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Medicare question

We currently have a medicare advantage plan in CA, Kaiser Sr Advantage. We are moving to NC and need to select a different plan because Kaiser is not avail there. We like medicare advantage plans because they cover parts A, B and C but I have been following with interest the thread about tge GUIDE program through Medicare. That program is not avail if you select Medicare Advantage. I was thinking the respite hrs would be useful but I'm not sure the limited number of hours is worth not getting drug, vision, dental hearing and Silver Sneakers coverage. I have been researching the Medicare options in the County we want to move to. I was wondering if any of you have decided to go MA or traditional Medicare and why. For those who have used the GUIDE program, do you think the benefits are worth giving up Rx, vision, dental, hearing and fitness benefits?

Comments

  • harshedbuzz
    harshedbuzz Member Posts: 6,453
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    @RetiredTeacher

    Be sure you investigate any MAP you sign with.

    My mom and I both have a MAP as a retirement benefit. Her plan is excellent (retired NJ public school teacher) and mine is pretty good (DH is retired from a Fortune 500 Co.) Neither of ours includes vision or dental. Mine includes Silver Sneakers; I'm not sure about hers. Neither includes anything like transportation to appointments. Both include a rewards program for routine preventative care; her tops out at $250 but mine is considerably lower. They're both administered by Aetna but different in many respects including how drug coverage is handled.

    HB

  • Quilting brings calm
    Quilting brings calm Member Posts: 3,162
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    I decided not to go with Medicare advantage, which was offered by my former employer. I chose Medicare plus a G supplement. We also pay for a part D plan, a dental plan, and a vision plan. Are there things a MAP would give us? Probably, but I’d had enough in my working years of pre-approvals, coverage restrictions, in/out of network, etc. There are actually doctors/hospitals that aren’t just out of network - they don’t even accept your MAP.
    My supplement is good everywhere in the US and even provide a limited amount overseas.

  • jfkoc
    jfkoc Member Posts: 5,076
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    I think $$$ is the deciding factor. Having A B D and F gives you better coverage. Consider the tax deductions also. BTW…F is no longer available.

    I do reconsider my choices annually but have not changed for 20 years.

  • BPS
    BPS Member Posts: 477
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    I have an Advantage plan. Before I signed up I checked if it covered my doctors and the hospital I would go to, and my medications. It cover 50% of dental up to $3,000. It is a $0 premium plan so the only cost is the Medicaid deduction from social security. In our area there are a lot of options, but I think in other places there are fewer choices. Check with your doctor to see what insurance they take. A few years back my mom had regular Medicare with a supplement plan and her doctor told her that they were going to stop accepting regular Medicare so she would need to change to an advantage plan or change doctors. There are places that have all the options in your area and can help in picking one that is best for your needs. Chapter medicare is one and I am sure there are others.

  • RetiredTeacher
    RetiredTeacher Member Posts: 361
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    Ty all very much for your input. We hope to move later this summer so i will start checking what plans are offered in the county we would like to live in, what the plans cost and what they cover. Thanks again

  • Victoriaredux
    Victoriaredux Member Posts: 158
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    I buy insurance to cover what I can't afford myself. The goodies list of an Advantage plan are designed ,IMO , to draw attention away from how they will approach a major treatment.

    With consolidations in the medical field and so many Doctors retiring I went for regular MC and plan G to get maximum choice. When one is really sick time matters more than a gym membership.

  • RetiredTeacher
    RetiredTeacher Member Posts: 361
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  • Quilting brings calm
    Quilting brings calm Member Posts: 3,162
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    Plan G is the most comprehensive Medicare supplement option. Pays for all the hospital ( plan A) doctor and durable equipment ( plan B) Medicare deductibles and co-pays- except the $257 annual doctor deductible. It’s offered by all the Medicare supplement companies eligible to write policies in a state, all plan G policies, regardless of company cover the same things. You would still need a Plan D for prescriptions. Medicare advantage plans are Plan C ( A, B and D plus extras).

    Please call the department of aging in your state to get contact information for a SHIP counselor. I don’t remember what the acronym stands for but they are there to educate you on supplements and advantage plans

    Or contact a reputable Medicare supplement insurance agent, who can do the same thing.

  • JJ401
    JJ401 Member Posts: 400
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    Since you are moving you have a special enrollment window of 63 days where you don’t have to medically qualify for a supplement. Just be sure you get the coverage within the window. If you don’t, they can turn you down or charge higher prices.

    Also when you cancel your current insurance be sure to tell them you are moving out of their area.

    The previous advice to call a SHIP counselor is a solid one. Even before you move you should connect with one (phone, zoo, email) in your new state.

  • Victoriaredux
    Victoriaredux Member Posts: 158
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    QBC covered what G is, thank you, SHIP is [from AI]: SHIP stands for the

    'State Health Insurance Assistance Program. It is a free, federally funded service that provides local, personalized counseling to Medicare beneficiaries, their families, and caregivers to help them navigate Medicare enrollment, coverage options, and benefits.'

    I've listened to few lectures by these counselors through the years - some were , um, probably borderline MCI , others were absolutely fantastic . Even though I've stuck with G , I've learned something new every year I've listened .

    Some health libraries have events near the annual enrollment time , usually on line . In Calif the program is called HICAP . Here is an excellent one from 11/2025.

  • RetiredTeacher
    RetiredTeacher Member Posts: 361
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    Ty all so very much for the helpful info. I will get in touch with SHIIP soon and see what is avail in NC. I really do appreciate your experience and advice. Thanks again

Commonly Used Abbreviations


DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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