Community Chat

[kaydee50]

@monicakm  A supplemental insurance or an "Advantage" plan is absolutely essential.  Get a plan that allows you to go to any doctor that accepts Medicare.  

It is very confusing.  Get professional advice and good luck!

[Icegoddess]

@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. 

[spent2much]

@Icegoddess  Thank you.  I wasn't aware of that facebook group.

[Icegoddess]

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@spent2much wrote:

@Icegoddess  Thank you.  I wasn't aware of that facebook group.

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@spent2much I'll give credit to someone over on the Proboards forum for telling me about that group.  I don't want to name names though.  

[Group 5 minus 1]

What Kachina says.

[sunsetbeach]

DH has been on Medicare for approximately 10 years.  He has original Medicare Part A & B, has a supplement through Blue Cross, Plan F and each year I choose the Part D prescription drug plan that covers his medications.  We have been ecstatic with these choices.  He has had Cancer surgery, 2 colon surgeries, hernia surgery, eye surgery etc. and has never paid a penny out of pocket.  He has multiple specialists and has ongoing health issues. 

I have been on Medicare for 1 year and have the same, except I could only get a Plan G supplement with Blue Cross, as opposed to Plan F.  I am extremely cautious in the choices I make for our healthcare, but if you have no health issues, then maybe you would make other choices. I would never choose an Advantage plan, I feel its much too risky as you never know when your plan may be dropped by a hospital or doctor.

[Zwervend]

@monicakm - I am in the intial enrollment period for Medicare. I had a two hour long meeting today with an independent broker who represents supplemental, advantage and part D plans.

The first third of the meeting focused on my needs. Current health needs, concerns, wants, needs, and "not in a million years would I do that". 

The second third of the meeting was focused on different options with each of their pros and cons.

The last part of the meeting was the actual selection of a plan and the enrollment process. The person I met with made it very clear that this was not mandatory, and I could continue to review my options and ask more questions before signing up. I'd already done a tremendous amount of research though and was ready to make a decision.

I won't tell you what I choose because everyone is different, and what I choose is right for me, but may not be for anyone else.

I simply urge you to talk to a professional agent/broker/navigator who is independent of any insurance company to pick what is right for you. I thought I had a good grasp of what all the options entailed, but on several points I was off the mark. 

[Desert Lily]

@monicakm  The info from @Icegoddess  & @gidgetgh  is valuable.

They advised that you'll need either a Supplement plan or an Advantage plan with Medicare.

Each state offers different additional "Medicare" coverage plans. You could google "Medicare plans Your State's Name" and be sure to click on the site that is .gov for your state to find out which plans are offered in your state. (a . com site may only give you 1 company's plan info)

*Or, you could go to medicare . gov and click on the Health and Drug Plans tab at the top. It then asks for your zip code and the type of plan(s) you're seeking. Excellent info is there.

People can be impacted differently by premiums, out-of-pocket $, copays, % covered, coverage, etc.

For any plan, I'd check closely to see what is covered & what is not, how much an annual out-of-pocket expense could be, etc.

Supplement plans (also called "medigap" plans) are offered by a variety of companies, Advantage plans are offered by a variety of companies, and Drug plans are offered by a variety of companies. Each one available should be listed via your state.

The other poster was correct in saying that if your husband chooses a Supplement (medigap) plan, he will also need a Drug plan (aka Supplement D).

Supplement F was closed to new members about 4 years ago, but Supplement G is almost the same & is currently offered.

I'd research & read some news articles about Advantage plans.

*In the 2 states I've lived in recently, once a person goes on an Advantage plan s/he cannot change to a Supplement plan. 

Types of plans and regulations are specific to each state, so it's important to find what your state offers.

Medicare sent out a guide booklet called "Medicare and You 2024" that may still be available by request if your husband didn't receive one.

In the 1st year, insurance brokers receive about $300 in commission for Supplement plans they sell, and about $600 in commission for Advantage plans they sell, so in my mind I'm not sure that insurance brokers are objective.

I did my own research when preparing to get Medicare and then called my older brother to see what additional Medicare coverage he had & what he thought of it. He had a Supplement plan (medigap). I checked online at the govt. site to see the premium $ and more details about that specific Supplement plan & the company he used. Then I called that insurance company directly.

My BFF has an Advantage plan. It's run like an HMO, & she's always waiting for referrals, etc.

[millieshops]

@Ronettes   I do hope you never get to use Medicare for the many dollars it would probably take to change your mind..  Many of us who have had years of Medicare experience will tell you that Medicare takes care of many major expenses right up to your lifetime limits. It is expensive, but private insurance is even more costly.  Most costly - thinking you have enough money to live a long life and self insure! 

[Q-Checker]

You can learn a great deal about originsl Medicare on their website. I opted for original Medicare instead of Medicare Advsntage  as MA plans are HMO's and PPO's. I prefer fewer restrictions in selecting my healthcare providers and services. It has proved to be well worth it to me over the years. And, yes, a Supplemental plan is essential for your financial protection. I use the plan provided to retirees by my former employer. It all adds up to a fair amount of money to pay out but nowhere near the cost of even one serious illness.