Medicare as a Nomad in 2024

[RvNaut]

My time has come and I will be enroilled in the system soon. I have the opportunity to choose various paths and would like to hear from fellow nomads and thier experiences. My residence is South Dakota ( which may not be the best in some ways) and I assume that in a year or three I will likely move it to NV or AZ, and possibly CA for the health iIns

What is your experience with In-Network versus Open plans? Seems to me that moving around would not work well with In-Network...???

My ssi last year was around 16k.... are there effective programs that help with the cost of supplemental programs??

Did you move States while covered? How much of a PITA was that? I understand that coverage changes from State to State.

Any other thoughts?

 

[bullfrog !]

Find a SHIP organization person to help you. Do it quickly as there are time limits and preexisting conditions like even high blood pressure become a reason to reject you after a few months and the other options limit your coverage. There are nationwide programs. Read some of the previous threads here but realize sometimes things change. In my opinion original Medicare with supplemental to cover additional costs is the way to go but like I said there are time limits until preexisting conditions prevent you from getting coverage so do not hesitate.

 

[Morgana]

What Bullfrog said. Don't try to sort this out on your own and don't rely on individual opinions and experiences when there's trained expert help available for free. There are too many moving parts to this thing and as B. said too many consequences for picking the "wrong" option. Good luck!

 

[maki2]

I joined AARP so I could get the Medicare advantage plan from United Health Care. That does give me nationwide coverage at a substantial discount but you need to keep your AARP membership active to get that ongoing discount. The payoff is there on this one for joint and ketoingnip sn AARP membership. United Health Care does have supplemented programs that they coordinate with for qualified low income individuals. You may or not qualify as low income. There is an income limit and you can look that up online today from a .gov website. Be very sure you also apply in advance of when you turn 65 for the part D prescription coverage from Medicare , it is NOT an automatic enrollment. You apply for all of these things just before you turn 65. When the deadline is for applying for part D coverage and how you apply is also on the dot gov website. You can diectly talk on the phone with agents at places such as United Healthcare and also request to get that information mailed to you. Just be sure to request to be put on their do not mail list for affliatevoffers. The same thing holds true for AARP, immediately request to get put on their “do not mail list” or your junk mail will substantially increase. Insurance companies are also vile offenders for selling your address to so called “affiliate” companies. .

For some Medicare benefits such as the free initial health exam and the annual free wellness check ups you must get them from your designated primary care physician. You can look up on the internet what those annual wellness test are. They work nicely for getting ongoing prescriptions renewed. Checks for colon cancer, diabetes, etc and a chance to discuss any new issues and changes such as a mole beginning to look suspicious. Rural health care locations have higher Medical insurance cost rates than larger urban areas have. So get medical insurance quotes when deciding on a domicile location because it could impact your budget, sometimes significantly.

 

[RvNaut]

Yes... I undersand that it is complicated... but.. please answer the questions if you can.

How does being a nomad affect my decision?

I don;t have a "primary care doc".. haven't been to a doc in 20+ years... I have lived hand to mouth for a long time no things like insurance and dental care and doctors weren't an option... I was hoping Medicare would giove me some basics, but appears to be only good for finding out what may be wrong, ... but where does the money come from if I do have mdical needs.... anyway.. I am rambling....

I have the basics of when and how.. I need deeper information RE going solo or netwrk... etc...

 

[maki2]

Head to a local senior center or library. They will have a list of direct helpline numbers for seniors approaching 65 that you can call to get all this stuff sorted out. A one on one conversation from an expert on the government programs is way more valuable than asking insurance questions in a forum of strangers not qualified to discuss your options. At some senior centers you can also arrange an in person consultation on the subject. If you domicile is fixed in South and that will not change before you are 65 then you need to connect with a helpline in that state as your medical insurance is based in that state. You can figure out changing your domicile issues to another state when that time approaches. Right now you need to deal with right now. You are automatically enrolled in Medicare at 65 but need to get ID cards sent to you. You are not automatically enrolled in part as Medicare so that is your first critical deadline before you turn 65.

Supplemental insurance policies can be changed once a year. You are not locked into the same one forever.

Finding a personal primary physician is something only you can sort out. You will need to find one who is accepting new patients who are using Medicare. I chose my primary care doctor who was part of a large medical group because that doctor while being a general practitioner also had a subset specialty of geriatric care. There are things that frequently come along for senior men and senior women. So that put me in sharper focus for better medical care to have a primary care doctor who actually prefers having senior patients and keeps up on the new treatments and medications for their ailments as well as knowing the traditional treatments including alternative, non medical clinic treatments that have worked for ages. This doctor even told me that perhaps I should go on the paleo diet to reduce joint inflammation.

 

[maki2]

^!Forgot to make a typo change. You are automatically enrolled in basic Medicare at age 65 But you are not automatically enrolled in part D Medicare which is additional prescription coverage.

 

[RvNaut]

AS A Nomad.... How Has It Worked For You?

Was moving from State to State and issue....

An expert on the programs is not going to be able to tell me how it works from the perspective of a nomad. That is what I am seeking. I can apply it to my own situation.

 

[user 22017]

Yes... I undersand that it is complicated... but.. please answer the questions if you can.

How does being a nomad affect my decision?

I don;t have a "primary care doc".. haven't been to a doc in 20+ years... I have lived hand to mouth for a long time no things like insurance and dental care and doctors weren't an option... I was hoping Medicare would giove me some basics, but appears to be only good for finding out what may be wrong, ... but where does the money come from if I do have mdical needs.... anyway.. I am rambling....

I have the basics of when and how.. I need deeper information RE going solo or netwrk... etc...

I am 65. I started to look for help with my decision a year ago... A couple months before my birthday . Turns out the government did everything for me without my input. If you don't choose a plan early on... Maybe 3 months before ur birthday, the government will pick one for you . At least that is what happened with me .

My meds are expensive, so I was happy to discover Illinois picks up the tab for anything not covered by Medicare. Based on income.

This year the government switched me to a new provider stating that United Healthcare would start charging deductibles. (they did) So I was switched to Wellcare.

Be sure to check reputable sources for states that provide the best medical coverage. Illinois is good, but there are even better. Ie. Massachusetts, Minnesota and Washington.

If there is a downside to my experience it is that I wanted standard government Medicare and no supplemental insurance . They assigned me to a provider. Also, I'm still pretty uninformed since they did all the work for me . I have read for years to avoid Medicare advantage plans, btw .

 

[NctryBen]

Jason old buddy old pal… been on Medicare quite a while. Ive found using a deal like blue cross, United health care or what I use is UCare in Minnesota… something like that beneficial. I’ve had several health issues pop up and when I was on straight Medicare my bills added up. Using UCare has helped me be able to afford what I have going on. The key is having a plan that is recognized nationwide. Mine is called Multiplan Medicare Advantage. You have to kind of make sure providers are in sort of a network… they are contracted at certain rates. I’m not saying I have the best… but it sure has saved me!
I’m stuck down here for a while needing surgery and care here after that six weeks. I will pay the same here as I would in Minnesota. I’m hoping by then I’ll have someone to help me make the trek home. And continue my care up there…
If your anything like me though, you need to be careful where you go for care. Many doctors will hold you hostage as a patient and you’ll be stuck. Be upfront with doctors about your plans to move around and such. The good ones will work with you.

 

[frodo2222]

Yes... I undersand that it is complicated... but.. please answer the questions if you can.

How does being a nomad affect my decision?

I don;t have a "primary care doc".. haven't been to a doc in 20+ years... I have lived hand to mouth for a long time no things like insurance and dental care and doctors weren't an option... I was hoping Medicare would giove me some basics, but appears to be only good for finding out what may be wrong, ... but where does the money come from if I do have mdical needs.... anyway.. I am rambling....

I have the basics of when and how.. I need deeper information RE going solo or netwrk... etc...

As someone who did a ton of research and just got it 2 months ago in AZ at least for me due to low income ALL my deductibles are paid as well as part C and D...they also give me spendables which here is $125 a month to buy gas, food etc etc..HOWEVER the advantage programs for the most part suck big time and do not cover even the full state one lives in...a interesting thing I found out is that the one I have has some coverage out of country which regular medicare does not...I called SHIP and while they were very nice I found them to be wrong on a couple of key points and after asking him to cal medicare with me on the line to clarify it turned out he was wrong and I was right...do your own research as much as possible and look at all the gov sites...the coverage will change with in the counties even in your own state and some plans are available in some counties but not others...AS A NOMAD I think the advantage plans are worthless but I will be keeping mine since I am going to be travelling in Mexico and nicaragua and the $125 extra is nice as is the emergency out of country care but that is a peculiar situation for the most part

 

[Morgana]

No point saying an expert can't help you till you've tried.
Between SHIP and Medicare's own help desk you should be able to find out a lot.
Some parts of Medicare (the whole plan? just the drug plan? ?) change depending on location. If you have worked out other home-base-related issues, presumably with a little effort you can work out this one too.
If you have particular drugs, for example, that you need to be sure are covered under the plan you choose, they give you plenty of resources for researching that. (And if you don't, then you have one less problem to figure out.)
Medicare is not just for diagnosis, it's for treatment too; what it covers can get complicated; that's why help is offered (through SHIP etc) in figuring it out while doing your planning.
You don't need to live full-time in one town to have a primary care doc there. From what I've read, fewer people have one specific doc they go to nowadays anyway, nomad or not nomad, so that shouldn't be a deal breaker to anything. Under Medicare you often /don't/ need a PMD referral to see a specialist.
On a more sour note, I found that the quality of much of my medical care went to hell once I started paying for it with Medicare. Still hoping that's just coincidence (I've moved around so much it's hard to tell what's causing what change). It hasn't been 100%. I've survived it.
Maybe find out as much as you can through the official "expert" programs and then if you find a specific nomadism-related question that they can't help you work out, see if someone here has found a solution.
It's like computer or car repair, you're not going to find a perfect turnkey solution from the first person you ask.

 

[bullfrog !]

For nomads once again it requires a national program. Unfortunately states are in charge of administrating programs. Unless you are a veteran receiving health care through the VA or get a supplemental insurance from a national provider along with original Medicare you will end up dealing with major insurance companies with all their restrictions and limitations in my opinion. Supplemental insurance companies can refuse to accept you into their programs after a few months of your 65th birthday if you have any previous health conditions so don’t hesitate to enroll. Life for my wife is so much better and easier when dealing with health problems than it is for me as I take blood pressure medication and waited too long to enroll into supplemental insurance. Just our situation and opinions.

 

[WanderingRose]

I don’t really understands the ins and outs of enrolling in this, that and the other, but as a half time or so nomad I can tell you that I have been on Medicare almost 10 years and have had no trouble obtaining labs, prescriptions, emergency and non emergency care anywhere in the country.

 

[Morgana]

What Bullfrog said about not waiting too long -- that applies to more than just supplemental insurance. The drug plan maybe? There's some part of it that if you don't sign up within x amount of time then you have to pay a big penalty to get into it later.

 

[tx2sturgis]

On the medicare website there is a basic chart comparing options.

https://www.medicare.gov/basics/get.../compare-original-medicare-medicare-advantage

For me, the major difference is that Original Medicare is more 'portable'...compared to most of the 'Advantage' Plans that require you to use in-network providers.

 

[RonDean]

On the medicare website there is a basic chart comparing options.

https://www.medicare.gov/basics/get.../compare-original-medicare-medicare-advantage

For me, the major difference is that Original Medicare is more 'portable'...compared to most of the 'Advantage' Plans that require you to use in-network providers.

I am now on a Medicare Advantage Plan which (lucky for me) I hardly ever use. It covers my yearly check-up and one fairly low-cost medicine. I have absolutely no idea if I picked a good plan (AARP-UHC) or if it is better or worse than standard Medicare. That is partly (mostly?) my own fault - as I have no interest in or desire to learn a lot about medicine or insurance. I have a life to live here! I HAVE tried to research it occasionally and discovered no good independent sources. Every single website is mostly ads written by the industry or long lists of "benefits" that all look the same to me.

If someone knows of a site where I can just click off personal information boxes and which will then come back with a "this is the one you should pick" please let me (and others) know.

 

[bullfrog !]

I did a poor job of researching and failed to get what would be best for me. Afterwards learning from my mistakes my wife contacted a well recommended SHIP volunteer and got referenced sources of information from them which she considered and checked before filling out paper work and applying with the aid of the SHIP volunteer and now she has had no problem getting treatment that has not to this date cost her any additional money.

 

[wanderlust]

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