Re: Medicare and Supplemental Ins

Josmad · ‎12-10-2018

@Icegoddess wrote:
There's Original Medicare, Parts A & B, and then you can go with either a Supplement + Part D prescription coverage or Part C which is an Advantage Plan. I'm not sure if ALL Advantage plans include the prescription coverage or not.

He really neads either one of the Supplement plans mentioned above or an Advantage plan. I can't remember all the Part numbers you can choose from for the supplement plans. I know there is N and G. F is reserved for people born before a certain date. I just started this year, but I'm too young to get F, so my guess is your husband is too. I don't think it's recommended to get a medical plan outside of those choices unless you want to get a cancer plan that would cover cancer drugs that the Medicare prescrption plan may not cover. I know the company I used to sign up for my supplement plan does not recommend a secondary medical plan since I've seen a question about doing that on their Facebook page.

He could also get a dental and vision plan. I have dental which I already had because I was on Obamacare before that and it doesn't cover dental or vision. I'm not wow'd by my dental plan though. They don't cover near what the claim.

From what I've read, Medicare Advantage plans, depending on your State, can dictate what doctors you can/cannot see, what tests you can/cannot have, etc. With a regular supplement, as long as your doctor accepts Medicare assignment, Medicare will pay for any procedure/test that Medicare covers.

Since I've only been on it since May, I don't have much of an idea about what Medicare actually covers or doesn't cover except what they call a yearly wellness visit is NOT a physical. Medicare does not cover a physical.

Not exactly. If the provider accepts Medicare the supplemental will pay if Mediare pays. Accepting Mediare assignment is a totally different thing.

Josmad · ‎12-10-2018

@Icegoddess wrote:
@monicakm I just wanted to add one more thought. You can change Part D prescription plans every year during the open enrollment period. However, you need to pick your supplement, if that is what you choose to get, very carefully since, in most states, if you decide you want a different plan, whether inside or outside of the Plan letter, you will probably have to go through underwriting in which the insurane company can deny you.

I don't know how Advantage plans work, whether you can jump from one to another during open enrollment without underwriting or not. Apparently, you can jump from a supplement to an Advantage plan without underwriting judging by all the commercials trying to convince people to do so. That might be one clue as to whether you might or might not want an Advantage plan.

The fall open enrollment period is for changing Part D prescription plans or Advantage plans. Advantage plans do not have any underwriting.

Nightowlz · ‎03-11-2010

@Icegoddess wrote:
A good place to just read, if nothing else, if you're on Facebook is a group called. Medicare Q&A with Boomer Benefits. That is the company I used to get my supplement plan. They also offer Advantage plans and are registered in all states except NY.

On that FB page, they answer all sorts of questions whether you're a client of theirs or not. I lurked on that page for quite some time before I decided to go with them. The deciding factor or me was that if you get a statement that you feel a charge was declined that shouldn't have been, they will look at it for you and even go to bat for you if they agree, at no charge to you.

@Icegoddess @monicakm

ITA with Boomer Benefits. After your signed up if you need help they will help you if you sign up with them. I don't know what we would have done without the book the Co-Founder wrote. "10 Costly Mistakes You Can't Afford to Make" by Danielle Kunkle Roberts. Sep 23, 2020. Best $10 we spent. I also got some info here & mellyg proboard. Go over the book before calling Boomer Benefits so you know what they are talking about.

DH said the only thing he didn't remember seeing in the book is you have 63 days from credible insurance coverage to sign up to Part D without penalty.

Caffeina · ‎03-09-2010

@monicakm

Look up your location on the State Health Insurance Assistance Program site at https://www.shiphelp.org/ . Where I live they have workshops at the public libraries. Maybe there's something similar near you.

CatsyCline · ‎07-24-2013

@Caffeina wrote:
@monicakm

Look up your location on the State Health Insurance Assistance Program site at https://www.shiphelp.org/ . Where I live they have workshops at the public libraries. Maybe there's something similar near you.

This ^

SHIP

CONTACT YOUR SHIP

Health Information, Counseling, and Advocacy Program (HICAP)

Call	1-800-252-9240
Website	https://hhs.texas.gov/services/health/medicare

i used my state's SHIP the first time. Medicare can be very confusing, They will help.

River Song · ‎03-15-2010

The book Medicare For Dummies explains everything in plain English. I suggest you read the book before talking to someone. It will be far less confusing.

If you choose traditional Medicare, I suppose you can think of it as paying for treatment up front. Sure, you may pay nothing if you need medical care but that is because you've already paid for it with the monthly premiums.

If you choose an Advantage plan, if available in your area, you may be able to get a plan with $0 monthly premium, but you will be paying for medical care later with co-pays and having to meet a deductible.

So, the choice is pay now or pay later, lol.

If you have on-going medical issues, it makes sense to choose traditional Medicare. If you're as healthy as a horse, don't need to see doctors, don't take medications, well, it might make more sense to choose an Advantage plan.

Some parts of the country don't offer Advantage plans because the population numbers aren't high enough to support the plans.

There's no 'right' answer on whether to choose traditional or an Advantage plan. It depends on your specific needs and what is available in your area.

conlt · ‎03-16-2010

Don't talk to an insurance broker who works for an insurance company. They will try and sell you their Advantage Plan. I have a lot of experience with Medicare and this is my choice for coverage. I have it for myself:

1. Medicare Part A pays for 80% of hospitalization (this is free once you are 65)

2. Medicare Part B pays for 80% of MD visits, medical equipment, xrays, tests, labs etc. (costs usually around $164 per month, depends on income)

3. Supplement G plan (mine is $169 per month right now) All G plans are the same, just try and pick 1 that is a solid company. I have Mutual of Omaha. G supplement has a deductible of around $226 per year, and pays the other 20% that Medicare Part A and Part B do not cover. It is totally worth it. The only bill I get is until I reach the $226 in a year.

4. You will need a Part D medication plan. Go on Medicare.gov and enter the medications that you take and pick what is best for you.

I am not a fan of advantage plans, and I just outlined why in another thread under "wellness." Many do like the advantage plans but I have not seen good things with my patients. They do not receive optimal care.

Good luck, this Medicare confusing.