Medigap or Medicare Advantage Plan?

I have a great Medicare Advantage plan. It's tied to our biggest and best hospital and healthcare group, and with a huge network of providers. I don't pay anything for it, except the regular Medicare premium. Low co-payments and great coverage. I wouldn't consider anything else.
 
Medicare Advantage for myself. It's no charge with Medicare, and it works for me. I'm not dealing with any health issues at present and don't want to pay for something I don't need.
On the other hand, Medigap can get very expensive. My late husband had to have that coverage due to heart issues and he could only see his heart specialists thru Medigap coverage. ..
So for me, it all comes down to what kind of coverage do you need, and how much do you want to pay for it.
 

Are there any other 64-year-olds on SF trying to sort this stuff out? I find it very confusing . . . :confused:
 
My husband is Glinda, and also needs to find out certain things before he enrolls in Medicare. We're both on Kaiser plans in the ACA, so that will need to be handled also. He plans to use a Medicare supplement plan from Kaiser. But he hasn't begun to research, getting a lot of offers in the junk mail though, funny how many people know how old you are.

Guess we'll be applying for ACA separately this time, as I'm not Medicare age yet. We used a free agent for the Affordable Care Act plan last year, since we had some bumps with the website, she's already contacted us to say she'll help us do what's necessary when we see her again.
 
I have a Medicare Advantage, and I really like it. My co-pays are low, and it covers a fitness membership with Silver and Fit, so we can go to the fitness center as often as we want to. I enjoy the swimming and cardio exercises, but they also have a complete fitness center with all of the workout machines here.
If you live in a place where there is no fitness center close, or are not interested in that; then this feature would not help you much, but otherwise, it is terrific.
I totally recommend finding an independant agent when you choose your supplement.
It is like going to the grocery store for a can of beans. The beans are all the same, but each store will charge a different price for the same item.
An independant agent can find out what your needs are, and then find the company that offers that plan for the best price.

Agents are not allowed to discuss Advantage plans unless you ask about them, so when you talk to an agent, be sure to ask about the advantage plans as well as the regular medicare supplement plans.
 
SeaBreeze, I'm in this same place. My wife and I have ACA insurance , I'm 64 she will be 59 soon. Lots to learn about this, I hope to find an ACA navigator soon to help us and my CPA.
 
I would say don't fail to check into the Advantage plans. Many are wonderful, some not so much so. Mine falls into the wonderful category, but is only available here, because it is tied to a large hospital and huge medical group.
 
We have had Medicare Advantage with 3 different companies in 2 different states. Never had a reason to consider medigap.

I went from a regular HMO when I was working to the same coverage under Cobra, to Medicare Advantage when I turned 65.
 
I just like the idea of being able to see any doctor or go to any hospital... I don't like the restrictions of an HMO.. which is what Medicare Advantage is. It's not Medicare.. it's private insurance, and they will call the shots.
 
Ken N Tx said:
View attachment 21583..Do your homework!!!
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Over the years, I have seen far to many families surprised when medical care was refused at the hospital they were taken to. For example.. Grandma falls and breaks her hip. She is taken to the nearest hospital. The family is shocked to hear that Grandma has to be transported clear across town for her hip surgery. "But She has Medicare!!" they say. Sadly, I have had to inform them that even though she has a Medicare card, and pays her premiums... she does NOT have Medicare. She has a private HMO and they will decide exactly where she will receive care... and by who.

As you said Ken... people need to do their homework.. If they are happy limiting themselves to the doctor and the hospital covered under their plan.. then that's fine.. They need to understand that they cannot go anywhere else or see any doctor they choose as they can with traditional Medicare. These plans sound very good.. but as you said.. folks need to know what they are getting before they sign away their Medicare.

That said... I don't think HMO's are all bad.. Usually they cost less. Some of the plans have no co-pay or offer prescription drugs. If you know for certain you can limit your healthcare to their preferred providers and are happy with the choices given, then the Advantage plans are fine.
 
I'm really confused!!! (Wife says I have been for many years!) We both currently covered under each of our employer's medical group plans. It appears we will both be finally retiring at the end of 2015. So, we need to pick up our "Part B" and "Part F"... or at least that's what I thought. It appears the Part F covers all the deductibles from Part A and Part B, so has very little out of pocket. Part F is available in a Medicare Advantage plan and that is the direction we planned on heading.

Now, a couple posters said their Advantage plans cost them nothing. Huh??!!?? I've priced a number of the Advantage plans and they run from ~$130/month and up. Part B is a standard cost item which is around $115/month. So, I assumed we would be out the $115... the $130... and our Part D (Prescription Plan), $40 for a total of about $300/month for each of us.

Where have I erred in that analysis? How do I find Advantage plans that have zero cost??
 
I also plan to retire at the end of next year. At that point I will pick up Medicare part B and also purchase a Blue Cross Medicare supplement to pick up everything part A and B do not.. I will still have traditional Medicare and be able to go anywhere and see any doctor I choose.
 
QuickSilver said:
I also plan to retire at the end of next year. At that point I will pick up Medicare part B and also purchase a Blue Cross Medicare supplement to pick up everything part A and B do not.. I will still have traditional Medicare and be able to go anywhere and see any doctor I choose.
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The above is what my 94 year young MIL has. She pays $203 a Month for the BC&BSof Illinois. Has United Healthcare for drug plan, not sure what the premium amount is as it is deducted by MC.

She does not pay any deductibles or Co-pays to anyone.

She has had these plans for YEARS and we are well pleased..
 
Grumpy Ol' Man said:
I'm really confused!!! (Wife says I have been for many years!) We both currently covered under each of our employer's medical group plans. It appears we will both be finally retiring at the end of 2015. So, we need to pick up our "Part B" and "Part F"... or at least that's what I thought. It appears the Part F covers all the deductibles from Part A and Part B, so has very little out of pocket. Part F is available in a Medicare Advantage plan and that is the direction we planned on heading.

Now, a couple posters said their Advantage plans cost them nothing. Huh??!!?? I've priced a number of the Advantage plans and they run from ~$130/month and up. Part B is a standard cost item which is around $115/month. So, I assumed we would be out the $115... the $130... and our Part D (Prescription Plan), $40 for a total of about $300/month for each of us.

Where have I erred in that analysis? How do I find Advantage plans that have zero cost??
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Well here where I live, there are two medicare advantage plans that cost nothing additional over the $104 that we pay for Medicare. I have one of them, pay NOTHING in addition to the medicare premium, and I am extremely pleased with the plan. Both the plans available here are local and tied to large hospitals and medical groups in the area. I don't know where else to look, as I never tried looking for anything else because this is such a good deal for me.
 
Glinda said:
Which do you prefer and why?
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Many Advantage plans have benefits that original Medicare does not. Plans may have dental, vision, over the counter coverage, prescription drug coverage and or health clue memberships. All with a lower premium the Medigap plans. The trade off is you have small copays when you see health care providers.
 
Check with your local SHIP representative. You can usually find them in the local senior center if you have one.
If Humana is in you area, they have employee sales representatives that will come out explain all the A's B's and C's of Medicare to you.
 
Grumpy Ol' Man said:
I'm really confused!!! (Wife says I have been for many years!) We both currently covered under each of our employer's medical group plans. It appears we will both be finally retiring at the end of 2015. So, we need to pick up our "Part B" and "Part F"... or at least that's what I thought. It appears the Part F covers all the deductibles from Part A and Part B, so has very little out of pocket. Part F is available in a Medicare Advantage plan and that is the direction we planned on heading.

Now, a couple posters said their Advantage plans cost them nothing. Huh??!!?? I've priced a number of the Advantage plans and they run from ~$130/month and up. Part B is a standard cost item which is around $115/month. So, I assumed we would be out the $115... the $130... and our Part D (Prescription Plan), $40 for a total of about $300/month for each of us.

Where have I erred in that analysis? How do I find Advantage plans that have zero cost??
Click to expand...

Medicare advantage plans are administered by private insurance companies. The plans all differ basically by county or ZIP Code. When you enroll in a Medicare advantage plan Medicare pays the plan monthly for your health care whether you go to the doctor or not. So basically, the Insurance company collects money for everybody on the plan you are on in you area the money is pooled together and the plan is administered from there. The more people you have on the plan the lower the premium. So some plans and a problem zero premium.
You will soon be getting your Medicare and you book in the mail. Your book will be able to tell you how many plans are available in your area, the Medicare star rating (A grading system Medicare gives to all
plans) and what the premiums are.
 
For me, coverage is more important than premium!!

For the past 4 years I have paid what some consider a high premium, but I have never paid out a dime for doctors or hospitals!!

You get what you pay for...
 
Ken N Tx said:
For me, coverage is more important than premium!!

For the past 4 years I have paid what some consider a high premium, but I have never paid out a dime for doctors or hospitals!!

You get what you pay for...
Click to expand...

You may have spent more in premium (Medicare Supplement and Part D) than the maximum out of pocket that the Medicare Advantage plan has.
If I add up the $$ saved in over the counter coverage, my YMCA membership, Part D premium, vision w/ eye glass coverage, dental and mail order Rx for free. All for ZERO $$ a month. I'll gladly pay the $15 doctor copay.
 
Dudewho said:
You may have spent more in premium (Medicare Supplement and Part D) than the maximum out of pocket that the Medicare Advantage plan has.
If I add up the $$ saved in over the counter coverage, my YMCA membership, Part D premium, vision w/ eye glass coverage, dental and mail order Rx for free. All for ZERO $$ a month. I'll gladly pay the $15 doctor copay.
Click to expand...

Have you had a major hospital stay??
 
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