Baffled by Zero Premium @ Medicare.gov

Jun 17, 2019

  1. CalifSenior
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    CalifSenior New Member

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    Single lady here. About to retire and take SS due to health, I will receive about $1300-$1400 a month.
    No other income so will live on that. $50 house payment, new house and have hydro for power regarding our newly built off grid home.
    So...I understand from the medicare.go forum I qualify for free part b premiums so will not have to pay it. It should or might be covered by a medicare savings program. If not, I surely qualify for "Extra Help" the full subsidy per my reasearch to assist with costs for drugs.

    Either way, when I use the find a plan at medicare.gov and click I qualify for extra help OR I am in a medicare savings program, I end up with supplemental plans which cost anywhere from zero premiums to $58 a month. How is this possible? A zero deductible supplemental plan PLUS not having to pay $135.50 a month for part b? See below. I live in Calif.

    P.S Oh and I guess the $189 deductible for part b I'd pay& $1260 if I am admitted to a hospital? Thanks so much.
     

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  2. CalifSenior
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    CalifSenior New Member

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    Not sure if this is relevant but I am Native American. I donate to the non-profit tribe which sponsors our health clinic ($50 a doctors visit) but do not legally pay for doctors visits at the clinic. Our drugs are provided "at cost". So a drug plan isn't that important to me. I will be 65 soon. Thanks alot
     
  3. springbokhouston
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    springbokhouston Guru

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    You are looking at Medicare Advantage Plans not Medicare Supplements. There will be copays, coinsurance and deductibles with an out of pocket max. Please feel free to PM me and I will help you go over all your options. Depending on where you live you may also want to look at an MA only plan, particularly if you get your meds from Native American healthcare.

    PS you will only qualify for the $0 Part B if you get Medicare Savings Program. Extra Help only helps with your drug costs, premiums, deductibles and copays.
     
  4. Rob Lion
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    Rob Lion Guru

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    I'm potawatomi not sure if it's any different where you're at, but from my knowledge you don't have to pay for health services if you just go through the tribe.
     
    Rob Lion, Jun 17, 2019
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  5. mickeyma
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    mickeyma Guru

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    Based on your income, you qualify for Medi-Cal - the best health insurance plan in America. Contact your local county social service agency (i have a list for all counties. Email your county & I'll be happy to send the info - [email protected]).

    Medi-Cal will pay your Part B premiums. They will put you in a Cal-MediConnect plan with $0 monthly premium and $0 copay for everything including hospital stays. It also includes Part D prescription drug with prices from $0 to $1.25 for prescription.
     
    mickeyma, Jun 18, 2019
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  6. CalifSenior
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    CalifSenior New Member

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    Thanks so much. I don't pay for low level clinical services but do donate at each visit. the tribe has set it up as a non-profit organization so that is possible. Our Doctor visits are almost always a Nurse or Nurse Practitioner.
     
  7. Rob Lion
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    Rob Lion Guru

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    I was going to say, i get dental, health and vision for free all through the tribe. Before, any of these ding bats have you sign up for anything make sure they'll even be able to save you anymore money.
     
    Rob Lion, Jun 18, 2019
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  8. CalifSenior
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    CalifSenior New Member

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    Hi Mickema, thanks so much for the info and your email address offer.
    We do not have mediconnect yet, it 's a trial taking place in certain counties from what I understand. One that is going well so I expect to see it within a few years or so here in Placer County.
    Mediconnect reads it requires full medi-cal or aka full scope medi-cal. So my SS would be over that limit. A single person in Calif can only make about $1270 (give or take $10) a month. There is a medi-cal/medicaid spend down but it would disqualify for mediconnect program eligibility.
    If the $1270 a month limit is earned income then there is a huge 50% deduction. the quick formula is to double that income (since it's deduction is 50%) and some amt added on, I've forgotten. Maybe it's. $20. This is not the way the Eligibility Workers do it, it's just the easiest formula for me to explain here ( which is also accurate). I have the medicaid rough copy forms here at the house. Let me know if you would like a copy though you may already have them. Then you can teach yourself to know the formula and whether your clients qualify, it's often a little complex imho. But maybe you do that already.

    There is maybe one way, at some point, I would qualify for mediconnect. A bill passed a year or more ago, allowing Seniors income eligibility to increase to the ACA medical-eligibility. ACA is 138% of FPL whereas the seniors are only allowed to have up to 120% of the FPL. It passed unanimously and is stuck in the ways and means committee. Likely waiting until after Trump is no longer president since he will surely NOT sign it. Then, and only then, will I qualify for mediconnect considering it expanded to our county.

    Mediconnect requires you to be eligible for full medical, not just partial medical which pays your part B premiums (and/or maybe other things like co-pays, deductibles, whatever).

    Thanks so much for your note and directing me to mediconnect! I did alot of research before responding. In the past, I was a receptionist for CPS & ADP Services, aka the county. So the Calif ALL County Letters (posted online) I'd keep track of regarding changes in the health programs. It also helped a little to learn aspects but unfortunately, not enough to know how to put all the aspects together as needed.
     
    Last edited: Jun 18, 2019
  9. CalifSenior
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    CalifSenior New Member

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    This is a great reminder I'd forgotten about. I have a separate plan which covers that. It is $10 a mo. for up to 2k a year dental and VSP vision via my ex employer.
     
    Last edited: Jun 18, 2019
  10. CalifSenior
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    CalifSenior New Member

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    Thanks so much for this helpful info and offer to assist. There is one MA only plan but they want $139 a mo which is alot more$. This makes no sense to me.
    I didn't include it in the screenshot.
     

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    Last edited: Jun 18, 2019
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