Can Joe Namath steer you wrong?
Posted on 12/03/2020 9:51:41 AM PST by Captain Peter Blood
I turned 65 in June and got on Medicare. I got the normal Medicare plans including Plan D, and optional Dental and Vision overage. Cost about $150 a total.
I opted not to go Medicare Advantage at that time until and I could research it and see if it was all that was claimed.
I recently talked to the Blue Cross rep here in Arkansas and after all my questions were answered and i knew my doctor was in the network I opted for a Advantage Plan, PPL plan for $49.00 a month and I am satisfied I made a good choice.
Now I take care of a 94 year old Aunt who is in good health. Recently though she was in the hospital with a UTI, slight case of pneumonia, and low potassium. She recovered well and is home.
Now she has a Medigap policy through Cigna for about $150 a month, Plan G, deductible of $195. It pays for everything that Medicare doesn't and is a good policy.
The advice I am asking is if switching her to a Advantage Plan would make sense or should I leave her where she is given her age and such?
My understanding is that there can be significant increases to the price of Medicare supplemental policies depending upon how much you have to use it.
If you’re fairly healthy, most people recommend the Advantage plans.
I just went through all this a little over a year ago for my wife. In the end, we opted to go with supplemental plan G.
With a supplemental, you can see any doctor that accepts Medicare anywhere in the country.
I was going to switch in 2020 to and advntg,stayed with plan N broke my ankle total charges 50,000.00 +
No idea what and advantage would have cost me out of pocket and no one can tell me
Advntg has unknowns,Plan G takes care of everything Medscrae does not
If she has the 150 pay it although she needs script and if needed dental
Once she leaves Plan G she may neuver be able to get it back with out underwriting and will probably be denied. She can switch to and advntg at anytime if she decides to
The Medicare Advantage plans are as advertised except that you surrender your freedom of choice in choosing providers. Most MA’s operate as PPO’s that lock you into their preferred contracted providers. If you need cancer treatment that is only offered at Hospital B but Hospital B is not in the network, you likely will be hit with large financial penalties. Do your due diligence on which providers are part of the MA before you buy.
The advantage plans have a few more coverages for hearing / dental/ health clubs etc and generally lower premiums if any after you have paid your medicare B costs. However they also had higher deductibles/day if hospitalized. I think the slight dental / hearing benefit was so little I opted to stay with Mutual Of Omaha supplement plan G. Also the pharmacy plan is purchased separately on non Advantage programs the pharmacy approved drug list was more restrictive.
What you see on TV are really HMOs. With all their limitations. A good Medi-Gap is generally the way to go.
I have Pln N broke my ankle this year,prem from 2020 to 2021 goes uo 3 bucks a month
“With a supplemental, you can see any doctor that accepts Medicare anywhere in the country.”
That’s also something to take into consideration. If you travel often, supplemental might be better. However, the Advantage plan should cover temporary emergency care out of state. You’ll have to check with the Advantage plan.
The whole Medicare - Medigap - Advantage conundrum is unnecessarily complicated. For me, the Part A which is very limited, (you must be admitted to a hospital (overnight) to be covered), is no brainer since it is granted to everyone. Part B covers everything else and is a must have since that is where most your medical expenses are (no dental or vision). Medicare Advantage is a flavor of Part B, but has too many drawbacks, stay away. Basically Advantage protects you from a maximum out of pocket but may limit you geographically from medical coverage, so if you don’t travel it may work. Then the gap plans can be considered, but this is strictly insurance, you pay significant premium, must involve third parties with tedious medical transactions to get coverage, spend hours on the phone etc. The drug plans are so cheap, they are a no brainer to get, but you will probably never have to use.
Well at her age she isn’t going anywhere.
Can Joe Namath steer you wrong?
You have only until Dec 7 to enroll in an Advantage plan. I can’t address her age, but I absolutely recommend an Advantage plan.
You can go to www.medicare.gov and find the plans available for her location. All plans are under Medicare control, so they are not scams. I am on Humana and love it - everything is paid for, including medications.
Another family member is on Optum (through AARP) and it is just as good, and covers her extensive meds completely. On Humana, her meds would be $3000 or more per year.
Hope this helps a bit.
Went with Mutual of Omaha supplemental over BCBS for about $20 less per mo. Not like that’s an unheard of firm. I think it best to lock in vs delay THEN go shopping when they don’t have to take you or, take you on but at a premium rate for ever
One broken ankle isn’t going to raise rates.
The increase seems to be with chronic illness and repeated hospitalizations.
IMO
1) Medigap a b c d whatever
2) Advng PPO
3) Advng HMO
Advng = Save now pay later if something serious pops up and it will
The only thing to consider is if the out of pocket maximum is greater or less than the cost of the annual premium of the Medigap policy & if her doctors are in the network.
Talk to a good insurance broker that specializes in Medicare. He will be a good resource.
Hubby and I also have Supplemental Plan G, through Mutual of Omaha. Sis and BIL have Supplemental Plan G through Blue Cross (or Shield). We’ve been happy with the coverage. Of course, in our 70s, we see the doctor more often than we used to. Ten years ago it probably wouldn’t have been worth it.
My friend who was always bragging about the low cost of her advantage plan fell and actually broke her neck. She couldn’t get permission for surgery, or even the hospital. She’s single and had to lie in bed at home for several weeks.
Advantage plans seem to have a lot of bells, whistles, and cutsie stuff, but when something becomes a big deal, you’r often SOL.
I should add that I pay no additional premium, and get $75 per quarter to spend in their online pharmacy. All my doctors and dentists are in network.
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