# Medicare Advantage vs. Medigap policies aka Medicare Supplement plans



## momeason (Nov 14, 2015)

MEDICARE ADVANTAGE- SIMPLE, INEXPENSIVE to ENROLL
                         Complicated and Costly to Use

Medicare Advantage Plans are a very popular choice for many over 65 consumers. The plans are aggressively marketed for 3 reasons

1.	These plans remove risk and lower costs to the federal government, risks are absorbed by the insurance carriers.

2.	Insurance carriers are in the business of making money. Medicare Advantage Plans must be approved by the Centers for Medicare Services, however, all insurance plans (Health, Life, Homeowners, Auto) are designed to make money for the insurance company offering the plan. Risks versus rewards for each plan offered have been carefully researched by the insurance carrier.

3.	Sales agents push Medicare Advantage because the commission rates for Medicare Advantage plans are double the commission rates for Medicare Supplement policies, also known as Medigap policies.

Original Medicare offers 80/20 coverage to Medicare beneficiaries. There is no maximum or cap that Medicare will pay annually for any one beneficiary. In other words, the cost per beneficiary has no limit. When a Medicare beneficiary enrolls in a Medicare Advantage Plan, that beneficiary is now fully insured by United Healthcare, BCBSNC, Humana or any other approved insurance carrier. The government limits risk by paying a fixed amount per enrollee in a Medicare Advantage Plan. This allows the government to reduce their costs and more effectively budget each year. The risk for the individual Medicare beneficiary is also not capped; there is no out of pocket maximum for the Medicare beneficiaries in Original Medicare. Medicare Advantage Plans and Medigap policies do offer the protection of out of pocket maximums. This why it is important to have either a Medicare Advantage Plan or a Medigap policy. I recommend Medigap plans as a preferred choice for many reasons.

All Insurance Carriers play a game of averages. Each Medicare Advantage Plan has been carefully designed with the goal of providing service to each enrollee at a profit. Each Medicare Plan offered must meet strict guidelines and be approved by CMS, the Center for Medicare Services. However when a plan ceases to make a profit for the insurance company, the plan is terminated by the insurance company. Remember, CMS pays a fixed amount for each member of a plan. If a plan, over time, enrolls too many members who have a high need for medical services, the plan may no longer be profitable. Since the insurance company only receives a fixed amount for each enrolled member the incentive is to limit care, especially expensive care from specialists. Medicare Advantage Plans, like Medicare, are also 80/20 plans. The out of pocket maximum is still relatively high in most MA plans, usually between $4500-$6700 per year. Other disadvantages of Medicare Advantage Plans include limited networks that may drop a favorite doctor or hospital, high copays and limited access to Specialists as well as coverage which is only local or regional. Many MA plans require a referral from a designated Primary Care Physician (PCP) before the plan will pay for the member to visit a Specialist. If the member is allowed to visit a Specialist, the Specialist is chosen by the PCP not by the member. As stated above, commission rates are much higher for Medicare Advantage Plans providing a large incentive for agents to promote these plans rather than Medigap policies. 
Medicare Advantage Plans are marketed as having everything you need in one simple plan. The policies operate very similarly to the major medical plans offered to under 65 consumers. Offering low premiums, these health plans are attractive and seem familiar to enrollees. However, many beneficiaries do not understand the richer benefits of Medigap policies. Although the premiums for many Medigap policies are higher than many Medicare Advantage Plans, there are many superior benefits. Any doctor who accepts Medicare will accept any Medigap policy; there are no network restrictions. The plans are good nationwide and several plans even include Foreign Travel insurance. There are currently 10 levels of Medicare Supplements. The benefits of each level are established by CMS and are the same from each insurance carrier. Plan F, for example, will pay all the beneficiary’s portion of the costs of any Medicare approved service from a doctor or facility which accepts Medicare in the USA for the rest of one’s life. Plan F even covers 80% of most foreign travel emmegencies. All Medigap policies are guaranteed renewable if premiums continue to be paid. Original Medicare pays the first 80%, these supplemental policies fill in the gaps of Medicare. Medigap policies are surprising affordable ($37-$211/month) for the amount of coverage offered. Even the lower level Medigap offer richer benefits including lower annual out of pocket costs, ease of use and nationwide coverage rather than local or regional coverage compared to Medicare Advantage plans with similar premiums. Medicare Supplement Plans offer a great way to budget for future medical needs at a reasonable monthly cost. 
Advice from a respected independent agent is invaluable in helping a Medicare beneficiary choose the best plan at the lowest cost. An independent agent can also offer advice on purchasing a prescription plan that offers the prescriptions needed at the lowest annual cost. Many new Medicare beneficiaries make the mistake of calling or visiting an exclusive agent who sells plans from only one company, believing the name of the insurance carrier is an important consideration. Actually, because the benefits of Medigap plans are established and regulated by the government, the brand name of the Medigap carrier should be only a minor factor in choosing a Medigap policy. It is best to shop around or visit a trusted advisor, rather than an exclusive sales agent representing only one insurance company. 
The optimal time to purchase a Medigap Policy is during the period just before or after one’s 65th birthday or the date one qualifies for Medicare Part B. When purchased in the 6 month window immediately after enrolling in Medicare, no health questions are asked. Acceptance is guaranteed. 
There is another guaranteed issue period of 63 days following the termination of an enrollee’s Medicare Advantage Plan. Again, in this period, no health questions will be asked. This is a great opportunity to move into a Medicare Supplement. Currently, NC (where I live) has the 3rd highest number of Medicare beneficiaries affected by Medicare Advantage Plan terminations. Other guaranteed issue periods may be triggered by specific events. Send me a private message or call Sherry Eason at 910-750-2605 if you have further questions. (This time of year, I am not on the BBS much at all.)


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## cissy (Nov 14, 2015)

Thank you for explaining the difference.  I currently have an Advantage plan which has gotten very expensive, so I'm looking to switch.


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## WinniWoman (Nov 14, 2015)

Thank you! I have always suspected that the Medigap plans are the best. (I used to work in Health Insurance commercial lines).

I guess then, if you are enrolled in an employer plan with an HSA you should still apply for the Medicare and Medigap policy then, even though you will no longer be able to contribute to the HSA?

I know in some instances it can be beneficial to delay enrolling in medicare if you have an employer plan with an HSA so you can keep contributing.

But it seems, considering the pre-existing condition clause, in most cases one should apply for Medicare and the Medigap plan as well when one turns 65, even though still working?


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## WinniWoman (Nov 14, 2015)

PS I heard the G plan is just as good as the F plan, but less expensive?

And- can't people just enroll on-line for these plans? Why would they need an agent at all?


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## bogey21 (Nov 14, 2015)

This year I am paying about $600 a month for a Medicare Supplement and a Prescription Plan.  For next year I switched to Medicare Advantage at $0 per month.  Thus I am getting rid of $7,200 in annual premiums in exchange for a $4,900 maximum Out of Pocket with the Advantage Plan.

I know, limited Doctor and Hospital selection, more hassle, co-pays, etc.  My mistake was taking the HMO version of the Advantage Plan for $0 per month.  I should have taken the PPO version for $32 per month.  Hopefully I will not need to use it this year for other than prescriptions, annual check-up, etc. and will change next year to the PPO version.

George


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## momeason (Nov 14, 2015)

mpumilia said:


> Thank you! I have always suspected that the Medigap plans are the best. (I used to work in Health Insurance commercial lines).
> 
> I guess then, if you are enrolled in an employer plan with an HSA you should still apply for the Medicare and Medigap policy then, even though you will no longer be able to contribute to the HSA?
> 
> ...



Not necessary. You can wait until you stop working and lose your employer plan if you wish. You will have 63 days of guaranteed issue to buy a Medigap policy and a Prescription plan. One of the things that can be better with traditional insurance is a longer list of prescription drugs available. Thank heavens in about 6 years, the Donut hole will disappear. It gets smaller each year now as part of the ACA.
It pays to re-evaluate your Medicare Prescription Plan every year as the drug formulary lists constantly change within plans and so may your needs.

There are 2 ways to get great Medigap coverage at a low cost. One is Plan G as you mentioned. The consumer will pay the Part B deductible only. In 2015, that is $147. The other is to sign up for the high Deductible Plan F. The out of pocket max for High Deductible Plan F is currently $2180, much lower than most under 65 plans. There is one carrier who even adds "Silver Sneakers" to their plans. This is a membership in 9000 gyms across the country. I am independent, I just give people the facts to help others make an informed choice.

P.S.  You can pay your Part B Medicare Premiums with any leftover funds in your HSA.


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## momeason (Nov 14, 2015)

bogey21 said:


> This year I am paying about $600 a month for a Medicare Supplement and a Prescription Plan.  For next year I switched to Medicare Advantage at $0 per month.  Thus I am getting rid of $7,200 in annual premiums in exchange for a $4,900 maximum Out of Pocket with the Advantage Plan.
> 
> I know, limited Doctor and Hospital selection, more hassle, co-pays, etc.  My mistake was taking the HMO version of the Advantage Plan for $0 per month.  I should have taken the PPO version for $32 per month.  Hopefully I will not need to use it this year for other than prescriptions, annual check-up, etc. and will change next year to the PPO version.
> 
> George



I do not know what you are paying for. I do not know of any Medigap plan over $211/mo for those over age 65. That is Plan F from one of the most expensive carriers. Most prescription plans run about between $20-$40/mo. If you are under age 65 and are receiving Medicare as the result of a disability the plans could be that expensive. I would not usually recommend a supplement policy until some one reaches 65. Even if you receive Medicare early, you will have an Open Enrollment period to buy a supplement policy without medical underwriting for the 6 months after you turn age 65. I was not directly addressing people under 65.


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## momeason (Nov 14, 2015)

bogey21 said:


> This year I am paying about $600 a month for a Medicare Supplement and a Prescription Plan.  For next year I switched to Medicare Advantage at $0 per month.  Thus I am getting rid of $7,200 in annual premiums in exchange for a $4,900 maximum Out of Pocket with the Advantage Plan.
> 
> I know, limited Doctor and Hospital selection, more hassle, co-pays, etc.  My mistake was taking the HMO version of the Advantage Plan for $0 per month.  I should have taken the PPO version for $32 per month.  Hopefully I will not need to use it this year for other than prescriptions, annual check-up, etc. and will change next year to the PPO version.
> 
> George



You can still fix your mistake. It is open season right now and you have a 30 day return and there is also a Disenrollment period in January. You have lots of options. HMOs suck!!


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## bogey21 (Nov 14, 2015)

momeason said:


> I do not know what you are paying for. I do not know of any Medigap plan over $211/mo for those over age 65.



It isn't really a Medigap Policy.  Out of inertia (my bad) I just kept what my ex-employer was providing.

George


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## isisdave (Nov 14, 2015)

Alas, most of the people who need to read this thread, won't.

The most serious disadvantage to HMO-type MA plans is the limited network and the difficulty in obtaining a referral to a specialist. This will be worse if you don't live in or near a big city, because, for some reason, the best doctors don't live in East Nowhere.  DW, a psychotherapist, had several clients during her career who died (or whose relative/friend died) because of such delays, mostly because it took months to get an appointment with the specialist that correctly diagnosed them.

You might take a look at PPO-type MA plans, but they are rare. There is only one serving my zipcode.

One non-obvious thing about Medigap plans was mentioned in the original post and bears repeating: any doctor who takes Medicare also takes any Medigap policy. So if you buy it from Blue Shield, that doesn't mean you have to find a doctor on a Blue Shield network. After a lifetime of qualifying your doctors to match your insurance, this is a surprise to many.

Another is that Medicare, after paying its part, automatically forwards the claim to your Medigap company. Neither you nor your doctor have to track and handle this. Aren't computers great?


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## momeason (Nov 14, 2015)

isisdave said:


> Alas, most of the people who need to read this thread, won't.
> 
> The most serious disadvantage to HMO-type MA plans is the limited network and the difficulty in obtaining a referral to a specialist. This will be worse if you don't live in or near a big city, because, for some reason, the best doctors don't live in East Nowhere.  DW, a psychotherapist, had several clients during her career who died (or whose relative/friend died) because of such delays, mostly because it took months to get an appointment with the specialist that correctly diagnosed them.
> 
> ...



Yes Dave, You have this right!:whoopie:

I have a lot of difficulty getting people to understand the concept of No Networks.  BTW, BCBS is one of the most expensive providers. There are many Life Insurance Companies offering the exact same benefits for a much lower price. One in my area is a Berkshire Hathaway company backed by Warren Buffet.


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## bogey21 (Nov 15, 2015)

isisdave said:


> The most serious disadvantage to HMO-type MA plans is the limited network and the difficulty in obtaining a referral to a specialist.



First, is any Doctor who is not your Primary Care Physician considered a specialist?  For example if one sees a Cardiologist for for an annual check-up, is he considered a specialist?  Or is a specialist only a Cardiologist one sees for a major procedure?  Another example might be an Opthamologist one sees for an eye exam.  Or is an Opthamologist one visits for cataract surgery considered a specialist?  Assume for the sake of this question that all are in the HMO Network.  Second, do all HMOs look at this the same way?

George


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## ronparise (Nov 15, 2015)

I started with an advantage plan, but when we started travelling more I went with the supplement,

Its mice knowing I should have no "budget buster" health care issues, no deductables and no co pays... Just one (high) premium a month built into mu budget. Its also nice that I dont have to worry when I travel.. any doctor, anywhere (as long as they participate in Medicare) will be covered.


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## Passepartout (Nov 15, 2015)

bogey21 said:


> First, is any Doctor who is not your Primary Care Physician considered a specialist?  For example if one sees a Cardiologist for for an annual check-up, is he considered a specialist?  Or is a specialist only a Cardiologist one sees for a major procedure?  Another example might be an Opthamologist one sees for an eye exam.  Or is an Opthamologist one visits for cataract surgery considered a specialist?  Assume for the sake of this question that all are in the HMO Network.  Second, do all HMOs look at this the same way?
> 
> George



First: No.
Though why one would see a cardiologist for an annual checkup is a mystery. s/he might give you an annual HEART checkup, but you wouldn't see him/her if you had a suspicious mole or your knee swelled up.
Many plans will cover your annual visit to an ophthalmologist for cataract or glaucoma (medical screening) but not for a refraction for glasses- mine throws this in gratis but the eyeglass prescription isn't written by the (MD) ophthalmologist.

Second: No. All HMOs are governed by their own rules and capabilities. One has to read their prospectuses to know exactly what is covered and to what extent. Just like each insurer for prescription drug coverages has their own 'formulary' of preferred meds, and one has to carefully check to see that what you are prescribed is covered by your insurer.

For instance, where I live there is just one pretty-much all encompassing healthcare provider. It didn't make a lot of sense to have to get a referral to every specialist, so for 2016 it looks like every Medicare supplement insurer removed PCP referral from he requirements. We'll just call the specialist of our choice and pay the $65 co-pay.

Jim


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## isisdave (Nov 15, 2015)

momeason, the other Big Thing No One Understands on MA is whether the policy is community-rated (everyone pays the same), issue-age-rated (cost is based on age at signup), or attained-age-rated (just what it sounds like). Where I live, almost all are the last type. But AARP's UHC plan is community rated. This is explained well here.

I have Blue Shield because I'm 66, it's age-rated here, and they offer a discount for the first 5 years.  At some point, it will no longer be the cheapest game in town ... but most folks won't notice and will just pay the new price.

I think my first-five-year discount is flat 10%; the age-rated premium goes up some percentage every two years. And of course the whole premium schedule goes up all the time!

To compare, start here.


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## PStreet1 (Nov 15, 2015)

Having recently (May) had a health crisis where it became suddenly necessary to see the best people I could see, I'd caution against signing up for any plan that limits your choices.  I went to Mayo Clinic and M.D. Anderson in Houston.  The advice I got from the two--both at the top of the heap of providers--was totally different.

You don't know you're going to need a particular specialist......until you do.

I'd also point out to anyone reading that Medicare pays for 2nd opinions, and there's no cost for getting one.  My charges from M.D. Anderson were $0.00.


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## Kal (Nov 15, 2015)

With an Advantage Plan, the networks are often very small with few good MDs in that system. That means a visit to your preferred MD would be an "out-of-network provider" thus a high co-pay. Those co-pays really add up and become a deal buster.

 If you are in an HMO, then you are really limited to MD choices.


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## WinniWoman (Nov 15, 2015)

isisdave said:


> momeason, the other Big Thing No One Understands on MA is whether the policy is community-rated (everyone pays the same), issue-age-rated (cost is based on age at signup), or attained-age-rated (just what it sounds like). Where I live, almost all are the last type. But AARP's UHC plan is community rated. This is explained well here.
> 
> I have Blue Shield because I'm 66, it's age-rated here, and they offer a discount for the first 5 years.  At some point, it will no longer be the cheapest game in town ... but most folks won't notice and will just pay the new price.
> 
> ...



I agree these are better plans than the Advantage plans, but from the looks of the premiums you have to be pretty well off to afford them, especially with no salary coming in anymore. $12,000 per year for a couple?! Yikes! What's the point of even having Medicare? Scary stuff. Between just these kinds of premiums in retirement and our school and property taxes it would be like $24,000 per year!I am dreading this when the time comes.


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## Passepartout (Nov 15, 2015)

mpumilia said:


> I agree these are better plans than the Advantage plans, but from the looks of the premiums you have to be pretty well off to afford them, especially with no salary coming in anymore. $12,000 per year for a couple?! Yikes! What's the point of even having Medicare? Scary stuff. Between just these kinds of premiums in retirement and our school and property taxes it would be like $24,000 per year!I am dreading this when the time comes.



Look, if you can't afford a supplement, just take basic Medicare after age 65. $104 pp a month, withdrawn from your SS. If you are reasonably healthy and don't take a lot of meds, you can save a lot of money. And no one forces you to live in a jurisdiction with expensive schools and high property taxes. Move to 'tax haven' New Hampshire.


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## WinniWoman (Nov 15, 2015)

Passepartout said:


> Look, if you can't afford a supplement, just take basic Medicare after age 65. $104 pp a month, withdrawn from your SS. If you are reasonably healthy and don't take a lot of meds, you can save a lot of money. And no one forces you to live in a jurisdiction with expensive schools and high property taxes. Move to 'tax haven' New Hampshire.



You know that is my plan, Jim- I mean the New Hampshire thing. Unless something changes. As I have mentioned in other posts, a lot will depend on whether or not we CAN sell our home then. Homes are sitting for sale for years around here, so might not have the choice of moving. No one else wants to buy homes with high taxes either.

I have quite a few years yet until Medicare. Who knows what it will be like by then? You know the story I posted about my 80 year old friend with the high deductible Medicare supplement and how she is thinking of doing exactly what you have stated here. But the overwhelming opinion about that is that it is a stupid idea. I don't think I would feel comfortable without a supplemental plan. But- again- we shall see. I am collecting a lot of info. so I can learn about SS and Medicare. My husband takes absolutely no interest, so it all falls on me to understand it.


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## Luanne (Nov 15, 2015)

Passepartout said:


> Look, if you can't afford a supplement, just take basic Medicare after age 65. $104 pp a month, withdrawn from your SS. If you are reasonably healthy and don't take a lot of meds, you can save a lot of money.



Maybe I have completely misunderstood, but I have "basic" Medicare, which for me is a bit more than $104/month withdrawn from SS.  I also have a Medicare supplement (Medigap) plan since Medicare might not cover everything.  For that I'm paying another just over $100/month.  The advice I was given by several people was to pick the "cheapest" supplement plan.  What that meant was that if I picked plan F, which I did, all insurers have to offer the same coverage since it's regulated by the government.


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## John Cummings (Nov 15, 2015)

I have had a Medicare Advantage Plan with Healthnet for 10 years. My wife has the same policy and has had hers for 3 years.

We are very happy with ours. We do NOT pay any premiums, Zero copays for any Doctor, prescription drugs are covered and it also included dental insurance. Both my wife and I have been to many specialists and received special services. We have never had a problem seeing a specialist or getting CT Scans, MRIs, etc. Trust me, I have been to several different specialists. I have been in the hospital 3 times in the last 2 years and it never cost me a dime. Tomorrow, I am having a hip injection and MRI. They can use out of network Doctors if your network doctor doesn't work for you and there is no cost. My Orthopedic surgeon is not in our network. I switched to him 10 months ago because I wasn't happy with the network Orthopedic surgeon.

Most referrals do not require authorization by the insurance company. For example, authorization is not required to be referred to an Orthopedic Surgeon, Cardiologist, and several others.

It all depends on choosing the right Medicare Advantage plan and choosing the right primary care doctor. We are fortunate in having many different plans to choose from so there is a lot of competition. A lot depends on where you live.


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## John Cummings (Nov 15, 2015)

Kal said:


> With an Advantage Plan, the networks are often very small with few good MDs in that system. That means a visit to your preferred MD would be an "out-of-network provider" thus a high co-pay. Those co-pays really add up and become a deal buster.
> 
> If you are in an HMO, then you are really limited to MD choices.



That depends on the HMO and where you live. There are over 5,000 providers in my MA's network.


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## Luanne (Nov 15, 2015)

John, how do you have coveage without paying any premiums?  How is your plan paid for?


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## John Cummings (Nov 15, 2015)

Luanne said:


> John, how do you have coveage without paying any premiums?  How is your plan paid for?



The government pays the insurance company so much per month for each subscriber. In other words the government pays the premium. For this the Insurance company takes over paying the providers. Medicare requires that the insurance company meets their standards That is how the Medicare Advantage plans works. If you really think about it, the Medicare Advantage plans are very much like a voucher system. In each case, you choose your insurance company and the government pays for it. The only difference is in a voucher system, the government pays you via a voucher and then you pay the insurance company.


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## John Cummings (Nov 15, 2015)

One other thing. With my MA plan, I can go to any urgent care facility anywhere for $10 and I can go the Emergency Room of any hospital anywhere for $65. If you are admitted to the hospital then the $65 is waived and you don't pay anything. This is great when traveling. My mother had a MA plan and they reimbursed her charges for going to the ER at the Sharp Hospital in Mazatlan Mexico.


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## Fern Modena (Nov 15, 2015)

Whether Medicare Advantage Plans have a premium or not depends on where you live. John's area has some/many/all (don't know) plans with no premium. Not all areas do.

Fern


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## John Cummings (Nov 15, 2015)

Fern Modena said:


> Whether Medicare Advantage Plans have a premium or not depends on where you live. John's area has some/many/all (don't know) plans with no premium. Not all areas do.
> 
> Fern



Fern, as I said before, your location makes a big difference. We have many different plans available with no premium.


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## WinniWoman (Nov 16, 2015)

John Cummings said:


> Fern, as I said before, your location makes a big difference. We have many different plans available with no premium.



WOW! That is unbelievable! I live in NY and I went onto the Medicare page to compare rates of Medigap plans in our area and they came in at over $5000+ per year per person! I do not know about the costs of the Advantage plans, but no one around these parts has mentioned free premiums.

Just doesn't seem right...I guess this is why my elderly friend is dropping her supplement after many years of paying....She just moved from NY to New Jersey (to live with her daughter) although her house in NY did not sell yet. I wonder if she realizes the Medigap and Advantage plan costs are different in each state? Will have to mention it to her.

I have a single 71 year old friend also who is retiring next month and she has been agonizing over the same thing. She lives in Connecticut.  Crazy...

So this is yet another criteria for choosing where to retire......


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## WinniWoman (Nov 16, 2015)

So upon further investigation, it seems that the Medigap policies in John's zip code in California are just as expensive as in NY, so it must be just the Advantage plans that are cheaper or free.


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## rapmarks (Nov 16, 2015)

we have a medicare advantage plan through our state retirement which we pay an additional fee for, $250 deductible, then we pay 20 percent til one thousand out of pocket at which time everything is covered.   PPO and out of network pays the same as in network. this was a plan negotiated by our state with UHC.  We have found UHC very good to work with


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## John Cummings (Nov 16, 2015)

mpumilia said:


> So upon further investigation, it seems that the Medigap policies in John's zip code in California are just as expensive as in NY, so it must be just the Advantage plans that are cheaper or free.



I have not said anything about Medigap policies. I am only referring to Medicare Advantage plans. I have no interest in Medigap polices unless things change.

Medigap policies are NEVER free anywhere.

The title of this thread is "Medicare Advantage vs Medigap policies aka Medicare.


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## John Cummings (Nov 16, 2015)

rapmarks said:


> we have a medicare advantage plan through our state retirement which we pay an additional fee for, $250 deductible, then we pay 20 percent til one thousand out of pocket at which time everything is covered.   PPO and out of network pays the same as in network. this was a plan negotiated by our state with UHC.  We have found UHC very good to work with



My Medicare Advantage plan does not have any deductibles. They pay 100% of all costs with a couple minor exceptions like ambulance.


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## rapmarks (Nov 16, 2015)

John Cummings said:


> My Medicare Advantage plan does not have any deductibles. They pay 100% of all costs with a couple minor exceptions like ambulance.



yes, i read your summary , but we live half a year in one state and half in another, so this works for us.    can you do that with yours?    also we never need a referral for any kind of specialist.  this year I met my thousand deductible on May 6, and have had horrendous bills following that, but no cost to me.


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## John Cummings (Nov 16, 2015)

rapmarks said:


> yes, i read your summary , but we live half a year in one state and half in another, so this works for us.    can you do that with yours?    also we never need a referral for any kind of specialist.  this year I met my thousand deductible on May 6, and have had horrendous bills following that, but no cost to me.



I suppose it could be done by using urgent care and the hospital's ER in the state that was not my primary residence. However it is not something I ever considered as we have no intention to ever live in any other location. There is no reason to want to do that as we have great weather all year and our kids live in California.


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## rapmarks (Nov 16, 2015)

John Cummings said:


> I suppose it could be done by using urgent care and the hospital's ER in the state that was not my primary residence. However it is not something I ever considered as we have no intention to ever live in any other location. There is no reason to want to do that as we have great weather all year and our kids live in California.



that is probably the difference between my plan and yours and why we have to pay a deductible.   It is a plan intended for those who travel and/or are snowbirds.


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## WinniWoman (Nov 16, 2015)

John Cummings said:


> I have not said anything about Medigap policies. I am only referring to Medicare Advantage plans. I have no interest in Medigap polices unless things change.
> 
> Medigap policies are NEVER free anywhere.
> 
> The title of this thread is "Medicare Advantage vs Medigap policies aka Medicare.




Yes, I see that you were talking about Medicare Advantage plans and not Medigap. 

I know what the title of this thread is. Isn't that what we are all talking about?


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## momeason (Nov 18, 2015)

isisdave said:


> momeason, the other Big Thing No One Understands on MA is whether the policy is community-rated (everyone pays the same), issue-age-rated (cost is based on age at signup), or attained-age-rated (just what it sounds like). Where I live, almost all are the last type. But AARP's UHC plan is community rated. This is explained well here.
> 
> I have Blue Shield because I'm 66, it's age-rated here, and they offer a discount for the first 5 years.  At some point, it will no longer be the cheapest game in town ... but most folks won't notice and will just pay the new price.
> 
> ...



MA is Medicare Advantage. Your response is speaking of Medicare Supplements.
There are 3 ways to rate. 
In some states, TransAmerica offers direct sales of Issue Age, you can stay 65 forever..lol

United AARP is Community Rated but it also includes Silver Sneakers- membership to 9000 gyms simultaneously.

The majority of plans are attend age

Hi-Deductible F is less than $40 a month in many states at 65 years old from some carriers ( Medico in NC, for example). High Deductible is only the first $2140 of the gap. Medicare pays 80%, you pay 20% until paying $2140 max out of pocket, then 100% coverage. No networks, use across the country with 80% coverage of Foreign travel emergencies. It beats the pants off any Medicare Advantage plan. 

When looking at copays, co insurance and high out of pocket maximums, Medicare Advantage low premiums are no deal.


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## momeason (Nov 18, 2015)

John Cummings said:


> My Medicare Advantage plan does not have any deductibles. They pay 100% of all costs with a couple minor exceptions like ambulance.



In general, I was not considering State, Federal or Employee Retirement Benefits. 
Those are subsidized by employers. 

I was speaking primarily to those who do not have retirement health benefits and choose from a vast array of options on the individual market.

There are 10 levels of supplements. Hi Deductible F and Plan G are 2 of the better lower cost options. The cadillac plan is F. 

Again there are many carriers in every state and the plan benefits are the same, prices vary tremendously.


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## John Cummings (Nov 18, 2015)

momeason said:


> In general, I was not considering State, Federal or Employee Retirement Benefits.
> Those are subsidized by employers.
> 
> I was speaking primarily to those who do not have retirement health benefits and choose from a vast array of options on the individual market.
> ...



I do NOT have any retirement health benefits at all. I was self employed. I have the standard Healthnet Medicare Advantage Gold Select plan that is available to all seniors residing in Riverside County California.


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## momeason (Nov 19, 2015)

*Medicare Advantage-Advantage not to the consumer*

Medicare Advantage Plans are a very popular choice for many over 65 consumers. The plans are aggressively marketed for 3 reasons:
These plans remove risk and lower costs to the federal government, risks are absorbed by the insurance carriers.
Insurance carriers are in the business of making money. Medicare Advantage Plans must be approved by the Centers for Medicare Services, however, all insurance plans (Health, Life, Homeowners, Auto) are designed to make money for the insurance company offering the plan. Risks versus rewards for each plan offered have been carefully researched by the insurance carrier.

Sales agents push Medicare Advantage because the commission rates for Medicare Advantage plans are double the commission rates for Medicare Supplement policies, also known as Medigap policies.

Original Medicare offers 80/20 coverage to Medicare beneficiaries. There is no maximum or cap that Medicare will pay annually for any one beneficiary. In other words, the cost per beneficiary has no limit. When a Medicare beneficiary enrolls in a Medicare Advantage Plan, that beneficiary is now fully insured by United Healthcare, BCBSNC, Humana or any other approved insurance carrier. The government limits risk by paying a fixed amount per enrollee in a Medicare Advantage Plan. This allows the government to reduce their costs and more effectively budget each year. The risk for the individual Medicare beneficiary is also not capped; there is no out of pocket maximum for the Medicare beneficiaries in Original Medicare. Medicare Advantage Plans and Medigap policies do offer the protection of out of pocket maximums. This why it is important to have either a Medicare Advantage Plan or a Medigap policy. I recommend Medigap plans as a preferred choice for many reasons.

All insurance carriers play a game of averages. Each Medicare Advantage Plan has been carefully designed with the goal of providing service to each enrollee at a profit. Each Medicare Plan offered must meet strict guidelines and be approved by CMS, the Center for Medicare Services. However when a plan ceases to make a profit for the insurance company, the plan is terminated by the insurance company. Remember, CMS pays a fixed amount for each member of a plan. If a plan, over time, enrolls too many members who have a high need for medical services, the plan may no longer be profitable. Since the insurance company only receives a fixed amount for each enrolled member the incentive is to limit care, especially expensive care from specialists. 

Medicare Advantage Plans, like Medicare, are also 80/20 plans. The out of pocket maximum is still relatively high in most MA plans, usually between $4500-$6700 per year. Other disadvantages of Medicare Advantage Plans include limited networks that may drop a favorite doctor or hospital, high copays and limited access to Specialists as well as coverage which is only local or regional. Many MA plans require a referral from a designated Primary Care Physician (PCP) before the plan will pay for the member to visit a Specialist. If the member is allowed to visit a Specialist, the Specialist is chosen by the PCP not by the member. As stated above, commission rates are much higher for Medicare Advantage Plans providing a large incentive for agents to promote these plans rather than Medigap policies.

Medicare Advantage Plans are marketed as having everything you need in one simple plan. The policies operate very similarly to the major medical plans offered to under 65 consumers. Offering low premiums, these health plans are attractive and seem familiar to enrollees. However, many beneficiaries do not understand the richer benefits of Medigap policies. Although the premiums for many Medigap policies are higher than many Medicare Advantage Plans, there are many superior benefits. Any doctor who accepts Medicare will accept any Medigap policy; there are no network restrictions. The plans are good nationwide and several plans even include Foreign Travel insurance. 

There are currently 10 levels of Medicare Supplements. The benefits of each level are established by CMS and are the same from each insurance carrier. Plan F, for example, will pay all the beneficiary’s portion of the costs of any Medicare approved service from a doctor or facility which accepts Medicare in the USA for the rest of one’s life. Plan F even covers 80% of most foreign travel emergencies. All Medigap policies are guaranteed renewable if premiums continue to be paid. Original Medicare pays the first 80%, these supplemental policies fill in the gaps of Medicare. Medigap policies are surprising affordable ($37-$211/month in my state of NC) for the amount of coverage offered. Even the lower level Medigap offer richer benefits including lower annual out of pocket costs, ease of use and nationwide coverage rather than local or regional coverage compared to Medicare Advantage plans with similar premiums. Medicare Supplement Plans offer a great way to budget for future medical needs at a reasonable monthly cost. Plan F, known fondly as the Cadillac plan, will pay 100% of the deductibles and coi insurance for all doctor and hospital charges approved by Medicare.

Advice from a respected independent agent is invaluable in helping a Medicare beneficiary choose the best plan at the lowest cost. An independent agent can also offer advice on purchasing a prescription plan that offers the prescriptions needed at the lowest annual cost. Many new Medicare beneficiaries make the mistake of calling or visiting an exclusive agent who sells plans from only one company, believing the name of the insurance carrier is an important consideration. Actually, because the benefits of Medigap plans are established and regulated by the government, the brand name of the Medigap carrier should be only a minor factor in choosing a Medigap policy. It is best to shop around or visit a trusted advisor, rather than an exclusive sales agent representing only one insurance company.

The optimal time to purchase a Medigap Policy is during the period just before or after one’s 65th birthday or the date one qualifies for Medicare Part B. When purchased in the 6 month window immediately after enrolling in Medicare, no health questions are asked. Acceptance is guaranteed. If a beneficiary waits until he/she has health problems to try to buy a supplement, denial is likely because the individual must pass underwriting.

There is another guaranteed issue period of 63 days following the termination of an enrollee’s Medicare Advantage Plan. Again, in this period, no health questions will be asked. This is a great opportunity to move into a Medicare Supplement. Currently, NC (where I live) has the 3rd highest number of Medicare beneficiaries affected by Medicare Advantage Plan terminations. Other guaranteed issue periods may be triggered by specific events. Email Sherry Eason at sherry@getcoveredwithcare.com you have further questions.


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## WinniWoman (Nov 19, 2015)

Well, I agree that the Medigap plans are better, but,  like I said I checked on line (Plan F and Plan G) and in NY, and NH Medigap plans are $500 + per month per person! This is the issue! That is a lot of money when there are no salaries coming in anymore.

I don't understand how the plans could be so much cheaper elsewhere.


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## John Cummings (Nov 19, 2015)

momeason said:


> Medicare Advantage Plans are a very popular choice for many over 65 consumers. The plans are aggressively marketed for 3 reasons:
> These plans remove risk and lower costs to the federal government, 		risks are absorbed by the insurance carriers.
> Insurance carriers are in the business of making money. Medicare 			Advantage Plans must be approved by the Centers for 			Medicare Services, however, all insurance plans (Health, Life, Homeowners, Auto) are designed to make money for the insurance company offering the plan. Risks versus rewards for each plan offered have been carefully researched by the 			insurance carrier.
> Sales agents push Medicare Advantage because the commission 			rates for Medicare Advantage plans are double the commission rates for Medicare Supplement policies, also known as Medigap policies.
> ...



Would you please put paragraph breaks in your post. It is very difficult to read as is..


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## John Cummings (Nov 19, 2015)

mpumilia said:


> Well, I agree that the Medigap plans are better, but,  like I said I checked on line (Plan F and Plan G) and in NY, and NH Medigap plans are $500 + per month per person! This is the issue! That is a lot of money when there are no salaries coming in anymore.
> 
> I don't understand how the plans could be so much cheaper elsewhere.



You can't say that Medigap plans are better or worse. It all depends on where you live, and what you want. There is absolutely no way that a Medigap policy is better for me because it can't get much better than what I have. We have been big users of our health care so we have a lot of experience with it.

Medicare Advantage plans work the best in areas with a large subscriber base and large provider network. That is why they are very good in Southern California. There is a great deal of competition here with several plans offered by many insurance companies. Some are non-profit and some aren't. Then of course we have Kaiser Permanente which has a 5 star rating which also offers an MA plan.

The point is that you cannot make a generalization that one is better than the other. Maybe where you live, Medigap would be the best and where I live an MA is preferable.

We are very fortunate to have a lot of medical facilities for our population. There are 4 hospitals within 15 minutes of my home, Surgical outpatient centers, skilled nursing facilities etc., etc. Two of the hospitals are pretty new.

Medigap policies cost over twice as much where you live. We have many options for medigap policies that range in cost from $21.00 to $372.00 /month for a Cadillac plan. There are several options for each category. There are various premiums for F and G plans from $21 - 267 and there are additional categories of K, L, M. and N plans as well as the A, B, and C ones. The $372 plan covers absolutely everything with no deductibles and 100% coverage.

Again it is a matter of competition.

As a side note, my sister is also a senior that lives in British Columbia Canada. We often compare notes and there is no question that My Medicare advantage plan is far superior to their government healthcare as mine covers many things that are not covered by hers. Also they have tremendous waits to see specialists, get CT scans, MRIs etc. She needs a knee replacement and will have to wait at least 2 years before it can be done.


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## isisdave (Nov 19, 2015)

mpumilia said:


> Well, I agree that the Medigap plans are better, but,  like I said I checked on line (Plan F and Plan G) and in NY, and NH Medigap plans are $500 + per month per person! This is the issue! That is a lot of money when there are no salaries coming in anymore.
> 
> I don't understand how the plans could be so much cheaper elsewhere.



Mary Ann,

I went to the AARP UHC Medicare Supplement page and used their pricing tool with zip 12566, and plan F was $209 and Plan N $143 using ages of 66 and 76. They don't offer plan G in New York.

But looking at Mutual of Omaha, F is $352 (68% more); G is $283; they don't offer N. So you see the price varies a lot from one company to another for the very same product.

It looks like ALL companies in New York have community-rated pricing (same for all ages). Can you tell us what company/companies  you were looking at?

Unless you have frequent doctor visits, plan N is a good deal. Basically the same as F if your doctor accepts assignment, except they don't pay the annual deductible of $166, and there's a $20 copay for SOME doctor visits.

Get an independent agent to help you navigate this.  The AARP plan is community-rated, meaning everyone pays the same regardless of age. Other (age-rated) plans will cost more as you get older. BUT THEY ALL HAVE THE SAME COVERAGE -- that is, Plan F has the same benefits regardless of what company sells it to you.

There is a good table for comparing all the plans here.

Good luck.


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## Talent312 (Nov 19, 2015)

John Cummings said:


> Would you please put paragraph breaks in your post. It is very difficult to read as is.



I second that motion.
My tired eyes simply won't go more than 5 lines into a lengthy post w/o any white-space.
.


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## momeason (Nov 19, 2015)

mpumilia said:


> Well, I agree that the Medigap plans are better, but,  like I said I checked on line (Plan F and Plan G) and in NY, and NH Medigap plans are $500 + per month per person! This is the issue! That is a lot of money when there are no salaries coming in anymore.
> 
> I don't understand how the plans could be so much cheaper elsewhere.



Are you over 65?
If you are under 65, the rates are much higher.

Send me your zip codes, county and state and your ages and let me check for you.
I am not licensed in your state but I certainly know how to check rates.


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## momeason (Nov 19, 2015)

isisdave said:


> Mary Ann,
> 
> I went to the AARP UHC Medicare Supplement page and used their pricing tool with zip 12566, and plan F was $209 and Plan N $143 using ages of 66 and 76. They don't offer plan G in New York.
> 
> ...



N is not the same as F because it does not cover excess charges. Many doctors in my region do not accept assignment so many do charge excess charges. Across the country there is a shortage of primary physicians. To save money, Hi-Deductible F is an option. The premiums are very low.  The beneficiary would still have much lower out of pocket maximum than any MA plans in my region. Of course, if a beneficiary is dual eligible for Medicare and Medicaid, that individual would not need a Medicare Supplement or a Medicare Supplement.


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## John Cummings (Nov 19, 2015)

If you go to Medicare.gov you can check the rates, coverages, etc. for all the different plans in your zipcode.


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## isisdave (Nov 20, 2015)

>>N is not the same as F because it does not cover excess charges. <<

momeason,

>>Basically the same as F *if your doctor accepts assignment*<<

Isn't it true that if a doctor accepts assignment, he can't make excess charges?

Hardly anyone does a "what-if" analysis on these.  If your doc charges 15% extra on three office visits a year, it's not a big deal, and you'll come out ahead with the cheaper plan. If your heart surgeon marks up your valve replacement 15%, it's another matter. 

But, as with most insurance, without your crystal ball it's hard to tell what to buy!


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## John Cummings (Nov 20, 2015)

isisdave said:


> >>N is not the same as F because it does not cover excess charges. <<
> 
> momeason,
> 
> ...



I believe you are referring to "balance billing" which is not allowed if the doctor agrees to take the assignment. This happened to me a few years ago. I contacted my insurance company and they informed the doctor that it was not allowed.


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## WinniWoman (Nov 20, 2015)

isisdave said:


> Mary Ann,
> 
> I went to the AARP UHC Medicare Supplement page and used their pricing tool with zip 12566, and plan F was $209 and Plan N $143 using ages of 66 and 76. They don't offer plan G in New York.
> 
> ...



Thank you so much, Dave! I went on the Medicare.gov page and I must be doing something wrong or I am just not reading it the right way. I will have to look at the AARP page- I am not a member. When I have more time I will go on the sites and try again.


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## WinniWoman (Nov 20, 2015)

momeason said:


> Are you over 65?
> If you are under 65, the rates are much higher.
> 
> Send me your zip codes, county and state and your ages and let me check for you.
> I am not licensed in your state but I certainly know how to check rates.




LOL! Not yet. My husband is 62 and I am 59 but I am gathering information so that I understand everything for when my husband is ready. I am also trying to help an elderly friend.

I just must be doing something wrong when I go on the page (from the link). I thought I saw rates like $5000 per year! LOL! I will look at it again.


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## isisdave (Nov 20, 2015)

This is probably what is happening. When you go there, put in dates that make you at least 65.


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## momeason (Nov 28, 2015)

mpumilia said:


> PS I heard the G plan is just as good as the F plan, but less expensive?
> 
> And- can't people just enroll on-line for these plans? Why would they need an agent at all?



There are a vast number of insurance carriers with large differences in price and financial stability and the different plan levels are confusing. I am licensed in 3 states. For example, in one state, Mutual of Omaha is a great deal, in the other two states not so much. A good independent agent can help you enroll in the plan that best meets your needs and budget. It does not cost you to get advice and shop. One of my new clients enrolled online at Medicare Mall 3 years ago. She is eligible for Extra Help, no one told her. She also was not told about needing a prescription plan. She has not had one for 3 years. Luckily since I discovered and helped her start the process for help, she will get a prescription plan and not pay the penalty. She also will get her part B premium and her Part D premium paid and low cost drugs. Visiting me, an individual agent, saved her over $200/mo.

There are bad agents but some of us offer much needed expertise. Not usually the online sales people though.


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## momeason (Nov 28, 2015)

John Cummings said:


> I believe you are referring to "balance billing" which is not allowed if the doctor agrees to take the assignment. This happened to me a few years ago. I contacted my insurance company and they informed the doctor that it was not allowed.



I am referring to allowed excess charges which are not rare at all and are becoming more common every day.


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## momeason (Nov 28, 2015)

Passepartout said:


> Look, if you can't afford a supplement, just take basic Medicare after age 65. $104 pp a month, withdrawn from your SS. If you are reasonably healthy and don't take a lot of meds, you can save a lot of money. And no one forces you to live in a jurisdiction with expensive schools and high property taxes. Move to 'tax haven' New Hampshire.



High Deductible F is very reasonable and protects you from unlimited out of pocket expenses. I would never go without any out of pocket limits with just original Medicare.


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## Glynda (Dec 3, 2015)

*Medigap and RX*

I have an AARP United Health Medigap F plan and an AARP UH RX plan.  The RX plan is not going to cover four of my expensive drugs in 2016.  I've spent hours on medicare.gov trying to compare drug plans but the site does not seem to recognize my Medigap plan. Am I to compare as if I have just Original Medicare and a drug plan?  I've tried each method...just my zip or my personal information...both having my drugs listed.  Each comes back with very different results.  Yes, I've waited till the last minute.


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## simpsontruckdriver (Dec 3, 2015)

This is my article on Medicare. Technically, I am still a licensed Health Insurance agent, but since I am not appointed (changed career), I can only advise, not sell. The numbers between this article and current numbers may change. And yes, I can find you a local agent if you need.

Medicare

TS


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## Glynda (Dec 4, 2015)

*Thread*



simpsontruckdriver said:


> This is my article on Medicare. Technically, I am still a licensed Health Insurance agent, but since I am not appointed (changed career), I can only advise, not sell. The numbers between this article and current numbers may change. And yes, I can find you a local agent if you need.
> 
> Medicare
> 
> TS



Good thread!  Thanks.  I'm going to get on the phone with Medicare again today.  They sent me to AARP yesterday but that really wasn't what I needed either.  I think I can word my questions better today. The search results are confusing me as I'm not sure each of the two methods is taking the same facts into consideration.


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## simpsontruckdriver (Dec 5, 2015)

AARP Medicare is United Healthcare, but an independent agent would be a better person to talk to. If you call them (AARP Medicare), you're talking to licensed insurance agents appointed ONLY with UHC.

In terms of Medicare Supplements, I used to be appointed with United American, their High-Deductible F (HDF) plan was HALF the cost of United Healthcare. With the HDF, you pay around $65/month (in addition to Part-B premium), pay the Part-B deductible then pay 20%, and/or Part-A copays. Once your out-of-pocket reaches the HDF's deductible, you pay $0. Would the AARP agent have that info? Yes and no, they have access to Medicare, but being a Captive Agent, they can not discuss it.

TS


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## Glynda (Dec 6, 2015)

*Solved one problem!*



simpsontruckdriver said:


> AARP Medicare is United Healthcare, but an independent agent would be a better person to talk to. If you call them (AARP Medicare), you're talking to licensed insurance agents appointed ONLY with UHC.
> 
> In terms of Medicare Supplements, I used to be appointed with United American, their High-Deductible F (HDF) plan was HALF the cost of United Healthcare. With the HDF, you pay around $65/month (in addition to Part-B premium), pay the Part-B deductible then pay 20%, and/or Part-A copays. Once your out-of-pocket reaches the HDF's deductible, you pay $0. Would the AARP agent have that info? Yes and no, they have access to Medicare, but being a Captive Agent, they can not discuss it.
> 
> TS



I do understand that.  My problem on comparing drug coverage on the medicare.gov site turned out to be glitch that I finally recognized.  Two calls to them and one to AARP were of little help.  While I had updated my drug list and imported the new ID number and date into my search and the site was showing my current drug list, it was actually estimating my drug costs based on an old ID number and date drug list.  I knew the figure was wrong. The Medicare agent just kept saying "I'm sorry." and wanted to proceed to point out another policy based on false results. Later I saw the old ID number was being used even though a list of current drugs was showing. Got that fixed and moved on to a new drug plan. Spent the better part of a day and a half over that!

Thanks for the information!


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## WinniWoman (Dec 6, 2015)

Can you imagine the very elderly having to deal with all of this nonsense?


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## Glynda (Dec 6, 2015)

*No!*



mpumilia said:


> Can you imagine the very elderly having to deal with all of this nonsense?




I _FELT_ very elderly there for a bit! I knew it couldn't be right as I got different results from when I hand typed in the current drug list from when I imported that same drug list back in to use again but no one could tell me why or what to do about it.  I was about to give up when I spied that the site was pulling up the right drugs in the list but the wrong ID number and realized that the low estimate had to be based upon the fewer, and less expensive, drugs listed in the earlier list. ARGH!  It is not easy even when it's working!  A lot of reading and studying is necessary or someone you trust to guide you.  Obviously, the people I got on the phone didn't know.


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## WinniWoman (Dec 6, 2015)

Glynda said:


> I _FELT_ very elderly there for a bit! I knew it couldn't be right as I got different results from when I hand typed in the current drug list from when I imported that same drug list back in to use again but no one could tell me why or what to do about it.  I was about to give up when I spied that the site was pulling up the right drugs in the list but the wrong ID number and realized that the low estimate had to be based upon the fewer, and less expensive, drugs listed in the earlier list. ARGH!  It is not easy even when it's working!  A lot of reading and studying is necessary or someone you trust to guide you.  Obviously, the people I got on the phone didn't know.



This is what goes on. As complicated as it is for us to understand the people that work there know even less than we do!

I find this to be the case on many areas of life! Ugh!


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## vacationhopeful (Dec 6, 2015)

mpumilia said:


> Can you imagine the very elderly having to deal with all of this nonsense?



Really .. the Affordable Care Act is just as bad, IMHO.


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## WinniWoman (Dec 6, 2015)

vacationhopeful said:


> Really .. the Affordable Care Act is just as bad, IMHO.



Agree with you, Linda.


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## momeason (Dec 6, 2015)

On Medicare.gov to search for a plan to cover all your drugs, You need to check Original Medicare as your coverage. (Your Medigap policy does not cover prescriptions.) Check that you want to look at prescription plans only. Then just list the prescriptions you take and what pharmacy you wish to use. Call me if you have problems  910-750-2605. I can do it for you.

You can always do a general search without name if you are having trouble with your list.

Tomorrow, 12/7 is the deadline for changes to your prescription plan for 2016


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## Glynda (Dec 7, 2015)

*Thanks!*



momeason said:


> On Medicare.gov to search for a plan to cover all your drugs, You need to check Original Medicare as your coverage. (Your Medigap policy does not cover prescriptions.) Check that you want to look at prescription plans only. Then just list the prescriptions you take and what pharmacy you wish to use. Call me if you have problems  910-750-2605. I can do it for you.
> 
> You can always do a general search without name if you are having trouble with your list.
> 
> Tomorrow, 12/7 is the deadline for changes to your prescription plan for 2016




Thanks.  Went through both processes numerous times.  Both the "General Search" and "Personalized Search" options.  Tried both hand typing in drugs and importing same list by its ID number and date.  I checked "Drug plans with Original Medicare."  And chose pharmacies. 

My problem was a glitch with the site apparently as it kept using an older ID number to estimate drug costs though I could see new drugs listed. Once I figured that out myself, I was able to get it fixed and compare plans and enroll in a new one.  It was just frustrating that I had to spend most of a day and a half and long hold phone calls only to find the problem myself in the end as they did not catch it.

I appreciate your willingness to share and help!


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## Miss Marty (Dec 7, 2015)

*Medicare - Medigap - VA and more*

*
National Council on Aging 
Webinar Videos on Vimeo *

https://vimeo.com/channels/ncboe


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## momeason (Dec 12, 2015)

simpsontruckdriver said:


> AARP Medicare is United Healthcare, but an independent agent would be a better person to talk to. If you call them (AARP Medicare), you're talking to licensed insurance agents appointed ONLY with UHC.
> 
> In terms of Medicare Supplements, I used to be appointed with United American, their High-Deductible F (HDF) plan was HALF the cost of United Healthcare. With the HDF, you pay around $65/month (in addition to Part-B premium), pay the Part-B deductible then pay 20%, and/or Part-A copays. Once your out-of-pocket reaches the HDF's deductible, you pay $0. Would the AARP agent have that info? Yes and no, they have access to Medicare, but being a Captive Agent, they can not discuss it.
> 
> TS



Absolutely right. I am a very independent agent, licensed and appointed  in NC, SC and VA with many carriers.
Medicare is not supposed to recommend anything. When you call any particular company, they will try to sell you only what they sell and what earns the highest commission. I do not favor any one company but give you the low down on each, pros and cons.
This is one of my business numbers. It is already public. 910-750-2605..call or text if you have questions. I am a consumer advocate. I fix problems and offer free assistance all the time. You can find my site with lots of free tips on Facebook. Call or text me if you want free expert help. I help lots of people who already have coverage..kind of like TUG except for health plans...lol


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