Medicare vs. Medicare Advantage.

[Nanjeanne]

58. Get a Medigap Plan to supplement Medicare. My advice is Do Not get an Advantage Plan which

is a private insurance plan (subsidized by taxpayers -- but don't get me started on that stupidity). The Advantage plans are typically cheaper than what your Medicare plus Gap plan might be but are usually much more restrictive which might not be an issue when you aren't ill - but can become extremely troublesome when you are. And honestly, the Medicare plus Gap isn't a huge amount of money out of our pocket although more than the Advantage policies seem to be.

Anecdotal but here's an example. We spoke to advisor when we turned 65 and (luckily it turned out) when we said we wanted the freedom to go to any doctor, not have to deal with what state we might be in as we travel, wanted freedom to seek out specialists, etc. steered us to regular Medicare plus a Medigap Policy N. Medigap Policies cover the same things no matter where you are - so all N policies are the same, as are all C plans, etc. Private insurance companies that handle these plans compete by price and customer satisfaction. Some plans may not be available in all states - but the Medicare website (not the "fake insurance agent sites) can show you easily what is covered in each Plan A-N.

A few years into Medicare - my husband got diagnosed with multiple myeloma which is a blood cancer disease - termed incurable but "manageable". This was in 2014. Since that time he has had countless chemo treatments, undergone a stem cell transplant and most recently just did a new FDA approved treatment called Car-T. I cannot tell you how much money these treatments cost - it would be blow your mind. We traveled to Dana Farber to have his treatment overseen by a myeloma specialist - did his sct there as well. His regular oncologist is at Yale and he did his CarT treatment there. We have never had an issue with any doctor we wanted to see, or been turned down or had to jump through hoops for any regime he has been on in all these years.

My dear friend and husband wanted to save a few dollars and "loved" their Advantage plan . . . until she was diagnosed with a glioblastoma. Then they found out that even though they lived in New York City - they were only able to see doctors at one hospital in NY. Second opinions were very hard to get. They couldn't choose the surgeon they wanted and weren't able to travel to another state to seek medical advice. Glioblastomas are deadly - and unfortunately when it came time for hospice care - her husband was shocked to find that there was only one facility in Manhattan that he could access and it was not one he wanted to place her in. He found out that he could put her in hospice where he wanted it would have to be covered by Medicare. That meant 80% would be covered but the Advantage plan wouldn't pay anything and he didn't have a supplemental to cover the additional 20. So he went into debt to keep her at the hospice he wanted.

Research on the Medicare.gov website - and try to understand what you ultimately want from your healthcare and what you can afford to do. It's hard to know far in advance what treatments or care you may need but try to look at what is important to you. Switching from Advantage to a Gap is possible with some restrictions - and once you have become ill - you may find you have to wait a certain number of months, etc. It's a shame we have to do so much research and wade through so much confusion to simply get care but our system of healthcare is so screwed up . . . do your homework and think about your future needs before committing. My 2 cents!