that gym membership with Cigna Plan G for $25 a year. But Aetna and the other providers dropped that this year ( and some the year before).

You make a good case for being on a Medicare Advantage plan. But just make sure you stay put in your local network and don't get sick if you are travelling outside your local network. If you do, you will be charged a small fortune, outside of what is considered an emergency.

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From: Rarebird8/20/2021 4:40:54 PM
1 Recommendation   of 116213
 
GDXJ with a close below $40 for the week. I expect more follow through to the downside next week, with an initial strong bounce at the 200-SMA.

Gold miners are good for a huge 7 month rally every 4 years. Otherwise, they are a short sellers dream, as close to a sell and hold as you get.

Interesting that the Gold bugs still dream about the Miners rallying while the broad market tanks. That happens after the Fed stops tightening and the first of a long series of rate cuts is anticipated.

MSFT and AAPL are the real safe havens today, not the Gold Miners


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To: Rarebird who wrote (115184)8/20/2021 6:05:10 PM
From: John Koligman
1 Recommendation   of 116213
 
As with most of American healthcare, Medicare is probably more complex than it needs to be, and I often wonder how many folks really know their exposure and the potential 'gotchas' in the system. That said, the monthly cost for a supplemental around here would have been close to $400/month for my wife and I, so I figure we are saving around $4500 on those, throw in $600 a year for glasses that we both need, a grand or so for dental, and $600 for a nice gym membership and I figure we are ahead almost 7k a year. Last year due to Covid we really didn't go to the doctor much at all, this year the savings will be a bit less as we have been going, although the costs are really low. I had a bunch of expensive tests and co pays were $25 each. I don't think emergency care is a problem, the plans will cover it outside your area if needed. If you live in multiple places regular medicare would generally be the ticket, I have not looked into the possibility that some Advantage plans may cover more one locale. The one biggie people need to be aware of is that it is easy to switch from regular medicare to an Advantage plan, but after the first year it may not be so easy to switch back depending on where you live, as you may be subject to medical underwriting when buying a supplemental.

One thing that was 'music to my ears' is that my plan does not allow 'balance billing', that may also be the case for all medicare, I am not sure. I see that Congress has finally gotten around to fixing that glaring hole in our medical system. It's disheartening that one could do as much homework as possible, go in for a procedure, and face large surprise bill anyway because the hospital uses an out of network doctor on the team performing the operation. Anesthesiology is the specialty that seems to pop up most often in these cases.

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