Posted on 10/20/2025 8:48:19 AM PDT by Sequoyah101
This time it is breath taking. Our Plan G premium went up 37%.
Here we go again. Spin the roulette wheel of health care costs and see how high they go. Wonder if it is you being singled out or another gift to the state board of insurance or just what it is and how much.
In our hospitalization last Spring the case worker said, “I see you have traditional Medicare and Plan G. You should see hardly any bills at all.” I asked about Advantage, she rolled her eyes and said, “Disaster for many people.”
There are always exceptions that are so far not worth the risk.
Exactly what we’ve been told by docs and older relatives. DON’T DO IT!!
It’s a pretty present all wrapped with a nice bow ... until you travel or need specialists and specialized care, per their description.
Later
What is the name of that Aetna plan?
“The withdrawal of major insurers like Mutual of Omaha and Clear Spring from the Part D market in 2025 left approximately 537,000 enrollees without a drug plan.”
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I cannot imagine someone losing their Part D “option” “in their area”, with “ALL the Part D options in that area are lost” and that loss not including Part D in a Medicare Advantage plan; meaning NO PLACE to go, but out of pocket.
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Wasn’t this addressed in a previous AI query? The number of PDPs is decreasing and this is not correlated to changes in the Advantage program.
Call a local agent. Ask him or her if she knows of any clients who have had to shift from Medigap to Advantage because of loss of a PDP, or coverage for a drug within a PDP.
If you’re in an urban area I would think you would be the last to face this.
Obviously it is being faced nationwide or the AIs would not be so clear about loss of PDPs.
Incredible
#7 About 10 years ago my cousins husband who worked in a hospital buying supplies lost his job as the hospital closed due to the cost of illegals getting free care. Free meant costing hundreds of Americans their jobs.
Aetna Medicare Advantage.
“Call a local agent. Ask him or her if she knows of any clients who have had to shift from Medigap”
Again - Medigap plans do not include part D to begin with!!!
They sit as insurance on top of what Medicare offers in Medicare A & B. They do not insure prescription drugs.
Again, I cannot believe PDP (Part D) insurers have greater losses on Part D than, in the same area, is being experienced by Medicare Advantage Plans (with Part D included) because the adverse Part D conditions apply across the board to all carriers of Part D, whether independent PDPs or Part D within Medicare Advantage. I don’t think anyone escapes the problem by suddenly getting a Medicare Advantage plan. The thing is the cost for Part D is going up universally.
This is laid out earlier.
A law change affected the subsidy sent to Part D plans from Medicare. There is also a $2K/yr cap on Part D users added and caps of that sort were ALREADY on Advantage plans. Not a big change for them, and their subsidy from Medicare is different paragraphs in the laws.
This derives from election year tweaks to the rules. And that doesn’t matter. That’s how it is. Dinosaur realities — adapt or die.
I asked about Advantage, she rolled her eyes and said, “Disaster for many people.”
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Lots of such stories around. And it doesn’t matter. If your Part D plans in your area die, there is no alternative.
The disaster stories are addressed by Hospital Indemnity Policies.
If you still have a Part D plan with your drug reqmts covered, you don’t have to maneuver. If you do not still have such, your options are Advantage (+Indemnity) or sell your house and relocate to where there are Part D plans you can use, or go without meds.
I think the idea that Medicare Advantage plans could long sustain some financial advantage to insurers is proving to be fiction in two ways - what was promoted as “better plans” to consumers is proving to not be “better” plans due to the preferred provider network restrictions in the plans (restrictions plain jane Medicare does not have), and even then Medicare costs are outpacing the revenue of the Medicare premiums (handed over to the insurers running the Medicare “Advantage” plans, just as with Medicare itself, with insurers getting cost reductions by more restrictive networks. I think it was a lose-lose situation time was going to deliver no matter what.
The insurers would have been better off lobbying for totally separate “Medicare Age” plans that Medicare beneficiaries could consign their premiums to, as part payment for better plans than Medicare - better for the insurers and for consumers. Then insurers could compete in both their premiums and their offerings, and not held to Medicare’s limitations.
Here’s a follow-up of note:
I received notice today from Mutual of Omaha, my plan G premium is increasing from $203/month to $260/mo.
Increase of 28%. Ouch.
Those no-premium policies start to look good, as long as you stay healthy.
Don’t particularly want to push Medicare Advantage, but they are indeed often zero monthly premium. If you get sick, there will be copays for doctor visits.
There is also an annual max on those copays.
Disaster scenarios seem to derive from a time in the hospital. The answer is an added Hospital Indemnity plan.
Call a local Medicare Insurance Agent and ask questions.
New folks turning 65 who endure what we all endured and have to do extensive research, and phone calls, and websites and whatever . . . thinking it through as best they can — About 50% of those now choose Advantage right at day 1 of age 65.
They look great until you need them. Good luck with that. The way the world is looking these days a quick death is looking better all the time but we don’t get a choice in the matter.
“Those no-premium policies start to look good, as long as you stay healthy.”
Better: Those no-premium policies start to look good, as long as you ARE healthy.
And if you have health issues, that may result in major medical expenses, Supplemental G plans can soften the blow of some very major expenses, provided you can afford the premiums as opposed to sudden huge expenses.
Supplemental G plans vary by carrier and by state. New Jersey is a higher than average medical premium state, and my G plan exceeded $300 last year. But also, I had medical bills last year including two surgeries all of which exceeded $13,000 of which after Medicare and my Plan G I owed a couple hundred.
My wife and I originally chose Plan G because she was getting cancer treatments that cost over 70,000 a month. Her premium was only a little over $100 a month! She met her deductible for the entire year in january. She’s gone now and I don’t run up the expenses she did, but I have health issues that could balloon at any time so I’ll probably stay with Plan G just in case.
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