Need for Medicare supplemental plan?

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pshonore
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Re: Need for Medicare supplemental plan?

Post by pshonore » Sat Mar 17, 2018 2:27 pm

munemaker wrote:
Sat Mar 17, 2018 2:09 pm
Curious why most on this thread prefer a supplemental plan to an advantage plan?
One reason is with Plan G, after you pay the $183 deductible, there are no other costs as long as its for a covered charge. Of course you do have to pay the monthly premium as well. My annual January cardiology visit eats up most if not all of the deductible. I find a lot of Advantage plans (Anthem, UHC, etc.) have hospital admission fees, ambulance fees, ER fees, lab fees, xray fees, co-pays, etc. which can add up

barefootjan
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Re: Need for Medicare supplemental plan?

Post by barefootjan » Sat Mar 17, 2018 2:45 pm

daytona084 wrote:
Sat Mar 17, 2018 11:14 am
Same thinking applies to Part D prescription coverage. Some drugs have unbelievably large costs, especially the new ones. Without part D coverage, you pay 100%.
100% of what though. I was without any insurance for a period of time and the drug I had been taking was going to cost me somewhere north of $300 for a one month supply (side note: I'm not eligible for Medicare yet). I remember thinking I was doing GREAT when I found it through a Canadian pharmacy for $100 for 90 day's supply.

Come to find out I can get it through Good Rx (https://www.goodrx.com/) for around $8/mo - which is what it costs me through my insurance.

Obviously this may not be the case for all situations or all drugs. But you better believe I checked my husband's prescriptions on Good Rx before he signed up for his Part D plan LOL.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sat Mar 17, 2018 2:47 pm

munemaker wrote:
Sat Mar 17, 2018 2:19 pm
dm200 wrote:
Sat Mar 17, 2018 1:55 pm
munemaker wrote:
Sat Mar 17, 2018 1:53 pm
barefootjan wrote:
Fri Mar 16, 2018 11:05 am
...if you have Medicare and buy a supplemental policy with your own money, you are effectively giving an insurance company your money so that they can keep it.
Well, kind of. They keep your money, pool it with others, use it to pay your claims and hope to have some left over to make a profit.
No - the insurance company pays out most of its premiums received for benefits
Isn't that what I said (claims = benefits)?
OK - sorry about that - was reading the other post ..

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sat Mar 17, 2018 2:49 pm

Same thinking applies to Part D prescription coverage. Some drugs have unbelievably large costs, especially the new ones. Without part D coverage, you pay 100%.
Note that most (but not all) Medicare Advantage Plans INCLUDE drug coverage (out MC plan does) as part of the MA premiums you pay. Ours (including drig coverage) is only $30/month.

prd1982
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Re: Need for Medicare supplemental plan?

Post by prd1982 » Sat Mar 17, 2018 2:50 pm

Someone asked why a Medicare supplemental rather than Medicare Advantage. For me, it was not having to deal with an every-changing approved list of hospitals and doctors. I remember that several years ago a major MA plan dropped the dominant hospital/doctor group in my half of the state. And this was in the middle of the year! That convinced me to stick with a supplemental.

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dodecahedron
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Re: Need for Medicare supplemental plan?

Post by dodecahedron » Sat Mar 17, 2018 3:08 pm

munemaker wrote:
Sat Mar 17, 2018 2:09 pm
Curious why most on this thread prefer a supplemental plan to an advantage plan?
Good question! Most (though not all) Advantage plans are HMOs with network gatekeeper gotchas. You have to be watch out for non-network providers, you may have to deal with a primary care provider who is a "gatekeeper" and get specialist referrals from him/her, etc. Your HMO has some discretion over what procedures to authorize and can use your primary care physician gatekeeper to control costs, require prior authorization that involves delays, etc.

I was planning to go with a nationally top-ranked HMO organization with excellent customer service that offered what looked like ideal PPO/POS Medicare Advantage plans but unfortunately that organization has now dropped their PPO/POS Advantage plans and only offer HMO plans. The only PPO/POS Advantage plan in my area is offered by an HMO with a less stellar reputation for service.

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CWRadio
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Re: Need for Medicare supplemental plan?

Post by CWRadio » Sat Mar 17, 2018 3:18 pm

Here is a good web site to check the price of supplements insurance in your state:
https://www.freemedicarereport.com/

Just give zip code and go to "just view results" Paul

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Re: Need for Medicare supplemental plan?

Post by Good Listener » Sat Mar 17, 2018 3:28 pm

munemaker wrote:
Sat Mar 17, 2018 2:09 pm
Curious why most on this thread prefer a supplemental plan to an advantage plan?
By definition, advantage plans have networks and when you really want to see somebody or go to a specialty hospital (think cancer and Sloan Kettering or MD Anderson), you can't. Also, doctors come in and out of network. My company switched everybody to Medicare advantage a few years ago and I didn't know it as I just started in November. I had to get prior authorization for a surgical procedure in-office which had me come back a second time when I otherwise wouldn't have had to. And mine has out of network benefits, meaning that they will pay Medicare rates to any provider who will accept it. But I didn't like it and switched to regular Medicare and Plan F in January. Low and behold, I have a particular neurologist I am going to see and I asked if they would have taken the Medicare Advantage. NO. NO. NO. Because the office people said they wanted to be able to do what was needed for the patient and couldn't if a desired service (think EMG/NCS) or an MRI was needed and the MA plan denied it.

If one can afford it, I very strongly recommend getting Original Medicare plus a supplement (F or G) and a Drug plan.

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FrugalInvestor
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Re: Need for Medicare supplemental plan?

Post by FrugalInvestor » Sat Mar 17, 2018 3:30 pm

munemaker wrote:
Sat Mar 17, 2018 2:09 pm
Curious why most on this thread prefer a supplemental plan to an advantage plan?
For one, as I mentioned above, when I needed care I could not have gone to the nationally recognized provider in my area. They don't accept any Medicare Advantage plans.

Secondly and related, most Medicare Advantage plans in our area limit which doctors you can see. Most doctors in our area accept traditional Medicare with a supplement.
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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sat Mar 17, 2018 3:32 pm

dodecahedron wrote:
Sat Mar 17, 2018 3:08 pm
munemaker wrote:
Sat Mar 17, 2018 2:09 pm
Curious why most on this thread prefer a supplemental plan to an advantage plan?
Good question! Most (though not all) Advantage plans are HMOs with network gatekeeper gotchas. You have to be watch out for non-network providers, you may have to deal with a primary care provider who is a "gatekeeper" and get specialist referrals from him/her, etc. Your HMO has some discretion over what procedures to authorize and can use your primary care physician gatekeeper to control costs, require prior authorization that involves delays, etc.
I was planning to go with a nationally top-ranked HMO organization with excellent customer service that offered what looked like ideal PPO/POS Medicare Advantage plans but unfortunately that organization has now dropped their PPO/POS Advantage plans and only offer HMO plans. The only PPO/POS Advantage plan in my area is offered by an HMO with a less stellar reputation for service.
Yes - that puzzles me as well. Over the decades (before Medicare) we have had the range of "old fashioned" no restrictions or network plans to PPOs and HMOs. While there have been small degrees of "convenience" differences, I can say that I/we never experienced an HMO situation where we were denied required (or even highly desired) access to a specialist.

In our current Kaiser Medicare plan, in my seven years, I have never been denied a desired referral. In a few cases, my PCP fully and 100% convinced me that I did not need a referral. In one case, based on my previous non-Kaiser PCP's push, I successfully convinced my Kaiser PCP to give me a referral - but a year or two later with 20.20 hindsight - I concluded she was right and the referral I got was not medically necessary or even a good idea. In this plan, once I get a required referral, I do not need to go back to get another one. That referral to a specialist is good for as long as that specialist (or a follow up one if he/she leaves Kaiser) tells me to keep seeing him/her). For some kinds of referrals required, I must actually see my PCP, but in others (such as Podiatry) - I get that by email.

My wife and I speak from actual experience over the decades with HMOs. In my opinion, but without knowing others whole story, it seems that a lot of such criticism of MA plans and HMOs is ill informed and relies on unsubstantiated horror stories and anecdotes.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sat Mar 17, 2018 3:34 pm

Secondly and related, most Medicare Advantage plans in our area limit which doctors you can see. Most doctors in our area accept traditional Medicare with a supplement.
True. That does not bother me because, in this area, there are many, many very competent and experienced Physicians (both primary care and specialists).

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munemaker
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Re: Need for Medicare supplemental plan?

Post by munemaker » Sat Mar 17, 2018 3:50 pm

Thanks for all the responses to my question about preferences for Supplement Plans vs. Advantage Plans. The main objection to Advantage Plans seems to be the network limitations and freedom to seek any care outside of the network.

We live within range of Pittsburgh, where UPMC (University of Pittsburgh Medical Center) is the dominant health care provider and also an insurer that offers ObamaCare and Advantage Plans.

We have been using UPMC insurance for ObamaCare and have been very pleased with both the insurance company and the provider end. Yes, it is a network but it is the dominant provider in the area. UPMC does have operate a cancer hospital. If you have a procedure done in a UPMC facility, you do not have to be concerned about any out-of-network charges (such as radiologist or anesthesiologist).

The one downside of UPMC, both ObamaCare and Advantage Plan is coverage out of the area (Western PA) is limited to emergency, except for the Advantage Plan, where UPMC does have an affiliation with some network in FL (don't know the details).

I have to make a decision on Medicare later this year. I am leaning toward UPMC Advantage Plan, and that's why I asked the question about preferences of Supplemental over Advantage Plans.

Any further comments are welcome and appreciated.

Thanks!

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sat Mar 17, 2018 4:07 pm

munemaker wrote:
Sat Mar 17, 2018 3:50 pm
Thanks for all the responses to my question about preferences for Supplement Plans vs. Advantage Plans. The main objection to Advantage Plans seems to be the network limitations and freedom to seek any care outside of the network.
We live within range of Pittsburgh, where UPMC (University of Pittsburgh Medical Center) is the dominant health care provider and also an insurer that offers ObamaCare and Advantage Plans.
We have been using UPMC insurance for ObamaCare and have been very pleased with both the insurance company and the provider end. Yes, it is a network but it is the dominant provider in the area. UPMC does have operate a cancer hospital. If you have a procedure done in a UPMC facility, you do not have to be concerned about any out-of-network charges (such as radiologist or anesthesiologist).
The one downside of UPMC, both ObamaCare and Advantage Plan is coverage out of the area is limited to emergency, except for the Advantage Plan, UPMC does have an affiliation with some network in FL (don't know the details).
I have to make a decision on Medicare later this year. I am leaning toward UPMC Advantage Plan, and that's why I asked the question about preferences of Supplemental over Advantage Plans.
Any further comments are welcome and appreciated.
Thanks!
While there may be restrictions or conditions of going from an Advantage plan to Original medicare + supplement - I believe that you can switch without restrictions in or after the first year. Check out the details, but I think you risk little by trying the Advantage plan (as long as you check it out) for the first year. Also, read all the fine print, policy documents, talk with others, etc.

What I find with our Medicare plan is that there are many net (financial and health) benefits that are not obvious in reading the letter of the plan.

Just one example is that the plan documents say referrals are necessary for most specialists. In actual practice, only the first is really needed. BIG difference! Also, our plan includes - no referral - annual Optometry exams (including refractions) for a copay of only $20.

Telephone appointments, emails, two way smart phone - appointments are no charge. Parking is FREE at all facilities. Most prescriptions can be refilled by mail - just contact mail order pharmacy - I do it online - no need to contact doctor - and get refills in the mail.

If you do not like your primary care physician, we can change any time for any reason.

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CWRadio
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Re: Need for Medicare supplemental plan?

Post by CWRadio » Sat Mar 17, 2018 4:39 pm

If I remember correctly you have a window of 3 months before and 3 months after your 65 birthday to sign up for a supplement plan without medical underwriting.
Paul

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Re: Need for Medicare supplemental plan?

Post by barefootjan » Sat Mar 17, 2018 5:38 pm

Regarding needing a referral from your primary care provider to see a specialist: In my past experience as an uninsured person, the specialists themselves require that you have a referral before they'll book time with you. (This may be a regional thing, I don't know.) The reasoning, as I understood it, was that a layperson might not be able to determine if they have an actual need for specialized care.

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HueyLD
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Re: Need for Medicare supplemental plan?

Post by HueyLD » Sat Mar 17, 2018 6:00 pm

The one downside of UPMC, both ObamaCare and Advantage Plan is coverage out of the area (Western PA) is limited to emergency, except for the Advantage Plan, where UPMC does have an affiliation with some network in FL (don't know the details).
This is a very important detail. If you will be snowbirding in FL during the winter months, it is critical that you find out exactly what are covered in FL with your MA from Pitt. AFAIK, a lot of people who split their time between two homes have traditional + supplement because MA plans do not travel well. Of course if you never get sick, it won’t be a problem.
The specialists themselves require that you have a referral before they'll book time with you. (This may be a regional thing, I don't know.) The reasoning, as I understood it, was that a layperson might not be able to determine if they have an actual need for specialized care.
Yes indeed. Some specialists will not deal with patients without a referral from another physician (typically a PCP) no matter what kind of insurance a patient has.

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Steelersfan
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Re: Need for Medicare supplemental plan?

Post by Steelersfan » Sat Mar 17, 2018 6:40 pm

Spirit Rider wrote:
Sat Mar 17, 2018 1:53 pm
Plans C, F and F high deductible will be grandfathered to existing policy holders on 12/31/2019. No new such plans can be sold effective 1/1/2020.

Plan G high deductible will be available 1/1/2020, but it is not known if it will be available earlier. Also, it is not known if current Plan G or Plan F high deductible policy holders will be able to change to Plan G high deductible policies without medical underwriting.
I have regular Plan F and I was told that when F goes away I can opt for Plan G without underwriting. They don''t seem to want a pool of ever aging, more costly, people. That may be specific to my provider.

There doesn't seem to be any firm plan from Medicare yet on how Plan F policy holders will be dealt with when Plan F is no longer available to new subscribers. My provider said they might switch all their Plan F people to Plan G next year ahead of the deadline.

Unless they change their mind.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sun Mar 18, 2018 6:51 am

CWRadio wrote:
Sat Mar 17, 2018 4:39 pm
If I remember correctly you have a window of 3 months before and 3 months after your 65 birthday to sign up for a supplement plan without medical underwriting.
Paul
I think, though, that there may be exceptions.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sun Mar 18, 2018 6:54 am

barefootjan wrote:
Sat Mar 17, 2018 5:38 pm
Regarding needing a referral from your primary care provider to see a specialist: In my past experience as an uninsured person, the specialists themselves require that you have a referral before they'll book time with you. (This may be a regional thing, I don't know.) The reasoning, as I understood it, was that a layperson might not be able to determine if they have an actual need for specialized care.
I think it may depend on the type of specialist and/or the particular specialist him/herself.

In the past, with a PPO (no referral needed), I have booked directly (no referral) with an Endocrinologist, Dermatologist and Gastroenterologist - and (I think) with an ENT. I was never declined, as best I recall.

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Re: Need for Medicare supplemental plan?

Post by pshonore » Sun Mar 18, 2018 9:27 am

Has anyone compared the reimbursement rates for traditional Medicare versus a typical Medicare Advantage plan? I imagine the Advantage plan is more generous but it probably depends on the carrier.

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Re: Need for Medicare supplemental plan?

Post by pshonore » Sun Mar 18, 2018 9:28 am

duplicate
Last edited by pshonore on Sun Mar 18, 2018 10:20 am, edited 1 time in total.

Big Dog
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Re: Need for Medicare supplemental plan?

Post by Big Dog » Sun Mar 18, 2018 10:09 am

In our current Kaiser Medicare plan, in my seven years, I have never been denied a desired referral. In a few cases, my PCP fully and 100% convinced me that I did not need a referral.
For California residents, Kaiser works great, as long as you have a Kaiser hospital within a short driving distance. My folks had Kaiser's MA and had the same experience as above -- no issues with referrals whatsoever. Sure, you may not be able to see the Orthopedic surgeon tomorrow, but then I can't see my PPO Ortho on a day's notice either, unless I tell the receptionist that I think I broke something. :twisted:

I would think that UMPC would be even better. Top-ranked health center at your disposal.

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Re: Need for Medicare supplemental plan?

Post by radiowave » Sun Mar 18, 2018 11:03 am

vested1 wrote:
Sat Mar 17, 2018 12:34 pm
It's extremely important to call your current or previous employer's insurance provider to ask how they handle transition to Medicare. In most cases that insurance becomes secondary, or is cancelled/exhorbitant when Medicare age is reached. In some cases the employer provided insurance is better than Medicare supplemental plans and also covers prescriptions. The employer won't necessarily volunteer this information because doing so results in additional insurance cost to them.

Such was the case with my wife's insurance, which transitions to secondary at age 65. My retiree insurance was very expensive through my previous employer, even more so when I added my wife. By simply calling her insurance company and asking, I found that her insurance was superior to authorized Medicare supplemental plans, covered all prescriptions, and covered us both beyond age 65 indefinitely. This information was not in the brochures we were sent when it came time to renew the insurance when I transitioned to Medicare. Using her insurance for prescriptions eliminates the Part D penalty of not signing up soon after Medicare begins. If her insurance ever gets too expensive we can transition to Part D with no penalty.

Her premiums go up slightly every year, but this year we only pay $191 a month to her insurance to cover us both. Last year it was $177 a month. I cancelled the insurance from my previous employer. Now we only have Medicare parts A and B, as well as my wife's insurance, which covers everything it used to before Medicare except vision and dental, which we will self insure. She takes a very expensive medication, which from my recent research would have a yearly co-pay using the best plan I could find for Medicare part D of around $4,500, not including the cost of the insurance.

In fact, she is on a program with the drug manufacturer which makes that medication cost only $10 every 3 months. The manufacturer for that drug told us she would no longer able to participate in that program after she started Medicare. I made further calls and it was determined that they were wrong, and that she can remain on the program due to her insurance. Not so if she was on Part D.

A few short calls may save you a ton of $$$.
If you work past 65 say to 67 or 68, how does that affect your ability to purchase a supplemental plan (assuming you are covered by your employer to the later age)?
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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sun Mar 18, 2018 11:48 am

pshonore wrote:
Sun Mar 18, 2018 9:27 am
Has anyone compared the reimbursement rates for traditional Medicare versus a typical Medicare Advantage plan? I imagine the Advantage plan is more generous but it probably depends on the carrier.
Do you mean for the Physicians/providers that work in their own offices? My guess is that the reimbursements may be more complex.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sun Mar 18, 2018 11:50 am

If you work past 65 say to 67 or 68, how does that affect your ability to purchase a supplemental plan (assuming you are covered by your employer to the later age)?
As long as you can document acceptable coverage, you should be OK

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sun Mar 18, 2018 11:52 am

Big Dog wrote:
Sun Mar 18, 2018 10:09 am
In our current Kaiser Medicare plan, in my seven years, I have never been denied a desired referral. In a few cases, my PCP fully and 100% convinced me that I did not need a referral.
For California residents, Kaiser works great, as long as you have a Kaiser hospital within a short driving distance. My folks had Kaiser's MA and had the same experience as above -- no issues with referrals whatsoever. Sure, you may not be able to see the Orthopedic surgeon tomorrow, but then I can't see my PPO Ortho on a day's notice either, unless I tell the receptionist that I think I broke something. :twisted:
I would think that UMPC would be even better. Top-ranked health center at your disposal.
Here (Wash DC area) - no actual Kaiser Hospitals - but arrangements with several good ones. Urgent care (24x7) can handle 99% of any kinds of after hours needs for modest copay - just like a hospital - can keep you up to 24 hours.

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Re: Need for Medicare supplemental plan?

Post by HueyLD » Sun Mar 18, 2018 12:02 pm

dm200 wrote:
Sun Mar 18, 2018 11:50 am
If you work past 65 say to 67 or 68, how does that affect your ability to purchase a supplemental plan (assuming you are covered by your employer to the later age)?
As long as you can document acceptable coverage, you should be OK
The size of the employer determines whether you may be able to delay Part A and Part B without having to pay a penalty if you enroll later.
https://www.medicare.gov/sign-up-change ... lapse-3156

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Re: Need for Medicare supplemental plan?

Post by Big Dog » Sun Mar 18, 2018 12:13 pm

Here (Wash DC area) - no actual Kaiser Hospitals - but arrangements with several good ones.
Yeah, I get that, but IMO, Kaiser works best when you are in their ecosystem -- their owned and operated facilities. Otherwise, its just like every other HMO, where providers come and go.

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Re: Need for Medicare supplemental plan?

Post by S&L1940 » Sun Mar 18, 2018 1:12 pm

pshonore wrote:
Sat Mar 17, 2018 2:27 pm
munemaker wrote:
Sat Mar 17, 2018 2:09 pm
Curious why most on this thread prefer a supplemental plan to an advantage plan?
One reason is with Plan G, after you pay the $183 deductible, there are no other costs as long as its for a covered charge. Of course you do have to pay the monthly premium as well. My annual January cardiology visit eats up most if not all of the deductible. I find a lot of Advantage plans (Anthem, UHC, etc.) have hospital admission fees, ambulance fees, ER fees, lab fees, xray fees, co-pays, etc. which can add up
Main reason why we avoid the advantage plans is the ability to see any doctor anywhere in the US that accepts Medicare. Same with hospitals, we need not ask permission, we simply make the appointment
Yes, expensive, very, as a couple we pay nearly $6K in premiums. If ever that becomes a burden and loses its value we will re-think Advantage plans.
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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sun Mar 18, 2018 1:50 pm

Big Dog wrote:
Sun Mar 18, 2018 12:13 pm
Here (Wash DC area) - no actual Kaiser Hospitals - but arrangements with several good ones.
Yeah, I get that, but IMO, Kaiser works best when you are in their ecosystem -- their owned and operated facilities. Otherwise, its just like every other HMO, where providers come and go.
It turned out that a few years ago, Kaiser here dropped the largest Northern Virginia Hospital from sending patients there. They added/enhanced the relationship with a smaller one - that happens to be very near where we live :)

Such hospitals, though, are more than "just a provider" to Kaiser. it has wing(s)/floors dedicated to Kaiser patients and Kaiser Physicians (Hospitalists) there all the time. When DW was hospitalized several years ago, it was a very nice Kaiser Hospitalist that interviewed her shortly after admission, reviewed her records, helped coordinate her care and called a Kaiser Gastroenterologist from home (Sunday evening) to see her, etc. I think (not 100% sure how it worked) some of the nurses on the floor are either Kaiser employees or hospital employees "dedicated" to Kaiser patients.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sun Mar 18, 2018 2:00 pm

S&L1940 wrote:
Sun Mar 18, 2018 1:12 pm
pshonore wrote:
Sat Mar 17, 2018 2:27 pm
munemaker wrote:
Sat Mar 17, 2018 2:09 pm
Curious why most on this thread prefer a supplemental plan to an advantage plan?
One reason is with Plan G, after you pay the $183 deductible, there are no other costs as long as its for a covered charge. Of course you do have to pay the monthly premium as well. My annual January cardiology visit eats up most if not all of the deductible. I find a lot of Advantage plans (Anthem, UHC, etc.) have hospital admission fees, ambulance fees, ER fees, lab fees, xray fees, co-pays, etc. which can add up
Main reason why we avoid the advantage plans is the ability to see any doctor anywhere in the US that accepts Medicare. Same with hospitals, we need not ask permission, we simply make the appointment
Yes, expensive, very, as a couple we pay nearly $6K in premiums. If ever that becomes a burden and loses its value we will re-think Advantage plans.
Yes - very true. BUT - the question (I am sure it varies by plan) is what the Advantage Plan does or allows when out of that area. It may be related to how much travel you do and where. Then, seems to me there is a tradeoff of benefit vs cost!

I/we have never used our Kaiser Medicare plan from another area, but my reading of the documents - as well as talking to friends who have done so - is that medically necessary care outside the area is covered. The monthly premiums are hard to beat $30 per month. Those "savings" go a long way towards what a high expense (out of pocket annual limit) year would entail.

Today, almost all surgery is done "outpatient". Kaiser here has an outpatient surgery center - just had some done ten days ago. The ONLY cost for the surgery was $250 plus $1.50 for 15 pain pills plus $20 pre-surgery office visit/ECG. DW is having surgery in another 10 days and hers will also be only $250 as well - and she had several $20 pre-surgery tests/visits. I suspect that outpatient surgery on Original medicare at a hospital would be a lot more.

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Re: Need for Medicare supplemental plan?

Post by Good Listener » Sun Mar 18, 2018 2:23 pm

dm200 wrote:
Sun Mar 18, 2018 2:00 pm
S&L1940 wrote:
Sun Mar 18, 2018 1:12 pm
pshonore wrote:
Sat Mar 17, 2018 2:27 pm
munemaker wrote:
Sat Mar 17, 2018 2:09 pm
Curious why most on this thread prefer a supplemental plan to an advantage plan?
One reason is with Plan G, after you pay the $183 deductible, there are no other costs as long as its for a covered charge. Of course you do have to pay the monthly premium as well. My annual January cardiology visit eats up most if not all of the deductible. I find a lot of Advantage plans (Anthem, UHC, etc.) have hospital admission fees, ambulance fees, ER fees, lab fees, xray fees, co-pays, etc. which can add up
Main reason why we avoid the advantage plans is the ability to see any doctor anywhere in the US that accepts Medicare. Same with hospitals, we need not ask permission, we simply make the appointment
Yes, expensive, very, as a couple we pay nearly $6K in premiums. If ever that becomes a burden and loses its value we will re-think Advantage plans.
Yes - very true. BUT - the question (I am sure it varies by plan) is what the Advantage Plan does or allows when out of that area. It may be related to how much travel you do and where. Then, seems to me there is a tradeoff of benefit vs cost!

I/we have never used our Kaiser Medicare plan from another area, but my reading of the documents - as well as talking to friends who have done so - is that medically necessary care outside the area is covered. The monthly premiums are hard to beat $30 per month. Those "savings" go a long way towards what a high expense (out of pocket annual limit) year would entail.

Today, almost all surgery is done "outpatient". Kaiser here has an outpatient surgery center - just had some done ten days ago. The ONLY cost for the surgery was $250 plus $1.50 for 15 pain pills plus $20 pre-surgery office visit/ECG. DW is having surgery in another 10 days and hers will also be only $250 as well - and she had several $20 pre-surgery tests/visits. I suspect that outpatient surgery on Original medicare at a hospital would be a lot more.
If you have original Medicare and a supplement like F or G, the cost would be zero (after your 183 deductible for the year if you have G). The MA plans have copays for everything generally.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sun Mar 18, 2018 2:39 pm

If you have original Medicare and a supplement like F or G, the cost would be zero (after your 183 deductible for the year if you have G). The MA plans have copays for everything generally.
Yes - that is true. The "offset", though, is the monthly fee for the supplement. Our $30/month premium plan does have copays now for many things. $20 PCP office, $45 specialist, $20 XRAY/ultrasound, $150 CT/MRI, $20 for Optometrist including refractions - but ZERO for blood and urine lab tests, zero for email solutions to problems, zero for telephone and smartphone appointments, etc. Neither any charge for email or telephone advice nurse (24x7). Never have to find a specialist - they find everyone.

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Re: Need for Medicare supplemental plan?

Post by pshonore » Sun Mar 18, 2018 4:06 pm

dm200 wrote:
Sun Mar 18, 2018 11:48 am
pshonore wrote:
Sun Mar 18, 2018 9:27 am
Has anyone compared the reimbursement rates for traditional Medicare versus a typical Medicare Advantage plan? I imagine the Advantage plan is more generous but it probably depends on the carrier.
Do you mean for the Physicians/providers that work in their own offices? My guess is that the reimbursements may be more complex.
Anthem is starting to become a big MA provider in CT using the PPO model. No gatekeepers. See any doc you want. I'm not certain but believe that most physicians/providers work out of their own offices although the hospitals are buying out many offices. My guess is they pay more than Medicare, possibly even the same rates they would pay for the under 65 folks.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Sun Mar 18, 2018 4:10 pm

pshonore wrote:
Sun Mar 18, 2018 4:06 pm
dm200 wrote:
Sun Mar 18, 2018 11:48 am
pshonore wrote:
Sun Mar 18, 2018 9:27 am
Has anyone compared the reimbursement rates for traditional Medicare versus a typical Medicare Advantage plan? I imagine the Advantage plan is more generous but it probably depends on the carrier.
Do you mean for the Physicians/providers that work in their own offices? My guess is that the reimbursements may be more complex.
Anthem is starting to become a big MA provider in CT using the PPO model. No gatekeepers. See any doc you want. I'm not certain but believe that most physicians/providers work out of their own offices although the hospitals are buying out many offices. My guess is they pay more than Medicare, possibly even the same rates they would pay for the under 65 folks.
If straight payment for service (say $X for office visit), I wonder how Medicare could justify paying more than Original Medicare? If this is, somehow, payment just from the MA plan - then the MA plan must have some way to control such costs?

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GerryL
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Re: Need for Medicare supplemental plan?

Post by GerryL » Sun Mar 18, 2018 4:16 pm

Spirit Rider wrote:
Sat Mar 17, 2018 1:53 pm
Plans C, F and F high deductible will be grandfathered to existing policy holders on 12/31/2019. No new such plans can be sold effective 1/1/2020.

Plan G high deductible will be available 1/1/2020, but it is not known if it will be available earlier. Also, it is not known if current Plan G or Plan F high deductible policy holders will be able to change to Plan G high deductible policies without medical underwriting.
I've been wondering whether the insurance companies were going to start offering G high deductible. I am hoping that I would be able to switch from F-HD to G-HD, since it is, essentially a plan with lower benefits. Here in Oregon we are allowed to make changes to Medigap coverage -- within certain constraints -- in our birthday month.

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Re: Need for Medicare supplemental plan?

Post by Spirit Rider » Sun Mar 18, 2018 4:25 pm

GerryL wrote:
Sun Mar 18, 2018 4:16 pm
Spirit Rider wrote:
Sat Mar 17, 2018 1:53 pm
Plans C, F and F high deductible will be grandfathered to existing policy holders on 12/31/2019. No new such plans can be sold effective 1/1/2020.

Plan G high deductible will be available 1/1/2020, but it is not known if it will be available earlier. Also, it is not known if current Plan G or Plan F high deductible policy holders will be able to change to Plan G high deductible policies without medical underwriting.
I've been wondering whether the insurance companies were going to start offering G high deductible. I am hoping that I would be able to switch from F-HD to G-HD, since it is, essentially a plan with lower benefits. Here in Oregon we are allowed to make changes to Medigap coverage -- within certain constraints -- in our birthday month.
I'm wondering the same thing maybe for 2019.

The only difference between Plan F HD and Plan G HD is when you have exceeded the Plan deductible with Part A charges before exceeding the Part B deductible. A low probability event for most people.

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Re: Need for Medicare supplemental plan?

Post by pshonore » Sun Mar 18, 2018 4:59 pm

dm200 wrote:
Sun Mar 18, 2018 4:10 pm
pshonore wrote:
Sun Mar 18, 2018 4:06 pm
dm200 wrote:
Sun Mar 18, 2018 11:48 am
pshonore wrote:
Sun Mar 18, 2018 9:27 am
Has anyone compared the reimbursement rates for traditional Medicare versus a typical Medicare Advantage plan? I imagine the Advantage plan is more generous but it probably depends on the carrier.
Do you mean for the Physicians/providers that work in their own offices? My guess is that the reimbursements may be more complex.
Anthem is starting to become a big MA provider in CT using the PPO model. No gatekeepers. See any doc you want. I'm not certain but believe that most physicians/providers work out of their own offices although the hospitals are buying out many offices. My guess is they pay more than Medicare, possibly even the same rates they would pay for the under 65 folks.
If straight payment for service (say $X for office visit), I wonder how Medicare could justify paying more than Original Medicare? If this is, somehow, payment just from the MA plan - then the MA plan must have some way to control such costs?
I thought Medicare paid $x per person to MA "Insurors" and the insuror was free to make its own contracts with docs/hospitals, set co-pays, deductibles,etc just as they do for the under 65 crowd. If the insuror pays out more - its their loss, pay out less - its their gain.

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Re: Need for Medicare supplemental plan?

Post by Good Listener » Sun Mar 18, 2018 5:11 pm

pshonore wrote:
Sun Mar 18, 2018 4:59 pm
dm200 wrote:
Sun Mar 18, 2018 4:10 pm
pshonore wrote:
Sun Mar 18, 2018 4:06 pm
dm200 wrote:
Sun Mar 18, 2018 11:48 am
pshonore wrote:
Sun Mar 18, 2018 9:27 am
Has anyone compared the reimbursement rates for traditional Medicare versus a typical Medicare Advantage plan? I imagine the Advantage plan is more generous but it probably depends on the carrier.
Do you mean for the Physicians/providers that work in their own offices? My guess is that the reimbursements may be more complex.
Anthem is starting to become a big MA provider in CT using the PPO model. No gatekeepers. See any doc you want. I'm not certain but believe that most physicians/providers work out of their own offices although the hospitals are buying out many offices. My guess is they pay more than Medicare, possibly even the same rates they would pay for the under 65 folks.
If straight payment for service (say $X for office visit), I wonder how Medicare could justify paying more than Original Medicare? If this is, somehow, payment just from the MA plan - then the MA plan must have some way to control such costs?
I thought Medicare paid $x per person to MA "Insurors" and the insuror was free to make its own contracts with docs/hospitals, set co-pays, deductibles,etc just as they do for the under 65 crowd. If the insuror pays out more - its their loss, pay out less - its their gain.
You are exactly right.

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Re: Need for Medicare supplemental plan?

Post by Big Dog » Sun Mar 18, 2018 5:15 pm

I've been wondering whether the insurance companies were going to start offering G high deductible.
Me too, but not holding my breath that the CAlif will approve it for sale. (The powers-that-be in our state hate high deductible plans.)

I am hoping that I would be able to switch from F-HD to G-HD, since it is, essentially a plan with lower benefits. Here in Oregon we are allowed to make changes to Medigap coverage -- within certain constraints -- in our birthday month.
I think the same is true in California.

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fishnskiguy
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Re: Need for Medicare supplemental plan?

Post by fishnskiguy » Sun Mar 18, 2018 6:47 pm

My 89 year old mother in law opted for a Medicare Advantage plan with no monthly premium when she retired at age 65. It worked great for her until last September when she was hospitalized for ten days for stage four chronic kidney failure, then discharged for a week and then readmitted for another ten days. She was told that she should no longer live alone, so she moved in with her other daughter and SIL who lived nearby in Philadelphia. In January the family decided it would be best for her to live with my wife and I here in Arizona.

As she was preparing to come out here I did my homework and found out that when permanently relocating, she could shift to a Medicare Supplement Plan F and would not have to answer any medical questions. With congestive heart disease, early stage diabetes along with stage 4 CKD, there would be no way anybody would issue her a medicare supplement plan if they could ask questions. The day she arrived here we signed her up for a no deductible supplement plan with USAA for $209 per month and a drug plan with Express Scripts for $30 per month. Although her only income is SS, we think that is quite affordable.

Two weeks ago she got a bill from the hospital back in Philadelphia for $4,200 for co-pays. When she saw it she had a heart attack. A real one. We rushed her to the ER two blocks away and she was then transported to the hospital by ambulance and stayed there five days. Thanks to the supplement plan she will pay mothing. She is back home with us now and is doing remarkably well.

That medicare supplement plan is making all of us breath easier.

My mission for next week is to contact the hospital in Philly and try to work out a reasonable repayment plan for that $4,200.

Chris
Trident D-5 SLBM- "When you care enough to send the very best."

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munemaker
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Re: Need for Medicare supplemental plan?

Post by munemaker » Sun Mar 18, 2018 7:21 pm

fishnskiguy wrote:
Sun Mar 18, 2018 6:47 pm
My 89 year old mother in law opted for a Medicare Advantage plan with no monthly premium when she retired at age 65. It worked great for her until last September when she was hospitalized for ten days for stage four chronic kidney failure, then discharged for a week and then readmitted for another ten days. She was told that she should no longer live alone, so she moved in with her other daughter and SIL who lived nearby in Philadelphia. In January the family decided it would be best for her to live with my wife and I here in Arizona.

As she was preparing to come out here I did my homework and found out that when permanently relocating, she could shift to a Medicare Supplement Plan F and would not have to answer any medical questions. With congestive heart disease, early stage diabetes along with stage 4 CKD, there would be no way anybody would issue her a medicare supplement plan if they could ask questions. The day she arrived here we signed her up for a no deductible supplement plan with USAA for $209 per month and a drug plan with Express Scripts for $30 per month. Although her only income is SS, we think that is quite affordable.

Two weeks ago she got a bill from the hospital back in Philadelphia for $4,200 for co-pays. When she saw it she had a heart attack. A real one. We rushed her to the ER two blocks away and she was then transported to the hospital by ambulance and stayed there five days. Thanks to the supplement plan she will pay mothing. She is back home with us now and is doing remarkably well.

That medicare supplement plan is making all of us breath easier.

My mission for next week is to contact the hospital in Philly and try to work out a reasonable repayment plan for that $4,200.

Chris
Thanks for sharing that. I am surprised she was able to move from an Advantage Plan to a Supplement Plan without underwriting, even considering the relocation. I am just learning about Medicare and don't have all the rules down yet.

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EyeYield
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Re: Need for Medicare supplemental plan?

Post by EyeYield » Sun Mar 18, 2018 8:26 pm

FrugalInvestor wrote:
Fri Mar 16, 2018 11:43 pm
jebmke wrote:
Fri Mar 16, 2018 5:42 pm
invst65 wrote:
Fri Mar 16, 2018 5:15 pm
First time I've ever heard of Plan "G".
G is basically F with a $183 deductible. At some point, F plans will no longer be sold to new enrollees.
As far as I know Plan G is exactly the same as Plan F except that F pays the part B deductible (currently $183) and G does not. A $183 per year in premiums difference between the two plans is the breakeven point. More than a $183 difference and Gi is the better deal. Less and F is the better deal. When I purchased the difference was somewhere around $260, so I chose G.

Plan F will no longer be sold to those becoming eligible for Medicare after December 31, 2019. This means that the insured pool for plan F with no new enrollees will begin to age relatively faster than the insured pool for plan G which is the closest substitute for F. This suggests to me that premiums for plan F are likely to increase at a faster rate than for plan G (assuming that rates are based on claims experience which are highly dependent upon age).
Yes, the break even point is what I’m keeping my eye on too. So far I haven’t been able to get a G plan that saves more than $143 from my current plan, so I’m staying with F for now.

To find out what supplement plans are available and how much they cost in California, go here:
https://interactive.web.insurance.ca.go ... NO:SESSION::

Other states probably have similar.

There is a Plan F that is $32 cheaper than mine, but not worth the effort to leave my State Farm family and the discounts available.

My Plan F rate has gone up from last year’s $1716 to $1946, which is more than I estimated, so maybe Plan G is in my future.
Unfortunately SF doesn’t offer G right now.

CWRadio wrote:
Sat Mar 17, 2018 3:18 pm
Here is a good web site to check the price of supplements insurance in your state:
https://www.freemedicarereport.com/

Just give zip code and go to "just view results" Paul
This is not accurate for my state and doesn’t include the policy or company I’ve had for the last two years or many others listed on the ca.gov link (https://interactive.web.insurance.ca.go ... NO:SESSION).
And since it’s a sponsored site, I wouldn’t trust it very much anyway.
"The stock market is a giant distraction from the business of investing." - Jack Bogle

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Re: Need for Medicare supplemental plan?

Post by RetiredArtist » Sun Mar 18, 2018 8:38 pm

I enrolled in a Plan F supplement 6 years ago, so some of my info may be out of date, and the rules may vary by state.
I found a very helpful independent agent. The agent is paid by whatever insurance company you select. He pointed out that by law, all Plan F's must offer the same benefits. Your price depends on whether the insurance company rates by age, community, etc.
Mutual of Omaha was expensive in my city, and cheaper 100 miles away.
AARP United Healthcare Plans factor in age, so rate goes up yearly. (Actually, a discount slowly disappears over 10 years.) But it was still cheaper in my area.
You can look up costs for supplement plans in your zip code on Medicare.gov.
You can look up drug plans, and get costs for the meds you currently take.
State Department of Insurance websites also offer information.
My understanding is, once you sign up for a Supplement Plan, you can change Supplement Plan insurance companies once a year. You can change to a less comprehensive plan. Of course you can cancel. But you cannot change from a less comprehensive supplement plan to a more comprehensive one.
Another good thing about Plan F is, no bills for co-pays, non-covered services, out of network providers, etc.

That said, Kaiser Medicare Advantage (HMO) is highly rated. They provided very good care for several older relatives. My current mix of doctors does not co-ordinate care. I deal with 5 different online patient portals. When I get seriously old, or sick, I may switch to Kaiser.

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Re: Need for Medicare supplemental plan?

Post by marielake » Sun Mar 18, 2018 8:51 pm

I pay $26/month for Plan F high deductible. Since I am in good health, it seemed like a no brainer when I signed up a year ago. I did not do the Advantage Plan because I didn't think I'd be able to switch plans down the road and I didn't think all doctors accepted the plan. I am happy with my decision.

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Re: Need for Medicare supplemental plan?

Post by billfromct » Sun Mar 18, 2018 9:16 pm

I have just looked at Medicare plans in January due to losing my employer health plan.

When I looked in Massachusetts, Medicare Advantage (Harvard Pilgrim) had a $3,600 "out of pocket" cost plus co-pays. You also had to stay in the HMO network or get authorization to go out of the network.

Supplemental, had no co-pays, no "out of pocket" cost, could go to any doctor without authorization, but was much more expensive. If my memory serves me correctly, Supplemental was about $210/month while Advantage was about $150/month (?).

Of course this is in addition to Medicare Part B (starting at $130+/month, depending on income) as well as Medicare Part D, prescriptions, starting at $30/month.

If I wasn't eligible for an old employer retirement health care plan, I would have gone with the more expensive Medicare Supplemental plan plus Medicare Part D, prescriptions.

bill

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Re: Need for Medicare supplemental plan?

Post by Spirit Rider » Sun Mar 18, 2018 11:30 pm

GerryL wrote:
Sun Mar 18, 2018 4:16 pm
I've been wondering whether the insurance companies were going to start offering G high deductible. I am hoping that I would be able to switch from F-HD to G-HD, since it is, essentially a plan with lower benefits. Here in Oregon we are allowed to make changes to Medigap coverage -- within certain constraints -- in our birthday month.
The National Association of Insurance Commissioners (NAIC) adopted the new revisions to the Medicare Supplement Model on August 29, 2016. They sent the approved Model to the federal Centers for Medicare & Medicaid Services (CMS) on October 14, 2016 for publication of a notice in the Federal Register recognizing the NAIC revisions to the federal minimum standard. The amazing bureaucracy of CMS managed to rapidly approve/publish that notice in the Federal Register on September 1, 2017.

In the past Congress has consistently directed that changes to the Model Regulation must be adopted by the States one year after the date the NAIC adopted the amended Model Regulation. They did not do that this time, but the NAIC has recommended States adopt the MACRA revisions before December 31, 2017 in order to give Medigap issuers a timely window to file MACRA compliant amendments to policies and for approval by states.

I have been watching out for news on this, but I have not really heard anything. Now it is possible that there has been movement under the radar and we will see some Plan G high deductible policies offered for sale by some issuers in some states in 2019. It is just as likely that we don't see such policies until just in time for 1/1/2020.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Mon Mar 19, 2018 10:12 am

fishnskiguy wrote:
Sun Mar 18, 2018 6:47 pm
My 89 year old mother in law opted for a Medicare Advantage plan with no monthly premium when she retired at age 65. It worked great for her until last September when she was hospitalized for ten days for stage four chronic kidney failure, then discharged for a week and then readmitted for another ten days. She was told that she should no longer live alone, so she moved in with her other daughter and SIL who lived nearby in Philadelphia. In January the family decided it would be best for her to live with my wife and I here in Arizona.
As she was preparing to come out here I did my homework and found out that when permanently relocating, she could shift to a Medicare Supplement Plan F and would not have to answer any medical questions. With congestive heart disease, early stage diabetes along with stage 4 CKD, there would be no way anybody would issue her a medicare supplement plan if they could ask questions. The day she arrived here we signed her up for a no deductible supplement plan with USAA for $209 per month and a drug plan with Express Scripts for $30 per month. Although her only income is SS, we think that is quite affordable.
Two weeks ago she got a bill from the hospital back in Philadelphia for $4,200 for co-pays. When she saw it she had a heart attack. A real one. We rushed her to the ER two blocks away and she was then transported to the hospital by ambulance and stayed there five days. Thanks to the supplement plan she will pay mothing. She is back home with us now and is doing remarkably well.
That medicare supplement plan is making all of us breath easier.
My mission for next week is to contact the hospital in Philly and try to work out a reasonable repayment plan for that $4,200.
Chris
Glad that she was able to get the coverage she wants/needs in the new location.

I did not see what she was most recently paying for her MA plan that had no premiums 24 years ago. Twenty-four years of low/no premiums (to me) makes the $4,200 not seem so financially terrible, on balance. Sounds like she is probably quite a bit ahead, financially.

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dm200
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Re: Need for Medicare supplemental plan?

Post by dm200 » Mon Mar 19, 2018 10:18 am

billfromct wrote:
Sun Mar 18, 2018 9:16 pm
I have just looked at Medicare plans in January due to losing my employer health plan.
When I looked in Massachusetts, Medicare Advantage (Harvard Pilgrim) had a $3,600 "out of pocket" cost plus co-pays. You also had to stay in the HMO network or get authorization to go out of the network.
Supplemental, had no co-pays, no "out of pocket" cost, could go to any doctor without authorization, but was much more expensive. If my memory serves me correctly, Supplemental was about $210/month while Advantage was about $150/month (?).
Of course this is in addition to Medicare Part B (starting at $130+/month, depending on income) as well as Medicare Part D, prescriptions, starting at $30/month.
If I wasn't eligible for an old employer retirement health care plan, I would have gone with the more expensive Medicare Supplemental plan plus Medicare Part D, prescriptions.
bill
Based on our plan (and some others I have researched), an annual out of pocket max of $3,600 seems typical. [Ours is $6,000 this year]. Ours, however, INCLUDES copays during the year in the annual maximum. Neither do we have any initial annual deductible to satisfy.
Of course this is in addition to Medicare Part B (starting at $130+/month, depending on income) as well as Medicare Part D, prescriptions, starting at $30/month.
Most (but not all) MA plans INCLUDE drug coverage as part of the monthly premium. Ours does - and the premium is only $30/month.

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fishnskiguy
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Re: Need for Medicare supplemental plan?

Post by fishnskiguy » Mon Mar 19, 2018 12:05 pm

dm200 wrote:
Mon Mar 19, 2018 10:12 am
fishnskiguy wrote:
Sun Mar 18, 2018 6:47 pm
My 89 year old mother in law opted for a Medicare Advantage plan with no monthly premium when she retired at age 65. It worked great for her until last September when she was hospitalized for ten days for stage four chronic kidney failure, then discharged for a week and then readmitted for another ten days. She was told that she should no longer live alone, so she moved in with her other daughter and SIL who lived nearby in Philadelphia. In January the family decided it would be best for her to live with my wife and I here in Arizona.
As she was preparing to come out here I did my homework and found out that when permanently relocating, she could shift to a Medicare Supplement Plan F and would not have to answer any medical questions. With congestive heart disease, early stage diabetes along with stage 4 CKD, there would be no way anybody would issue her a medicare supplement plan if they could ask questions. The day she arrived here we signed her up for a no deductible supplement plan with USAA for $209 per month and a drug plan with Express Scripts for $30 per month. Although her only income is SS, we think that is quite affordable.
Two weeks ago she got a bill from the hospital back in Philadelphia for $4,200 for co-pays. When she saw it she had a heart attack. A real one. We rushed her to the ER two blocks away and she was then transported to the hospital by ambulance and stayed there five days. Thanks to the supplement plan she will pay mothing. She is back home with us now and is doing remarkably well.
That medicare supplement plan is making all of us breath easier.
My mission for next week is to contact the hospital in Philly and try to work out a reasonable repayment plan for that $4,200.
Chris
Glad that she was able to get the coverage she wants/needs in the new location.

I did not see what she was most recently paying for her MA plan that had no premiums 24 years ago. Twenty-four years of low/no premiums (to me) makes the $4,200 not seem so financially terrible, on balance. Sounds like she is probably quite a bit ahead, financially.
I agree. My point is that now that she has significant medical issues it is highly likely that the MA plan would be much costlier going forward than a MS plan and had she not relocated, she would be stuck in the MA plan. Folks should consider this when they opt for an inexpensive MA plan when they are young and healthy. It may not work out so well when they are old and get issues.

Chris
Trident D-5 SLBM- "When you care enough to send the very best."

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