Community Chat

[gertrudecloset]

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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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Yes indeed.  I sure do wish I lived a State where I could have Kaiser Permanente @quilter61 .  That would be an Advantage Plan I would have loved to have tried.  I hate UHC and AETNA.  I don't want an Advantage Plan that has it's own Pharmacy as well and prefer I get my meds from their pharmacies.  That ruins my choices.  Under no circumstances will I do business with either of the big two.  They cover most of the United States and will write policies in most.  

[gertrudecloset]

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@Mz iMac wrote:

@YouGoGirl1   In addition to what everyone else has already posted, you need to read/review your "Medicare & You 2023" booklet which is specific to your state.  Inside you will find all the plans that are specific to your State and/or County you live in.

If you live in N.J., not only are the plans "State" specific, quite a few are "County" specific as well.

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Yes this is true @Mz iMac NYC gets different plans to choose from those who live in Upstate and other parts of NYS.  That's how it is.

[gertrudecloset]

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@cantdrive55 wrote:

@YouGoGirl1,

I am happy to help by relating my experience in what is a difficult & sometimes overwhelming process.

 I recommend boomerbenefitsdotcom as an excellent resource and highly regarded company who can help you navigate the process.

bbcom does not do business in all states, though, including mine, New York. Nevertheless,  the reps were very helpful and the website consolidated the pertinent information I had spent untold hours researching in a very readable and complete guide.

The letter of the plan, say F or G, has the same benefits regardless of what company you purchase it from. Armed with all this knowledge, I went to my state's website, where I could enter my zip code and the letter of the plans I was interested in and see a comparison of pricing for each company that offered that plan. 

I was very fortunate to know a CFO of a health system who said to call when I was ready to begin the process. I did, and her advice was to buy the best insurance I could afford and not to purchase a Medicare Advantage plan.

I started with Plan F, the best plan, and never saw a bill. Plan F covers everything., even the $220.00 (approximately) Medicare Part B deductible. When the plan went up & up, my insurance agent advised me to switch to Plan G, which has all the same benefits, except you have to pay the Medicare Part B deductible. However, the monthly savings in the premium costs far outweighed that deductible cost.

Companies make the Medicare Advantage plans sound good, but those plans lock you into that company's network, and many doctors & specialists do not participate. That was a deal breaker for me, but everyone is different.

My experience has been AARP plans offered through United Health Care are often the most competitive price. The customer service is excellent. The monthly statement of claims & payments are easily understood and promptly handled.

You must purchase the prescription plan, Part D, separately and at age 65 to avoid penalties & problems. Your choice will depend on the number & type of prescription drugs you take.

Lastly, be advised insurance agents and brokers  may not handle all the companies offering Supplemental Plans or Part D Plans, and may not be forthcoming regarding that.

I hope this helps you & wish you the best!

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@cantdrive55 , When I had United Healthcare (AARP they really had nothing to do with the insurance company) it was a marketing tool; my prescriptions were included in the HMO plans that I chose.  Each year I would choose a differentUHC Plan because of the price of my existing plan going up.  They have some HMO plans in NYC that cover drugs too.  You just have to check to see what Tiers they are on before signing on the dotted line.  I didn't have to buy a standalone part D drug Coverage plan.

Then I went to Aetna because I got sick of the price gouging from United Healthcare for my drugs.  I was ok in a PPO.  I chose a PPO from Aetna because United Healthcare's PPO (whenever they offered one) was too much money in NYC).  I had no problem with their drugs coverage and most of the meds I was taking at that time were Tier 1 or tier 2.  I dropped Aetna when CVS Drugstores acquired them.  Can't do...won't do.  CVS is not a good place for prescriptions where I live.  Their prices are cheaper, because they have the negotiating power.  However, I got tired of trying to figure out which pill they were giving me everytime they did a refill. It was always different.  

I now get my scripts from a Good Neighbor Pharmacy which costs me just a tad bit more, but they are in Network for my current Part D drug plan.

[Carmie]

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@gertrudecloset wrote:

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.

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I hope and pray I misunderstood what you wrote.

Forgive me if I did.

You can only purchase a Medicare supplement within your personal 6 month enrollment period.  After that, there is no guarantee you will be able to enroll in one.  If you are fortunate to find one, it will be super expensive.  The insurance company will apply PreX conditions as well.

I personally know of no insurance co that will sell anyone a policy after their enrollment period runs out....there are exceptions, of course, but they EXTREMELY specific.

Supplement Plan C was a super great policy, but it is no longer sold and was discontinued on Jan 1, 2020.  People who had it before then can keep it, but no new policies can be sold.

This info is available on the Medicare gov website under "when can I buy a Medigap policy."

[gertrudecloset]

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@Carmie wrote:

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@gertrudecloset wrote:

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.

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I hope and pray I misunderstood what you wrote.

Forgive me if I did.

You can only purchase a Medicare supplement within your personal 6 month enrollment period.  After that, there is no guarantee you will be able to enroll in one.  If you are fortunate to find one, it will be super expensive.  The insurance company will apply PreX conditions as well.

I personally know of no insurance co that will sell anyone a policy after their enrollment period runs out....there are exceptions, of course, but they EXTREMELY specific.

Supplement Plan C was a super great policy, but it is no longer sold and was discontinued on Jan 1, 2020.  People who had it before then can keep it, but no new policies can be sold.

This info is available on the Medicare gov website under "when can I buy a Medigap policy."

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@Carmie I am well versed with what I can do.  I can and will be purchasing a Supplement Plan F in my jurisdiction.  When and how I received both Parts A and B are not something I'm willing to divulge.  Please don't address me as you feel you are the only one here who knows anything at all about Medicare.  You are not the only one.  You seem to feel threatened when I post about the subject matter when there is no need for it.

There's a lot to know and it is overwhelming and I try to give general information because that's the best way to go about that.  I won't be discussing my personal needs and plans here.

[gertrudecloset]

Finally, @Carmie:

Don't you know this is all age specific and State specific?

[Desert Lily]

Medicare Supplement Plan F was being phased out as of January 1, 2020. If a person already had Plan F, they can keep it as long as they want. If someone became eligible for Medicare after January 1, 2020, they cannot purchase Plan F.

This info is available on Medicare dot gov.

[Carmie]

@Desert Lily   You are correct, a few plans have been phased out...plan C and  H  are gone too.

These plans all covered the Medicare Part B deductible.  Our government really messed with senior coverage.

[gertrudecloset]

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@Desert Lily wrote:

Medicare Supplement Plan F was being phased out as of January 1, 2020. If a person already had Plan F, they can keep it as long as they want. If someone became eligible for Medicare after January 1, 2020, they cannot purchase Plan F.

This info is available on Medicare dot gov.

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Wrong @Desert Lily   It is not available to new enrollees.

It is specific to when your age and when you became eligible for Medicare as well as your State.

That is only true if your birthday was on a certain date.  Here is the actual information regarding Supplement Plans F:

Medigap Plan F is a Medicare Supplement Insurance plan that’s offered by private companies. It covers "gaps" in Original Medicare coverage, such as copayments, coinsurance and deductibles.

Plan F offers the most coverage of any Medigap plan, but unless you were eligible for Medicare by Dec. 31, 2019, you can’t purchase Plan F. Even if you’re eligible, it can be significantly more expensive than its Medigap alternatives, so you may spend more than the additional coverage you’d get. If you’re not eligible to buy Plan F, you can purchase other Medigap plans with nearly as much coverage.

Who Is Still Eligible for Medicare Plan F?

Those who were eligible for Medicare on or before January 1, 2020 can still sign up for Medicare Plan F. People who already had or were covered by Medicare Plan F before January 1, 2020 are also able to keep their plan.  For this purpose this means (65) years of age on or after 2020.  

Eligible people can purchase Medicare Plan F from private health insurance companies, such as Aetna, UnitedHealthcare and Kaiser Permanente, says Price.

https://www.forbes.com/health/medicare/medicare-plan-f/

[Carmie]

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@gertrudecloset wrote:

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@Desert Lily wrote:

Medicare Supplement Plan F was being phased out as of January 1, 2020. If a person already had Plan F, they can keep it as long as they want. If someone became eligible for Medicare after January 1, 2020, they cannot purchase Plan F.

This info is available on Medicare dot gov.

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Wrong @Desert Lily   It is not available to new enrollees.

It is specific to when your age and when you became eligible for Medicare as well as your State.

That is only true if your birthday was on a certain date.  Here is the actual information regarding Supplement Plans F:

Medigap Plan F is a Medicare Supplement Insurance plan that’s offered by private companies. It covers "gaps" in Original Medicare coverage, such as copayments, coinsurance and deductibles.

Plan F offers the most coverage of any Medigap plan, but unless you were eligible for Medicare by Dec. 31, 2019, you can’t purchase Plan F. Even if you’re eligible, it can be significantly more expensive than its Medigap alternatives, so you may spend more than the additional coverage you’d get. If you’re not eligible to buy Plan F, you can purchase other Medigap plans with nearly as much coverage.

Who Is Still Eligible for Medicare Plan F?

Those who were eligible for Medicare on or before January 1, 2020 can still sign up for Medicare Plan F. People who already had or were covered by Medicare Plan F before January 1, 2020 are also able to keep their plan.  For this purpose this means (65) years of age on or after 2020.  

Eligible people can purchase Medicare Plan F from private health insurance companies, such as Aetna, UnitedHealthcare and Kaiser Permanente, says Price.

https://www.forbes.com/health/medicare/medicare-plan-f/

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You're correct, but good luck finding an affordable policy. I truly mean it.  I hope you can find what you need at an affordable price.