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Medicare Advice Wanted
FreeRepublic ^ | 11/6/25 | Self

Posted on 11/06/2025 11:35:57 AM PST by Blood of Tyrants

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To: Neanderthal

Those in the know say A, B, D, G.


41 posted on 11/06/2025 12:48:39 PM PST by Boardwalk
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To: Blood of Tyrants
Relatively new to Medicare myself. Single, no outstanding medical issues right now (knock on wood), no prescription medications...but with age the ticking time bombs I know are there.

I signed up for the same plan my brother had (who is going through some medical issues) it's a Blue Cross of Michigan Medicare Advantage plan. I also included dental and eyeglass, an additional option that took $20 per month out of my SS(or added an additional $20 to the medicare deduction from my SS).

I received information that this plan will no longer be available for me, I can only "assume" it's related to my zipcode(rural), as my brother, who only lives about 20 miles away(but more urban), got no such letter of cancellation.

As I was only on it for a year...and only used it for 1 general check-up, I couldn't vouch for how good/bad it was, though my brother, who actually needed/used it, seemed satisfied by it.

Now I have to find another plan...not to hijack your thread, but if there is anyone in SE Michigan who has a Medicare Advantage Plan/other they are satisfied with...if they could chime in I'd appreciate it.

42 posted on 11/06/2025 12:49:57 PM PST by RckyRaCoCo (there are demons out there, and they look like people)
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To: Blood of Tyrants

There are way too many variables for you to consider to get a good answer here.

My wife and I went to a Medicare “counselor” in our state. It was an independent person who walked us through our options. In our case we won’t need to act until the middle of next year because my wife is still working and insures us both.

But, the variables we considered were:

1. Current health status and history. My wife’s history of cardiac issues and cancer mean that we will “likely” be heavy users of the medical services in the future. This means any plan with a lower deductible and out of pockets will be better.

2. Current medication. The same issues apply for any “specialized” meds. If you don’t take any...then lower monthly/higher out of pocket might work. That was not the case with us. You can look up each prescription and see what the out of pocket costs for you will be. Make a list and do the work. It will give you the amount to budget for.

3. What is your use of current docs? We live in one state and my wife’s docs are in another. Some plans don’t “travel” well. Also, what are the policies for referrals and specialists. If you have ever been through a serious heart attack or cancer process—getting the best people to work on you means that having to deal with pre-approvals and specialist approvals can add to the costs, stress, and outcomes. This is very serious and should not be dismissed.

There are other things that come into play. But they likely apply to the plans available in your state.

Look up senior services for your state. You will likely find a guide on line, and then your state might have “navigators” like we met with. It is well worth the time and effort to find the plan that works best for you.

(Hint: It is likely not the cheapest plan! In a lot of cases, less expensive this week turns into very expensive six months from now.)


43 posted on 11/06/2025 12:58:36 PM PST by Vermont Lt
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To: left that other site

The one in my town in MA was excellent.

In 65 years I don’t think I’ve ever taken advantage of a “government” program. But the woman who met with us was incredible. She was informed and straightforward. She apologized for being “blunt”, and we all laughed. I would rather someone who laid it out plainly and makes sense than some of the wishy washy folks you usually run into from the state.

I would highly recommend that experience.


44 posted on 11/06/2025 1:02:18 PM PST by Vermont Lt
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To: Blood of Tyrants

I got this from my health ins agent, Good luck. It was real easy. The dates and time frames are for me so use your BD in place of mine.

Enrollment: Taxpayer can apply for Medicare Parts A & B (these two parts work together) three months prior to the Medicare effective date of November 1, 2025 (the first of the month in which Taxpayer turns age 65). This would be any time after August 1st, 2025. I suggest you apply sooner versus later as you cannot move forward with ANY type of plan until you have your Medicare Beneficiary Number (it will arrive on a red, white and blue ID card).

It’s best to enroll online at www.SSA.gov. It only takes a few minutes to apply. If you need help, you can call Social Security at (800) 772-1213. You will be enrolling for Parts A & B of Medicare (whether or not you choose to take your Social Security monthly benefit). Be sure to apply for BOTH Parts A and B.

Cost: Most people qualify for Part A at no cost. This is called “Premium Free Part A”. Part B does have a cost based on your income. Many people pay the standard amount ($185/month in 2025) for Part B . More if you are a high-income earner. Social Security will notify you directly if you fall into this category. The Part B premium can go anywhere from $185/month up to $628/month depending on AGI.

If you decide to take your monthly Social Security benefit at age 65, then Social Security will automatically deduct your Medicare Part B premium from your monthly benefit. If not, they will send you a quarterly paper bill in the mail.

Once Taxpayer is safely approved for Medicare Parts A and B as well as a Supplement and PDP drug plan (or a Medicare Advantage plan) to begin on 11-1-2025, you will want to call Blue Shield Member Services at (888) 256-3650 to cancel Taxpayer off of your individual “under 65” plan. Wife can remain on the plan. Blue Shield will only take cancellation requests from the Subscriber.


45 posted on 11/06/2025 1:03:24 PM PST by US_MilitaryRules (#PureBlood )
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To: Ronald77

We went to seminar, then signed up for their service. Got the video link too.
Fee was very reasonable, especially since we went on Medicare 3 years apart.
This is the video they sent us when we made further inquiries. It’s outdated, but I’m sure they have updated ones, but the info is still every close to accurate. It’s 40 minutes that will answer most of your questions.

https://www.youtube.com/watch?v=oEZaD-UXwkU&t=14s


46 posted on 11/06/2025 1:06:36 PM PST by fastrock
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To: Blood of Tyrants

Just get Aetna Medicare Advantage. Its great insurance and no premium. We have had it for years. $5 copay at primary physician, $45 copay at specialist. $110 co-pay ER. $80 urgent care. Out patient surgery $300 co-pay. Hospital stays $298 first 5 days then 100% coverage. Dental $1200 per year allowance. Vision and hearing allowances. I think tier one drugs are free or maybe $10. Tier 2 drugs very reasonable. I take a tier 3 drug for asthma that’s $68 per month.


47 posted on 11/06/2025 1:08:33 PM PST by Georgia Girl 2 (The only purpose of a pistol is to fight your way back to the rifle you should never have dropped)
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To: Blood of Tyrants

bump


48 posted on 11/06/2025 1:08:53 PM PST by Hatteras
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To: Blood of Tyrants

If you’re prioritizing the lowest cost, opt for Medicare Part C (Medicare Advantage). This replaces Original Medicare entirely—you’re no longer under Medicare but enrolled in a private insurance company’s plan with a predefined provider network that can (and often does) change annually. Once enrolled, your ability to switch back to Original Medicare (Parts A and B) is severely restricted, especially if you develop health issues. While it typically provides comprehensive coverage, you’ll face network limitations, copays, deductibles, and prior authorizations. Many plans have $0 premiums and include extras like dental, vision, hearing aids, gym memberships, or over-the-counter allowances—benefits not available in Original Medicare.The gold standard for flexibility and predictability is a Medigap Plan G combined with Original Medicare. This includes:Part A (hospital insurance, fully covered after deductible).
Part B (outpatient/medical services, with you paying the standard 20% coinsurance).
A Medigap supplemental policy from any private insurer, which covers 100% of Part A and B gaps (including the Part B deductible in most cases with Plan G).

All Medigap Plan G policies are standardized—identical benefits regardless of insurer—so you’re essentially shopping for price, customer service, and rate stability. You retain full freedom to see any doctor or hospital nationwide that accepts Medicare (over 90% do), with no networks or referrals. You can stay with your chosen insurer indefinitely or switch carriers anytime without medical underwriting (as long as you’re in good standing). For prescription drugs, you’ll need a separate Part D plan; dozens of options exist, and you can (and should) re-evaluate annually during Open Enrollment (Oct 15–Dec 7) based on your medications and preferred pharmacies.Key Tip: Use medicare.gov’s Plan Finder tool to compare Part C, Medigap, and Part D options side-by-side using your ZIP code, health needs, and prescriptions. For personalized guidance—especially if you take multiple medications or have chronic conditions—consult a licensed, independent Medicare broker (not a captive agent). They’re paid by insurers, not you, and can reveal unadvertised rate increases or network exclusions. Avoid enrolling directly through TV ads or unsolicited calls; verify everything on medicare.gov or via 1-800-MEDICARE.


49 posted on 11/06/2025 1:10:30 PM PST by brutuss (A brief overview. HT to Grok!)
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To: brutuss

You’re right—my earlier phrasing was too absolute. You can switch Medigap Plan G carriers any time of year, but most switches require medical underwriting unless you qualify for a guaranteed issue right or live in a state with special rules (like the Birthday Rule).Corrected & ClarifiedScenario
Can You Switch Without Underwriting?
Guaranteed Issue Rights (e.g., insurer bankruptcy, MA plan leaves area, loss of creditable coverage)
Yes — new insurer must accept you, no health questions.
Normal circumstances (just want lower rate or better service)
No — new insurer can underwrite. They may deny, exclude pre-existing conditions (up to 6 months), or charge more based on health.
Birthday Rule states (CA, OR, NY, CT, ME, etc.)
Yes — 30–60 days around your birthday, switch to same or lesser letter plan (e.g., G to G) with no underwriting.
Anniversary Rule (rare, insurer-specific)
Yes — some companies allow switching within their own plans around your policy anniversary.

Bottom LineYou’re not locked in, but you’re not guaranteed acceptance either.
Shop carefully: Apply to the new insurer first, get approved, then cancel the old policy.
Best strategy: Compare rates annually (via medicare.gov or broker). If your current Plan G premium jumps >15–20%, explore options—but only switch if you’re healthy enough to pass underwriting.

Thanks for catching that—accuracy matters.


50 posted on 11/06/2025 1:19:00 PM PST by brutuss (Oops. Always double check. Bad Grok!!!)
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To: Wuli

Thanks for posting great info. Bkmk


51 posted on 11/06/2025 2:36:59 PM PST by Track9 (Liberal tears make me smile. Thank you DJT!)
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To: Vermont Lt

Indeed.

The SHINE counselor that I sat with has retired, and the new one can’t hold a candle to her.

Oh Well


52 posted on 11/06/2025 3:47:32 PM PST by left that other site ( For the Lord is our judge, the Lord is our lawgiver, the Lord is our king; He will save us Is.33:22)
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To: brutuss
Can You Switch Without Underwriting? Guaranteed Issue Rights (e.g., insurer bankruptcy, MA plan leaves area, loss of creditable coverage) Yes — new insurer must accept you, no health questions. Normal circumstances (just want lower rate or better service) No — new insurer can underwrite. They may deny, exclude pre-existing conditions (up to 6 months), or charge more based on health

thanks for posting this - it's a very important question to know to ask when considering whether to change plans

53 posted on 11/06/2025 5:41:38 PM PST by blueplum ("...this moment is your moment: it belongs to you... " President Donald J. Trump, Jan 20, 2017) )
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To: Blood of Tyrants

Good luck.

Our friends have ALL warned against Part C/Advantage.

Nonstop commercials pushing this nonsense from EVERY company imaginable.

Think about it ... if it sounds too good to be true ... it IS.

Once you need major medical care, you are completely scrooged.

Oh, but enjoy your “lower” payments, “free” glasses and crappy dental coverage.

The Happy Road to Single Payer.

Interesting how it’s easy to go from Plan G to DisAdvantage ... but, try going from Advantage to Plan G. Just sayin’.

Just passing along info that friends on Medicare have told us.

Stick with Plan G.


54 posted on 11/06/2025 5:46:43 PM PST by Jane Long (Jesus is Lord!)
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To: brutuss

How easy is it to switch from Advantage to Plan G?

Friends of ours on Medicare say it’s almost impossible.

Easy to switch from G to C (Advantage).

Telling.

But ... you may have better, expert advice.


55 posted on 11/06/2025 5:48:58 PM PST by Jane Long (Jesus is Lord!)
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To: Jane Long; Blood of Tyrants; All

Advantage (”C”) to “G” requires medical underwriting (heath Q’s, medical records, etc.) and usually people wait until they have a “major medical event” (cancer, heart attack, stroke) to find out that their low/no cost “Advantage” plan has co-pays that add up fast in a major med. event, “in-network” specialist/doctor issues, insurance co. “prior authorization” issues, etc.. Then it is too late because they can’t “pass” the medical underwriting with them having a major med. condition.

“G” to “C” is allowed w/o any medical underwriting.

A few good YouTube Medicare plan info. resources:

https://www.youtube.com/@MedicareSchool/featured

https://www.youtube.com/@AbtInsuranceAgency

https://www.youtube.com/@Theretirementnerds/videos

https://www.youtube.com/@ChristopherWestfall


56 posted on 11/06/2025 6:08:05 PM PST by Drago
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To: Drago

Yes...I know this.

Now ... what if someone with SAME, exact underlying condition wants to move from G to C (Advantage)? Not that anyone would/should.

Same underwriting requirements and scrutiny? I doubt it :-) Come right in to Single Payer!

>>> The ‘Advantage’ Plan has co-pays that add up fast in a major med event <<< ... is exactly what friends of ours have warned about and, hopefully, others here, take heed.


57 posted on 11/06/2025 6:21:28 PM PST by Jane Long (Jesus is Lord!)
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To: Jane Long

“G to C” is allowed w/o medical underwriting, but usually in that situation the person is looking for a cheaper/no cost plan (vs. G) and is in good health/does not have major medical issue anyway. If they have a major medical issue their best bet is to stay on a G/N/high deductible G plan.


58 posted on 11/06/2025 6:39:40 PM PST by Drago
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To: Drago

Well, yes...exactly.

My point being the unfairness/socialist style “healthcare” of allowing one to move DOWN, to the crappy, single payer plan without underwriting/scrutiny, vs, moving up to the better, free choice plan (G) ...without penalty or underwriting.

So much for overlooking any preexisting conditions, right?

Glad our friends have explained all of this and, again, hope those in the market take heed.

ONLY go with Plan G!!

We have a family member whose had several medical issues, and, thankfully they’re on Plan G.

We know of another who’s on Advantage and had to stop taking vision saving eye injections due to the high copay cost per injection.


59 posted on 11/06/2025 6:46:27 PM PST by Jane Long (Jesus is Lord!)
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To: MayflowerMadam

One of our doctors calls it Medicare “Disadvantage”. He told us we shouldn’t get that when the time comes.


60 posted on 11/06/2025 6:53:04 PM PST by FamiliarFace (I got my own way of livin' But everything gets done With a southern accent Where I come from. TPetty)
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