Buying Medigap G, what're your thoughts? AARP plan G plus opinions wanted

[Robb.hisself]

As far as I can see we can't change once we've started with one, so I guess just be sure it is something you want for the rest of your life.

That is not at all true. Nothing in Medicare is 'forever'. When I first signed up for Medicare I signed up for the traditional plan, a supplementary policy, and part D. After about six months I switched to a C plan (which you can do at any time throughout the year from a traditional Medicare plan to a C plan). The main reason was simply cost. I eventually realized I had to pay about the same for traditional medicare as for my private medical insurance I was self paying before going on medicare. But, plan C in my location was far less expensive for much better service.

 

[Knight]

With Medigap, you can see any doctor that takes Medicare. No networks. Also, if you start with Medigap, you can switch to an Advantage plan with no medical checkup but once you are on an Advantage plan, you can not switch back to Medigap without disclosing your medical history.

Since we have traveled everywhere we ever wanted to go the need to see any doctor other than the one we have is not a problem. As you might have read the network were in does an amazing job of meeting our needs. Then there is the computer documentation of medical history, why would anyone want to deny a "new" doctor access to any & all prior medical issues?

If for some strange reason we should happen to have an emergency out of state the emergency would be covered even thought it would be out of network.

In another post of mine if we were to select part G the $200.00 a month or in our case $400.00 a month equaling $4,800.00 a year, that amount won't provide any more care than what we have for zero cost.

But to each their own in doing what they think suits their medical needs.

 

[Ken N Tx]

Good info Michael Z.
That's the kind of info people need to be checking before they pick a plan. The state & area of a state might make a difference, rural vs. urban. Quantity of doctors, hospitals all might make a difference. Income might make a difference.
A lot of factors play into making the best choice for an individual. I can't express this enough
research what you think will suit you best.

Ditto...

 

[gb4au]

Then there is the computer documentation of medical history, why would anyone want to deny a "new" doctor access to any & all prior medical issues?

If for some strange reason we should happen to have an emergency out of state the emergency would be covered even thought it would be out of network.

In another post of mine if we were to select part G the $200.00 a month or in our case $400.00 a month equaling $4,800.00 a year, that amount won't provide any more care than what we have for zero cost.

But to each their own in doing what they think suits their medical needs.

Yes, what meets your needs is important. You try to make it sound like anyone would be a "fool" to get a supplement instead of an advantage plan, which is also what the insurance companies do.

It's not that you don't want to "deny a new Dr access to any & all prior medical issues," it's that you don't want the insurance company to use that to determine your rates.

I am just turning 65 as well and am looking for a Part G plan. I currently have an existing cancer issue that is now in remission. Hopefully that will continue, but you never know.

I want a plan G instead of an advantage plan because I can see any Dr that takes medicare. What that means is that if my cancer returns, I can go out of state to a place like MD Anderson, which is the highest rated cancer center in the US. Or to Johns Hopkins or Mayo Clinic or Sloan Kettering, all in different states. I could not go there with an Advantage plan because it's out of state and not covered in any of my states' "in-network" coverage.

With standard medicare and a plan G to cover costs, I can go to any of them without even getting a referral.

If I get a Plan G now, my first time, I can get it without them taking into account pre-existing conditions, so my rates won't be affected by that. If I got an advantage plan now, and changed to a plan G later, they would be able to look at pre-existing conditions and my rates would be much higher. So it's better to get a plan G now instead of getting an advantage plan and trying to change at a later time.

What I'm trying to sort through, and it sounds like the OP was as well, is why there is such a big difference between all the plan G pricing. Plan G, like all the supplement plans, is standardized. So the coverage is the same. But in my state there are around 60 different companies that offer plan G's! All with different pricing. I'm trying to understand why I wouldn't just choose the lowest cost one?

My research suggests that some companies start you out with a low price and increase it rapidly, while others do not. But I don't know where to find that info? And I'm still unsure if I choose one plan G in my state, can I switch to another Plan G in the future without pre-existing conditions affecting it? Or is it just this first time and I have to stick with that plan to avoid big charges due to my condition?

Interestingly, the most popular Plan G's in my state are not the lowest cost ones. They are the ones from the most well known providers. I don't know if that means most people just go with a name they know or if they research it and they are the best. In other words, is the provider the most well known because they are the best or because they have good advertising?

 

[Knight]

Yes, what meets your needs is important. You try to make it sound like anyone would be a "fool" to get a supplement instead of an advantage plan, which is also what the insurance companies do.

It's not that you don't want to "deny a new Dr access to any & all prior medical issues," it's that you don't want the insurance company to use that to determine your rates.

Why such a negative response to my pointing out why an advantage plan might be al alternative to ask about?

The rates an insurance company charges isn't something I need to be concerned about since I have zero out of pocket costs to me other than a copay IF I need to go to a hospital emergency room. Back in 2018 I had spinal surgery, the hospital & surgeons fees were in excess of $800,000.00 dollars. My out of pocket then was the $50.00 emergency room copay.

If paying for supplemental insurance works for you by all means do what you need to do.

 

[leastlongprime]

Have AARP/UHN, plan G, which pays for a lot. Haven't seen a doctor's bill for a long time even with a bike accident this year. I should really look into our AARP/UHN plan since we haven't used a gym since early 2020. Will be changing to a lower cost D because all our drugs are generic and we don't make the annual 545 deductible. We have overpaid D premiums, probably +$1000 for the last 4 years.
I need to watch all of this more closely.

 

[Knight]

Have AARP/UHN, plan G, which pays for a lot. Haven't seen a doctor's bill for a long time even with a bike accident this year. I should really look into our AARP/UHN plan since we haven't used a gym since early 2020. Will be changing to a lower cost D because all our drugs are generic and we don't make the annual 545 deductible. We have overpaid D premiums, probably +$1000 for the last 4 years.
I need to watch all of this more closely.

I had/have no idea the cost of plans. Since we don't have out of pocket costs we've been able to invest some money in a Fidelity mutual fund FGBRX that is separate from what our self directed & traditional IRA's reinvest the dividends.

When you says pays a lot, does it compare to my post #6. Or the fact that since signing onto the plan we each have the total out of pocket for very expensive care has been a total of $140.00

My only intent is to explain my situation & my out of pocket health care cost. Comparing makes it something to think about.

 

[gb4au]

Why such a negative response to my pointing out why an advantage plan might be al alternative to ask about?

Not a negative response, just pointing out why a supplemental plan might be an alternative to ask about.

 

[Knight]

Not a negative response, just pointing out why a supplemental plan might be an alternative to ask about.

Does that mean my posting about the zero cost to me compared to buying a supplemental insurance could help others investigate what more closely what their best option is?

 

[gb4au]

Does that mean my posting about the zero cost to me compared to buying a supplemental insurance could help others investigate what more closely what their best option is?

Why of course it does!

Just like my posting that if you have cancer, and want the best treatment from a top cancer center that is out of state could help others investigate what their best option is. That won't be covered by your advantage plan, but would be covered by a supplemental plan.

If you're lucky enough to be in a state/city with top medical care that is in-network, then your "zero cost" advantage plan is great. If you're in a rural area in a state without some of the top hospitals, then you'll either have to live with substandard care or choose regular medicare and a supplemental so you'll be able to go anywhere to get treatment.

 

[Knight]

Why of course it does!

Just like my posting that if you have cancer, and want the best treatment from a top cancer center that is out of state could help others investigate what their best option is. That won't be covered by your advantage plan, but would be covered by a supplemental plan.

If you're lucky enough to be in a state/city with top medical care that is in-network, then your "zero cost" advantage plan is great. If you're in a rural area in a state without some of the top hospitals, then you'll either have to live with substandard care or choose regular medicare and a supplemental so you'll be able to go anywhere to get treatment.

So we agree investigating what is best for people is essential to their health care.

 

[JB in SC]

Advantage Plans….some like them, some don’t. I have traditional Medicare with a supplement, the cost isn’t an issue. I prefer to make my own choices.

 

[Knight]

Advantage Plans….some like them, some don’t. I have traditional Medicare with a supplement, the cost isn’t an issue. I prefer to make my own choices.

I agree choice is up to each person.
I'm not understanding the part about making choices. Even way back when my employer paid for top end blue cross blue shield I wasn't familiar or maybe better said I didn't have a lifetime family doctor. So choice was based on a list closest to us. Never needed specialist/surgeon/surgery until 2018. There again I didn't have a family specialist/surgeon to request he perform the needed surgery.

Even now at age 82 my health is excellent so the once a year with labs & every 6 months scheduled visit to my PCP that is why the advantage plan works for me. Cost wasn't really the consideration when we 1st. signed up for the advantage plan. An explanation of why good health played a part in selecting a plan that fit our needs was.

It didn't take long to realize that no cost meant that would free up money to invest. Thus the $500.00 a quarter invested in FGBRX began.

And yes I understand others don't enjoy good health & need a variety of doctors to assure their health needs are taken care of. A lot of factors play into what works for health care needs that is why making a choice for what works for each is what I've been promoting all along.

 

[JB in SC]

I agree choice is up to each person.
I'm not understanding the part about making choices. Even way back when my employer paid for top end blue cross blue shield I wasn't familiar or maybe better said I didn't have a lifetime family doctor. So choice was based on a list closest to us. Never needed specialist/surgeon/surgery until 2018. There again I didn't have a family specialist/surgeon to request he perform the needed surgery.

Even now at age 82 my health is excellent so the once a year with labs & every 6 months scheduled visit to my PCP that is why the advantage plan works for me. Cost wasn't really the consideration when we 1st. signed up for the advantage plan. An explanation of why good health played a part in selecting a plan that fit our needs was.

It didn't take long to realize that no cost meant that would free up money to invest. Thus the $500.00 a quarter invested in FGBRX began.

And yes I understand others don't enjoy good health & need a variety of doctors to assure their health needs are taken care of. A lot of factors play into what works for health care needs that is why making a choice for what works for each is what I've been promoting all along.

When you have a cancer diagnosis, choice becomes a priority, unless you live in a large urban area with some top tier hospitals and providers. Systems can refuse to accept plans, one area (we have three) teaching hospital will no longer accept any UHC insurance including Advantage. That does not bode well, IMO.

 

[Knight]

When you have a cancer diagnosis, choice becomes a priority, unless you live in a large urban area with some top tier hospitals and providers. Systems can refuse to accept plans, one area (we have three) teaching hospital will no longer accept any UHC insurance including Advantage. That does not bode well, IMO.

Another excellent reason for people to investigate what health care system will meet their needs.

 

[Puff TMD]

I had/have no idea the cost of plans. Since we don't have out of pocket costs we've been able to invest some money in a Fidelity mutual fund FGBRX that is separate from what our self directed & traditional IRA's reinvest the dividends.

When you says pays a lot, does it compare to my post #6. Or the fact that since signing onto the plan we each have the total out of pocket for very expensive care has been a total of $140.00

My only intent is to explain my situation & my out of pocket health care cost. Comparing makes it something to think about.

As the OP for this thread perhaps I need to make folks aware that I have a preexisting condition that makes it unwise for me to choose an Advantage product.

 

[Teacher Terry]

That is not at all true. Nothing in Medicare is 'forever'. When I first signed up for Medicare I signed up for the traditional plan, a supplementary policy, and part D. After about six months I switched to a C plan (which you can do at any time throughout the year from a traditional Medicare plan to a C plan). The main reason was simply cost. I eventually realized I had to pay about the same for traditional medicare as for my private medical insurance I was self paying before going on medicare. But, plan C in my location was far less expensive for much better service.

Rob, it really depends on what state you’re in. New York for example lets people switch from an advantage plan to a supplement plan. However, many states don’t and once you choose an advantage plan you can only switch between those plans in many states.

In fact 60 minutes did a segment on how overall detrimental these plans are for many people. There’s also starting to be media coverage of these issues. The insurance companies are making money by denying treatment and it’s costing the government more money than traditional plans.

 

[Robb.hisself]

Rob, it really depends on what state you’re in.

Each state has their own rules. While it is true you can switch easily between c plans you are usually limited to a certain time of year to do so. But, in California there is a little known rule that allows you to switch between c plans at any time of the year.

The rule works like this: you can only switch from a plan that is less than a five star plan to a plan that is a five star plan. In my state only Kaiser has a five star plan. But, the trick is that if you are in Kaiser and want to try a different c plan you really have nothing to lose since you can switch back to Kaiser at any time. I don't know why the authorities don't make this rule more widely known.

 

[JB in SC]

Rob, it really depends on what state you’re in. New York for example lets people switch from an advantage plan to a supplement plan. However, many states don’t and once you choose an advantage plan you can only switch between those plans in many states.

In fact 60 minutes did a segment on how overall detrimental these plans are for many people. There’s also starting to be media coverage of these issues. The insurance companies are making money by denying treatment and it’s costing the government more money than traditional plans.

We can’t even change from one supplement plan to another (ie F to an G) without underwriting that usually denies pre-existing condtions. There is a big reason insurance companies push advantage plans, they control the services and providers not the individual…which translates to cost. Insurance companies never act in the patient’s interest unless the government forces them to do so…