I am shopping for a medicare supplemental plan

[chillfactor]

I will AVOID all medicare advantage pans. There are hospitals and clinics that will not accept them as they do not pay benefits...decline way too many.

https://www.beckershospitalreview.com/finance/hospitals-are-dropping-medicare-advantage-left-and-right.html#:~:text=1%20York%2C%20Pa.-based%20WellSpan%20Health%20will%20no%20longer,Medicare%20Advantage%20plans%20in%20October.%20...%20More%20items

[flying_wahini]

1. I stick with the Medicare supplement and have never had a problem.

Not overseen by any insurance companies.

[Evolve Dammit]

22. Which company do you use for the supplemental?

[yellowdogintexas]

2. Supplements must be the same within their category across the board

This chart from Medicare.gov is very helpful

https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits

You are making a great choice!
Part B is accepted everywhere; there are no networks to contend with. With an Advantage plan, if you go out of network your out of pocket costs will be ridiculous.

You have reminded me that I need to review my Part D just in case it has revamped the formulary and no longer covers one of my medications.

[chillfactor]

6. Thank you!!!!!!!!!!

That site really helped!

[MiniMe]

3. I too avoid all Medicare Advantage programs

And I absolutely HATE all the commercials for them. I have also heard that once you go with Advantage, you can't go back to regular Medicare. I have had no problem so far with Medicare. Wouldn't touch Advantage with a 10 foot pole

[IbogaProject]

18. You can switch back at huge costs

I think you have to pay all the skipped supplemental premiums or some such.

[MiniMe]

20. It's not worth it to me.

I'll stick with my original Medicare with Supplement.

[Ms. Toad]

35. You MAY be able to switch back - but in most states there is no guaranteed issue -

Which means you may be completely unable to switch back.

If they choose to issue a policy, they are permitted to charge you based on your personal health status. That means the premium will be considerably higher.

[IbogaProject]

38. I was more covering the negatives

Thanks for the extra details on how bad advantage can become and how, unless its a state retiree one it can be a trap. What a mess it's time to set a 5 year plan to nationalize all health insurance and get more doctors and other medical professionals coming into health care. All actuarial estimates see cost savings and an overall savings to all but the top 20% and higher costs, for even less of the population in a wealth tax. But savings I saw for the 'average' taxpayer was $2,500 per family. That doesn't include eventual savings in banality insurance and such.

[keithbvadu2]

53. The Medicare Advantage Trap:

The Medicare Advantage Trap: In 46 states, once you choose Medicare Advantage at 65, you can almost never leave

https://prospect.org/health/2023-11-29-medicare-advantage-trap/

https://www.democraticunderground.com/100218490955

[Evolve Dammit]

24. I was told I could switch once. I have an Advantage Plan and it has a max out-of-pocket of 3400. I do

not like Aetna (plan underwriters) so I'm torn. Have looked into United Health Care (AARP sponsored) Plan G but not switched yet.

[Haggard Celine]

29. Check Humana.

I’ve never had any problem with Humana not being accepted. I have a secondary, too, that’s very good. I can’t go into all of my business here, but if you’re retired, it’s probably going to be a little different than my situation. But go ahead and check to see what Humana can do for you. Do it by Dec. 7th. That’s the day open enrollment ends.

[chillfactor]

32. I had Humana at one point.

Switched because they fought everything. And there are hospitals, doctors, and clinics that refuse to work with them. Hope you are never seriously ill of injured.

[Haggard Celine]

36. I've had them for several years and I've

had multiple surgeries and procedures. With my secondary, I haven't paid much of anything. I was in the hospital for most of 2020 and all of it was paid for by Humana and my secondary. Your situation sounds different from mine. Are you retired? I'm disabled, so my insurance covers most things anyway.

[Evolve Dammit]

46. thanks

[Ms. Toad]

37. In most states that is only true if you are within a year (sometimes less)

Of your initial enrollment period, or are within a MA "try it" switch period.

So, as a general rule, you don't get a chance to switch. If you are unsure and have to make a decision now, choose a Supplemental plan. You can always switch to MA. The reverse is NOT true- you generally can't switch from MA to a supplement plan.

[Evolve Dammit]

45. Dang, I've been on it for over a year

[dflprincess]

39. My friend works for UHC and is "covered" by their employee plan

She's also dealing with cancer. Standard of care (which insurance companies love to push) for where she's at is a PET scan. UHC denied it though her oncologist got it covered.

It's almost 20 years since I worked there. Nothing makes a person believe in single payer faster than working at UHC.

I'd advise you to stay away from UHC.

[Evolve Dammit]

44. The brainwashing to make Americans believe single-payer (Medicare expansion) is a communist evil plot

has worked spectacularly. Other countries don't have these issues with "health care."

[CrispyQ]

41. I'm very happy with my Kaiser Advantage plan.

I know someone will come along & tell me how bad it is but I really put it to the test last year & I'm very happy with it. I'm in a Kaiser rich environment, though. Lots of Kaiser doctors & facilities where I'm at.

[Evolve Dammit]

43. The whole "in-network" thing is what can change instantly. Aetna even has a disclaimer that (summarized)

they may be in network now, but that is not a guarantee of benefits. I took that to mean that it can change and you (as a consumer/patient) won't know it. I also worry if you contract (God forbid) some rare disease and need special meds/ treatment, they will just deny benefits. That is probably my biggest concern.

[dalton99a]

4. States should allow switching from MA to supplement without underwriting.

Countless people on MA did not have this critical information when they signed up

MA is great if you are healthy and not needing serious medical care/rehab

[ariadne0614]

5. Good for you! I've been happy with Plan G through United of Omaha since it became available.

Before that, I was on Plan F.

Until now, the annual premium increases were relatively modest until I moved to Florida, where the population must be older and sicker than it was in Arizona and Wisconsin. A few weeks ago, I almost choked on the notification that my new monthly premium is going up from $245 to $346!

Even so, I’m glad I didn’t succumb to the lure of free-to-cheap MA plans. Thanks to Thom Hartmann, (who has been sounding the alarm about the MA scam for at least a decade), I made the choice not to help kill Original Medicare. #MedicareForAll!

[GoodRaisin]

7. I'm also on plan G and never had a problem with any of my

medical bills being covered, including a 2 week stay in the hospital for spine surgery. I also noticed an increase in my supplemental premium from $179 to $212 for this year.

[Evolve Dammit]

25. Mutual of Omaha?

[ariadne0614]

47. Yes. U of O is a subsidiary of M of O. n/t

[Evolve Dammit]

48. Thanks. I had not heard of that, but companies/ subsidiaries/contractors/ partners/sub-contractors.....

it all is a shell game in my opinion, and the consumer is left to deal with a "rigged system." Elizabeth and Bernie were and are, correct.

[LetMyPeopleVote]

51. I have a Blue Cross plan G supplement

I have been very happy

[Evolve Dammit]

59. Plan G saved my Mom years ago. Through AARP, underwritten by Prudential. Now they use United Health Care??

Not sure how good they are but AARP has a lot of clout

[NewHendoLib]

8. My wife and I haved loved our supplemental plans for

3 years now

[vapor2]

9. WHEN will someone (anyone) do something about the Disadvantage plans?

I want to scream when I hear their commercials and they prey upon uninformed people. We were lucky and got plan G and have never had any denials.

[Silent Type]

30. Yeah, the 51% who choose MA are so stupid. Glad we have people telling them what

is right for them. Do I need a sarcasm thingy?

[mucifer]

10. I'm worried by the time I retire there will

Be no plan G or F and Medicare will be privatized.

The greed is so sick

I’m 58

I feel so bad for everyone who got scammed 😢

[MiniMe]

55. My housemate is old enough to have a plan F

That covers basically everything. It wasn't available to me when I was eligible for Medicare last year.

[XanaDUer2]

11. My Drs told me

Keep traditional Medicare and do not get MA. So, I'll pay. I'd like to see MA have to remove the word Medicare from their commercials. If I was super healthy, maybe MA is okay. But I'm going traditional.

[MiniMe]

56. I agree, but the insurance lobby won't allow it

They want to be associated with Medicare. Bastards.

[progree]

12. Be sure to sign up for a Medigap aka a Medicare Supplement program within the designated 6 month period

Last edited Sun Dec 3, 2023, 11:14 PM - Edit history (1)

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This is the 6-month period that starts the first day of the month you're 65 or older and signed up for Part B. After this period, your options to buy a Medigap policy may be limited and the policy may cost more.

Or you can't get a Medigap policy at all.

https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy

EDITED TO ADD

After reading some comments down-thread, there are additional circumstances where one can get a Medigap policy with guaranteed issue rights -- see the section in the above link titled:

What if I miss my Medigap Open Enrollment Period?

There are certain situations where you may be able to buy a Medigap policy outside of your Medigap Open Enrollment period. Situations where an insurance company can’t deny you a Medigap policy are called “guaranteed issue rights” or “Medigap protections.” What are guaranteed issue rights?

Check with your State Insurance Department to see if you can buy a Medigap policy outside of your Medigap Open Enrollment Period. You may have additional rights under state law.

Emphasis added by Progree. In the original clicking on the "What are guaranteed issue rights" triggers a pop-up that give the other circumstances. Similarly, clicking on "State Insurance Department" gives contact information.

[dalton99a]

14. I bet most people who sign up are not aware of the significance of that restriction.

All they hear is free dental cleaning and gym membership

(and free grocery money if you are eligible for Medicaid)

[progree]

15. Yes, unfortunately /nt

[Dave says]

16. I'm anxious about retirement

I am on my wife’s insurance plan, which by the numbers is best for 2024. My understanding, shared by several people who should be in the know, is my “clock” begins running once I’m off of my wife’s plan. At that time guaranteed issue is in force, as well as premiums issued as if I was 65. It should go smoothly.

The people “in the know” include help desk for Medicare, help desk for social security, an insurance broker, and consultants at a law firm my company buys for us to help with the transition into retirement.

Still, though, I’m anxious that something might go wrong. And my yearly medical bills run in the hundreds of thousands of dollars. I’m dead if denied coverage.

[Ms. Toad]

40. My spouse stayed on my work plan until she was 69.

The process is a bit more complex, since the assumption is that you sign up at 65 and the interface is designed for the default. But it's manageable.

Unless you're spouses plan is not an ACA compliant plan, you're fine.

[Dave says]

49. Thank you

I’m pretty sure it’s an ACA compliant plan. It’s pretty good.

[Voltaire2]

58. Yeah you're fine until her coverage stops.

You will have to document that coverage though.

[Desert grandma]

13. Original Medicare and a Supplement is the best option IMO

When comparing supplement plans, note how they are rated. Each plan is rated in one of 3 ways...+
Age Attained is the most common. these plans will increase every year as you age and can increase due to the cost if medical inflation. Most plans will be rated this way.
Age Issuedplans are priced at the age you are when you took them out. They will only increase do to medical cost inflation.There is usually only 1 or at the most 2 plans rated this way.
Community rated plans charge the same to everyone in the community:, regardless of age.

Over time, Issue Age, if you take it out when you are first eligible will be the least expensive. Age Attained can end up being the most expensive of all. You are not told this when you first apply for Medicare. Also once you have enrolled in a supplement, if you ever decide to choose a different one, you can be subject to underwriting, so CHOOSE WISELY.
Good Luck!!

[Lulu KC]

17. We've enjoyed TransAmerica

"Enjoy" might be too strong a term, but it's been satisfactory.

[nature-lover]

19. Very happy with this plan. Had it for 5 years now.

If a charge is approved by Medicare, TransAmerica always picks up the remainder. No hassle.

[Desert grandma]

31. We have TransAmerica as well.

We got on Medicare 10 years ago. TransAmerica was one of only two plans that were Age Issued rated.They have been very reliable and have not increased the premium much. We just got a notice that is is increasing by $5.00. BTW, they no longer sell Medicare Supplement plans, so I guess we are fortunate that we have them. They will continue to service plans they have sold.

[MLAA]

21. Husband has AARP UnitedHealthcare supplemental (called plan F I think).

It is pricey, however it has paid for itself over and over the last 5 years. 1 heart attack and bypass surgery, one bleeding stomach ulcer procedure and hospital stay. These 2 incidents were back to back and required a month hospital stay and 2 week rehab stay. Since then a hospitalization for influenza, another for pneumonia and then yet another for kidney stones in a 2 month period. He sees a cardiologist and pulmonologist regularly as well as visits to Primary Care Dr. Toss in several ER and urgent care visits in last 5 years.
During all this time we only got one bill that wasn’t covered for $39. When I called about the office said they didn’t have his supplemental insurance on file and to ignore the bill.

I’m not sure if this plan is still available, but if it is and it’s the same coverage, you wouldn’t have to worry about a medical bill again.

[brer cat]

26. That is the plan that I have. It is no longer available except for those

who signed up for it earlier.

[MLAA]

42. Thanks for the update, I guess it was too good to be true!

I can’t wait to qualify for Medicare plus a supplement. Private insurance for me is crazy expensive. Hopefully in a little less than 2 years I’ll be able to find something almost that good 🙂

[Freddie]

54. Yes we have the AARP supplement

DH just had knee replacement surgery, all covered including the physical therapy. I bought a dental and vision plan (about $850 annual for both of us) through the retired teachers organization. My daughter, an RN case manager, very strongly recommended we do NOT take an Advantage plan.

[MLAA]

57. How great to have a daughter with such experience in the healthcare world to help guide you.

She has probably seen it all.

[doc03]

23. I retired 13 years ago, our union pushed us into a Medicare Advantage

program. I looked at a supliment about 5 years ago, I was totally confused with the alphabet plans. If I leave my group MA
plan and am not happy with the supliment I can't get back on it. At the time the supliment cost was around 50% more at my age and then you need a drug plan that makes it about double. I think MA is OK if you can find in network providers but if you get sick in another area it is not. I honestly think the union got money to sign us up to MA.
I pay $125 for myself. But I don't understand some people pay zero and get dental and hearing aids, that I dont.

[Evolve Dammit]

27. Let me just say: IT DOESN'T NEED TO BE THIS FUCKING CONFUSING AND DIFFICULT". Rant off.

Many other countries don't have this convoluted mess.

[claudette]

28. I was fortunate

enough to join the plan offered by the company from which I retired. The premiums aren't that bad and the coverage is good. No dental or eyeglass, but I can live with that as long as everything else is paid for.

Good luck in finding a good plan. Maybe the Affordable Care Act can help you?

Edit: My plan is a Supplemental Part B plan - and it has been fine with me!

[eallen]

33. Pay attention to their rate basis

The link below explains the difference between attained age, issue age, and community rating. You get only one chance to acquire an issue-age plan at the age of 65. It will cost more initially than an attained age plan, but less eventually. There are some issue age plans out there from established companies at a reasonable cost. You just have to look.

This is something that many insurance agents don't well understand. Of course, they're mostly trying to sell Advantage plans. Which isn't to the advantage of their customers. The Medicare waters are tricky, and we have to navigate them ourselves. When you call the companies involved and get routed to an agent, be firm about what you want.



https://www.gohealth.com/medicare/medicare-supplement/attained-age-vs-issue-age-rates-with-medicare-supplement/

[chowmama]

34. Decide on your personal parameters

or wishes, or standards, etc., to limit your choices. If you're looking at everything, it's too much, too complicated and you'll go nuts. Over a really long period of time.

I switched to Medicare and a supplement at 65, although I'm still working and could have stayed with my company's program. I wasn't about to do that because our paycheck contributions were going up by a lot every year. Not just me - everybody's. They were stuck with it, but I'd just gotten an out.

My parameters were: 1) My budget for Medicare and the supplement together was what I was already paying for the company policy.

2) I wanted a non-profit company. (My company insurance group claimed to be non-profit in our state, but they must have a very interesting definition of the term.)

3) I like to buy as local as I can. I'm in the Twin Cities, MN, so this is possible - it may not be where you live. But it helps to know that if I have a real problem, and phones and internet are being...unsatisfying, I can actually go and present myself at somebody's desk. I have the nerve to do it. A plan out of Hartford, CT won't do.

Throwing out every option that didn't meet all these, I still had a few choices. I checked BBB, complaints and general feedback, especially how they handled claims. I ended up with a plan that has good coverage, for only part of what I was paying in my contribution to the previous company (the rest got paid to Medicare) and decided I could stretch just a little to include dental and glasses.

And the experience has been good - after I was on it a year, DH switched over, as well. A month later, he had his heart attack. I think our end cost for the first crisis, not counting the ongoing meds, was $200. He was in the cardiac ward for 2 overnights and got a stent. Now, I'm pretty healthy - for years, no company has had to pay for more than vaccinations and I'm on no meds at all - but I'm starting to work on my teeth, so we'll see how the dental coverage works out. If you live in Minnesota, try UCare. I have UCare Basic, not even one of the upscale plans.

Anyway, these were my preferences. Yours may differ, and your available choices certainly will. Budget's definitely a factor - at least I could afford a supplement that was more than part D. But it's mainly about figuring out what not to even consider - when you try to do everything, you end up accomplishing nothing. Established limits are your best friend and a real timesaver.

Also check reviews and references. Doesn't matter what they charge or promise, if they won't deliver.

[LetMyPeopleVote]

50. Several of my law partners and I have schedule G supplements

I have been very happy with this and a supplent drug plan

[NewHendoLib]

52. We have Blue Cross supplemental G and a part D - here is what we pay

Medicare A and B (mandatory) - A no cost, B is around 160 monthly, BCBS supplemental 100 monthly, part D is 5.00 monthly - I get preventative Dental as a retiree from my pharma job - that's 20 monthly. So - grand total is around 280.00 I have a cheap part D plan because I use Good RX to get the lowest cost.

Why do we avoid Medicare Advantage plans? As many have said, the loads spent on advertising - spam emails, phone calls, TV and snail mail. Anything that pushes itself that much can't be good.