OT: When to take Social Security
- Thread starter RULoyal
- Start date
Switching out of Medicare advantage is easy if you're not happy with it. Especially in the first year. From the doctor's point of view, Medicare advantage plans generally are suboptimal. The payment & denials suck. The data collecting for them sucks. The pre-authorization process for them sucks. The formulary issues suck. The limitations on seeing doctors out of network sucks. For people who are great at self-advocating then Medicare advantage plans can be okay. They're also fine for healthy older people who just go to the doc once or twice a year. If you want freedom and flexibility then you might consider staying away from Medicare advantage plans even though they're forced down your throat very often. They go out of their way to entice patients by offering free vision and dentures and gym memberships. They put all the risk on the provider
FA wanted us to consider that… becomes expensive … he saying it ‘ll be paid back to you through your current holdings. Sure it always sounds good. Told my family no assisted living facility / LTC facility . The thinking is LTC well it’s cheaper than AL….once you have experienced the shills in those factories attitudes change. My dad had great insurances but in the EOL they make sure they get their share.😘 Out of pocket for father 300k+ 5 years. “ they shoot horses don’t they?”
Besides the expense the major drawback that I've seen with patients is that they cover a certain amount of time. So I've seen patients who have great coverage and long-term care and they continue to outlive expectations and they're forced to move back in with their kids or other alternatives.
In 8+ years never had any issues with our advantage Plans … specialty drugs…,surgeries…rehabs…or who we can go to out of network… no referrals required… as I stated the entire issue is from Big Pharma- AMA- and the elitists in government who are in a whole different category.
Most kids do return or help that is absolutely a true statement. Better to be destitute and broke…never pay back loans … lol
For those of you that might not have a spreadsheet for retirement this is a pretty good app that you can plug in different numbers, asset allocation, when to take SS, growth and inflation estimates, etc. and see likely outcomes. Of course, with any model, it depends on you underlying assumptions but you might find this a useful tool to explore different scenarios.
firecalc.com
FIRECalc: A different kind of retirement calculator
Again, that's because you as a patient are probably a very good advocate for yourself and your wife. I'm giving you the doctor's point of view when dealing with Medicare advantage plans in particular. When I am a patient, especially Medicare age, I want my doctor to be happy with my insurance and to know that it is not an impediment to best care. Ignorance is bliss to many patients including many of my own family. What goes on in the background or "in the kitchen" sort of speaking is kept from patients knowledge or vision. Insurance industry is a shitshow in America & Medicare advantage plans are the worst of it from my pov. The amount of denials and appeals that are done in the hospital is appalling. I spent 10 years as a medical/nursing liaison and director at a local hospital here in Middlesex county. Half the time was spent breaking up fights with the discharge nurses and the docs because insurance denials had cut off the patient's hospitalization benefits and the patient was still occupying a bed. The patients themselves were unaware of this war going on behind the scenes other than them signing off on a form that allowed us to appeal on their behalf.
Here are the exact numbers - and what counts against it are wages and/or net earnings from self-employment (what's on a Schedule SE) - none of the other stuff counts against it.
From the SSA website:
Exempt Amounts for 2024
"We determine the exempt amounts using procedures defined in the Social Security Act. For people attaining NRA (Normal Retirement Age) after 2024, the annual exempt amount in 2024 is $22,320. For people attaining NRA in 2024, the annual exempt amount is $59,520. This higher exempt amount applies only to earnings made in months prior to the month of NRA attainment.
Benefits Withheld When Earnings Exceed Exempt Amounts
We withhold $1 in benefits for every $2 of earnings in excess of the lower exempt amount. We withhold $1 in benefits for every $3 of earnings in excess of the higher exempt amount. Earnings in or after the month you reach NRA do not count toward the retirement test."
So normal Medicare plus quality gap insurance is best from an HCP point of view?
Well this is what most physicians themselves opt for. In terms of " medigap" , there are 4 or 5 levels of supplemental Medicare insurance each with different levels of deductible and coverage. I believe they can vary from a couple hundred dollars to up to $500 a month cost. I may be wrong about the specific amounts. You also need to have drug coverage by getting a supplemental part D drug plan. I am lucky because I married a "rich woman" who retired after teaching for 39 years & got the golden parachute that Chris Christie hated. So, My personal Medicare supplement is covered by the retired teachers plan. In my case, I chose horizon ppo. Now that's an interesting story because the state of New Jersey tries to shove a Medicare advantage plan down the throats of their retired state workers. Many don't realize that they can opt out of the NJ state Medicare Aetna advantage plan because the state purposely tries to hide it from them and purposely shove them into the Medicare advantage plan by default. They do that because it obviously saves the state money since Aetna assumes all the risk which they then pass on to the providers and the hospitals. Many don't realize that you can opt out of the Aetna default they force you into and take the fee for service indemnity ppo plan they also "offer" that comes with drug coverage as well.
That looks like a random line generator. Is that link right?For those of you that might not have a spreadsheet for retirement this is a pretty good app that you can plug in different numbers, asset allocation, when to take SS, growth and inflation estimates, etc. and see likely outcomes. Of course, with any model, it depends on you underlying assumptions but you might find this a useful tool to explore different scenarios.
FIRECalc: A different kind of retirement calculator
Medicare advantage is part C. Is one of many options for medigap or supplemental coverage. Under 65 you are only eligible for the Advantage Part C.
Over 65 gives you more options.
The most comprehensive plan is Plan G. will pick up costs after Part B deductible is met. and after Part D deductible has been met. Cost of plans vary.
Isn't the important information the expected remaining life from the age of the decisionmaker? (e.g.life expectancy at age 62 is much higher than the average of that from birth, aight?)
The cost of Medigap changes, going up as you get older beyond the normal annual increase. 65-70 is one class, 70-75 the next
You use the tabs up top and plug in various assumptions (portfolio, growth, inflation, spending, pension, social security, etc.) and it calculates the range of outcomes and probabilities of “success.” It could be more intuitive where to start and how to work through it but it’s relatively easy once you rough it. The tabs up top allow you to input your information.
Last edited:
The cost for a 65-year-old is the same as for an 85-year-old enrollment for initial outside of additional risk including smoking. It does go up annually just like everything else in life.
You cannot get Medicare advantage before age 65 unless you qualify for medicare based upon disability etc.
Last edited:
My supplemental is about $176 a month and you have Medicare part B $174.70 a month and about $13 for drug plan. I think I pay about 15/ mth vision and another $15 for dental.
The supplemental cost goes up and my mom is 92 pays $278.50/mth. Again , my dad company use to pay the $540/ mth x 12 x 30 years= $194,400 in premiums saved.
I say you need this insurance if you have assets to protect( have to be middle class and up). If you don’t have enough assets, you will be wipe out with the premiums. If you don’t have it, when you die, the hospital, doctors and nursing homes get stuck with the unpaid bills.
T2K, you definitely need supplementary insurance. Nursing home care is not covered by any of this but rehabilitation care, which may occur in a nursing home, for a limited number of days. Your LTC insurance covers the nursing home, I don’t have this. Will have to pay out of my assets but don’t want to go to a nursing home. Time to jump off a building.
Last edited:
Under 65 you are qualifying for Medicare in general for a disability or some other issue. Medicare advantage is Medicare - it is a replacement for Medicare plus supplement.
Pretty much what we pay what I do love is my Vision care covers 80% up to a max of $ 685 on glasses/ lenses every year and frames every 2 years.… or contacts every year … includes eye exams/ dilations … separate from my eye care with surgeries/ cataracts etc. Dental if in network covered 100% for up to 4 cleanings per year , yearly full series rays once per year, X-rays for check ups covered , fillings. Drug plan excellent on all tiers … better than many. Co pays are in the average range . Max out of pocket medical issues is good.
My mother suffered a broken hip. 6 weeks rehab in a nursing home. Medigap covered the 20%
I do but my rational in addition to what posted was the ability to leave more in my own retirement accounts letting them grow tax free and leaving more funds there in event of early death vs. losing the ss benefit in such case ( net of spouse survivor benefit).
Now of course there's higher RMD too so it's all entertwined lol.
No doc I get it however I have never had an issue. Sometimes you realize attitudes of many PCP’s has drastically changed. Don’t know how many years you have been in practice but times are much different. And quite honestly why should your patients be aware of “ fights” docs between Nurses and admins are having? Most just expect an honest , accurate diagnosis. Most doctors aren’t on their lonesome anymore. Most are incorporated with large groups for protection purposes.
We are in large groups for protection?
I have been in practice since 1984 & have practiced in multiple states when I was younger
If you mean protection from overhead in general & administrative hassles ? Horizontal integration among health care systems is the now norm & even integration w the insurance co is also occurring. Dealing w insurance companies and all the obstacles is worse than ever. Burnout just dealing w pre-authorization & denials not going away soon. Patients may be happy but largely now "employed" docs generally very unhappy. Not sure what you are talking about. You will be getting even more accurate dx since AI coming but will never fully replace compassionate caring physician
Come on doc protection of a large group … it is nothing more. Your overhead? Really sounds more like protecting your bottom line. If it’s that bad.maybe a change in venue is overdue. No actually I know probably 5-6 friends who are physicians for a number of years. No offense doc but if they hate it maybe they should be pharmaceutical sales directors. I ‘m not saying your chosen field is not frustrating but maybe those patients you swore to “ do no harm” can tell you how their jobs sucked . And guess what … they probably don’t have as good a life as you. Going into my junior year of high school I had aspirations to become an orthopedic surgeon. I had the grades but not the desire or academic discipline needed . 56 years later I’m happily married still… have great kids… wonderful grandkids… some money… no real bills… and did what I wanted in business for 42 years. Stop feeling sorry for yourself. I realize your hours are long… pay and comps in 2023 are not where you believe it should be.Your patients probably count on you but blaming the bureaucracy and patients and nurses? So late 60’s is still time to find a new area that you can find satisfying. This has been caused through political maneuvering in government , pharmaceuticals, over the top regulations. Your negative feelings should be directed at the elected boards who make those monetary decisions.
Here is another app that I mentioned might be more in line with regard to different account types,strategy,RMD, legacy, etc.
Optimal Retirement Planner - Home and Essential Parameter Form
The Optimal Retirement Planner (ORP)is a retirement planning calculator that computes the maximum amount of money available for retirement spending based on age, spouse's age current saving balances, savings plans, taxes, and inflation. Tax-deferred and after-tax savings are treated separately...
www.i-orp.com
Don't know or acquainted with any physicians who complain about money. It is all about insurance co. & Ceos interfering with the quality of physician patient interaction and the transferentially gratifying relationship that's developed through the years. Not sure where you read about me complaining about the nurses or the patients. Maybe you're reading somebody else's post or maybe there's a problem with your comprehension. This is not a knock on the patients who have Medicare advantage plans that work for them. Especially for somebody as gifted as yourself. As a patient you are not supposed to be invited to what goes on behind closed doors. I'm giving my opinion about the problems with Medicare advantage plans as far as what goes on behind those closed doors that makes them more difficult to deal with, as a physician - given the age of the patient, the complexity of the problems. And if you think physicians, on the average, are happy about working for hospital administrators and large for profit equity firms then you be "cray- cray" as my granddaughter would say . Maybe you should Google "physicians moral injury" since you appear to be ill informed about what's going on on the provider end of things. As a patient myself I want my doctor to be treated reasonably well & not be stonewalled by whatever plan I, as a patient, have selected (if I'm lucky enough and well off enough to have my pick). But appreciate your sage advice anyway on me finding a new career. You do remind me of somebody else, a man of many letters with grandiose ideas & projections. I can't quite put my finger on it though. I'm sure it will come to me.
Exactly the point… the medical profession still does quite well … so whining to your patients is beneath the level you claim. For a doctor you seem a bit smug. Don’t like hearing the things patients are also frustrated. You may hold a medical degree but don’t expect much sympathy. One thing I agree with …you should be paid well ( if your good) many are not. But crying about your being over stressed is another story. Don’t think others working long hours and underpaid maybe would agree with you. No it’s neither Doc… you’re what about late 60’s approaching 70? Just take a few extra days off. You understand they are trying their damndest to solve the doctor shortage… that should be wonderful.lol
People need to keep in mind that the longer they live, the longer their life expectancy is. For example, at age 60, an American man can expect to reach 82; a woman, 85 and, obviously, the further you make it the further you can expect to make it relative to people who haven't made it that far.
https://thehill.com/business/4076702-retirees-are-underestimating-how-long-they-will-live/#:~:text=At%20age%2060%2C%20an%20American,they%20didn't%20know%20it.
This is a very good point that most don't know about.
As for SS money, if you start collecting at 62 and put the money into VTI or VOO (Vanguard broad market ETFs), you would make out way more than waiting until 70 to collect.
You remind me of a man, likely small in stature, small-minded man who must spend the remainder of his days banging on a computer keyboard 24/7. Pressing on others that your really that fulfilled, loving, beloved family guy - not at all that pyrrhic keyboard Goliath. From thread to thread, topic to topic; Denying to all that he's really not overly committed to his keyboard martyrdom; fantasizing in his own little echo chamber in retaliation to all those bitterly missed opportunities of his youth or that were just beyond his reach..Every other sentence must be turned into a debate or some sort of argument lest anybody have a different point of view that doesn't match exactly; small minded paranoid little man - an ultimate contrarian keyboard warrior. Every imagined victory puffs up a deflated sense of self worth. And in that paradigm, his fragile ego must remind itself that it again emerged victorious; Rather than shrivel up and die in imagined defeat. Babble on Bobby.
Yeah I may be all those things ( which I’m not you quack) however I’m not a physician crying about his tough life, business overhead and how people don’t care about him. You are a sad example for the medical profession. Actually I’ll match my life, my accomplishments and even my failures few that they are. Do you really believe being a doctor entitles you to special place In life or society . If anyone has proven their simple mind it is quite assuredly you. Thanks quack… you’re not worthy of any praise though you fail to see nobody cares . Coming on a sports board and complaining and then intimating your dislike for how you perceive the inequity you face. So what… you work long hours… you don’t agree with the bureaucrats who cost you money. Go away you self centered tool. As for Bobby babble … RUfubar you are a pathetic example for a medical expert … actually thought you might get it but you don’t.
I have a couple of financial calculators I use but nothing as integrated as this looks like. Thanks. I'll play around with it after the holiday. Looks pretty cool.
Again I am not telling anyone what to do but just openly sharing my situation and thoughts for anybody's consideration. BUT one additional outside consideration for folks living in NJ is the ever changing Senior Tax saving plans and thresholds and how taking SS vs. your own funds impacts your NJ taxes. I lost my $1,500 Anchor rebates for this year and next year because NJ announced them using income thresholds years in arrears (this year based on 2020 Income next year 2021). I re-classified IRA funds to Roth and therefore lost the benefit due to an "on paper" income by just a few thousand dollars each year that I couldn't go back and address! Same thing with the same damn thing with the 100%/50%/25% Retirement income deduction the first year because they announced AFTER the fact.
I know it is not a ton of cash (like 2%) but getting that $1,500 plus tax reduction plus getting the 25% deduction on the retirement income for being under the NJ $150k plus the soon to be 50% Property tax relief can add up. (although I think the $1,500 has to go away then). Those benefits could be worth $10k+ to some folks so managing your NJ based income becomes a significant consideration.
So by taking both mine (couple years now) and my wife's starting right now at 62 we are able to 50K a year NJ Tax free which also doesn't count against those Senior Income Thresholds and helps us qualify for even more benefit (vs. had we taken out our own funds which do count).
Cheers! Merry Christmas/Happy Holidays .
Last edited:
Not really a critical question, just curious - I have read where it can take 3-5 months to get your first SS check once you apply. So is your benefit calculated from the date you apply or the date you actually start receiving the benefit?
You apply online and it asks you when you wish to start receiving checks. If you are past the "standard" retirement age, Social Secuirty will allow you to "backdate" your checks for up to six months in the immediate past. Of course, you lower the monthly amount you get should you choose to go that route.
A person from Social Security will contact you by phone shortly after you apply online to confirm your identity and will also help with any questions. Checks are usually sent (actually wired) into your bank account about the 3rd of each month. But your first check will come several weeks after you've been confirmed.
Have direct banking info into an established account (account number and routing number) ready to go.
My understanding is once you have been at a facility for x amount of time they can’t kick you out. They have to take what Medicare or Medicaid pays. That’s why people always die shortly after their money runs out
Similar threads
