Medicare Advantage and Medicare Supplement Plans (Medigap)

Butterfly said:
It is the Presbyterian Senior Care plan and is tied to our Presbyterian Hospital system and our Presbyterian Healthcare Group of physicians and medical professionals.

It is a local plan available in two counties in New Mexico where the hospitals and care group are.
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The plan says it covers urgent or emergency services anywhere in the world. Neither I, nor anyone I know personally, have had any personal experience with this benefit. This isn't a big worry for me because I really don't travel much anymore -- primarily because I can't afford it, but also because I don't particularly feel the inclination to do so. I did an awful lot of travelling in my younger days.
 
Sorry for the late reply. I've been SO busy helping my clients with the annual election period.

Like all Medicare Supplements, Plan F (which I almost never recommend due to cost vs. G or N) only pays for services authorized by Medicare. If Medicare doesn't cover the service neither will your supplement.

Some here keep pointing out how wonder their HMO is. That's great unless you want to choose your own doctors, hospitals, etc. In many areas (ie. Los Angeles) many great doctors are available. But if you want to see a doctor out of network you're going to pay yourself.

So I agree that a Medicare supplement is always the best choice if money is not an object. In fact, I'd much rather go with a high deductible plan f (HDF) which kicks in to pay your out of pocket after a $2,300 deductible. Keep in mind Medicare will still pay their share so unless you have a hospitalization or something like chemo you won't spend much. And the premium generally is $40-50 monthly. Must better access to care than any Medicare Advantage and generally the out of pocket in most areas is lower.

Hope that helps a bit.

Rick
 

GreenSky said:
Sorry for the late reply. I've been SO busy helping my clients with the annual election period.

Like all Medicare Supplements, Plan F (which I almost never recommend due to cost vs. G or N) only pays for services authorized by Medicare. If Medicare doesn't cover the service neither will your supplement.

Some here keep pointing out how wonder their HMO is. That's great unless you want to choose your own doctors, hospitals, etc. In many areas (ie. Los Angeles) many great doctors are available. But if you want to see a doctor out of network you're going to pay yourself.

So I agree that a Medicare supplement is always the best choice if money is not an object. In fact, I'd much rather go with a high deductible plan f (HDF) which kicks in to pay your out of pocket after a $2,300 deductible. Keep in mind Medicare will still pay their share so unless you have a hospitalization or something like chemo you won't spend much. And the premium generally is $40-50 monthly. Must better access to care than any Medicare Advantage and generally the out of pocket in most areas is lower.

Hope that helps a bit.

Rick
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Hi Rick,

Some comments on Medicare Supplemental Plan F.

My understanding is that Plan F is going to be discontinued for new enrollments as of 12/31/2019. If you already have that plan by that date, you can keep it and will be grandfathered in.

That being the case, what do you think of this analysis.

Since there will be no new enrollees in Plan F after 12/31/19, the pool of people already enrolled will have an increasing average age since younger people will not be added. So the premiums for this plan will probably increase sharply after that date. Perhaps another good reason not to enroll in Plan F now.

Also, if you do sign up for Plan F, and the premiums start to rise, you may not be able to switch to another supplemental plan if you develop a serious health condition and be stuck with Plan F and the rapidly rising premiums.

That being the case, it seems to me that Plan F is probably not a good choice even now based on what we already know about the near future of that plan.

This same logic may or may not apply to the high deductible Plan F as I am not sure if that is also being discontinued or not. Do you know?

And even if the high deductible plan is being discontinued, it might still make sense now in some cases for those who want a lowe(r) premium plan and can self insure up to the deductible.

Thoughts?
 
Ryan said:
Hi Rick,

Some comments on Medicare Supplemental Plan F.

My understanding is that Plan F is going to be discontinued for new enrollments as of 12/31/2019. If you already have that plan by that date, you can keep it and will be grandfathered in.

That being the case, what do you think of this analysis.

Since there will be no new enrollees in Plan F after 12/31/19, the pool of people already enrolled will have an increasing average age since younger people will not be added. So the premiums for this plan will probably increase sharply after that date. Perhaps another good reason not to enroll in Plan F now.

Also, if you do sign up for Plan F, and the premiums start to rise, you may not be able to switch to another supplemental plan if you develop a serious health condition and be stuck with Plan F and the rapidly rising premiums.

That being the case, it seems to me that Plan F is probably not a good choice even now based on what we already know about the near future of that plan.

This same logic may or may not apply to the high deductible Plan F as I am not sure if that is also being discontinued or not. Do you know?

And even if the high deductible plan is being discontinued, it might still make sense now in some cases for those who want a lowe(r) premium plan and can self insure up to the deductible.

Thoughts?
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You are "almost" correct. Plan F will be closed to those who get their Medicare after next year but it's still open to "older people".

But your analysis is exactly correct. Without new people enrolling the prices will have to continue to skyrocked. HDF won't be as big an issue since enrollees tend to be pretty healthy. HDG will be available to new enrollees.

Lastly, I have almost never seen where Plan F makes financial sense as companies charge more to cover the deductible than the actual cost of the deductible. I took a look a few years ago and 78% of my clients were in Plan N.

Rick
 
If someone becomes eligible for Medicare in 12/2019 and enrolls in Medicare for the first time on or after 1/1/2020, can they enroll in HDG?
 
I have traditional Medicare with a BCBS PPO plan as secondary.

I love it.

It's expensive but my coverage is almost as good as Canadians get from their system for free.

I would not touch a Medicare Advantage Plan with a 10 foot pole.
 
Trade said:
I have traditional Medicare with a BCBS PPO plan as secondary.

I love it.

It's expensive but my coverage is almost as good as Canadians get from their system for free.

I would not touch a Medicare Advantage Plan with a 10 foot pole.
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Just to clarily, the Canadians don't get medical care for free. It's buried in taxes.

If you don't like Medicare Advantage, you would hate single payer like Canada.

Rick
 
GreenSky said:
Just to clarily, the Canadians don't get medical care for free. It's buried in taxes.

If you don't like Medicare Advantage, you would hate single payer like Canada.

Rick
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I seem to remember discussing this with you before. Please correct me if I am wrong, but I seem to remember that you are a Medicare advantage sales person. Am I that correct?

As for how I would feel about Canadian health care I would appreciate it if in the future you would not be so presumptuous as to attempt to speak for me.

Thanks in advance.
 
Trade said:
I seem to remember discussing this with you before. Please correct me if I am wrong, but I seem to remember that you are a Medicare advantage sales person. Am I that correct?

As for how I would feel about Canadian health care I would appreciate it if in the future you would not be so presumptuous as to attempt to speak for me.

Thanks in advance.
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I've sold hundreds of Medicare advantage plans and even more supplements.

As far as speaking for you, I did not. I tried to liken long waits and lack of service from Canada to the same with MA plans.

You're welcome in advance.

Rick
 
GreenSky said:
I've sold hundreds of Medicare advantage plans and even more supplements.
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Then with all due respect I would submit that you are biased towards Medicare Advantage Plans due to the fact that you sell them for a living.

As for the Canadian Health Care System there are several Canadians that are members here and again with all due respect I would submit that they are in a much better position than you are to speak to it's effectiveness and efficiency.
 
Trade said:
I have traditional Medicare with a BCBS PPO plan as secondary.

I love it.

It's expensive but my coverage is almost as good as Canadians get from their system for free.

I would not touch a Medicare Advantage Plan with a 10 foot pole.
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A few questions.

1. What is a BCBS PPO plan?

2. Is a BCBS PPO plan better than Medicare supplemental Plan G or F? If so, specifically why?

3. How are the costs of a BCBS PPO compared to Medicare G or F?

4. Can you state the specific reason(s) why you would not get a Medicare Advantage plan?

Thank you.
 
Ryan said:
A few questions.

1. What is a BCBS PPO plan?

2. Is a BCBS PPO plan better than Medicare supplemental Plan G or F? If so, specifically why?

3. How are the costs of a BCBS PPO compared to Medicare G or F?

4. Can you state the specific reason(s) why you would not get a Medicare Advantage plan?

Thank you.
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My BSBS PPO plan is the plan I had as an employee of the state of Florida. When I retired I was given the option of keeping it at considerably higher cost than when I was an employee. It's not available on the general market. When I became Medicare eligible it became my secondary coverage at a reduced cost as it now only picks up what Medicare doesn't pay. However it also includes prescription drug coverage. The cost to me is $388 a month each for my wife and I. That's high, but it is not subject to increases with age as other supplementals are.

If I were to go to a medicare advantage plan I would be subjected to a limited network of providers. I don't like that idea at all. In addition I would have significantly higher prescription drug costs as my wifes epilepsy medication is one of those Tier 4 drugs. Right now I get a three months supply for a $100 co-pay. There is no Medicare Advantage Plan that would come even close to that. Another reason I stick with it is that if I ever drop my BCBS PPO I can not go back to it. It's gone forever.
 
Thanks for that info Trade.

That IS a high premium! My parents live in one of the most expensive insurance areas in the country and have supplemental Plan G. One is 97 and the other 89. I believe their premium is $273.50 a month each. Of course it does not include Part D, but fortunately so far their medications are not very expensive (my father used to get his from the VA but now finds he can get better prices from the private market). I have never seen a single penny out of pocket charge they have had to pay for doctors or hospitalization in spite of many years of both and they never have to file any claims or do any paperwork at all. The premium is the only cost they have in addition to the drugs.

PS: I like your song reference. I dig that song. :eek:nthego:
 
Two of my senior cousins were here for a visit and they ask me about supplemental plans.
So I brought them here where you people have went over the plans told them all the great benefits about this site. So at least one should be joining soon once she has time.
I told her if retires next year it would be helpful also to find out about her 401K plan. I think the majority should go towards paying off or down her home.
 
MeAgain said:
Two of my senior cousins were here for a visit and they ask me about supplemental plans.
So I brought them here where you people have went over the plans told them all the great benefits about this site. So at least one should be joining soon once she has time.
I told her if retires next year it would be helpful also to find out about her 401K plan. I think the majority should go towards paying off or down her home.
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Every penny out of a 401K is taxable. Taking out a bunch to pay off what is likely a low interest rate on a mortgage might not be the best advice.

Rick
 
MeAgain said:
Two of my senior cousins were here for a visit and they ask me about supplemental plans.
So I brought them here where you people have went over the plans told them all the great benefits about this site. So at least one should be joining soon once she has time.
I told her if retires next year it would be helpful also to find out about her 401K plan. I think the majority should go towards paying off or down her home.
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IMHO, someone who is trying to decide about medicare supplements/advantage plans should seek professional advice about which is better for their particular situation because there is no one size fits all answer. It's a big decision and one needs professional advice, NOT the advice of folks on some online forum (tho we do have a couple of professionals here). I believe the answer for each person includes looking at their medical situation, where they live, and of course their financial status.

ALSO, about the 401K, I believe one should definitely get professional financial and tax advice before using the proceeds of an IRA in a large chunk to do anything. There can be substantial tax consequences, as I understand it.
 
Butterfly said:
IMHO, someone who is trying to decide about medicare supplements/advantage plans should seek professional advice about which is better for their particular situation because there is no one size fits all answer. It's a big decision and one needs professional advice, NOT the advice of folks on some online forum (tho we do have a couple of professionals here). I believe the answer for each person includes looking at their medical situation, where they live, and of course their financial status.

ALSO, about the 401K, I believe one should definitely get professional financial and tax advice before using the proceeds of an IRA in a large chunk to do anything. There can be substantial tax consequences, as I understand it.
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Great advice!
 
not only is the 401k or ira taxable unless it is a roth but taking a large sum can rigger all kinds of nasties like getting your medicare premium increased or social security taxed if it is not . you can lose an aca subsidy too .

you can be bumped in to a higher tax bracket too .

can you imagine taking something with a decent rate of return despite some temporary dips , getting whacked with taxes and the nasties above just to pay off a low interest rate mortgage ????
 


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