which insurance plan to chose ?

[kenmac]

I turn 65 next mo.
I have recieved millions of calls from people wanting to help me sign up for an insurance plan.
One an Advantage plan, the other a suplement plan.

I realize everyone's situation is different, but any advice on which plan one would chose over the other, would be appreciated ?

 

[Torvy]

No specifics, but be very careful. Many times what you are being offered is a scam or will cost you more for the same service.

 

[KennyG]

If you can afford it, supplement plans have more flexibility and less potential red tape. Most of those TV ads you see are for advantage plans and are very misleading on cost and coverage. (i.e. don't trust Joe Namath or the Good Times actor.) If you know a trusted insurance professional talk to them. Some of the choices you make when you first sign up will restrict or eliminate your options to change later.

 

[RustyA]

I'm going through the exact thing right now. I chose a medigap policy plus an inexpensive drug policy as I don't presently take any medications. The way my advisor explained it to me is your initial enrollment there is no refusal for pre-existing conditions. If you choose medigap you can never be refused or denied coverage in the future even if you change insurance company that writes the policy. With advantage plans if you get sick the company can nonrenew you during open enrollment and you might have trouble getting affordable coverage due to your condition.
The other reason I chose medicare plus a medigap coverage is it is accepted anywhere Medicare is. Advantage plans may involve networks, HMO, and sketchy coverage when traveling. Some advantage plans are regional or limited to your home state. Talk to someone you trust like an insurance agent or financial planner to make sure you make the right choice for you.

 

[ljjhouser]

Well, this is about an hour-long topic. I will attempt to shorten it with a few suggestions.

1. Medicare is separated into 4 parts. You must choose where you want to get your insurance. Part C - the advantage plans -- OR -- Original Medicare -- OR -- Original Medicare with a Supplement plan (Medigap). This choice should be made relying on what you feel your needs are, your health in the future, and who you trust to cover those needs. And how much you want to contribute to health care cost if you need help. Examples: Advantage plans will include a drug plan, and cover much of your health needs. Most items in these plans have a copay and Max out of pocket. But the plan can be low cost with no monthly premium. If you choose a Part C advantage plan, you will not use Original Medicare (even though you must have it to enroll in Advantage). You will be dealing with the insurance company you choose, NOT Medicare. Most all Advantage plan features change every year, including the Max out of pocket. But you can change every year if you choose.
If you choose Original Medicare, you can switch adding an Advantage Plan or Part Drug Plan if you choose (you can change to be on Advantage or Original Medicare).
Original Medicare with a Pt D drug Plan. Original Medicare is a fee for service insurance. If you go to the hospital (part A) you will have a copay of about $1300 if you are admitted. That copay includes 60 days if you need to return again. Medical in OM has an annual deductible of about $190 and 20% copay on all medical services. That is 20% of the MEDICARE APPROVED PAYMENT, not the billed payment amount.

Only you can assess your needs and the costs you choose to incur.
Facts to remember,
At age 65, you enter the IEP - Initial enrollment period of Medicare. You can sign up for ANY medicare product. AFTER the IEP ends, you may not be able to make changes. For example, If you select Advantage and later decide to get a supplement, you may not be permitted after the first 12 mos. (with a SEP - Special Enrollment period).

You CANNOT have both an Advantage Plan and a Supplement (Medigap) plan at the same time.
There are free counseling services in most states and enrollment presentations. Good place to get info.
If you choose supplement, Plan G is very good, BUT look at Plan N. N covers most major costs and leave affordable copays for you. G pays everything (except the annual Medical (Pt B deductible).

Medicare is VERY good insurance at an affordable cost. It is the best insurance I have ever had. Choose wisely to best fit your health care needs.
Best wishes.

 

[duffer]

I won't give you advice, but I can provide some pros & cons of each plan.

Traditional (A+B)+(Medigap) Supplement policy will provide you the greatest flexibility, especially if you travel within the US. There is no set network you have to use, you can see a specialist without a referral if you want. So there is no doubt you can keep your current Dr and hospital you like for treatment. There are multiple Medigap policies (supplement policies) to choose from. Essentially you pick how much financial risk you want to take with each type of plan available in your state. The premium cost for each plan is different, as well as the deductibles. So..if you decide you want a Medigap policy "N", it will cost you $x. If you want policy "G" it will cost you $y. Now....all the different insurance companies in your state will offer the same plans, with the same deductibles and benefits. You need to decide which "plan" fits your needs, and then shop it around among the different insurance companies because the premiums you have to pay will differ. Wife and I had plan N, and it cost us about $300 a month for both of us combined. You'll also have to buy a Rx drug plan (D) separately to cover drugs. And pay deductibles and co-pays for each.

Advantage (Adv) plans are also specific by state. They are a little more complex to compare "apples to apples". Some offer HMO coverage, some offer PPO coverage, and some might offer open type coverage with no networks at all. (depends on your state). Essentially Adv plans combine Medicare part A & B into one, (technically called "C"). Most Adv plans cover the 20% you would normally owe for medical services from Traditional Medicare (which your extra Medigap policy you bought above, would pay for). So using an Adv plan would normally eliminate the need for buying a Medigap Supplemental policy. And Adv plans usually provide for Rx coverage (at least for generics), plus some dental, plus some eye care, and in our state even provide for a gym membership to get you in shape. Depending on your residence location, you might even get back some or all of your Part B premium that is deducted from your SocSec check. (although I think is rare) The downside to Adv plans is that they are not "portable". So if you travel, or have residences in multiple states, you won't be able to use the Adv plan in state #2 unless you go to the ER.

We started with Trad Medicare A+B at 65, because we refused to give up our primary Dr. Recently, he became available under Adv Plans. So we switched this year to an Adv plan (ours is a PPO). My drug costs have gone to $0. I use the gym membership several times a week. Went to an Ophthalmologist with $0 co-pay, and we're saving the $300/month for not having a Medigap policy to pay for. We do not have any restrictions we can't live with easily. The hospital network we want is also available under our Adv plan. You just need to do a little research with your Dr. & hospital to see if they're part of the Adv plan you want, AND from the Insurance company you intend to use. My Dr. has a sign up in the check-in window that says he does NOT take (1 particular insurance co.) Adv plans, but he does for most of the others. So you would be wise to verify with your own Dr. if he'll take your plan & insurance company....if you choose to use an Adv plan at all.

Good luck! Let us know how you come out.

 

[ljjhouser]

I turn 65 next mo.
I have recieved millions of calls from people wanting to help me sign up for an insurance plan.
One an Advantage plan, the other a suplement plan.

I realize everyone's situation is different, but any advice on which plan one would chose over the other, would be appreciated ?

About those calls. It is against Medicare licensing policies for an agent to contact you via phone or in person UNLESS you have contacted them first. They MAY loose their license if documented and sent to Medicare.

If you go to a store - grocery or the like, and there is a Medicare information table to discuss Medicare, they will ask you to complete a short contact card. If you do that, then that information you supply them is the first contact. They may call or knock on your door. Some do get away with calling anyway.

 

[Torvy]

I am truly sorry that Medicare is the best insurance you have had. I've seen what my parents go through. Fortunately, dad is a DAV and gets most of his Healthcare at the VA (his local is one of the better VA hospitals)

 

[ljjhouser]

No need to be sorry about my insurance. I just wish your father had the same insurance as I. I have Original Medicare and a F Medigap. I pay nothing but the Medigap monthly premium. It pays EVERYTHING else.

I am glad that that the VA has worked well for him. The VA has an excellent drug program.

 

[2manyrocks]

It is very difficult to understand the options and actual premium costs without consulting an independent agent who specializes in medicare supplement plans. There's a heck of a lot of marketing for advantage plans being affordable or not costing anything, but when you need or want medical care, those plans act like gatekeepers and you may not get the medical services you'd pick for yourself if you had that option.

If you carefully compare coverage and premiums among plans and various companies, there are some significant differences in coverage cost between them.

Give yourself adequate time to research and understand your options. Find a good agent. They deal with this stuff on a daily basis.