Courtesy George Gentry

Confused About Medicare

In the video Medicare Rights Center President Joe Baker explains why you need to sign up for Medicare Part B.

Our friend George Gentry in Atlanta made a costly discovery about his Medicare choices. He wrote, “I  just got a $1700 bill for ambulance service. My private insurance covered 70 percent but if I had Medicare Part B, it would have paid all of it. So how did I get sold on the idea that paying extra for private insurance was better?”

That’s a really good question. Many of us are confused about Medicare. Our health needs and concerns may be slightly different and every state has different insurance rules, but George’s story illustrates an issue that’s important for us all. His insurance situation is complicated because he’s a Vietnam veteran and has lingering health issues.
Courtesy George Gentry
Courtesy George Gentry

He says, “I am a 70 percent service-connected disabled vet so I need to use V.A. for things that are service connected, especially hearing aids and knee injury problems, but to do that I have to have a V.A. primary care doctor.”  Yet, he’s concerned about the quality of medical care offered by the V.A. “I don’t trust the V.A. medical care, so I also have a private primary care doctor.”

That means George has another health insurance layer. It’s a holdover from his last job for the federal government. He’s a brilliant videographer and photo journalist who set up the U.S. Fish & Wildlife Service TV Production Center for the National Conservation Training Center and trained a team of  videographers, producers and still photographers to produce education and outreach materials for the U.S. Department of the Interior and other conservation organizations.

He retired at 60 and continued the employer-based insurance he had with  MHPB, or Federal Employees Health Benefits. When he turned 65 he took Medicare Part A, but did not sign up for Part B and opted to pay for a continuation of MHPB. It worked pretty well, until recently when he discovered that he had a congenital heart defect and his medical costs started to pick up.

HOW DO YOU KNOW WHAT TO DO?

This it where it gets tricky. Decoding Medicare choices is complicated and while the Medicare website offers you a tool to try to figure out what to do, it is still a bewildering process.

Medicare experts tell us that when George turned 65, he should have signed up for Medicare B.  Joe Baker, President of Medicare Rights Center says, “A lot of people who take early retirement have the retirement coverage from their former employer and they say, ‘This is great.’ But it’s not enough. Baker is emphatic: “What they don’t realize is that when they turn 65 that coverage…becomes secondary to Medicare. You need to enroll in Medicare for primary coverage.

In addition, Barry Galkin, an insurance consultant who specializes in Medicare related issues says, “There have been cases that I’ve heard of where people who were 65 and still employed did not sign up for Part B. When they had medical issues, their insurers refused to pay anything at all because they were not signed up for Part B.”

KEY TIP

Don’t wait.  At 65 sign up for Medicare B

Going back to George-if he had  what MHPB calls its Medicare Part B Option, he would have paid nothing for the ambulance.  He can still switch over during an open enrollment period and sign on with MHPB to coordinate his Medicare Part B.  

That means he’ll have to use doctors in the MHPB network who accept Medicare. But since he is using MHPB anyway, it seems like it would work. One bad thing here, it’s likely that he’ll have to pay a penalty for signing up for Part B after 65.

Now George is not a whiner. He’s just like the rest of us. He’s trying to figure out the smartest way to get quality affordable health care.

But it’s not so easy.  He says, “I can afford the care and I’m really glad all this medical technology is available. Every time I go to the dentist and write big checks for  services or get something taken care of by a doctor, I am sooooo thankful that the service is there and that I can afford it. All that said, there is a lot of room for improvement.”

YOU MIGHT ALSO LIKE OUR OTHER STORIES ABOUT MEDICARE. 

readmore  Medicare Basics for Boomers and Everyone Else


 Boomers, Medicare Part B and Costly Mistakes

watchmore  Figuring Out Medicare Basics

readmore  Choosing Power of Attorney Tips

 

 

readmore Find out how to set up a College Savings  529 Plan for for your grandkids

 

Published by

Barbara Nevins Taylor

As the winner of 22 Emmy Awards and a slew of journalism honors and awards, I created ConsumerMojo.com to give you the straight story about complicated stuff. Tell us what you want to know and we'll get you the answers.

6 thoughts on “Confused About Medicare”

  1. MHBP paid all but about $700. So the “expert” saying after 65 Medicare is automatically primary and my MHBP is ” basically no coverage at all” seem to make it even more confusing. Vicki’s question is the same question I have been trying to answer for myself. When I passed on Medicare B at 65 it was because I thought I would be paying double premiums (Medicare and MHBP) and because of all the media coverage about how lousy Medicare was and that I couldn’t count on it. But now I’m confused about how much difference the premiums would be between choices so I don’t know if I am ahead after paying the $700. Did I save some premiums for those 5 years? For, me the bigger questions are: how did I get the idea that Medicare is lousy coverage, that my favorite dr may not accept it, it may go broke, and all the other negatives. Why does it have to be so confusing anyway? Why can’t I have a menu of plans that I can compare equal services — apples to apples? Why can’t I have a “single-payer” plan like some of my friends have in other countries/? Why am I paying more and getting less?

  2. Hopefully by bring this information and to the public’s attention, it’ll help to clarify the options available to FEHB retirees. I’d also like to note this website is a very value tool the public can use to get most if not all of their Medicare questions answers.

  3. Granted this can be a confusing situation, but I’ve found that your Medicare Interactive site clarifies and addresses the option available for retired FEHB employees very well. If those options have changed your site should be noted.

    1. Thanks Robert. The Medicare site is very good. But we do have an array of choices and instructions that are often confusing. So we’re trying to clarify things. We hope this helps.

  4. how many years was he not enrolled in Med B? did his savings in premiums, etc offset his $1700 ambulance bill?

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