Community Chat

[gertrudecloset]

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@shoesnbags wrote:

@gertrudecloset 

And I was making it more complicated!  Not an excuse, but I'm reading these posts while caring for a bedbound family member.  So it's sometimes a bit disjointed.  Thanks for the explanation!

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No worries @shoesnbags .  We're "talking just like if we were on the phone."  I'm handing you a nice drink and a snack so you put your feet up for a minute....you need a bit of respite!

[HLP]

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@quilter61 wrote:

My suggestion is to call an insurance broker in your area.  I have one that I use every year.  I give them all my info - doctors, prescriptions and they find the best plan for me.  As a previous poster stated every area of the country is different and offers different plans.

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I have this in my area too, and it has been wonderful to have someone figure out what way I should go. This is a tremendous suggestion to anyone needing help. I was going to say the same thing.

[Carmie]

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@Trailrun23 wrote:

Theh various Medicare plans do depend upon your area....but some even depend upon your actual zipcode. That's the first thing a broker wants to know when they start trying to help with finding plans for someone. I know somehow insurers are under the mistaken impression that our zipcode is where all the billionaires live....because almost none of the "free" or additonal coverage seen on TV and other places are availble in our zipcode. We have lived in this zipcode for many years and have never met a billionaire!

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This is true for Medicare Advantage plans only.  With Traditional Medicare of which there is only one plan, with two parts, A and B, you can purchase a supplement of your choice to go long with it.

Supplements with Medicare are VERY DIFFERENT than Advantage Medicare.  They do not have anything to do with your zip code.

Not all insurance compnies sell every supplement that is available though. You do have to purchase from a company that is located in your area.  If you live in NJ, for example, you cannot purchase a supplement from an insurance co. in Florida.  But, if you move to FL, you can keep your supplement.  It will be no problem.

If you move out of the area with an Advantage Plan, you will need a new policy.  Even getting sick on a vacation in a different state can be a hassle and complicated.

Brokers get paid on commission.  They can be helpful, but you might be directed to a higher priced policy or a company that pays a higher commission.

It is better to use a source provided by your state like SHIP. They have access  to every plan that is available to you with prices. They can also help you find ways to help you pay if you're low income.

[Trinity11]

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@Carmie wrote:

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@Trailrun23 wrote:

Theh various Medicare plans do depend upon your area....but some even depend upon your actual zipcode. That's the first thing a broker wants to know when they start trying to help with finding plans for someone. I know somehow insurers are under the mistaken impression that our zipcode is where all the billionaires live....because almost none of the "free" or additonal coverage seen on TV and other places are availble in our zipcode. We have lived in this zipcode for many years and have never met a billionaire!

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This is true for Medicare Advantage plans only.  With Traditional Medicare of which there is only one plan, with two parts, A and B, you can purchase a supplement of your choice to go long with it.

Supplements with Medicare are VERY DIFFERENT than Advantage Medicare.  They do not have anything to do with your zip code.

Not all insurance compnies sell every supplement that is available though. You do have to purchase from a company that is located in your area.  If you live in NJ, for example, you cannot purchase a supplement from an insurance co. in Florida.  But, if you move to FL, you can keep your supplement.  It will be no problem.

If you move out of the area with an Advantage Plan, you will need a new policy.  Even getting sick on a vacation in a different state can be a hassle and complicated.

Brokers get paid on commission.  They can be helpful, but you might be directed to a higher priced policy or a company that pays a higher commission.

It is better to use a source provided by your state like SHIP. They have access  to every plan that is available to you with prices. They can also help you find ways to help you pay if you're low income.

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We have a retiree Medicare PPO Advantage Plan. All benefits remain the same and not dependent upon where we live. I was in an ER in a different state...same exact benefits ..no hassle either. The reason we also like it, no cap on lifetime benefits. We have a Part D drug plan from Caremark. It is the only drug plan that will provide coverage for my insulin pens whereas straight Medicare with a supplement would not. Only insulin syringes were covered. We looked into many different plans with an advisor and this Advantage Plan was the most cost effective.

[Carmie]

@Trinity11   I have an Advantage plan that like that too.  It is supplied by my past employer, so it is group retiree coverage.

It pays providers in and out of network providers 100%.  It sounds like you have  a retiree plan with your past employer as well.

Unfortunately, these types of plans are not avaliable for the general public to buy.  I'm not saying there are none available anywhere, but I personally haven't seen any. They would be very expensive to purchase for the average Joe.

I do not have Part D for RX drugs.  They are covered under my Advantage plan.  Neither my husband or I have ever used the RX coverage though. We have no health issues.

It is unusual to need Part D with an Advantage plan. Most plans include RX coverge.  

[CatsyCline]

@Carmie   i have an HMO plan and SS deducts my Part B charge monthly. The HMO only works for in-network providers in my state. 

now i find i may need to travel out-of-state for family commitments.   So my insurer offers several other plans available .  Say "hypothetically" SS deducts $200 for Medicare off the top of my benefit monthly. I decide to enroll in an Advantage plan and they charge $250 every month. So I end up paying $450 for Medicare coverage per month?

[Carmie]

I would check to see what benefits you have for out-of-network providers.  Most HMO Plans will cover emergency claims, but non-emergent claims can be covered at a lower reimbursement rate or denied altogether or applied to a deductible.

You will always have Medicare Part B Premiums deducted from your SS no matter what insurance you have.

If your Advantage plan has a monthly cost, you will be on the hook for that too. So yes, you could end up paying $450 a month.

The good news is that most Advantage plans are reasonable...no where near $250.

If you are planning to be out of state for a while, choose an Advantage plan that has good  out-of-area benefits.  Thankfully, you can choose a different Advantage plan each year to meet your changing needs during open enrollment.

PPO plans are more flexible than HMO plans.

[pieman]

@gertrudecloset 

Guess we will have to agree to disagree

[gertrudecloset]

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@pieman wrote:

@gertrudecloset 

Guess we will have to agree to disagree

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@pieman Why should that bother "me?"  

I don't have questions or concerns about Medicare and it's various offerings.  I'm str8!!!  LOL

[gertrudecloset]

I have Medicare and a standalone Part D prescription Plan.  That means when I get my medical services I am billed the 20% that I am responsible for from the provider.  Medicare sends their part and I get the bill for the rest.

The amounts are minimal for doctor visits and bloodwork.  The 20% you are charged is based on the Medicare approved amount and not some willy nilly number that is made up by the physician or hospital.

I am eligible for one those Supplement Plans C or F and will be purchasing one as my circumstances allow me to able to have one because of when I began Medicare Part A and B.

Anyone who wants to be absolutely sure about the plans and benefits they are seeking should go through a Broker, or of course Medicare.gov. That's what we pay our taxes for.  It's what they are there for.  You can even call them when there is no Open Enrollment with questions.  Citizens should use them, our taxes go to fund these programs.