Posted on 10/20/2025 8:48:19 AM PDT by Sequoyah101
Reminder: AARP heavily pushed Obamcare, IMHO so that United can be one of the few insurance co’s left after the govt practically forced smaller insurance co’s to shutter.
Insurance for Medicare, Medicare Supplemental, Automobile, Pharmaceuticals, Home Owners, Flood, Specific Items, Life and similar make up a fourth of our whole annual budget.
As a person that has been hit with cancer and cardiac battles, going naked would have bankrupted me.
We have a friend in Polk County, FL (Lakeland), the Medicare supplement rates vary literally from one side of town to the other.
Her premiums are double ours here in KY. Ditto for my brother in Volusia County, FL.
When we got our supplements 9 years ago the BCBS agent told me that if you went across the river to IN, the rates were 20% higher.
Ours are almost double from the first year. Probably will pass that as soon as we get our 2026 notice.
Between that and our massive property tax increases (43% in 2024), I can’t afford to live another 10 years.
Illegals getting free health care has driven up costs for everyone.
We all have to pay our Fair Share.
These differences are based on medicare reimbursement per zone. And it also can be different from one provider to the next.
It doesn’t explain the massive increases, but the difference in zone can be based on the income of the area, and the amount of customers who have a non-government insurance.
Soon, you will see a growth in outpatient surgical and treatment centers. This is done by larger health groups because they are not “first contact” centers. In essence, you could have a surgical and diagnostic center that is the second step in treatment. And...no one is going there without insurance. It means the health group is not dealing with the staggering levels of bad debt that hospital systems are.
The bad debt is what is killing hospital systems. My wife works for a healthcare provider. I listen to some of their higher level admin meetings (she works in the kitchen and I have my coffee in the next room). The amount of uninsured and the amount of bad debt for a little hospital is in the millions each year. In order to stay open, they have to spread those costs across people who have the ability to pay. Combine that with huge start up and insurance costs for providers and it is going to drive us into a two tier system: One private, where you get good healthcare...and the return of the “free clinic” care of the 60’s.
I don’t know where this is all going...but I would suggest everyone get fit, eat well, and exercise. Because you do not want to get trapped in “the system.”
LISTEN UP.
The details of the OP’s layout notwithstanding, there is another far more intrusive problem.
Part D plans are disappearing. The Inflation Reduction Act ended several $Billion in subsidy that Medicare was sending to Part D plans. And some, most, went through their formulary and started extracting drugs they would cover.
They face that subsidy cut off. They are addressing it with sharp premium increases, ending coverage of certain drugs, or closing their doors altogether.
At this point Medicare Advantage enters the chat. Yes, there are horror stories about Advantage. How rare they are we are going to ignore because . . . the standard recommend now looks like this:
Your Part D plan has closed or is not covering a drug you need? Well, kill Medigap and its attendant Part D plan, get an Advantage plan whose built-in drug coverage addresses the specific drug you need AND, AND, AND add to the Advantage plan a Hospital Indemnity Policy.
This approach attacks the Advantage disaster scenarios. The standard Advantage copay for being in the hospital is about $500/night copay for nights 0-5. Beyond 5 the copay is $0/night. Obviously a long stay hammers the Advantage policy, so they have procedures focused on getting you booted out of the hospital even if only for 1 night (which restarts the 0-5 clock).
The Hospital Indemnity add-on policy erases this scenario. It pays for your hospital stay and the Advantage people are no longer facing bankruptcy from your long hospital stay. (Indemnity plans price about 40% of the Medigap premium you erased when you replaced Medigap/Part D with Advantage).
So heads up on this. Part D plans are disappearing or abusing you. Advantage plans + Indemnity are the response.
BCBS scrapped their Advantage Plans so I switched to Aetna. Next year the prices will raise, of course, so I’m looking into Humana. Looks like the best deal.
“Illegals getting free health care has driven up costs for everyone.”
and have driven wait times through the roof ...
once in an “advantage” plan, you’re stuck for life if you have poor health, because even though you can switch back to regular medicare, you won’t be able to buy a supplement, meaning you’ll be on the hook personally for at least 20% of your medical bills ...
“meaning you’ll be on the hook personally for at least 20% of your medical bills ...”
That happened to an old friend, and he just stopped going to dialysis and died.
once in an “advantage” plan, you’re stuck for life if you have poor health, because even though you can switch back to regular medicare, you won’t be able to buy a supplement, meaning you’ll be on the hook personally for at least 20% of your medical bills ...
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All of this is correct. When you leave Medigap for Advantage, returning to Medigap requires you to pass “underwriting” which is a medical exam. If it shows you have no medical problems, you can return.
It gets more detailed. If your exam shows some minor problems, sometimes Medigap will say okay, you can rejoin us but for 18 months (or whatever) we won’t cover you for anything involving those problems found.
But in general, leaving Medigap for Advantage is a one way street. My overall point was it is a street you may HAVE to travel if your Part D company closes its door and you have no alternate Part D company locally.
In that situation, you switch to Advantage, or you sell your house and relocate to another state or something that has Part D companies.
This is all becoming common. Ask an AI . . . Are Part D plans disappearing?
My doc told me I was near to needing dialysis. I said I will then go to a different doc. He said there is no doc available with a different outcome. I asked him was he aware of the smith and Wesson clinic? At first he did not get it then said that is not a solution. I told him maybe not for him. So far over last 2 years I have remained constant as late stage 4. So it works. Same as old joke doc gave guy 3 months to live. After 3 months said he could not pay his bill. Doc gave him another 3 months.
This was inevitable the very day the Medicare law was signed in 1965.
It’s taken a long time for complicated reasons, mostly conflicting ideologies and Congress kicking the can down the road.
Medicare “Advantage” was an extraordinarily cynical and reckless innovation, which may be the nail in the coffin, if it’s not PPACA subsidies.
Be sure to take your vitamins.
Sorry Owen, but that is FALSE! A hospitalization with deductible is a 60 day period and IF you are discharged too early and come back in that period for the same problem, the hospital HAS to treat you, and they get ZERO reimbursement for the re-admit! If you stay over 60 days THEN you pay a new period deductible for the first 5 days. That’s the CMS reg in effect... ymmv (from a Medicare Broker)
I really don’t understand any of this. So if there is a potential to have a problem..and as you age it is an obvious risk...it is better to stay on Medigap because you can’t go back?
I already have multiple rare issues. Does Medigap have to take me in the beginning?
That’s good input but it’s not really addressing the issue that Advantage plan disaster scenarios derive from hospitalization lasting over 5 days. The maneuvers to restart the clock may be bogus, but that’s not relevant to the issue of the moment — which is —
Part D plans are disappearing. The Inflation Reduction Act cut their subsidy. They are closing their doors or shutting off coverage of specific drugs.
This leaves people who need those drugs with no alternatives other than Advantage (+ Hospital Indemnity). Or outright relocation, finding a region that still has Part D plans.
Are Part D plans disappearing:
AI:Yes, Medicare Part D stand-alone prescription drug plans are disappearing, with a continued decline in available options for 2026. This trend is driven by financial pressures on insurers, including reduced government reimbursements and the impact of the Inflation Reduction Act, which has increased financial risk for plans by capping out-of-pocket costs.
The number of stand-alone Part D plans is expected to fall to 360 in 2026, down from 464 in 2025, representing a 22% reduction from the previous year.
Major insurers like Elevance Health and Anthem have announced their complete exit from the Part D market, affecting millions of enrollees.
This contraction is particularly acute for beneficiaries with low-income subsidies, as the number of premium-free plans for this group has dropped significantly from eight in 2021 to just two in 2025.
Jim, the Advantage plans are the Senior coverage that mirrors the Corporate Plans that the providers offer Fortune 500 businesses... it didn’t appear from nowhere, but had CMS writing the rules. More that 50% of Seniors now sign up for Advantage and get Zero premium, Dental, Hearing and Vision coverage and then pay for hospitalization with Co-pays (which can be paid with an Indemnity Plan). Works well for me and for some seriously sick clients as well, but it does have prior authorization, while Original Medicare is using next year for 17 expensive procedures that CMS thinks may be fraud.
We have Aetna Medicare Advantage. No monthly premium. Hospital stays cost $298 for the first 5 days then its 100% covered. In 2026 its increasing to $398. ER is $110, primary physician $5 per visit, specialist $40. $1200 per year dental coverage going to $2,000 in 2026. I think $350 per year for vision. MRI is $300 co-pay, colonoscopy $300 co-pay. Tier 1-2 drugs have no annual deductible. Tier 3 drugs like my asthma inhaler have a $590 annual deductible. All in all its fantastic insurance.
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