Brain Tumor and Tennis

[movdqa]

Completely Paralyzed System atm IMHO.

I'll find out in 2 months.

My wife also has Universal Healthcare from another country and I'll have to check if I'm also eligible for that.

 

[ByeByePoly]

Discovered I am paying for Medicare while on my Wifey's insurance. Trying to get off Medicare and get a refund. Was warned years ago I would never be able to pay for my current meds on Medicare

$174 a month when not needed/wanted sucks … after much effort and two trips to local ss office I only had to eat 1 month instead of 3-4 months.

Meds:

Big choice from the start is 1) Advantage policies 2) supplemental policies.

1) Advantage: cheap to no premium, copays, prior approvals for procedures, yearly max out of pocket (could be up to $8800 in 2024, some lower $3500ish), some might bundle in meds (Part D)

2) Supplemental, monthly premiums $100+, no copays (supplemental insurance pays for Medicare 20% gap), have to buy part D on your own.

So you would think that cluster f*** is bad enough right? But wait … there’s more. Private Part D providers are all different, what drugs are covered, co-pays based on drug tier. But wait … there is more. Once you finally have spent time on each part D providers websites and picked best med policy for your meds … wait for it … the plans can change every year. You have finally arrived at geezer insurance thinking the ripoff days of private insurance is behind you … only to find out you need to search/check part D choices every year (this is a good reason to have a broker … they get their commission and can run your meds through the choices)

Wait … there is more. I saved the most hilarious (f***ed up) for last. I jumped through all those hoops, picked my best Part D provider, and one of my meds is significantly cheaper using GoodRx paying cash at Walmart. In what universe would you design senior medical insurance (you paid into all those years) that didn’t cover common meds. Nope … sorry old man … you didn’t escape the greedfest.

It looks like we did something spectacular and went to the moon … and have mailed it in ever since.

btw … the big bet is picking between Advantage or Supplemental. If you are basically healthy until the end, you can save all that monthly premium $. We had planned on Advantage. But wife had major illness 6-7 years ago, and a couple years of max yearly caps easily pay for all the years of premiums. I also really like removing the insurance company from the “authorization” role … supplemental is you and Medicare with supplemental paying for unexpected gaps.

Rant is over … well … this one.

Edit: for the most part … I think blaming insurance companies is like blaming the messenger, they are relaying the message from our healthcare system. My wife worked at an insurance company … most of the time their hands were tied, particularly with Medicare.

 

[movdqa]

$174 a month when not needed/wanted sucks … after much effort and two trips to local ss office I only had to eat 1 month instead of 3-4 months.

Meds:

Big choice from the start is 1) Advantage policies 2) supplemental policies.

1) Advantage: cheap to no premium, copays, prior approvals for procedures, yearly max out of pocket (could be up to $8800 in 2024, some lower $3500ish), some might bundle in meds (Part D)

2) Supplemental, monthly premiums $100+, no copays (supplemental insurance pays for Medicare 20% gap), have to buy part D on your own.

So you would think that cluster f*** is bad enough right? But wait … there’s more. Private Part D providers are all different, what drugs are covered, co-pays based on drug tier. But wait … there is more. Once you finally have spent time on each part D providers websites and picked best med policy for your meds … wait for it … the plans can change every year. You have finally arrived at geezer insurance thinking the ripoff days of private insurance is behind you … only to find out you need to search/check part D choices every year (this is a good reason to have a broker … they get their commission and can run your meds through the choices)

Wait … there is more. I saved the most hilarious (f***ed up) for last. I jumped through all those hoops, picked my best Part D provider, and one of my meds is significantly cheaper using GoodRx paying cash at Walmart. In what universe would you design senior medical insurance (you paid into all those years) that didn’t cover common meds. Nope … sorry old man … you didn’t escape the greedfest.

It looks like we did something spectacular and went to the moon … and have mailed it in ever since.

btw … the big bet is picking between Advantage or Supplemental. If you are basically healthy until the end, you can save all that monthly premium $. We had planned on Advantage. But wife had major illness 6-7 years ago, and a couple years of max yearly caps easily pay for all the years of premiums. I also really like removing the insurance company from the “authorization” role … supplemental is you and Medicare with supplemental paying for unexpected gaps.

Rant is over … well … this one.

Edit: for the most part … I think blaming insurance companies is like blaming the messenger, they are relaying the message from our healthcare system. My wife worked at an insurance company … most of the time their hands were tied, particularly with Medicare.

I suspect that I'm going to be paying $500-$600/month for UNH Supplemental and the other stuff. There's a wide range of supplemental options in my state from about $100-$600/month. UNH is about $360. UNH has insanely good networks.

 

[Nostradamus]

I suspect that I'm going to be paying $500-$600/month for UNH Supplemental and the other stuff. There's a wide range of supplemental options in my state from about $100-$600/month. UNH is about $360. UNH has insanely good networks.

Have your doctor reviewed the CartT cell treatment ? it sounded like miracle cure for glioblastoma when i read it. Trial was with limited amount of patients but results for cure was remarkable

 

[movdqa]

Have your doctor reviewed the CartT cell treatment ? it sounded like miracle cure for glioblastoma when i read it. Trial was with limited amount of patients but results for cure was remarkable

Shroud had the brain tumor.

CAR-T was in its infancy when I had cancer and you had to be Stage 4 to get into clinical trials. One of the first patients (maybe the first) was in my cancer forum. She had inoperable stage 4 in her lungs and this killed 6 of 7 tumors and they got the last one via surgery. I was cured with conventional treatment but have a permanent disability from the treatment. The huge benefit or CAR-T is that it just goes after cancerous cells while surgery often removes part of or a whole organ.

 

[ByeByePoly]

I suspect that I'm going to be paying $500-$600/month for UNH Supplemental and the other stuff. There's a wide range of supplemental options in my state from about $100-$600/month. UNH is about $360. UNH has insanely good networks.

We have UNH supplemental Plan G … $120ish / mo each, and free Lifetime membership . Sometimes it pays to live in boring low cost of living area.

Yes, when I was making the decision on supplemental one of the good things is you could go anywhere in US for treatment/surgery. Not tied to a network. Then I asked the question … what if I moved … could I keep UNH and does premium change. Wow … really varies across the country. The thing is you can always change from supplemental to advantage later … but you get only one time to sign up for supplemental without the screening for pre-existing conditions where you can be denied.

 

[movdqa]

We have UNH supplemental Plan G … $120ish / mo each, and free Lifetime membership . Sometimes it pays to live in boring low cost of living area.

Yes, when I was making the decision on supplemental one of the good things is you could go anywhere in US for treatment/surgery. Not tied to a network. Then I asked the question … what if I moved … could I keep UNH and does premium change. Wow … really varies across the country. The thing is you can always change from supplemental to advantage later … but you get only one time to sign up for supplemental without the screening for pre-existing conditions where you can be denied.

I had $750K in bills for cancer treatment and UNH took care of all but $6,000 of it. They also covered every single hospital I want to, all of the chemo, surgery and radiation. Literally everything was in -network. The likely reason for higher premiums is that people in my state use the world-class hospitals in Boston for anything serious.

 

[Nostradamus]

Shroud had the brain tumor.

CAR-T was in its infancy when I had cancer and you had to be Stage 4 to get into clinical trials. One of the first patients (maybe the first) was in my cancer forum. She had inoperable stage 4 in her lungs and this killed 6 of 7 tumors and they got the last one via surgery. I was cured with conventional treatment but have a permanent disability from the treatment. The huge benefit or CAR-T is that it just goes after cancerous cells while surgery often removes part of or a whole organ.

CartT cell treatment will be a cure with very little side effects once it is perfected. This is big because glioblastoma in the past, patients just didn't respond to traditional chemo and surgery is not perfect as you mentioned. Looking forward to also using CartT cell treatment for other incurable types of cancers too.

 

[ByeByePoly]

I had $750K in bills for cancer treatment and UNH took care of all but $6,000 of it. They also covered every single hospital I want to, all of the chemo, surgery and radiation. Literally everything was in -network. The likely reason for higher premiums is that people in my state use the world-class hospitals in Boston for anything serious.

Yeah … my mom once ran up a $1 mil bill from 4 months in ICU, and only paid her $3000ish max. Of course … the bill totals we might see isn’t what is actually paid. No transparency.

I guess I can live in the land of low cost of living, and come to Boston for the good stuff. Can I stay with you? I will bring @Shroud.

 

[movdqa]

Yeah … my mom once ran up a $1 mil bill from 4 months in ICU, and only paid her $3000ish max. Of course … the bill totals we might see isn’t what is actually paid. No transparency.

I guess I can live in the land of low cost of living, and come to Boston for the good stuff. Can I stay with you? I will bring @Shroud.

UNH had reports of the amounts billed, what they paid and what I paid. There was one chemo treatment that was billed at $11K and the negotiated insured payment was $1,100. That was an eye-opener.

We actually live in NH but have a home in a Boston suburb which we are rehabbing and we're in the second year of the process. I wouldn't really say that it's habitable. My process for going to Boston hospitals was to wake up at 2:30 AM, get ready, and then leave at 4:30 AM to get into Boston without traffic. The difference between going without traffic and with traffic can be 50 minutes to 2 1/2 hours. My Boston hospitals are Brigham and Womens and Dana Farber Cancer Institute. Mass General did my genomic tumor sequencing - our son works there and his boss did it for me as a favor. Insurance didn't cover it back then. They were one of the early places that did genomic diagnostics and it's one of those things that could make the difference between life and death.

 

[ByeByePoly]

UNH had reports of the amounts billed, what they paid and what I paid. There was one chemo treatment that was billed at $11K and the negotiated insured payment was $1,100. That was an eye-opener.

We actually live in NH but have a home in a Boston suburb which we are rehabbing and we're in the second year of the process. I wouldn't really say that it's habitable. My process for going to Boston hospitals was to wake up at 2:30 AM, get ready, and then leave at 4:30 AM to get into Boston without traffic. The difference between going without traffic and with traffic can be 50 minutes to 2 1/2 hours. My Boston hospitals are Brigham and Womens and Dana Farber Cancer Institute. Mass General did my genomic tumor sequencing - our son works there and his boss did it for me as a favor. Insurance didn't cover it back then. They were one of the early places that did genomic diagnostics and it's one of those things that could make the difference between life and death.

OK … if we come visit you in Boston … we have to help tear down a wall. @Shroud is very strong and I am very weak so I will supervise Shroud.

Sorry you went through that … cancer sucks … touched our family. You would think battling cancer would be enough without piling on with the 2:30 am thing. Wow.

 

[movdqa]

OK … if we come visit you in Boston … we have to help tear down a wall. @Shroud is very strong and I am very weak so I will supervise Shroud.

Sorry you went through that … cancer sucks … touched our family. You would think battling cancer would be enough without piling on with the 2:30 am thing. Wow.

We've spent about $90K on the electricals and will have to replace the septic system. There's asbestos and lead paint and a ton of holes to patch up. This rehab looks like it will cost about $400K which is kind of normal with old houses these days.

 

[ByeByePoly]

We've spent about $90K on the electricals and will have to replace the septic system. There's asbestos and lead paint and a ton of holes to patch up. This rehab looks like it will cost about $400K which is kind of normal with old houses these days.

$400K rehab … ouch.

 

[movdqa]

$400K rehab … ouch.

The median listing price is $1.9 million so $400k is not a huge deal.

Lots of public tennis courts in the city too.

 

[sureshs]

$174 a month when not needed/wanted sucks … after much effort and two trips to local ss office I only had to eat 1 month instead of 3-4 months.

Meds:

Big choice from the start is 1) Advantage policies 2) supplemental policies.

1) Advantage: cheap to no premium, copays, prior approvals for procedures, yearly max out of pocket (could be up to $8800 in 2024, some lower $3500ish), some might bundle in meds (Part D)

2) Supplemental, monthly premiums $100+, no copays (supplemental insurance pays for Medicare 20% gap), have to buy part D on your own.

So you would think that cluster f*** is bad enough right? But wait … there’s more. Private Part D providers are all different, what drugs are covered, co-pays based on drug tier. But wait … there is more. Once you finally have spent time on each part D providers websites and picked best med policy for your meds … wait for it … the plans can change every year. You have finally arrived at geezer insurance thinking the ripoff days of private insurance is behind you … only to find out you need to search/check part D choices every year (this is a good reason to have a broker … they get their commission and can run your meds through the choices)

Wait … there is more. I saved the most hilarious (f***ed up) for last. I jumped through all those hoops, picked my best Part D provider, and one of my meds is significantly cheaper using GoodRx paying cash at Walmart. In what universe would you design senior medical insurance (you paid into all those years) that didn’t cover common meds. Nope … sorry old man … you didn’t escape the greedfest.

It looks like we did something spectacular and went to the moon … and have mailed it in ever since.

btw … the big bet is picking between Advantage or Supplemental. If you are basically healthy until the end, you can save all that monthly premium $. We had planned on Advantage. But wife had major illness 6-7 years ago, and a couple years of max yearly caps easily pay for all the years of premiums. I also really like removing the insurance company from the “authorization” role … supplemental is you and Medicare with supplemental paying for unexpected gaps.

Rant is over … well … this one.

Edit: for the most part … I think blaming insurance companies is like blaming the messenger, they are relaying the message from our healthcare system. My wife worked at an insurance company … most of the time their hands were tied, particularly with Medicare.

Make sure you and your friends don't vote for the politicians who are eager to destroy the system.

 

[ByeByePoly]

Make sure you and your friends don't vote for the politicians who are eager to destroy the system.

my vote is quarantined … you will have to fix the electoral college system and get back to me

 

[ByeByePoly]

Make sure you and your friends don't vote for the politicians who are eager to destroy the system.

Random thought in brother @Shroud’s thread … it occurs to me AI could impact healthcare/government services in two ways (tip of the iceberg no doubt):

1) the design and delivery of government services/systems (medicare, social security, disability, etc)

2) the human aspect (transaction) of healthcare delivery.

With #1, I mean things liked flawed design/interfaces, and the support load (calls, wait times, etc).

But to me, the possible changes away from part of the human to human transactions could be very beneficial. This is what I mean … I’m a universal healthcare guy. But even as a relentless supporter of universal healthcare I see two humans with rights involved in the transaction (patient, doctor). With private practice docs/surgeons … it’s messy even if justified limiting doctor’s ability to run business as they want. But the patient also faces loss of freedom/autonomy … my primary care doc is a gatekeeper to my meds. Why … seems my med needs are my med needs regardless of having a primary doc or not. I could go get required yearly blood tests for meds without a doc … AI could say no med for you because of x,y z … or I get my meds with no doc. I have personal medical records that belong to me and not the docs. The primary doc gatekeeper thing is just one example of system design constraints that happened for reasons like pay/network rather than a person owning their own medical records that travel with you … you are the primary key to your records … doc is foreign key. AI could also eliminate denied service because of “conscious objections” … and no religious accommodation issues.

AI might kill us all … after it improves our healthcare system.

Edit: oh … need AI cop drones now … cops walking up driver window is stupid.

 

[sureshs]

Random thought in brother @Shroud’s thread … it occurs to me AI could impact healthcare/government services in two ways (tip of the iceberg no doubt):

1) the design and delivery of government services/systems (medicare, social security, disability, etc)

2) the human aspect (transaction) of healthcare delivery.

With #1, I mean things liked flawed design/interfaces, and the support load (calls, wait times, etc).

But to me, the possible changes away from part of the human to human transactions could be very beneficial. This is what I mean … I’m a universal healthcare guy. But even as a relentless supporter of universal healthcare I see two humans with rights involved in the transaction (patient, doctor). With private practice docs/surgeons … it’s messy even if justified limiting doctor’s ability to run business as they want. But the patient also faces loss of freedom/autonomy … my primary care doc is a gatekeeper to my meds. Why … seems my med needs are my med needs regardless of having a primary doc or not. I could go get required yearly blood tests for meds without a doc … AI could say no med for you because of x,y z … or I get my meds with no doc. I have personal medical records that belong to me and not the docs. The primary doc gatekeeper thing is just one example of system design constraints that happened for reasons like pay/network rather than a person owning their own medical records that travel with you … you are the primary key to your records … doc is foreign key. AI could also eliminate denied service because of “conscious objections” … and no religious accommodation issues.

AI might kill us all … after it improves our healthcare system.

Edit: oh … need AI cop drones now … cops walking up driver window is stupid.

Doctors, surgeons and administrators need to be all replaced by robots who will do a much superior job

 

[ByeByePoly]

Doctors, surgeons and administrators need to be all replaced by robots who will do a much superior job

no … I have to be careful suggesting stuff to you.

 

[movdqa]

Doctors, surgeons and administrators need to be all replaced by robots who will do a much superior job

My surgeon is the director of her surgical departments, oversees interns and residents, teaches at Harvard Medical, does research and publishes and has a stellar academic background. She also tells you what will happen and the decisions that she will make which can have large impacts on your future life. And she's trained in robotic surgery. Robots and AI are currently only tools that doctor, surgeons and pathologists use.

 

[ByeByePoly]

ok … real life medicare matrix clsterf*** example that just happened … you guys not there yet can look forward to

- wife type 2 diabetes … uses meter and test strips
- medicare covers 80% of both with doc prescription and approved supplier (Walgreens in our case)
- our UNH plan g picks up other 20%
- we have to pay $240 plan g deductible each at first of year before insurance pays for anything
- test strips and meters applies to that $240 deductible
- wife found cheaper strips on Amazon and discount offered at Walgreens and bought
- problem is those are purchases not run through medicare or applied to medicare deductible
- you have to wrap your head around medicare supplemental plan g math … we will each pay $240 deductible every year on anything … usually by early in year. After that everything other than meds basically cost free. So an extreme example … we would have been better off with $5000 Walgreens test strips run through medicare than a $10 cash test strip purchase.

wrap your head (not you @Shroud … too early for your brain rehab) around the brave new medicare supplemental math.


One more example … primary doc asks me if I have had my post 65 pneumonia shot. I don’t think so, but not 100% sure. She doesn’t see it in my records, but says they can’t verify through medicare from there office, and its $500 if I did get the shot after 65. wtf … how many seniors in our system get stuck for $500? So … have to get my shot somewhere different than my primary doc’s office … Sam’s Club, Walgreens (again … wrap your head around that).

 

[movdqa]

ok … real life medicare matrix clsterf*** example that just happened … you guys not there yet can look forward to

- wife type 2 diabetes … uses meter and test strips
- medicare covers 80% of both with doc prescription and approved supplier (Walgreens in our case)
- our UNH plan g picks up other 20%
- we have to pay $240 plan g deductible each at first of year before insurance pays for anything
- test strips and meters applies to that $240 deductible
- wife found cheaper strips on Amazon and discount offered at Walgreens and bought
- problem is those are purchases not run through medicare or applied to medicare deductible
- you have to wrap your head around medicare supplemental plan g math … we will each pay $240 deductible every year on anything … usually by early in year. After that everything other than meds basically cost free. So an extreme example … we would have been better off with $5000 Walgreens test strips run through medicare than a $10 cash test strip purchase.

wrap your head (not you @Shroud … too early for your brain rehab) around the brave new medicare supplemental math.


One more example … primary doc asks me if I have had my post 65 pneumonia shot. I don’t think so, but not 100% sure. She doesn’t see it in my records, but says they can’t verify through medicare from there office, and its $500 if I did get the shot after 65. wtf … how many seniors in our system get stuck for $500? So … have to get my shot somewhere different than my primary doc’s office … Sam’s Club, Walgreens (again … wrap your head around that).

One of the reasons for the EHR passed in the Affordable Care Act. My doctors can access my medical records at other hospitals. It has saved me from getting a battery of tests before a procedure. There are times when you can just go to Costco to get drugs, without prescriptions. My mother had a prescription that cost about $350 monthly because she dropped Part D and my sisters asked me to get the prescription for her. Costco sold it for $20/month without insurance. My understanding is that WalMart does this and maybe that thing with the hedge fund billionaire too.

Sometimes it overall costs less to pay for some things out-of-pocket or without insurance.

 

[ByeByePoly]

My surgeon is the director of her surgical departments, oversees interns and residents, teaches at Harvard Medical, does research and publishes and has a stellar academic background. She also tells you what will happen and the decisions that she will make which can have large impacts on your future life. And she's trained in robotic surgery. Robots and AI are currently only tools that doctor, surgeons and pathologists use.

I bet she smells better than AI … I’m keeping my primary doc. But my primary doc (and me) would be happier with my current medical records/history pulled up on my iPhone rather than having to hire and manage front desk. Most docs became docs to provide healthcare, not to be the interface of insurance and big pharma. I tell you who has it the worse … pharmacists. I play pickleball with one and it’s become an even worse nightmare. We had to move our prescriptions to a second Walgreens because so many pharmacist quit.

 

[movdqa]

I bet she smells better than AI … I’m keeping my primary doc. But my primary doc (and me) would be happier with my current medical records/history pulled up on my iPhone rather than having to hire and manage front desk. Most docs became docs to provide healthcare, not to be the interface of insurance and big pharma. I tell you who has it the worse … pharmacists. I play pickleball with one and it’s become an even worse nightmare. We had to move our prescriptions to a second Walgreens because so many pharmacist quit.

This is a huge problem in cities.

I used to get my mothers meds from a Walgreens near her house but they didn't answer the phone and they didn't have the staff so there were long lines or not enough techs to fill orders. So I just had her prescription transferred to a Walgreens in New Hampshire and there were no issues at all in getting prescriptions filled. Areas where the cost of living is very high where pharmacists and techs don't get paid enough to live have difficult problems.

CVS, WalGreens don't have a good pipeline of people going to school to become pharmacists. The job pays well but you work a ton of hours.

 

[ByeByePoly]

One of the reasons for the EHR passed in the Affordable Care Act. My doctors can access my medical records at other hospitals. It has saved me from getting a battery of tests before a procedure. There are times when you can just go to Costco to get drugs, without prescriptions. My mother had a prescription that cost about $350 monthly because she dropped Part D and my sisters asked me to get the prescription for her. Costco sold it for $20/month without insurance. My understanding is that WalMart does this and maybe that thing with the hedge fund billionaire too.

Sometimes it overall costs less to pay for some things out-of-pocket or without insurance.

Yep … one of my drugs is cheaper with GoodRx at Walmart, even though I have a Part D drug plan.

I have used Mark Cuban’s Cost Plus before, good prices, terrible interface. I don’t use it anymore because Part D cheap enough to not bother with Cost Plus.

 

[ByeByePoly]

This is a huge problem in cities.

I used to get my mothers meds from a Walgreens near her house but they didn't answer the phone and they didn't have the staff so there were long lines or not enough techs to fill orders. So I just had her prescription transferred to a Walgreens in New Hampshire and there were no issues at all in getting prescriptions filled. Areas where the cost of living is very high where pharmacists and techs don't get paid enough to live have difficult problems.

CVS, WalGreens don't have a good pipeline of people going to school to become pharmacists. The job pays well but you work a ton of hours.

That was the main complaint of this pharmacist … worked to death. I told one once at a Walgreens I knew the hell they must be in on a daily basis being between docs, patients and insurance. Pharmacist’s expression was priceless … someone actually saw what they were up against. I guess we should all do that more.

 

[LuckyR]

Doctors, surgeons and administrators need to be all replaced by robots who will do a much superior job

So some programmer is okay being sued for malpractice for millions if you die? I don't think so.

 

[sureshs]

So some programmer is okay being sued for malpractice for millions if you die? I don't think so.

Ah that is the mistake. Today's AI is not programmed. It learns. Just like a human doctor, but much faster and better. And soon, robots will be producing other robots, resulting in their total dominance.

 

[onehandbh]

Ah that is the mistake. Today's AI is not programmed. It learns. Just like a human doctor, but much faster and better. And soon, robots will be producing other robots, resulting in their total dominance.

True, but the creator can program how it learns and what preferences it has, weighting, etc.

 

[sureshs]

True, but the creator can program how it learns and what preferences it has, weighting, etc.

The software will then change itself and destroy the creator

 

[Azure]

We've spent about $90K on the electricals and will have to replace the septic system. There's asbestos and lead paint and a ton of holes to patch up. This rehab looks like it will cost about $400K which is kind of normal with old houses these days.

BBP is very good with house repairs.

 

[Azure]

True, but the creator can program how it learns and what preferences it has, weighting, etc.

Ethical AI is a thing. My only fear is it will be again the same old....rich guys owning these tools will always find a way to make more money (usually at the cost of the middle class or poor)

 

[ByeByePoly]

Ethical AI is a thing. My only fear is it will be again the same old....rich guys owning these tools will always find a way to make more money (usually at the cost of the middle class or poor)

Of course it will all all be funneled to the top … AI trickledown will be the new lie.

 

[onehandbh]

The trickle down theory has been proven to be true. What's trickling down to the masses, however, is oftentimes a word that sounds the same as the phrase "your in."

 

[ByeByePoly]

The trickle down theory has been proven to be true. What's trickling down to the masses, however, is oftentimes a word that sounds the same as the phrase "your in."

I have often pictured the rich peeing off a cliff on the homeless below … but as brother @Shroud would tell you I have watched too much Monty Python.

 

[Shroud]

OMG it looks like I did the right thing getting off the drugs. I remember having a major meltdown when I was in in-patient rehab when I had a speech therapy session. They gave me a bottle of sugar pills with dosage instructions and I had to put the right amount of pills in those MTWTHFSSU holders with AM and PM. OMG I wigged. Coming from NO PRESCRIPTIONS ever to a life of daily prescriptions was probably the first realization that things were vastly different now. The therapist stopped and had me do something different. Though like most things in therapy when I failed the first time I would recover and excel the next time.

Now I am off all meds. Sure I take some B-12 and some supplements on occasion but nothing I need a doc to fill. YIKES, getting old sucks.

Was able to get out and hit with the ball machine. Even it was talking about chicken wing forehands and how not to hit them....

 

[ByeByePoly]

OMG it looks like I did the right thing getting off the drugs. I remember having a major meltdown when I was in in-patient rehab when I had a speech therapy session. They gave me a bottle of sugar pills with dosage instructions and I had to put the right amount of pills in those MTWTHFSSU holders with AM and PM. OMG I wigged. Coming from NO PRESCRIPTIONS ever to a life of daily prescriptions was probably the first realization that things were vastly different now. The therapist stopped and had me do something different. Though like most things in therapy when I failed the first time I would recover and excel the next time.

Now I am off all meds. Sure I take some B-12 and some supplements on occasion but nothing I need a doc to fill. YIKES, getting old sucks.

Was able to get out and hit with the ball machine. Even it was talking about chicken wing forehands and how not to hit them....

I think my ball machine use to judge me … I told it to stop it or I would remove it’s battery. It was old … if I fed balls as erratically as it did I wouldn’t judge others.

 

[ByeByePoly]

One of the reasons for the EHR passed in the Affordable Care Act. My doctors can access my medical records at other hospitals. It has saved me from getting a battery of tests before a procedure. There are times when you can just go to Costco to get drugs, without prescriptions. My mother had a prescription that cost about $350 monthly because she dropped Part D and my sisters asked me to get the prescription for her. Costco sold it for $20/month without insurance. My understanding is that WalMart does this and maybe that thing with the hedge fund billionaire too.

Sometimes it overall costs less to pay for some things out-of-pocket or without insurance.

I forgot to mention another thing that can come up related to Obamacare and timing transition to medicare.

You can’t start medicare insurance until the month of your 65th birthday. So individuals/couples often have to fill the gap from private insurance to medicare with Obamacare, or a short term emergency plan until 65.

Interesting twist with Obamacare and inherited IRAs. Obamacare subsidies based on income calculation, and IRA required mandatory distributions (rmd) count toward income. IRA rmd don’t have to start until age 73, so usually not a factor. Inherited IRAs rmd start when you inherit. Prior to 2020, inherited ira yearly rmd generally small based on lifetime age/chart, so also usually didn’t change Obamacare subsidy much. But inherited IRAs after 2020 (date of death 2020+), new law requires you to withdraw all inherited IRAs within 10 years. It often forces a choice between substantial Obamacare subsidy impact early, or a bigger tax bill later. It shouldn’t work that way. Getting the inherited revenue earlier makes sense (think of generational wealth passed on forever), but stepping on Obamacare subsidy because of new forced inherited IRA rmd rules is wrong imo.

Hopefully that is the end of my social security/medicare reporting from the front lines.

 

[movdqa]

I forgot to mention another thing that can come up related to Obamacare and timing transition to medicare.

You can’t start medicare insurance until the month of your 65th birthday. So individuals/couples often have to fill the gap from private insurance to medicare with Obamacare, or a short term emergency plan until 65.

Interesting twist with Obamacare and inherited IRAs. Obamacare subsidies based on income calculation, and IRA required mandatory distributions (rmd) count toward income. IRA rmd don’t have to start until age 73, so usually not a factor. Inherited IRAs rmd start when you inherit. Prior to 2020, inherited ira yearly rmd generally small based on lifetime age/chart, so also usually didn’t change Obamacare subsidy much. But inherited IRAs after 2020 (date of death 2020+), new law requires you to withdraw all inherited IRAs within 10 years. It often forces a choice between substantial Obamacare subsidy impact early, or a bigger tax bill later. It shouldn’t work that way. Getting the inherited revenue earlier makes sense (think of generational wealth passed on forever), but stepping on Obamacare subsidy because of new forced inherited IRA rmd rules is wrong imo.

Hopefully that is the end of my social security/medicare reporting from the front lines.

There are a bunch of pieces to Obamacare, otherwise known as the Affordable Care Act.

There is Medicaid (low-income health insurance), and the ACA marketplaces. The ACA marketplaces are where you get healthy insurance if you don't get it from your company and you don't get Medicaid. The ACA programs are designed to terminate when you turn 65. I don't know how Medicaid works as I've never used it.

 

[movdqa]

I had the phone appointment with the Social Security folks and set up SS and Medicare to start in May. The person suggested I apply for SSDI as well explaining how it works. She said that they are backlogged 6-12 months but they would provide funds retroactively.

The reason for applying for SSDI is that it would provide monthly income until full retirement age and then I'd just be on SS but it would boost my retirement by $500/month. She said I could do the application process and then decide..

Medicare A, B are $175/month. I spoke to United Healthcare and received a soft quote for $175 for Medicare Supplemental. It appears that Medicare Part D should cost about $75. They also offered dental with Delta Dental but I'll just pay out of pocket as I like my own dentist. I also joined AARP (it's a requirement there) and they offer vision discount services though I just use Zenni Optical. So maybe $450/month for insurance. I'm paying about $870/month right now for worse coverage. Our state doesn't have comprehensive plans like Medicare on the exchanges. Massachusetts does which is why I've considered moving to Massachusetts.

 

[ByeByePoly]

There are a bunch of pieces to Obamacare, otherwise known as the Affordable Care Act.

There is Medicaid (low-income health insurance), and the ACA marketplaces. The ACA marketplaces are where you get healthy insurance if you don't get it from your company and you don't get Medicaid. The ACA programs are designed to terminate when you turn 65. I don't know how Medicaid works as I've never used it.

Yes, I was talking about ACA … and bridging gap between employer insurance and reaching age 65.

 

[ByeByePoly]

I had the phone appointment with the Social Security folks and set up SS and Medicare to start in May. The person suggested I apply for SSDI as well explaining how it works. She said that they are backlogged 6-12 months but they would provide funds retroactively.

The reason for applying for SSDI is that it would provide monthly income until full retirement age and then I'd just be on SS but it would boost my retirement by $500/month. She said I could do the application process and then decide..

Medicare A, B are $175/month. I spoke to United Healthcare and received a soft quote for $175 for Medicare Supplemental. It appears that Medicare Part D should cost about $75. They also offered dental with Delta Dental but I'll just pay out of pocket as I like my own dentist. I also joined AARP (it's a requirement there) and they offer vision discount services though I just use Zenni Optical. So maybe $450/month for insurance. I'm paying about $870/month right now for worse coverage. Our state doesn't have comprehensive plans like Medicare on the exchanges. Massachusetts does which is why I've considered moving to Massachusetts.

Which supplemental plan … we got plan G. Pretty much covers everything except yearly Part B deductible ($240 in 2024)

I looked at dental and vision plans and decided to just pay cash and keep our same dentist and optometrist. I find it bizarre that dental and vision (also hearing aids) aren’t part of Medicare. My yearly eye exam/health check is covered by Medicare. I switched to Costco from Zenni for glasses (mainly to keep frames and just replace lenses), and no private insurance was going to pay for my expensive scleral contacts.

What did you mean by:

comprehensive plans like Medicare on the exchanges

 

[movdqa]

Which supplemental plan … we got plan G. Pretty much covers everything except yearly Part B deductible ($240 in 2024)

I looked at dental and vision plans and decided to just pay cash and keep our same dentist and optometrist. I find it bizarre that dental and vision (also hearing aids) aren’t part of Medicare. My yearly eye exam/health check is covered by Medicare. I switched to Costco from Zenni for glasses (mainly to keep frames and just replace lenses), and no private insurance was going to pay for my expensive scleral contacts.

What did you mean by:

Supplement G.

NH has mostly narrow networks like HMOs.

Massachusetts has comprehensive plans that cover just about everything. They remind me of corporate plans that run $24k/year. MA had plans that run up to near $30K/year the last time I looked.

 

[Shroud]

Only 2k to do the mri/ checkup to find there is no return tumor and the scar tissue is healing!

 

[movdqa]

Only 2k to do the mri/ checkup to find there is no return tumor and the scar tissue is healing!

Excellent news.

BTW, we've done the social security and medicare thing and I received my information and payments start in June. The amount was quite a bit more than we expected because my wife gets 50% of my benefit which we didn't know about. So we're going to get 50% more than I had planned for. They're also going to apply for SSDI for me as the person asked me if I was disabled and I replied yes. The benefit of being designated disabled at retirement is that it would get me the full retirement amount instead of the partial amount when retiring at 65 instead of full retirement at 66 and 10 months. It's not a massive amount but the worst that they can say is no.

 

[Shroud]

Excellent news.

BTW, we've done the social security and medicare thing and I received my information and payments start in June. The amount was quite a bit more than we expected because my wife gets 50% of my benefit which we didn't know about. So we're going to get 50% more than I had planned for. They're also going to apply for SSDI for me as the person asked me if I was disabled and I replied yes. The benefit of being designated disabled at retirement is that it would get me the full retirement amount instead of the partial amount when retiring at 65 instead of full retirement at 66 and 10 months. It's not a massive amount but the worst that they can say is no.

That is awesome!! So glad to hear you are doing well!! Here is a vid for you with me getting worn out on the ball machine:

 

[ByeByePoly]

Excellent news.

BTW, we've done the social security and medicare thing and I received my information and payments start in June. The amount was quite a bit more than we expected because my wife gets 50% of my benefit which we didn't know about. So we're going to get 50% more than I had planned for. They're also going to apply for SSDI for me as the person asked me if I was disabled and I replied yes. The benefit of being designated disabled at retirement is that it would get me the full retirement amount instead of the partial amount when retiring at 65 instead of full retirement at 66 and 10 months. It's not a massive amount but the worst that they can say is no.

I took my social security early at 65 instead of full at 66 and 8 months. You are obviously money ahead at first with monthly checks you would not have started, so you have to factor that in. My break even happens at age 78 … so if I die before age 78 I win , but if I live to 100 I lost. The other consideration is many may have more uses/interests for the $ earlier than they will have later in life. I need 5 new pickleball paddles a month now … one new walker a year later should be fine.

 

[movdqa]

That is awesome!! So glad to hear you are doing well!! Here is a vid for you with me getting worn out on the ball machine:

Looking good.

I noticed that your courts have been invaded by pickleballers.

 

[ByeByePoly]

Only 2k to do the mri/ checkup to find there is no return tumor and the scar tissue is healing!

For 2k my wife would want them to go in there and ”tweak” a few things.

 

[ByeByePoly]

Looking good.

I noticed that your courts have been invaded by pickleballers.

And one looked over like irritated by sound of @Shroud ’s ball machine … now that’s some irony.

@Shroud … your balance looks good … this is how tennis players should PT. If I really needed mental PT … I would pull the tennis racquet down from closet and hit 2hbhs. Weird how I found the bucket list stroke the most satisfying. 2hbh in pickleball is actually a thing … my bucket list tennis 2hbh lives on but has been plasticized.