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Esteemed Contributor
Posts: 7,043
Registered: ‎03-15-2010

Re: Getting switched with little warning into Medicare Advantage

[ Edited ]

I've read through most of the posts and not sure I fully understand how this could happen other than the woman NOT reading her insurance letter and staying informed about her coverage.

 

I'm a retired Federal employee and took my health insurance into retirement.  This acts as my "supplemental" insurance, while Medicare became the primary payer.  Since I do not receive SS benefits, I must pay for the coverage quarterly with a check paid directly to Medicare.  Someone told me you can have it deducted from your retirement, but I've not checked into that.

 

After reading a great deal about my options, I finally determined that the insurance coverage I had through Government Employees Health Association (GEHA - United Health), was as good or better than any plan I might purchase outside.  So, I stayed enrolled. 

 

I have an annual option to chose another plan during open season.

 

I realize that it is different for everyone, especially those who do not have an employer provided plan that they can take into retirement.  I pay a fair amount for mine, but it is the same for retirees and employees, and the government continues to pay a portion of that fee.  Premiums are deducted from my monthly retirement check.

 

Since DH is not 65 yet, his primary insurance continues to be GEHA.

 

Certainly, it can be confusing, but there are lots of resources for helping to figure things out.  It's unfortunate when someone is caught off guard, but it pays to remain vigilent when it comes to insurance matters.

Respected Contributor
Posts: 3,970
Registered: ‎03-16-2010

Re: Getting switched with little warning into Medicare Advantage

@Tinkrbl44

 

Medicare Part B should not ever be considered medi-gap insurance.  Medicare part B is part of a full coverage plan.

 

Supplemental insurance or Medi-gap insurance are plans that private insurance companies offer that help cover expenses that both Part A and Part B don't cover.

 

In fact, in order to subscribe to a Medi-gap plan, the individual must have both Part A and Part B portions of Medicare.

 

Medicare part A only covers major hospitalization, hospice, home health.  it does not cover doctor office visits, outpatient procedures, labs or tests run in or by a doctor's office, etc.  So Part B is the primary medicare coverage for those health care costs.

 

Here is the website that explains Medi-gap plans:

 

https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html


* Freedom has a taste the protected will never know *
Respected Contributor
Posts: 3,516
Registered: ‎04-04-2015

Re: Getting switched with little warning into Medicare Advantage

As a retired Fed, you can have your Medicare deducted from your retirement - I do.

 

This may be the only thing on this whole thread I do know.

 

However, I am learning.

 

I, too, kept my Federal insurance as my supplement.  Kaiser is an HMO and I think they offer Medicare Advantage plans (but don't quote me on that.)  However, they did not put me in one - so maybe they don't.

 

I still say that it should be something "offered" to the person - NOT something they have to make an effort to refuse.

Honored Contributor
Posts: 33,079
Registered: ‎08-23-2010

Re: Getting switched with little warning into Medicare Advantage


@pitdakota wrote:

@Tinkrbl44

 

Medicare Part B should not ever be considered medi-gap insurance.  Medicare part B is part of a full coverage plan.

 

Supplemental insurance or Medi-gap insurance are plans that private insurance companies offer that help cover expenses that both Part A and Part B don't cover.

 

In fact, in order to subscribe to a Medi-gap plan, the individual must have both Part A and Part B portions of Medicare.

 

Medicare part A only covers major hospitalization, hospice, home health.  it does not cover doctor office visits, outpatient procedures, labs or tests run in or by a doctor's office, etc.  So Part B is the primary medicare coverage for those health care costs.

 

Here is the website that explains Medi-gap plans:

 

https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html


@pitdakota

 

??????   What are you talking about???     I think you misunderstood (or didn't read) my original description.  

 

NEVER did I imply that Part A covers doctors, etc ... see your sentence underlined above.

 

Where are you getting this from?   Not trying to split hairs here.   The intention was to help clarify the difference in the simplest number of words.   That's all.   There are plenty of resources for those transitioning to some version of Medicare coverage and need to do more reading on the options.  

 

I hope neither of us accidentally confuses anyone even more. 

 

 

Respected Contributor
Posts: 3,970
Registered: ‎03-16-2010

Re: Getting switched with little warning into Medicare Advantage

@Tinkrbl44, I am trying to explain that Part B is not a medicare supplement or medi-gap plan.  That is all.  Just want to make sure that people understand what part A and part B covers. 

 

But I also don't want people getting confused thinking part B is a medi-gap plan and think that they don't need part B.   They are not the same thing.   

 

medi-gap plans are not offered by medicare at all, they are offered by private insurance companies and help to cover costs that are not covered by parts A and B for those enrolled in traditional medicare.     That's all.  Heart

 

 


* Freedom has a taste the protected will never know *
Honored Contributor
Posts: 9,310
Registered: ‎03-09-2010

Re: Getting switched with little warning into Medicare Advantage


@pitdakota wrote:

@Tinkrbl44, I am trying to explain that Part B is not a medicare supplement or medi-gap plan.  That is all.  Just want to make sure that people understand what part A and part B covers. 

 

But I also don't want people getting confused thinking part B is a medi-gap plan and think that they don't need part B.   They are not the same thing.   

 

medi-gap plans are not offered by medicare at all, they are offered by private insurance companies and help to cover costs that are not covered by parts A and B for those enrolled in traditional medicare.     That's all.  Heart

 

 


@pitdakota I'm learing a lot reading your posts, so thank you.  I'm not on Medicare yet but this is important information, I appreciate your knowledge.

Honored Contributor
Posts: 33,079
Registered: ‎08-23-2010

Re: Getting switched with little warning into Medicare Advantage


@pitdakota wrote:

@Tinkrbl44, I am trying to explain that Part B is not a medicare supplement or medi-gap plan.  That is all.  Just want to make sure that people understand what part A and part B covers. 

 

But I also don't want people getting confused thinking part B is a medi-gap plan and think that they don't need part B.   They are not the same thing.   

 

medi-gap plans are not offered by medicare at all, they are offered by private insurance companies and help to cover costs that are not covered by parts A and B for those enrolled in traditional medicare.     That's all.  Heart

 

 


@pitdakota

 

I went back and re-read all my comments and there is nothing to even suggest that people don't need Part B. The only suggestions of that came from your posts.  

 

If anyone is not clear, they can google "what is medicare supplement?" and see all the "initial" plan options for Part B. 

 

@pitdakota   I'm not presuming to hold a Medicare insurance class here, so if you wish to continue to go into details, by all means do.   That was never my intent here.

Esteemed Contributor
Posts: 7,043
Registered: ‎03-15-2010

Re: Getting switched with little warning into Medicare Advantage

@Isobel Archer

 

You may be the poster that told me about having Medicare deducted from their Federal retirement.  I've been meaning to check into it.

 

Did you have that deduction set up at the OPM retirement services online center, or is it something you did directly through Medicare's website. 

 

I don't mind paying quarterly by check, but would prefer to have that deduction made automatically .

 

Any suggestions you have are most welcome!

Respected Contributor
Posts: 3,970
Registered: ‎03-16-2010

Re: Getting switched with little warning into Medicare Advantage


@Tinkrbl44 wrote:

@pitdakota wrote:

@Tinkrbl44, I am trying to explain that Part B is not a medicare supplement or medi-gap plan.  That is all.  Just want to make sure that people understand what part A and part B covers. 

 

But I also don't want people getting confused thinking part B is a medi-gap plan and think that they don't need part B.   They are not the same thing.   

 

medi-gap plans are not offered by medicare at all, they are offered by private insurance companies and help to cover costs that are not covered by parts A and B for those enrolled in traditional medicare.     That's all.  Heart

 

 


@pitdakota

 

I went back and re-read all my comments and there is nothing to even suggest that people don't need Part B. The only suggestions of that came from your posts.  

 

If anyone is not clear, they can google "what is medicare supplement?" and see all the "initial" plan options for Part B. 

 

@pitdakota   I'm not presuming to hold a Medicare insurance class here, so if you wish to continue to go into details, by all means do.   That was never my intent here.


_______________________________________________________

 

@Tinkrbl44, I think we are basically on the same page, except your use of the wording along with part B medicare is not accurate and that is what could possibly be confusing to people that are trying to figure out what they need to do for Medicare.

 

You posted before in the thread:

 

"you will need to select a Medicare Supplement (Part B)" and 

 

"Depending on which informational website you review, the part B is often referred to as a supplement or Medi-gap policy"

 

If anyone is reading a website that refers to Medicare part B as Medi-gap insurance, they need to move on to another website because that information is not accurate and the author (s) are very confused.

 

Someone knowledgeable in the health insurance industry would not refer Part B as "Medi-gap" insurance and if they do, their understanding of Medicare is questionable.  That is why it is important to understand that Medicare part B is not supplemental coverage.  I don't mean that you are not knowledgeable.  That is not my point at all.  But if a website calls Part B a Medi-gap plan, that is a red flag to not rely on the information posted on that website.

 

For traditional medicare, in order to receive full coverage the individual should enroll in Part A and Part B. 

 

This traditional medicare coverage will not cover all expenses so there are medicare supplemental insurance plans offered by private insurance plans that will help cover what parts A and B don't cover.  That is what medi-gap or supplemental  insurance is.  

 

Someone might get confused if they call and start asking about Medi-gap insurance when they are really talking about Medicare Part B.  So it is important for people to understand the difference if they are evaluating enrolling in traditional medicare.  

 

 

* Freedom has a taste the protected will never know *
Respected Contributor
Posts: 3,970
Registered: ‎03-16-2010

Re: Getting switched with little warning into Medicare Advantage


@Mj12 wrote:

@pitdakota wrote:

@Tinkrbl44, I am trying to explain that Part B is not a medicare supplement or medi-gap plan.  That is all.  Just want to make sure that people understand what part A and part B covers. 

 

But I also don't want people getting confused thinking part B is a medi-gap plan and think that they don't need part B.   They are not the same thing.   

 

medi-gap plans are not offered by medicare at all, they are offered by private insurance companies and help to cover costs that are not covered by parts A and B for those enrolled in traditional medicare.     That's all.  Heart

 

 


@pitdakota I'm learing a lot reading your posts, so thank you.  I'm not on Medicare yet but this is important information, I appreciate your knowledge.


____________________________________________________

 

Hi @Mj12.  Thanks....it does get confusing which is why it is important to understand all of the various terminology when evaluating what is best for them.

 

I am not on medicare yet, either....but have to teach this stuff, so I do tend to get bogged down in details.  LOL!

 

Have a great day, I am getting ready to run out inbetween rain showers to get some things done!


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