Medicare: Just Starting Down The Rabbit Hole

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drawpoker
Posts: 2731
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare: Just Starting Down The Rabbit Hole

Post by drawpoker » Thu Nov 28, 2019 11:44 pm

rivercrosser wrote:
Thu Nov 28, 2019 11:30 pm
I know how it works and theirs no way she's giving up her F plan (she can afford whatever she wants) but why not let someone that's less fortunate save a few bucks a month by stepping down to a G plan.
Because the insurers only want Healthy People, that's why. If these "less fortunate" folks you know have robust health, they have nothing to worry about.

Don't you think the insurance companies hated to see the legal doctrine of "Open Enrollment", as it pertains to Medicare, enacted? A curse upon their House. Don't you think they would love to devise some way to make it go away? Like a bad rash?

You said Missouri, right? So your state doesn't have any special rules for seniors to get around medical underwriting.

Serves as a reminder to everyone pondering this - choose carefully, once that window closes, it stays closed. :(

Topic Author
BillyV001
Posts: 23
Joined: Fri Dec 14, 2018 4:50 pm

Re: Medicare: Just Starting Down The Rabbit Hole

Post by BillyV001 » Mon Dec 02, 2019 6:49 pm

drawpoker wrote:
Thu Nov 28, 2019 3:07 pm
fru-gal wrote:
Thu Nov 28, 2019 10:53 am

......employer insurance pre-Medicare - disallowed imaging, procedures, meds......Now if I need imaging, the doctor can just go ahead and order it, no waiting for approval. Medicare has covered 80% of it and Medigap automatically covers the remaining 20%.......
I also bought Plan F. But, must point out something here. It is all not quite as rosy as all that. Way ahead of M.A. managed care for sure. But not perfect.

No matter which supplement Plan is bought, Medicare's own rules are in place, and they must be followed. Otherwise, if Medicare doesn't cover it, neither does the Medigap.
You mention imaging. With imaging, for ex, they will not cover a PET Scan more frequently than every 90 days. This may sound reasonable. To anyone not familiar with chemo and immunotherapy treatment for certain cancers. (PET scans are far superior to CAT scans, as they drastically reduce the risk of pseudoprogression phenomenon being seen)

My advice for anyone weighing the decision of Medigap versus Medicare Advantage: No matter how healthy you are now (or think you are) ask yourself - What if I get cancer, which type insurance would I rather have?
For me, this post sums up the biggest problem picking a path forward. What dp lays out, at least for me (and I gotta believe most folks outside the medical profession), is unknowable. I agree that life is full of surprises, some as nasty as can be, but even if one assumes the worst going forward (cancer as dp mentions), how the heck can you pick a plan and now about PET vs CAT scans, etc?? Yikes.

So dp, are you saying, at least in the case you outline, that an MA plan is the best choice? If that what you've done?

Best,
Bill

drawpoker
Posts: 2731
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare: Just Starting Down The Rabbit Hole

Post by drawpoker » Tue Dec 03, 2019 12:13 am

BillyV001 wrote:
Mon Dec 02, 2019 6:49 pm

For me, this post sums up the biggest problem picking a path forward. What dp lays out, at least for me (and I gotta believe most folks outside the medical profession), is unknowable...even if one assumes the worst going forward (cancer as dp mentions), how the heck can you pick a plan....So dp, are you saying, at least in the case you outline, that an MA plan is the best choice? If that what you've done?
Er, if I am "dp", then I guess my post wasn't very clear. Sorry for that.

No, am not saying that an MA plan is the best choice. Just the opposite. 1) IF you live in one of the states (most of them) where buying a Medigap plan after the open enrollment period has passed will entail underwriting; and 2) IF you can afford the premiums for Medigap plan, and 3) IF you believe the the main purpose of an insurance product is to protect your assets in the event the very worst happens (very worst being advanced stage of one of the serious cancers)

If this profile fits you - Medigap, not a MA plan - will suit you better, IMO. I bought Plan F when first going on Medicare, and have never looked back.

FWIW - Some advise that family history should be considered when weighing odds of future health. Nothing wrong with that, a good suggestion. But don't count on it as a sure bet. For me, no incidents of cancer, parents, grandparents on both sides, lived to ripe old ages. Strokes got the ones who didn't make it into their nineties. Not cancer.

Topic Author
BillyV001
Posts: 23
Joined: Fri Dec 14, 2018 4:50 pm

Re: Medicare: Just Starting Down The Rabbit Hole

Post by BillyV001 » Tue Dec 03, 2019 1:58 pm

drawpoker wrote:
Tue Dec 03, 2019 12:13 am
BillyV001 wrote:
Mon Dec 02, 2019 6:49 pm

For me, this post sums up the biggest problem picking a path forward. What dp lays out, at least for me (and I gotta believe most folks outside the medical profession), is unknowable...even if one assumes the worst going forward (cancer as dp mentions), how the heck can you pick a plan....So dp, are you saying, at least in the case you outline, that an MA plan is the best choice? If that what you've done?
Er, if I am "dp", then I guess my post wasn't very clear. Sorry for that.

No, am not saying that an MA plan is the best choice. Just the opposite. 1) IF you live in one of the states (most of them) where buying a Medigap plan after the open enrollment period has passed will entail underwriting; and 2) IF you can afford the premiums for Medigap plan, and 3) IF you believe the the main purpose of an insurance product is to protect your assets in the event the very worst happens (very worst being advanced stage of one of the serious cancers)

If this profile fits you - Medigap, not a MA plan - will suit you better, IMO. I bought Plan F when first going on Medicare, and have never looked back.

FWIW - Some advise that family history should be considered when weighing odds of future health. Nothing wrong with that, a good suggestion. But don't count on it as a sure bet. For me, no incidents of cancer, parents, grandparents on both sides, lived to ripe old ages. Strokes got the ones who didn't make it into their nineties. Not cancer.
Yes...you are "dp". I should have written out "drawpoker".
Thanks for the response and clarification. And mentioning "family history " potentially impacting the Medicare/MA decision. Hadn't occurred to me but seems like a valid case to consider, at least.

Best,
Bill

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