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Medicare choices...What's the consensus?
Posted by: flareslow
Date: May 15, 2018 10:59AM
I mostly lurk here, but now I hope this discussion will help someone else too.

I hit the big 65 next month, and have been inundated with information from insurers offering advantage plans (plan C) and supplement plans. My daughter's FIL is/was an insurance agent and highly recommends going with a Supplement plan, and he really likes the plan G. One of the points he likes to make is that a typical heart attack will rack up to a $100K bill, and the plan G out of pocket costs, less prescription drugs would be $183.

Plan C- the advantage plans seem to lock you into a provider network and may have higher costs if frequent doctor visits are needed, while having lower or no premiums.

I'm leaning toward finding a plan G provider.

Does anyone have a plan or provider they really like or dislike?

Next we could discuss Part D plans - good or bad.

Thanks in advance
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Re: Medicare choices...What's the consensus?
Posted by: Dennis S
Date: May 15, 2018 11:32AM
Do NOT get an advantage plan. Get an F or G. For Part D, go to an agent and have them run your medicines through a program and see which plan is best, according to which pharmacy you prefer to use. I repeat, do not get an Advantage plan. This is going to cost you more than you expected, but if you do it right, the coverage and peace of mind are worth it.

Study up on the Open Enrollment Periods and understand if and when you are allowed to change plans.

Edit: Plan F is going away in 2020, so I would get G.



Edited 1 time(s). Last edit at 05/15/2018 11:59AM by Dennis S.
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Re: Medicare choices...What's the consensus?
Posted by: ka jowct
Date: May 15, 2018 11:36AM
My supplement plan frees me from the whole aggravation of referrals and networks. I got a plan through AARP, which one of my doctors recommended as being the one that patients complained least about. Am probably going to look at a different part D plan, given that it no longer gets me a decent price on one of the eye meds I take. You need to look at the provider’s formulary and what pharmacies you can use. I prefer to avoid mail prescription services.

I found an online tool that I used to compare D plans. Can’t remember where, but a bit of searching should turn it up.



Edited 1 time(s). Last edit at 05/15/2018 11:38AM by ka jowct.
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Re: Medicare choices...What's the consensus?
Posted by: Dennis S
Date: May 15, 2018 12:04PM
If you go to an agent and run the Part D costs for your medicines, they can give you a number off the search and you can continue to monkey with the search when you get home, using that number when you log in. Like ka jowct said, I would avoid mail order. I think Walgreens is trying to be the big dog in this area.
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Re: Medicare choices...What's the consensus?
Posted by: DeusxMac
Date: May 15, 2018 12:22PM
Quote
Dennis S
Do NOT get an advantage plan.

THIS!
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Re: Medicare choices...What's the consensus?
Posted by: riley5108
Date: May 15, 2018 12:53PM
Quote
Dennis S
Dennis S
Do NOT get an advantage plan.

THIS!

Use the Medicare site [www.medicare.gov] to determine the best Part D plan for your medications. Use the Medicare Plan Finder [www.medicare.gov]
Play with it, has a little learning curve, but well worth your time and money.

Make sure to select a Preferred Pharmacy for your plan -- the cost difference can be great. Just because it list the least expensive plan first does Not mean it's the best plan for you, check out all the restrictions and limits.

I've change Part D plans 4 or 5 times and you can do that right on the Medicare site. It's good you are starting a little early there's much to learn.

Good luck



- Riley
Southern Indiana, B-Town
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Re: Medicare choices...What's the consensus?
Posted by: graylocks
Date: May 15, 2018 01:06PM
Quote
DeusxMac
Quote
Dennis S
Do NOT get an advantage plan.

THIS!

why?

i too am inundated with mail (65 next month) and the information overload has me running for cover. i'll be on my employers plan until at least september 2019 so i feel i have a longer window to figure this all out.



"Success isn't about how much money you make. It is about the difference you make in people's lives."--Michelle Obama
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Re: Medicare choices...What's the consensus?
Posted by: mattkime
Date: May 15, 2018 01:09PM
Quote
graylocks
why?

Its fascinating to see what we determine to be an efficient way of working, isn't it?




Hint: England doesn't have this problem.



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Re: Medicare choices...What's the consensus?
Posted by: Bill in NC
Date: May 15, 2018 02:05PM
Plan G offers much more flexibility than Advantage plans.

Convinced a relative in their 70s (so broke they delayed signing up for Part B until this year) to go with the $120/month G plan (plus $15/month drug plan) vs. a $0 premium Advantage plan.
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Re: Medicare choices...What's the consensus?
Posted by: Dennis S
Date: May 15, 2018 03:08PM
My doctor told me DO NOT get an advantage plan. He said it's hard to refer patients to specialists because so many doctors won't accept it.
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Re: Medicare choices...What's the consensus?
Posted by: DeusxMac
Date: May 15, 2018 03:33PM
Quote
Dennis S
My doctor told me DO NOT get an advantage plan. He said it's hard to refer patients to specialists because so many doctors won't accept it.

Many doctors... AND many medical labs, many rehabilitation services, many assisted living providers, etc.
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Re: Medicare choices...What's the consensus?
Posted by: MrNoBody
Date: May 15, 2018 03:50PM
Quote
mattkime

Hint: England doesn't have this problem.

Please elaborate on your experiences with England's NHS.



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"I Call Shenanigans!"
-Kyle Broflovski

“If you can't explain it to a six year old, you don't understand it yourself.”
-Albert Einstein

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Re: Medicare choices...What's the consensus?
Posted by: DavidS
Date: May 15, 2018 04:50PM
What state do you live in? This may also help determine the best option.
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Re: Medicare choices...What's the consensus?
Posted by: flareslow
Date: May 15, 2018 05:59PM
Whoa--What a great set of responses. Thanks.

I live in Louisiana. I downloaded the State Insurance commission document about medicare plans, and it provides a list of providers, their ratings, and the plans offered. There are quite a few that offer plan G, but I've never heard of many of them - more research needed.

Thanks again!
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Re: Medicare choices...What's the consensus?
Posted by: Dennis S
Date: May 15, 2018 06:11PM
Open enrollment is October 15 to December 7. Be sure to find out which plans can be changed during that period in case you pick one you don't like. I would think that's most likely to be Part D.
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Re: Medicare choices...What's the consensus?
Posted by: AllGold
Date: May 15, 2018 08:14PM
Some things about Medicare...

First, you need to pay attention to detail when it comes to the alphabet soup of Medicare. There are Medicare Parts with letters and Medicare Supplement Plans with letters.

Medicare Part A is hospitalization (with a couple other less common things thrown in), Part B is doctors and outpatient services, Part D is prescription drug plans. Medicare "Part C" in my opinion is an awkward misnomer. "Part C" is Medicare Advantage. That is where a private insurance company contracts with Medicare to provide all services. It's much like an employer group plan you may have had. All claims go to the insurance company rather than Medicare. While you obviously still have Medicare, Medicare itself is not actually involved in the claims process or your care. Most MA plans also include drug coverage so you don't need to (and generally can't) get a separate Part D plan.

Also, I think they are trying to get away from calling them Medicare Advantage and prefer Medicare Health Plan (rather than implying it is always an "advantage" which it's not).

Medicare Supplement plans, also called Medigap plans, also have a bunch of letters, A, B, C, D, F, G, K, L, M, N to be exact. With these plans, Medicare is primary and the plan supplements or fills in the gaps of what Medicare does not cover. Medicare Supplement Plans do not cover prescription drugs; you will need to get a separate Part D plan.

One thing that I want to make clear about Medicare Supplements. Medicare is primary. All claims go directly to Medicare. The insurance company has no say in the claims process. When Medicare approves (or not) the claim, the insurance company is required to pay their part -- end of story. I bring this up because all Medicare Supplements are the same and work exactly the same. The reputation of the insurance company is of no concern to you. You may have heard someone with a Medicare Supplement plan say something like "I like Company XYZ because they pay their claims." Of course they do. Medicare tells them to and if they didn't, they would quickly be out of the Medicare Supplement business.

Now, the speed at which they pay those claims varies. And that's why you might have a doctor's office recommend a particular insurance company. But the speed at which the doctor is reimbursed is not your concern.

A Plan G is a Plan G. The only difference is how much it costs you. The easy part is picking the cheapest Plan G right now. The hard part is trying to guess which company's Plan G will increase in price the least over the years. As long as you're healthy, you can switch to another company with a lower price. But if you develop health conditions you will probably be stuck with your current company.

This is where Medicare Advantage can come to the rescue. No matter how bad your health gets (with only a couple exceptions like kidney failure), you will always be eligible to get a Medicare Advantage plan. MA plans almost always cost less than MedSupp. But you get what you pay for and you will have more out-of-pocket expenses with MA.

For drug plans, just go to www.medicare.gov and click on "Find health & drug plans". You can enter your information, including the drugs and dosages you take and it will give you a list of all Part D plans available in your area (state), sorted by lowest total cost. Note: even if your prescriptions don't change, Part D plans change every year and it's a good idea to rerun that check at medicare.gov every year. You can also find an insurance agent who will do this for you as well, and they might have an idea of which companies' Med Supps have had the lowest rate increases.

Also, Medicare Supplement Plan F is not going away in 2020. What is really happening is for those who are new to Medicare in 2020, you will no longer be able to get a Plan F. But if you already had Medicare before 2020, not only can you keep a Plan F that you already had, but you're still allowed to get a new Plan F.

P.S.: Please type in the URL "medicare.gov" in the address bar - don't do a Google or other search because the first few entries will be ads not the official Medicare site.







Edited 2 time(s). Last edit at 05/15/2018 08:20PM by AllGold.
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Re: Medicare choices...What's the consensus?
Posted by: mattkime
Date: May 15, 2018 09:12PM
Quote
MrNoBody
Quote
mattkime

Hint: England doesn't have this problem.

Please elaborate on your experiences with England's NHS.

No paperwork. No insurance calculations.



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Re: Medicare choices...What's the consensus?
Posted by: RAMd®d
Date: May 15, 2018 09:56PM
I have Kaiser and am not taking any medications so I haven't added any addition plans.

When in last time, the nurse seemed to expect I'd be using some medications, given my age, I assume.

Then a guy checked in next to me, and going through the 'what are you on' questions, I counted at least 23 medications that he was currently taking at various times. There was a lot of 'Are you still taking...' with replies of 'No I stopped that but now they got me on...'.

I couldn't believe what I was hearing, but wanted to tell him 'At least you got your health...'.




When a good man is hurt,
all who would be called good
must suffer with him.

You and I have memories longer than the road that stretches out ahead.

There is no safety for honest men
except by believing all possible evil
of evil men.

We don’t do focus groups. They just ensure that you don’t offend anyone, and produce bland inoffensive products. —Sir Jonathan Ive

-An armed society is a polite society.
And hope is a lousy defense.

You make me pull, I'll put you down.

Mister, that's a ten-gallon hat on a twenty-gallon head.

I *love* Sigs. It's Glocks I hate.
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Re: Medicare choices...What's the consensus?
Posted by: RAMd®d
Date: May 15, 2018 10:02PM
I was told that with Kaiser you get free access to some gyms, a couple which are close to me. Then I found out that it required an additional plan— Silver Advantage.

Hearing that, I lost interest. I should probably look into the cost of membership vs. the plan, but I don't expect it would be worth it.




When a good man is hurt,
all who would be called good
must suffer with him.

You and I have memories longer than the road that stretches out ahead.

There is no safety for honest men
except by believing all possible evil
of evil men.

We don’t do focus groups. They just ensure that you don’t offend anyone, and produce bland inoffensive products. —Sir Jonathan Ive

-An armed society is a polite society.
And hope is a lousy defense.

You make me pull, I'll put you down.

Mister, that's a ten-gallon hat on a twenty-gallon head.

I *love* Sigs. It's Glocks I hate.
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Re: Medicare choices...What's the consensus?
Posted by: Buzz
Date: May 16, 2018 06:40PM
As long as Mrs. Buzz keeps flying, we're gonna keep opting out of all the Medicare alphabet soup options. We had a couple of agent friends, as well as a couple from the myriad of solicitations that showed up, all check out the options, and everyone came back saying that as long as you can stay on the employer based plan, the better. That was based on my ongoing neuro crud treatment which runs about $400K per year. We also take advantage of the employer based dental coverage. Don't know what flareslow's health issues are, if any material, or access to alternative coverage, but Medicare is not always the panacea many people have been taught it to be. If your general health falls into the pigeon holes Medicare covers well, evidently it's pretty good. But if your health issues are outside of their norm, a competent agent that knows their stuff can be mighty helpful. Good stuff above, especially AllGold.
==
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