Partially OT - Medicare Advantage or Supplement?

Berryette

Quilting - I am so grateful your post came up again today.  I was going to search for posts about supplements and voila- here you are.  DH is 80 and he has plan F.  We are paying almost 500 a month for it.  Last year the supplement only paid out 300- so I was tempted to cancel and take a chance without.  Especially, since I found out that a nursing home isnt covered.  I am hoping and praying it never comes to that- but at this point, it seems like that would be our major expense.  I am just so confused by all of this and afraid to make the wrong decision since DH can not help with decisions.  One agent I spoke with suggested an Advantage plan- but from all the posts on here- I do not think that is something I want to pursue.  So my question- is- do I keep paying 500 monthly for the plan F or would it be smart to save that money and just have medicare A and B?  Does anyone have opinions on that?  Maybe everyone is thinking that I would be crazy to get rid of the supplement?  I am just frozen with the fear of making the wrong choice.  It feels all over again  like when I decided to move us to to town- I was panic stricken that I would make wrong choices and DH would blame me.  I guess my faith needs a boost!!!

Mint

Berryette would suggest that you look for something that explains how supplement and advantage plans work in easy to understand language.  The two You Tube channels I have found like this, sure there are others, is Abt Insurance and Medicare School.  They are independent agents, I don’t use either one, have a local agent but their education makes me feel very comfortable and prepared when I go in to talk with my local agent.

[Deleted User]

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Quilting brings calm

The difference in the coverage between Plan F and and G is the Medicare Part B deductible - which is $233 this year. The difference in premium is several times the $233.   So it may be in your best interest to switch to a G plan. Depends on the premium difference and the underwriting rules in your state.  I would  check to see if there is a SHIP office in your state and call them.  Their phone number might be on your state government’s department of aging’s website. They don’t  sell insurance, they just give advice. I’m going to call the one here about my thoughts for next year. I wish I had called them this spring. 

The supplement may not pay much unless your husband goes into the hospital or into rehab.  My mom’s Part F covered what Medicare didn’t for a month long rehab stay in 2019.  She didn’t have to pay 1 dime. Some Medicare Advantages say they do that too.  It’s just really hard to know which one is a good one. 

MaryG123

We have a regional Medicare advantage plan, and have been very happy with it.  We chose it because it has a manageable annual out of pocket maximum, low or no copays, and includes hearing, dental, and eyeglasses.  The choice of doctors is broad, and getting referrals is very easy.  The level of care has been excellent, including primary care, gastroenterologists for a stomach ulcer, psychiatrists and mental health staff for my DH bipolar disorder, pain management for my osteoarthritis, and a neurologist with all the necessary tests for his cognitive loss.  It’s a good fit for us.

ImMaggieMae

We have regular Medicare and a United Heath Care Supplement and separate RX plan. The supplement is expensive, but there are no approvals needed for anything we’ve encountered and they pay everything that Medicare doesn’t cover. We can go to any doctor we want and so far haven’t found any that don’t accept Medicare with the supplement.There are never any questions unless a doctor codes something wrong, and those get corrected by the doctor and paid. The RX insurance is getting more expensive over time and they have all sorts of tiers, even for drugs that are common. We almost always use GoodRX rather than the insurance because even generic drug copays can be way higher than GoodRX, depending on the pharmacy. We keep the RX insurance in case we ever needed a newer drug that GoodRX or the like doesn’t cover.

We live in a suburban/rural area but are half an hour from a big city and have 4 large hospitals relatively close. Finding specialists since Covid can still be a real challenge compared to before. Many have retired. We had to wait about 8 months for a Neurologist appointment. 

jfkoc

My undertanding is that the Advange  Plan will pay but the Dr will not participate. Same with Medicare. A Dr does not have to participate.

I have two Drs who are only private pay.

Pat6177

DH and I are on traditional Medicare with a supplement from United and we’ve been happy with that. For Part D, I just get the cheapest plan. None of the plans cover all my meds. One med I’m on is not FDA approved. Rather than go to a compounding pharmacy, I order from a Canadian pharmacy where the drug is manufactured in Canada so I trust the quality. I have also ordered a couple of dermatology creams from the Canadian pharmacy. And I use Goodrx regularly. Just today, I had to pick up a steroid cream. My copay would have been $60. On Goodrx, it was $28. For DH, he started on a couple of new meds this year. With the ALZ, he’s not flexible about using Goodrx instead of his insurance. I will research new drug plans for him this year. And as his disease progresses, he won’t notice if I use Goodrx.

JJAz

Berryette,

Keep in mind that if you switch to Medicare Advantage, you can always switch back to Medicare Part A, B and D.  It's only the supplemental plans that have underwriting requirement.  If you are low income, check out the combination Medicare/Medicaid.  It's a good solution. 

 Personally, I wouldn't have Part A, B and D without the supplemental plan.  You could be on the hook for 20% or your Medicare approved bills.  There is no maximum out-of-pocket.  If you have a healthy year, that might not be too much, but the real reason we have insurance is to cover us when unexpected costs exceed what we can afford.

Imogen Meagher

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Jo C.

Reported.

John_inFlorida

My DW has a part F & D plan, when I was able to get on I went with G & D (you can only keep part F if you already have it, its no longer offered. Not really a lot of difference anyway).

So far these have worked well for us, being able to pick our own doctors, and not needing to be  referred to a specialist.

I was always curious about advantage plans, they just seemed too good to be true. $0 monthly and vision and dental.  But the Dental isn't as good as the separate dental plan I have now, so I would still have needed something else to do with the dental. And I dont like needing to re referred.