Medicare Annual Enrollment Period coming up!

[bogey21]

So a gamble that you remain healthy for most of your life and save on the premiums. I understand. I was considering it for my husband, but that $2300 deductible bothers me. Plus, they could increase the deductible over time?

The deductible has in fact increased almost every year but the money I have saved over the 10 years of so I have had the plan has been significant. I'm guessing but I think if my health starts heading South I can switch to Plan G...

George

 

[WinniWoman]

The deductible has in fact increased almost every year but the money I have saved over the 10 years of so I have had the plan has been significant. I'm guessing but I think if my health starts heading South I can switch to Plan G...

George

When you switch don't you have to undergo underwriting?

 

[bogey21]

When you switch don't you have to undergo underwriting?

I don't know. My guess, purely a guess, is I don't if I stay with the same company. But I could be way off base here...

George

 

[Luanne]

When you switch don't you have to undergo underwriting?

I need a better understanding of what all underwriting entails. I've had to go through a series of questions when I've changed carriers (but not plans) the last two years.

 

[WinniWoman]

I don't know. My guess, purely a guess, is I don't if I stay with the same company. But I could be way off base here...

George

I think you are right. A new company will ask questions for their underwriting and that will determine the premium. I also read somewhere that you can downgrade from a plan (like an F to a G) but not upgrade.

Craziness...my brain has been on overdrive for days. LOL!

 

[Talent312]

I haven't seen a Plan D plan with a reasonable premium that covers expensive brand-name drugs well. For those with the $435 standard deductible, I'd pay that p-front in January, with a total cost of ~$1100/year.

I'g gonna see if an Advantage Plan can provide better coverage.
The drug may go generic in 2022, so maybe I should tuff it out.
.

 

[Luanne]

I think you are right. A new company will ask questions for their underwriting and that will determine the premium. I also read somewhere that you can downgrade from a plan (like an F to a G) but not upgrade.

Craziness...my brain has been on overdrive for days. LOL!

I can't seem to find anything that talks about whether or not you can upgrade. Everything I've seen just talks about changing Medigap plans.

 

[WinniWoman]

I can't seem to find anything that talks about whether or not you can upgrade. Everything I've seen just talks about changing Medigap plans.

I cannot remember where I read it. I have been reading so much about this these past few days I am going loony.

 

[simpsontruckdriver]

Underwriting is ONLY if you are changing MediGap plans between AEPs (between January 1 and October 14). When turning 65 or during AEP, you can join or up/downgrade MediGap without underwriting. If you disenroll from an MAPD plan during Open Enrollment (January 1 - March 31), you won't have to go through underwriting. Underwriting is similar to older Group Plans, with pre-existing conditions not covered (MediGap plans outside Annual Enrollment Periods are exempt from the Affordable Care Act ban on pre-existing conditions).

Essentially, just do like MAPD plans and enroll/change during AEP or certain Special Enrollment Periods (SEPs), and you won't have any concerns with underwriting.

TS

 

[simpsontruckdriver]

I cannot remember where I read it. I have been reading so much about this these past few days I am going loony.

Yeah, but on the other hand, everyone who has questions about Medicare in 2020 are getting their questions answered!

TS

 

[DancingWaters]

We have just went through these supplemental choices the last 4 months and I read everything and called everyone asking questions so I would make the best choice.. I went with my retirement supplemental—-only time will tell if I made the right choice. My husband went and talked to 1 insurance lady and signed up for the G plan with a company that has Silver Sneakers. I was shocked since he hates to exercise and shocked he made his decision so effortlessly. Should he have picked the F Plan?

 

[WinniWoman]

We have just went through these supplemental choices the last 4 months and I read everything and called everyone asking questions so I would make the best choice.. I went with my retirement supplemental—-only time will tell if I made the right choice. My husband went and talked to 1 insurance lady and signed up for the G plan with a company that has Silver Sneakers. I was shocked since he hates to exercise and shocked he made his decision so effortlessly. Should he have picked the F Plan?

That is what we are trying to decide. As for what the insurance company offers- like Silver Sneakers- I can't even see where that information is online.

And not for anything, but with VIA Benefits- only a couple of insurance companies come up! Not like there are lots of choices! But I do have an appt. with Via Benefits in a couple of weeks so I can ask about that as well.

 

[DancingWaters]

Hmmm, what are VIA Benefits? My husband went with Anthem BC/BS for his plan G. (They had the silver sneakers he wanted) In Ohio it was $118 @ month. Then he went with WellCare for his prescriptions since he’s only on one cheap pill. That costs $15 @ month, but I can’t remember his deductible on that. He’s then is waiting a year to get dental and vision insurance since he just had all those appointments under his work. I also have the silver sneakers and use the YMCA a couple times a week for an aqua ice class and aqua Zumba. Hopefully we are both covered medically. Moving toward getting a few other things in order. Time consuming decisions for sure.

 

[WinniWoman]

Hmmm, what are VIA Benefits? My husband went with Anthem BC/BS for his plan G. (They had the silver sneakers he wanted) In Ohio it was $118 @ month. Then he went with WellCare for his prescriptions since he’s only on one cheap pill. That costs $15 @ month, but I can’t remember his deductible on that. He’s then is waiting a year to get dental and vision insurance since he just had all those appointments under his work. I also have the silver sneakers and use the YMCA a couple times a week for an aqua ice class and aqua Zumba. Hopefully we are both covered medically. Moving toward getting a few other things in order. Time consuming decisions for sure.

VIA Benefits is essentially a broker that his employer uses but anyone can use. The benefit for us going through them is his employer will deposit $60 per month in a HRA for him (and me when I turn 65 and am on Medicare and go through VIA benefits for my plan- so $120 per month total.)

Also- Each state has different insurance companies for these Medigap policies. For example- NY does not have Anthem, but NH does. This is what is making things difficult for us to decide. Can we switch- let's say- to Anthem in NH when we move since Empire Blue Cross is not in NH? NY has Humana and NH has Humana- but in NY- the Humana plans are much more expensive since they are not community rated from what I can tell. Should we go with them anyway since we want to switch when we move? Will Humana then lower the rate we pay? NH Medigap policies are cheaper.

I don't care much about things like Silver Sneakers, though I have a friend that loves it. I am not even sure where/if one is held where we are moving. To me good medical coverage is the priority. I have exercise equipment at home and can take walks. But I would like to join a class or a gym- just doesn't seem to be any close by where we are going to live.

It doesn't matter which insurance company you go with except for the rates, since all the Medigap plans are the same.

Yeah- we are probably picking the Wellcare plan-though it is really hard to compare these drug plans, but moving to NH we will have to start over with another one. We never take vision insurance and we will not be taking dental insurance unless I see something great on the market- which I doubt exists with dental. I know the dental Cobra was very expensive, like $80 per month for the 2 of us.

It's crazy because by the time we get this insurance we will most likely be moving- probably in January or February and then have to change.

 

[simpsontruckdriver]

You mentioned only BCBS and Humana. I am pretty sure United Healthcare/AARP MediGap policies are available in most of the United States. Anyway, for those who have a Medicare Supplement plan in any state except Massachusetts or Wisconsin, this article may help you decide. Essentially, call your MediGap plan for information.

TS

 

[MULTIZ321]

VIA Benefits is essentially a broker that his employer uses but anyone can use. The benefit for us going through them is his employer will deposit $60 per month in a HRA for him (and me when I turn 65 and am on Medicare and go through VIA benefits for my plan- so $120 per month total.)

Also- Each state has different insurance companies for these Medigap policies. For example- NY does not have Anthem, but NH does. This is what is making things difficult for us to decide. Can we switch- let's say- to Anthem in NH when we move since Empire Blue Cross is not in NH? NY has Humana and NH has Humana- but in NY- the Humana plans are much more expensive since they are not community rated from what I can tell. Should we go with them anyway since we want to switch when we move? Will Humana then lower the rate we pay? NH Medigap policies are cheaper.

I don't care much about things like Silver Sneakers, though I have a friend that loves it. I am not even sure where/if one is held where we are moving. To me good medical coverage is the priority. I have exercise equipment at home and can take walks. But I would like to join a class or a gym- just doesn't seem to be any close by where we are going to live.

It doesn't matter which insurance company you go with except for the rates, since all the Medigap plans are the same.

Yeah- we are probably picking the Wellcare plan-though it is really hard to compare these drug plans, but moving to NH we will have to start over with another one. We never take vision insurance and we will not be taking dental insurance unless I see something great on the market- which I doubt exists with dental. I know the dental Cobra was very expensive, like $80 per month for the 2 of us.

It's crazy because by the time we get this insurance we will most likely be moving- probably in January or February and then have to change.

Hi MaryAnn,

It seems to me you should be able to get answers to these questions if you talk to a licensed insurance agent. A phone number is listed in the article about moving out of state posted by SimpsonTruckdriver in the next post.


Richard

 

[WinniWoman]

Hi MaryAnn,

It seems to me you should be able to get answers to these questions if you talk to a licensed insurance agent. A phone number is listed in the article about moving out of state posted by SimpsonTruckdriver in the next post.


Richard

Yes. I did mention in another post that I have an appt. with them in a few weeks.

 

[WinniWoman]

You mentioned only BCBS and Humana. I am pretty sure United Healthcare/AARP MediGap policies are available in most of the United States. Anyway, for those who have a Medicare Supplement plan in any state except Massachusetts or Wisconsin, this article may help you decide. Essentially, call your MediGap plan for information.

TS

I mentioned them because that is what VIA benefits offers for the F and G plans and others- 9 plans altogether for supplements. (BTW- the price of BCBS is the same as AARP United Healthcare in NY.) Again- we are usign Via Benefits because then my husbands employer will contribute to an HRA for us every month.

 

[coachBoris]

One TINY tidbit of politics. A week or so, President Trump stated in "heaven's waiting room" (The Villages in Florida) that he is signing an executive order increasing plans and dropping prices for 2020. The problem is, at least one of the providers I sell dropped prices and increased plans in July! It's best to listen to an agent, NOT politicians.

Anyway, it's time to sit down with an agent. AEP starts on October 15, but you can talk to an agent beforehand to go over what is new and such. You can enroll in a plan then, then if you change your mind find another, repeating if needed, but the plan you're "stuck with" is the one that you're enrolled in on December 7th at 23:59:59. Where I live/sell (Orlando area), I have insurers who sell Preferred Provider Organizations (PPO) for $0 premiums, in addition to HMOs and Medicare Supplements.

TS

You seem to know a lot about this subject. I am only 58 and retired Army so I will have Tricare for Life and believe I have to enroll in Medicare Part B. Can you explain options for retired military? I like to be informed and plan ahead. Currently I have Tricare Prime and a supplemental group plan for copays through the Military Officers Association of America (MOAA), works great for my wife (49) and I (58).

 

[simpsontruckdriver]

Well, a lot can change in the next 7 years. In terms of medical, when you hit 64 years 9 months (or 3 months before your 65th birthday), talk to your TriCare benefits person. Right now, some veterans who have VA benefits take Medicare Parts A & B, then they take just a Medicare Advantage plan without drugs. In that respect, they go to any private Medicare doctor, but let the VA take care of the prescriptions. On the other hand, if your Tricare benefits match or exceed Medicare benefits for less, you don't have to take Medicare.

TS

 

[csxjohn]

I chose to go with a UHC Medicare Advantage plan. It costs me about $21 per month. I'm now 72 so its been 7 years of payments. When we looked at the costs we factored in that we are both very healthy and seldom see doctors for problems knowing that may change in the future. Over those 7 years my monthly payments would have been much higher than what I've spent had I gone with a supplement plan.

With my plan I have an out of pocket maximum of around $3,600 to $3,900. When looking at the monthly cost of a medicare supplement plan plus a drug plan we felt this would end up being cheaper. I pay $5 for my Primary Care Physician and $25 for specialists.

I had two total knee replacements last year. The total amount I paid the hospital and doctor was $900 total for both and another $600 for physical therapy sessions so under $2,000 total, not even close to the $3,600.

So for me the advantage plan is way cheaper then paying the high monthly costs for the supplement plans. Plus my drugs are included as well as eye care and dental. I also get free rec center visits and UHC gives us $320 per year to purchase health care products from them. This includes thinks like canes, toilet seats, bathtub grab rails, bandages and band aids, ibuprofen, sea sick pills, hand lotion and a whole slew of things like that.

So for my circumstances the advantage plan is much more cost effective. The supplement plans would have been over $2,400 per year so we gambled that we would not pay over that the majority of the years. I don't recall the exact amount we would have been paying but it just seemed to us that worst case we might have to pay more in some years but the other years would make up for it

It's has worked out to our advantage so far.

 

[bogey21]

No question that Medicare Advantage is cheaper. I go the traditional Medicare, Supplement, Plan D route to have maximum flexibility but I pay more for it. Why do I do it? Because the cost difference is not important to me. To each his own...

George

 

[csxjohn]

No question that Medicare Advantage is cheaper. I go the traditional Medicare, Supplement, Plan D route to have maximum flexibility but I pay more for it. Why do I do it? Because the cost difference is not important to me. To each his own...

George

Exactly, everyone's situation is different. I wasn't trying to convince anyone how to go, just what I did and why.

 

[VacationForever]

My husband has Aetna Medicare Advantage Select PPO and it is working out very well. We have not found any doctor or specialist who is not in the network. It also covers out of state local PPO network, as well as overseas medical care if necessary, but we buy a medical and evacuation separate policy for the latter, regardless.

It includes a $75 per quarter OTC medical allowance, Silver Sneakers and twice a year dental cleaning and dental coverage up to $1000. His premium is $67 per month for this year and next year it is going to $70+ per month.

 

[simpsontruckdriver]

In terms of Medicare Advantage plans, they vary by zip code. For instance, I am working with a disabled (under-65) woman in Spokane WA to find her a good Medicare Advantage plan. Here in the Orlando area, she could get a Humana PPO for $0 premium, and because her meds are all generic, she could pay $0 for medicines with mail-order. Out there, PPOs from Humana and Aetna have a $100-ish/month premium. HMOs are inexpensive, but her doctors are not in the Humana network, only a couple take United Healthcare, and most take Aetna. Her only specialists are Ob/Gyn, chiropractor, and psychiatrist (neither require a referral). All plans from my 3 plans pay for mental health care.

Or, my sister-in-law who lives in Thousand Oaks CA is now Medicare-eligible. If she joined up with any of "my" Medicare Advantage plans, she would have an additional premium HMO. There are no PPOs in that part of Southern California, even in plans that I do not offer.

Or, I had a Medicare-eligible guy ask me a couple years ago about Mount Shasta CA. They do not have one single MAPD. They're only eligible for a Medicare Supplement + PDP. He was on our company's HSA plan and is not retired. The reason is, his area had a PFFS (Paid Fee For Service) plan through United, but they stopped offering it. PFFS is like a PPO, they can go to any doctor who accepts Medicare, BUT the doctor can deny that one plan if they choose.

So, if you look at any posts of people here saying they have x benefits with their MAPD with a certain company, your area's benefits are most likely different.

TS