Why sign up for Medicare next year at age 65?

From what I have read on the forums here, Medicare would become your primary health insurance and Medicaid would be your secondary insurance picking up the cost that Medicare won't pay. Best to contact both Medi-Cal and Medicare to ask what to do.

Payment for Medicare comes automatically out of your social security check.

What law exactly are you referring to which provides that "the microchip will be installed inside of people..."? And who are the "they" who hyou claim will 'figure a way to mark you with some electronic device...?"

Honestly, I've never heard of such nonsense.

BTW, can you get psychiatric services through the Indian Clinic?

Actually lots of reasons, to me the biggest is the lack of portability of Medicaid for a younger & active 65++ person. Medicare is a federal program so is available anywhere in the US or its territories. So you live in Maine but while on vacation you break your hand lunging for Mardi Gras beads in New Orleans.......you will be billed for your ER visit as your Maine Medicaid is not valid in Louisiana. However if you had Medicare it would be. Medicaid is limited to paying within the state yiu live in as Medicaid enrollment is done uniquely by each state. There are exceptions like for level 1 trauma hospitals that are right across the state line situation but otherwise, your Medicaid is only good in your state.

Also if you do not sign up for Medicare in the very first initial period, you will have to pay a significantky higher monthly rate when you do sign up. And I think the higher rate is till forever IF you didn't enroll within the initial period

Medicaid since its state run can change the eligibility rules.....it could require a co-sharing of costs for those who can get another insurance Payor. So if you could be on Medicare to totally cover your hospitalization under the Part A, and don't, Medicaid could decline to pay. Also Medicaid could change the income & asset rates, and you could disqualify from Medicaid.

Most hospitals take Medicare - as Part A covers hospitalization and reimburse pretty quickly - but many do not take Medicaid at all.

Also you have been paying into Medicare via FICA during your work life.

Medicaid does not have to have changes done by enacting new laws necessarily. It would be too too cumbersome to require this. Medicaid is set up to allow for the states to have waiver programs. Waivers are diversion of funding from skilled nursing services to broader community based programs via different waiver programs.

One issue with waivers is that policy can change from year to year, so often some providers will not participate or not renew in Medicaid waiver funded programs as its hard to do long term planning due to this. One trend right now is for states to establish PACE programs and phase out other older & established Medicaid paid for programs. Laws didn't have to be passed to do this as it's within the purview of Medicaid to allow for flexibility with funding by the states.

Medicare is pretty well set to have funding (even if reinbursement rates decrease) guaranteed.

As far as "loopholes" with Medicare, to me, that's really about finding the right secondary or medigap policy to take care of that. My mom had Medicare and federal employee BCBS as her secondary policy for years before she entered a NH, and she had zero copay. Between the two, everything was covered and it didn't matter whether she was in TX or visiting family in LA or on vacation in FL. My aunt had a really crappy secondary policy which limited payments 100% only to providers within a somewhat small health system and of course most of her old docs were NOT in the system, so she had out of pocket costs. You have to do the research to find what works best for your needs but you can get total coverage to happen within Medicare.

freqflyer has brought up an important point.....you need to find out if your state will require Medicare to become your primary and Meducaid your secondary once you are eligible to get Medicare.

Also on medicaid waiver funding, often if there is a PACE type of program available in your area that will provide the level of services Medicaid has determined that you need, then it will need to be the health care system that you will need to participate in if you want Medicaid to pay. You don't get a choice. It's how Medicaid can attempt to do cost-containment. Personally I think this (required participation in a PACE type of program) will be the new normal for those over 55 on Medicaid.

Medicare is "self-directed" so you can pick which doctors (that accept Medicare) to see.

Our Medigap premium is $122.86 a month. I would consider that pretty reasonable. It's through BCBSM. Given the cutbacks in Medicare due to sequestration, I think the loopholes there are more problematic, especially on the issues of DME supplies.

Sounds like you've evaluated all the options and made your choices; go with them, and I hope everything works out well for you.

Outdoorsy - so your Native American, right? Well that can change everything as IHS is its own entity as to how services are done & provided within your community as NA are special status. IHS does work in tandem with other programs, like I think IHS is working with PACE (I'd bet it's a catholic nonprofit group) in OK but policy is different for Native Americans. IHS may have it's own coding & bill payment system like what RailRoad Retirement Medical does.

It's special status situation & policy derived from that status.

Like what the special status is for Cubans in that they immediately qualify for food stamps, medicaid & SSI up to $ 733 a mo (SSI if over 65) and good for 7 years whether or not they apply for US citizenship and then forever once you become naturalized. Plus subsidized housing as well in some areas too.

But for most on this site, none of this will matter as their not Native American, Cuban or a RRR family.

If you don't sign up for Medicare part B when you are eligible (3 months before, the month of your birthday or by 3 months after your 65th birthday), you would be facing penalties. (Unless you are actively working). If you are receiving Social Security already, you will be signed up automatically with the option to decline part B. DO NOT DECLINE part B unless you are ACTIVELY working.

While I could could offer you lots of information here, I am going to suggest instead to seek a State Health Insurance Assistance Program (SHIP) within your county. The easiest way to find a counselor, free by the way, is through your local Area Agency on Aging. Just call and say you need a Medicare counselor and you will be directed or referred to one. You can sit one on one with someone by appointment, ask dozens of questions, and get recommendations for help with Medicare.

As an extra side note, you likely will continue on Medicaid and receive almost the same type of benefits; it's just that you will have a Meicare/Medicaid plan vs. solely a Medicaid plan. Also, it is likely that you will qualify for a program that will pay your Medicare Part B premium, and also the Federal Extra Help program that will keep your prescription prices low. that Medicare counselor can do those applications for you or help you with them. I'd suggest starting this process as soon as you receive your Medicare card in the mail and not waiting until later. This will avoid you seeing that deduction for Part B and then having to wait months to be reimbursed.

If your state is California, you can look up your SHIP here also:
https://www.aging.ca.gov/hicap/?AspxAutoDetectCookieSupport=1
Jen

Oh, I also wanted to add that Medigap policies are actually some of the best Medicare plans out there and there are rarely issues with them not paying. There issues with Medicare Advantage plans as you have to be concerned with networks. In terms of the Indian Clinic, there are May be other coordination of care and reimbursement issues as you mentioned.

Microchipping people huh? Well that is a great consoling feature for me. over here we only microchip animals who can be euthanised when they become terminally ill. if being microchipped means I can opt for voluntary euthanasia I am al for it....sadly I know that is not the case