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Medicare Advantage vs. Medigap policies aka Medicare Supplement plans

John Cummings

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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

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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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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.
 

WinniWoman

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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

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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.
 

rapmarks

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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
 

John Cummings

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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.
 

John Cummings

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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.
 

rapmarks

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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

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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.
 

rapmarks

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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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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? :shrug:
 

momeason

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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.

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.
 

momeason

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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.
 

John Cummings

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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.

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.
 

momeason

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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

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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.
 

John Cummings

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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) 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. 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.

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

John Cummings

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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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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

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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.
.
 

momeason

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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.
 

momeason

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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.

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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isisdave

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>>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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