Medicare Advantage Plans

[Rebecca Traylor]

Medicare

[Rebecca Traylor]

New to Medicare plans..so confusing..full time RVer.. any plans you all like or have ?

[Jim & Wilma]

We value the ability to go to providers of our choice and have elected for a Plan G supplement versus an Advantage plan. 

[Kirk W]

Welcome to the Escapee forums! We are here to  help and will do our best.

You might find it helpful to use the AON Healthcare Exchange, or one of several other similar exchanges. These people will help to guide you through the process buy asking questions about her health care needs and the drugs you take and from that narrow things down to help you arrive at the best coverage for the budget that you have. They do get paid but are paid by the companies that you are placed with, much like a realtor who helps you to find a house but is paid by the seller. There isn't anything that they do which you can't do for yourself but they do this all of the time and have computer systems to help them so can do this much more quickly. 

[Dutch_12078]

My wife and I have been very satisfied with our United Healthcare Advantage plans at zero additional premium plus $16/mo for Part D coverage. UHC lets us use any in-network provider wherever we are at the standard in-network co-pays or out of network providers at a higher co-pay. Even when we were going through my wife's cancer surgery and treatments, our annual out of pocket costs were less than the annual supplement plan F or G premiums.

[docj]

11 hours ago, Dutch_12078 said:

Even when we were going through my wife's cancer surgery and treatments, our annual out of pocket costs were less than the annual supplement plan F or G premiums.

I hope your wife is well.  Mine also had cancer surgery ~5 years ago.  My wife's cancer was rare enough that she has since then been under the care of the MD Anderson Cancer Center in Houston.  I just verified that MDAnderson essentially doesn't accept Medicare Advantage Plans.  I'm not saying that your plan wasn't good for your wife, but when my wife needed more advanced care it was available to her at no cost and with no questions asked.

Edited October 17, 2020 by docj

[Dutch_12078]

2 minutes ago, docj said:

I hope your wife is well.  Mine also had cancer surgery ~5 years ago.  My wife's cancer was rare enough that she has since then been under the care of the MD Anderson Cancer Center in Houston.  I just verified that MDAnderson essentially doesn't accept Medicare Advantage Plans.  I'm not saying that your plan wasn't good for your wife, but when my wife needed more advanced care it was available to her at no cost and with no questions asked.

She just hit 8 years as a survivor. Now we're more concerned about her COPD. MD Anderson is available to us if we needed it at the higher out of plan co-pays, but there are also other well rated cancer facilities that do accept Advantage plans to choose from.

[Twotoes]

As a full timer I went with a Medicare Supplement Plan. Advantage Plans are mostly HMO and if you travel you are almost li always out of network. I have a SD address and the choices were limited to United Health Care and Mutual of Omaha. I went with Mutual of Omaha and have never had a problem getting medical services. My Part D is with CVS who are almost everywhere. I am not limited to CVS and sometimes use Walgreens. 

[TXiceman]

We also went with a supplement plan G so that we can travel and not worry about in-plan networks.  Any Doctor of hospital that accepts Medicare accepts the plan G as well.

Ken

[Jim & Alice]

Count my Wife and I as Medicare Supplement Plan 'G' advocates... In 8 years of Fulltiming, we have used our policy in Michigan, Texas, South Dakota, and Arizona.   No problems whatsoever.   

[2gypsies]

We've always use Medicare Supplement; not Advantage.  We've gone through many surgeries including cancer and never paid a dime and no co-pays.

[Randyretired]

For those that travel a lot it requires a Medicare Advantage Plan that accommodates that.  Many don't but we have a employer plan that does accommodate traveling.  We have used it in AZ, CA and CO.  We also use some of the other benefits such as eye glasses and it saves us some money.   This plan from my DW's former employer also includes a good RX plan.

[ToddF]

Sounds good to me. (Turned 59 on Oct 10). 358 days until I can sign for Medicare Advantage. (Maybe)🤯

[Kirk W]

11 minutes ago, ToddF said:

(Turned 59 on Oct 10). 358 days until I can sign for Medicare Advantage.

Isn't the age to qualify for Medicare still 65? 

Quote

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).

 

[Dutch_12078]

36 minutes ago, Kirk W said:

Isn't the age to qualify for Medicare still 65? 

 

If elected, Joe Biden wants to lower the Medicare eligibility age to 60, with the option to keep your current insurance if desired. That may be what Todd is referring to...

[ToddF]

😀

[DanZemke]

I too have a Plan G supplement - with a twist. I have a High Deductible (HD) version.  Many insurance companies do not offer High Deductible plans.  Why?  Usually because they are less profitable.  How do I know that?  Because commissions on "standard" plans are much higher than HD plans.

The mandated Medicare High Deductible amount for 2021 is $2,370 or about $200 per month.

So let's do a little sniff test using some actual data for 2021 from the state I live in (Connecticut).   Let's up the $200 a month to $250 a month, to account for the time you might have to spend dealing with the first $2,370 of bills.

Here's a sniff test: is the monthly premium for your anticipated Plan G minus the lowest cost Plan G HD available to you more than $250 a month?  If so, it's probably worth your time to investigate a bit further.

Here's an egregious example using actual facts for company X:
    Plan G monthly rate         $551.59
    Plan G HD monthly rate      $66.65
    Difference                  $485.94
    
And another for company Y:
    Plan G monthly rate         $428.72
    Plan G HD monthly rate      $55.00
    Difference                  $373.72
        
The above two examples show dramatic advantages of going with a HD policy. You're likely to find examples like this in your State too.  But most will probably be less obvious.

The more subtle question is, what if your expected Medicare eligible health care expenses are well below $2,370 a year?  IMO, you should chose a HD plan, and potentially save thousands of dollars for the years you are relatively healthy.   I was on a Plan F HD for 5 years until I switched to a Plan G HD this year.  I saved over $5,000 by selecting the least expensive Plan F HD compared to the least expensive Plan F (standard) for those 5 years.

But what happens if your health starts to fail?  You still have the identical coverage as a "standard" Plan G but the very low cost you had enjoyed may be eaten away by the expenses you have to directly pay.  In many cases, the Plan G  HD (or F HD)  + $2,370 will still be less expensive than the standard Plan even though you had to pay the full HD amount.   Do the math and find out.

--------------------------------------------------------------

2021 High Deductible amount for 2021 is $2,370 : https://www.cms.gov/Medicare/Health-Plans/Medigap/FandJ
State of Connecticut available Medicare Supplement Plans for 2021 and their prices:  https://portal.ct.gov/-/media/CID/1_LifeHealth/Medicare_Supplement_Insurance_Rates.pdf?la=en

Edited October 19, 2020 by DanZemke
Clarity

[ToddF]

Dan is referring to the commission the insurance agency (agent) receive from the insurance company when a policy is sold (about 10% of the premium amount). Agents have no incentive to work through the math as Dan has done.

The high deductible policy paired with a dedicated savings account used for out of pocket costs makes financial sense, especially if one is not a high user of medical services. For non-Medicare insureds, the HSA can be paired with an HSA qualified policy and provide a significant tax advantage. (The HSA contribution, subject to certain limits, is tax deductible "above the line", in other words, an adjustment to gross income).

Both parties (Democrat and Republican) are talking about major changes to the health insurance situation. Medicare at 60 would "solve" the  issue folks getting ready to retire bring up as their #1 concern if they're not 65 yet. Many folks would find that Medicare at 60 allows them to retire before 65, potentially opening up jobs in the economy. It would make retirement planning much easier and potentially work us toward a lower retirement age for many folks.

[2gypsies]

Keep in mind that you can be a very high user of medical services within one day from the previous day.  Health at any age is not guaranteed from day to day.

[Zulu]

On 10/16/2020 at 5:54 AM, Rebecca Traylor said:

New to Medicare plans..so confusing..full time RVer.. any plans you all like or have ?

For sure. Been on Medicare for several years and it's still confusing . . . starting with all the terminology like Medigap, supplement plan, Medicare Advantage, Medicare Parts A, B, C, D. . .

For starters, Medigap plans and Supplement plans are the same thing.

Here's are handy Medicare 101 web site.

Jumping ahead, instead of opting for the standard Medicare Plan A (Hospitalization) and Part B (Physician Services), people often select a private Medicare Advantage (Part C) plan which takes the place of Medicare Plans A & B.

People who go with Medicare Plan A & B usually buy a Supplement (Medigap) plan (either A, B, C, D, F, G, K, L, M, or N). Most folks go with Plan F or G. In addition to a Supplement plan, you' probably want a Medicare Plan D (Prescription Drug) plan.

Easy, eh?

Finally, Medicare Advantage plans aren't available everywhere, and costs vary on where you live.

[ToddF]

There is an explosion in advertising in Minnesota of companies offering Medicare Advantage plans. (United Healthcare, Healthpartners, Humana, etc et). Or maybe I'm just noticing it for the first time (open enrollment) since I'm not usually in MN this time of year.

The Advantage plans seem to offer lots of perks like dental care, eye checkups, even meal delivery! 

I definitely plan to check into this when I become eligible as I am fine with a narrower network of providers. I'd most likely go with Healthpartners since that is who I have my major medical insurance through now and they have an excellent network of clinics and hospitals in MN. 

I think Medicare Advantage would be good for someone like me (zero premium option) who seldom takes any RX and gets sent home from the Doctors office with a "don't come back" more often than not.

[Kirk W]

43 minutes ago, ToddF said:

There is an explosion in advertising in Minnesota of companies offering Medicare Advantage plans. (United Healthcare, Healthpartners, Humana, etc et). Or maybe I'm just noticing it for the first time (open enrollment) since I'm not usually in MN this time of year.

The same is true in the Dallas TV market and probably most others. Think about it....  Do companies advertise the product that saves you the most money, or the one that makes them the most money? If you plan to stay with your present doctors, check to see if they will accept an Advantage plan as many do not. 

[bigjim]

I have been bewildered by this for some time now. Even los respect for the famous folks advetising it.  I  wonder if these plans may be good for many individuals in the short term, even a year or two but eventually there will be a change and not for the good. I have wondered if it is not a way to put the nail in the coffin of the Affordable Care act, and maybe down the line  medicare, medicaid, or any other national plan.  Everything I have been told is it costs the government/ aka the taxpayers more for medicare advantage type plans. If I am correct my supplement will not let me re-enroll if I ever drop it although that may not be correct.

[Kirk W]

41 minutes ago, bigjim said:

If I am correct my supplement will not let me re-enroll if I ever drop it although that may not be correct.

My sister in in an Advantage plan and it has been good for her, but she rarely leaves the community where she lives and never for more than a day or two. She is low income so would have difficulty in paying premiums for a supplement and changing doctors was acceptable to her. For us, traveling we feel that our Medicare & supplement serve us much better but I also have more ability to pay than my sister. 

Our favorite ad is the one by Joe Namath, the guy who tried to sell men on pantyhose!

[mptjelgin]

1 hour ago, Kirk W said:

Our favorite ad is the one by Joe Namath, the guy who tried to sell men on pantyhose!

I  think that you may have misinterpreted that ad. I was directed at women...