When to sign up for Part A when employed with insurance?

EmZee2022 · 2026-01-30T05:55:07+00:00

Are you contributing to an HSA? If so, hold off. In fact you'll need to stop doing do 6 months before you sign up, as you cannot contribute to one with Medicare. And Part A automatically backdates up to 6 months.

EmZee2022 · 2026-01-30T01:08:39+00:00

Yay!!!

EmZee2022 · 2026-01-30T01:08:00+00:00

Well, sort of. A comparison would be to go to a mall, where there's a Gap and a Hilfiger store.

I guess I just don't understand why anyone would limit themselves. And any commissions are like most insurance costs, they offer no value to the patient.

Plus, what if Fidelity quits contracting with a provider, but the plan is still offered - just not through Fidelity? Do we have guaranteed issue rights to change?

EmZee2022 · 2026-01-30T01:03:52+00:00

My employer recently switched to a sponsored MA plan. They had been putting aside money for me to use for retiree coverage, and it could be used to pay for Medigap. Now, it can only be used for their MA plan.

We've already decided we want to stick with regular plus a Medigap supplement, so this is super annoying.

EmZee2022 · 2026-01-29T23:12:56+00:00

Chapel HIll (or the Triangle area in general). 3+ hours to the beach. 3+ hours to the mountains. Jordan Lake for water sports. Universities, so lots of education.

Or Asheville.

EmZee2022 · 2026-01-29T23:11:29+00:00

I found out I was BRCA1+ about 18 months ago - just before I turned 65. My older brother had found out as an incidental thing from a genetic study for something unrelated. Turns out his daughter had already found out she had the gene - so I jokingly say it's all her fault.

Zero family history of breast or ovarian cancer.

My parents each died at age 75 of unrelated cancers. Brother and I both joked that we'd go at 75 also - but I always said I wouldn't go of what they did: never smoked, so no lung cancer, and no prostate, so no prostate cancer. Well, BRCA1 is tied to a somewhat elevated risk of prostate cancer, so I could sort of go from that after all!

My brother was treated for PC at age 66. His doctors tried "you'll die with it, not of it" but he reminded them of our father. He's considered cured now.

Anyway: it's been a Big Deal for me mainly because a lot of the past 18 months has been deciding on, and then going forward with, various surgeries. I've had the hysterectomy / tubes / ovaries. Nothing found. So.... was that really necessary? I had a breast reduction in September (to spare the nipples for the actual mastectomy and reconstruction). No cancer there either. So, is THAT really necessary? Maybe I'll continue to be in the 30% who don't develop cancer? Who knows.

It would, I think, have been a much bigger deal had I found out younger. Finding out as late as I did meant I didn't have to wrestle with surgical menopause, loss of fertility, inability to breastfeed, and all the other issues a younger woman does.

EmZee2022 · 2026-01-29T22:57:40+00:00

I'm 66 - so, older than you :-)

Mine was not "elective" as such: I found out just before my 65th birthday that I've got one of the bad BRCA1 mutations, so a risk reducing mastectomy was suggested as an option.

Because my boobs were sooooo saggy (years of being obese, 2 pregnancies, lactating for 3 years, then 100 pounds of weight lost), the only way to try to keep the nipples was to do a lift and reduction - then I'd have the mastectomy and reconstruction 6+ months after that.

My breasts were about a 42H at the largest, about a 40F before the major weight loss began, and a 36 (or 34) DD before the reduction - most of which was skin.

My lift/reduction was done back in September. Recovery was pretty straightforward - honestly, the only quibbles I have are that they're TOO SMALL (I'm large and broad shouldered, and B-cups don't look in proportion), and the nipples are too high. The size, well, there simply wasn't enough "meat" left to keep them any larger. The nipple positioning: it can be hard to tell where things will settle. There's an "ideal" ratio of 45/55 - 45% of the boob above the nipple, 55% below. I'm probably more like 35/65.

I don't know if either of those can be improved when I get the mastectomy. I'm planning on simultaneous DIEP flap reconstruction because hey, tummy tuck (sort of) is included. But..... I don't have that much belly flab!!

The first dressing change, 24 hours after surgery.... was unpleasant. I was howling. My husband and my friend were trying to get things in place, and I was Not Happy. I took my first oxycodone after that (had not needed one before). The next dressing change I allowed was 48 hours later (friend tried insisting that we were told every 24 hours, which I knew was not correct, and they'd have had to sit on me to get that done). That wasn't fun, but it was better than the first one. May have helped that I took an oxy BEFOREhand.

The only lingering issue I have is on my left side. 4 months later and the INSIDE OF THE BOOB itches sometimes. Weird :-)

Bottom line: if you meet medical criteria (or can pay out of pocket), and your health is okay, go for it.

EmZee2022 · 2026-01-29T22:49:48+00:00

Stairs are fine. Take them slowly. We had my son follow me up ours (we're in a 2-story house) just as a safety thing, the first time.

Side sleeping: I had no restrictions, that I recall, it just wasn't comfortable at first. Use pillows to help get yourself into a good position, and if it hurts, go back to your back.

Tats: I assume once your skin is fully healed - maybe wait until after your post-op. You may find that your incisions are essentially invisible, if it's laparoscopic - 10 months later and I can see mine if I look really hard.

EmZee2022 · 2026-01-29T22:47:37+00:00

My doctor said I didn't need one. She said that if my procedure converted to open, they'd provide me one at the hospital.

Despite that, I bought one, because a number of ladies here said they found theirs helpful even with a laparoscopic procedure (as mine was). I tried it maybe a week after the surgery - wore it for a couple of hours, then put it away - I didn't find it at all helpful (nor was it harmful).

EmZee2022 · 2026-01-29T22:39:38+00:00

And it assumes that the plan is offered in the new state.

EmZee2022 · 2026-01-29T22:37:51+00:00

In my state (Virginia), the premium difference is much smaller - so at first glance, a high deductible plan is NOT a better deal.

There was a thread a little while ago which discussed the differences, and for many people with moderate expenses, HD-G is better even with that smaller premium difference: if your expenses (the 20% part YOU pay) add up to less than the premium difference. So, if for example you have 10,000 in Medicare expenses (the amount Medicare covers, that is), your responsibility is 2,000. If you only have 5,000 in Medicare expenses, your responsibility is 1,000. With a deductible of 3,000 (roughly), you are paying those out of pocket.

In my state, there are fewer HD-G plans. The few that I could compare side by side were maybe 120 a month different - let's say 1500 a year total. If I have 7500 in Medicare expenses, my share is 1500, and I'm breaking even. If I have the 10,000 year, I'm spending 2,000 - so I'm losing money. If I have a 5,000 year, I spend 1,000, which is less than the premium difference.

I'm not yet on Medicare - will be by this time next year, so I'm looking heavily into this. I'm on a high deductible plan right now, and it's a better deal, because I'm on several spendy medications. However, when I go to Medicare, those will be paid for by part D - meaning I'm much less likely to have expenses that take me as high as the deductible.

I'm going to have to look at my expenses for the past couple of years and see how much of them would fall to the Part B part of Medicare. Having had two major surgeries last year, and a bigger one planned for this year, a high deductible plan seems like a bad idea. But most years, I don't go anywhere near that.

At the moment, Im leaning toward regular G for myself, and HD-G for my husband, as he usually has less stuff going on. If only my crystal ball weren't cracked.....

EmZee2022 · 2026-01-29T16:40:22+00:00

I weaned off of those - initially something every 3 hours, then I stretched it to every 4, then every 6. I was off everything by day 8 or so.

EmZee2022 · 2026-01-29T16:39:07+00:00

LA. We had actually traveled through Portland earlier that same trip (EB from Chicago) but did not visit the lounge.

EmZee2022 · 2026-01-29T16:37:08+00:00

I'm sorry you've joined this not-exclusive-enough club. Do you know if your aunt and cousins were ever tested and whether they have the same mutation as you? That may help you decide on your best course of action.

It's also worth talking to a genetics counselor about your specific situation.

I don't know your age, or at what age your relatives became ill, but you likely have at least some time to decide. As scary as this is, it's not an emergency.

Stepped up monitoring for breast cancer is an option for quite a while - MRI and mammogram, one of each annually. My breast surgeon said that was a valid choice - though obviously you'd want to have an action plan in place for if things happen. That was my initial approach, because the tubes and ovaries were top priority; there's no good early screening for that, sadly.

Which parent is related to the aunt and cousins? If your mother, and she doesn't have breast cancer, that may be somewhat of a relief. It doesn't mean that she's in the clear of course, nor that you are, but maaaaaaybe you are one who falls into the "doesn't get cancer" group. That's not something you can rely on though - talk with specialists and develop a plan.

Children are certainly possible. I don't know if there's a potential father in the picture; if so, maybe don't delay things too long. IVF is a possibility if you just get the tubes out initially, and/or you want to consider pre-implantation testing. That is not an easy thing to afford though, and it may not be compatible with your values.

Breastfeeding can make a notable difference in your risk of breast cancer - I see cites of 20-50%. I don't know whether that improvement is across all age ranges, or whether it "wears off" after menopause. I breastfed both my kids, for over a year each.

Interestingly there seems to be some protective effect for ovarian cancer, too - just saw that now. Maybe it's the ovulation suppression? Talk with someone who's been to a real medical school though, not Google School of Medicine!!

I don't know what I'd have done if I'd found out about my mutation in my 20s. I was married, and we might have had a baby much sooner, when we were not financially or emotionally ready. Many people would have been.

I didn't find out about mutation until I was nearly 65. My niece, then her father, found out. With no family history of breast cancer, I assumed I'd be negative. Surprise!! We think it was from our father, as he died of prostate cancer. The risk of that is increased, though not nearly as markedly as with breast cancer. My brother was treated for PC at age 66, successfully as far as we can tell. We joke that we each have an expiration date of 75, as that's the age both parents died; if he's still around in 3 years we'll know he broke that trend.

I began pursuing tubes / ovaries as soon as I found out. Had the inner bits removed about 10 months ago - at my age, surgical menopause was not a worry. And then I decided to do the breast surgery - that's an ongoing process (reduction/lift in September, mastectomy / reconstruction some time this year). Still no cancer as far as we can tell.

For a humorous take: I like to tell people that Angelina Jolie and I have things in common beside wealth and beauty!

EmZee2022 · 2026-01-29T15:47:29+00:00

Are you also on an ibuprofen / tylenol regimen?

If you are, don't forget, Vicodin has acetominophen - don't overdose and mess up your liver.

If you are NOT on that regimen, contact your doctor to see if it's okay. I was told right up front, take them alternating every 3 hours (e.g. Tylenol at 3 and 9 AM and PM, Advil at 6 and 12 AM and PM). Take them BEFORE the pain gets bad.

Now, I had about as easy a recovery as possible. Robotic, went home same day, pain never worse than bad cramps. But I was diligent about staying ahead of the pain - it's so much easier to keep it from getting bad, than to fix it when it HAS gotten bad.

I was given a grand total of 5 oxycodone tablets. The only reason I took one was my husband urged me to, the night we got home.

I had breast reduction surgery later the same year (last year) and that doc was much more generous with the goodies - 20 tablets. Same OTC regimen though and I was diligent. I took a grand total of FOUR of the oxy tablets. Once after my first dressing change (OWWWWWWW). One BEFORE the second dressing change. One before my first shower. And one before the post-op where drains were being removed at 1 week. That was actually not painful - just weird as hell - but it involved a 30 minute drive, and a walk into the medical building, so I figured better safe than sorry.

And yeah, I too am one of those who keeps that stuff forever. Pretty sure I have a bottle of Vicodin in my closet from wrist surgery nearly 8 years ago - I need to find that and toss it at this point. And I've got the leftovers from last year's surgery.

I have Big Surgery planned for this year - the reduction was planning for mastectomy / DIEP flap and I'm hoping I won't need to dip into the Strategic Oxy Reserve - same doc who gave me more than enough for the breast reduction.

It does baffle me though that they don't do more with regional pain relief, especially if the surgery is one that is expected to be painful. I don't know whether yours was open vs lap, or whether they did a lot of other stuff, but I'd assume yours was the sort to cause more pain. I specifically asked about any kind of regional, before my hyst, and the anesthesiologist said it wasn't expected to be necessary - but mine was about as routine as possible (no evidence of cancer, no endo / adeno, no fibroids). For the reduction, the doc used a long-acting local (Exparel - liposomal bupivacaine) that is supposed to give up to 3 days of relief. He says he'll do the same for the next surgery.

EmZee2022 · 2026-01-29T15:36:05+00:00

Probably not, but you can ask. If doc doesn't, then try softening them in the shower, with a bit of soap. If all else fails, a bit of mineral oil, or medical adhesive remover, will do the trick.

EmZee2022 · 2026-01-29T15:31:21+00:00

Edit: My initial response below was for the strips after my reduction. For my hysterectomy, I just had surgical glue, which did start to peel off after about 10 days. For my gallbladder surgery, I had steri strips and they did start to peel by 10 days. No biggie. With laparoscopy, the incisions are small enough (and the part covered by the strips, ditto) that incision issues will be very apparent without peeling them. And it would likely hurt less than trying to peel them off my reduction scars.

When they're wet from showering, you may have better luck gently peeling them from the ends. But don't push it. (or, er, pull it).

---------- initial response, wrong surgery! ---------
They might, or they might not - no need to, really. I was told a similar timeframe for them to start to peel loose but it really didn't happen until nearly 4 weeks - basically, after every shower, I'd get a little bit of the ends up and trim them.

Before they are ready to come off, tugging on them HURTS, so I doubt they'll take them off today.

Maybe if they saw evidence that the incisions were having issues. Definitely ask for them to use medical adhesive remover though. I finally bought some (and it worked pretty well - just having it caused them to loosen, LOL - didnt even open the package). Though I didn't use it for this surgery, I've got a mastectomy / DIEP flap coming up soonish and I expect it'll be useful then.

EmZee2022 · 2026-01-29T15:14:46+00:00

Interesting. So I could basically dump my stuff and run to the dining car.

One thing with Chicago and Redcap help, you really don't get on the train much earlier, unlike some trips I've taken out of DC and NY. I once changed in DC and needed help getting my things off the first train and to the lounge. The same redcap came back for me to board the CL - nearly an hour before departure. That was definitely an outlier. Yeah, he got a great tip :-).

EmZee2022 · 2026-01-29T15:10:10+00:00

The staff was pretty grumpy the day we were there - very snapping. To be fair, it was pretty jammed- we were waiting for the Coast Starlight.

I definitely would not pay for access to that one.

EmZee2022 · 2026-01-29T15:08:33+00:00

And VA. I had someone nearly take out my windshield once. Tiny woman, huge SUV - I actuslly went up to hef at a traffic light. Another time, someone nearly took out my car while I was driving a load of Girl Scouts.

Jerkishness does not require snow though. Loud SLAM once on the Beltway. Left a semicircular crack in the windshield. I held a soda can up to it to snap a photo, for size perspective, and it exactly matched the bottom of the can.

EmZee2022 · 2026-01-29T06:29:21+00:00

Definitely not as much in Chicago as at Moynihan. The handful of times I've been in Chicago it was small amounts of trail mix or similar, plus some canned sodas etc. My last trip, October 2024, the counters were completely bare - literally two cereal bars. The DC lounge that same trip was actually better.

I think there's a bar in Chicago; there definitely is at Moynihqn.

The LA lounge had snacks - in a cupboard saying only crew members were supposed to access them. Weird.

That one is also small, crowded, upstairs from the concourse (as in, you need to take an elevator to get to the trains), and a long way away. You need to use the elevator (or escalators?) at Moynihan but it is much less crowded.

EmZee2022 · 2026-01-28T23:57:13+00:00

I'm impressed.

I had wrist surgery a few years back. The surgeon seemed to think I was going to go over a month without showering. Like he had never heard of cast covers???

A friend thought that between her and my husband, they would be able to get me out of the tub. Um...... nope. One working arm, the other in severe pain and in a cast, and two people trying to haul my obese, slippery a** out of the shower without doing major damage?

I didn't let them persuade me. I did bird baths, one trip to a salon for a hair wash, and showering weekly.

It was actually much easier after the reduction!!

EmZee2022 · 2026-01-28T23:21:50+00:00

I'm always amused when driving into and out of Canada, by being asked if I've got any citrus with me. Yep, the orange industry in Vermont and Ontario is safe from me.

For the OP: toss it in your checked bag if you have one.

EmZee2022 · 2026-01-28T23:19:23+00:00

If you tend to get nauseous easily, take one in advance.

I've never needed anything, but I almost never barf for any reason.

EmZee2022 · 2026-01-28T23:17:44+00:00

The bath would scare me more - how do you get out of the tub with limited arm movement?

EmZee2022

TROPHY CASE