Deciding on Medigap vs Medicare Advantage

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ehh
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Re: Deciding on Medigap vs Medicare Advantage

Post by ehh »

jmw wrote: Fri Mar 24, 2023 4:16 pm I cheap out by not eating out very much, higher deductibles on insurance . . .
May I assume you went with G HD? :happy
ModifiedDuration
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Re: Deciding on Medigap vs Medicare Advantage

Post by ModifiedDuration »

orlandoman wrote: Fri Mar 24, 2023 4:22 pm Only very limited changes can be made on Traditional Medicare, for example when the annual Part B deductible went from $203 in 2021 to $233 in 2022 to $266 in 2023.
Actually the Part B deductible decreased from $233 in 2022 to $226 in 2023.

(And, needless to say, Congress can make whatever changes they want at any time to Traditional Medicare.)
ehh
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Re: Deciding on Medigap vs Medicare Advantage

Post by ehh »

Tom_T wrote: Fri Mar 24, 2023 4:18 pm Can someone on G-High switch to G later on, or is that a potential problem?
In most states it is a potential problem. You may be subject to medical underwriting. And, potentially, be denied coverage or be placed in a higher risk pool (and pay higher premiums).

From Medicare: https://www.medicare.gov/supplements-ot ... p-policies

https://www.medicareresources.org/enrollment-options/ Scroll down the page to the Medigap State Variation section.

Of course, the ability to switch without medical underwriting causes higher Plan G premiums. There are anecdotal reports on this board that Plan G in NY is expensive. As expected. If I understand the situation, in NY you can just start with G HD. Then, if your health goes south, switch to plan G. Basically, you are only at risk for the higher G HD "deductible" for one year - or until you can switch to G.
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Tom_T
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Re: Deciding on Medigap vs Medicare Advantage

Post by Tom_T »

ehh wrote: Fri Mar 24, 2023 5:14 pm
Of course, the ability to switch without medical underwriting causes higher Plan G premiums. There are anecdotal reports on this board that Plan G in NY is expensive.
It is true. I looked at AARP Plan G in NJ. It is $162/month. I then changed the zip code to a NY zip. The price jumped to $281/month.
ModifiedDuration
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Re: Deciding on Medigap vs Medicare Advantage

Post by ModifiedDuration »

ehh wrote: Fri Mar 24, 2023 5:14 pm Of course, the ability to switch without medical underwriting causes higher Plan G premiums. There are anecdotal reports on this board that Plan G in NY is expensive. As expected. If I understand the situation, in NY you can just start with G HD. Then, if your health goes south, switch to plan G. Basically, you are only at risk for the higher G HD "deductible" for one year - or until you can switch to G.
You can change Medigap plans and insurers at any time in New York State to any plan or insurer that you like.

As far as the anecdotal reports you have heard about high rates in New York State, here are the actual current Medigap Plan G rates in New York (community rated - every age pays the same rate) and you can decide for yourself if they are high or not (the least expensive Plan G in New York City is $281 a month);

https://www.dfs.ny.gov/consumers/health ... ons/plan_g

Here are the current Plan G-HD rates in New York State (the least expensive is New York City is $68 a month);

https://www.dfs.ny.gov/consumers/health ... lan_g-plus

So, one would save $2,556 a year in premiums in New York City by getting Plan G-HD vs Plan G and their maximum additional annual out-of-pocket exposure would be $2,467 ($2,700 less the $233 Part B deductible one would pay under both Plans).

So, you can’t lose by choosing Plan G-HD over Plan G in New York City.
Last edited by ModifiedDuration on Fri Mar 24, 2023 5:57 pm, edited 5 times in total.
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JAZZISCOOL
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Re: Deciding on Medigap vs Medicare Advantage

Post by JAZZISCOOL »

dagsboro wrote: Fri Mar 24, 2023 4:24 pm Advantage plans are great until they are not and I have been reading about many cases when they are not.
+1

A friend with a MA plan is having a serious problem with his PCP in terms of getting a referral for a very painful condition. It is taking weeks to even move closer up the "algorithm" to get a referral to a specialist despite severe pain for which PT etc. is not helping at all. Until this recent event, he and his wife have been generally happy with the plan.

The NYT and other publications have written about these types of issues as mentioned above. YMMV.
orlandoman
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Re: Deciding on Medigap vs Medicare Advantage

Post by orlandoman »

ModifiedDuration wrote: Fri Mar 24, 2023 5:10 pm
orlandoman wrote: Fri Mar 24, 2023 4:22 pm Only very limited changes can be made on Traditional Medicare, for example when the annual Part B deductible went from $203 in 2021 to $233 in 2022 to $266 in 2023.
Actually the Part B deductible decreased from $233 in 2022 to $226 in 2023.

(And, needless to say, Congress can make whatever changes they want at any time to Traditional Medicare.)
Yep, typo, thanks, for mentioning that!
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Re: Deciding on Medigap vs Medicare Advantage

Post by Northern Flicker »

Tom_T wrote: Fri Mar 24, 2023 5:23 pm
ehh wrote: Fri Mar 24, 2023 5:14 pm
Of course, the ability to switch without medical underwriting causes higher Plan G premiums. There are anecdotal reports on this board that Plan G in NY is expensive.
It is true. I looked at AARP Plan G in NJ. It is $162/month. I then changed the zip code to a NY zip. The price jumped to $281/month.
Keep in mind it is an age-based premium. But the total OOP cost of G-HD will rise similarly due to care needs increasing over time.
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Re: Deciding on Medigap vs Medicare Advantage

Post by ModifiedDuration »

Northern Flicker wrote: Fri Mar 24, 2023 6:20 pm
Tom_T wrote: Fri Mar 24, 2023 5:23 pm
ehh wrote: Fri Mar 24, 2023 5:14 pm
Of course, the ability to switch without medical underwriting causes higher Plan G premiums. There are anecdotal reports on this board that Plan G in NY is expensive.
It is true. I looked at AARP Plan G in NJ. It is $162/month. I then changed the zip code to a NY zip. The price jumped to $281/month.
Keep in mind it is an age-based premium. But the total OOP cost of G-HD will rise similarly due to care needs increasing over time.
The AARP Plan G premium in New Jersey would be based on age, but Medigap premiums in New York State are not age based, they are community-rated (all ages pay the same premium), so comparing the two premiums is an apples-to-oranges comparison.
Chuckles960
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Re: Deciding on Medigap vs Medicare Advantage

Post by Chuckles960 »

cheese_breath wrote: Fri Mar 24, 2023 6:35 am
Tom_T wrote: Fri Mar 24, 2023 4:42 am
jmw wrote: Fri Mar 24, 2023 1:39 am Only poor people take [Medicare] Advantage.
You may get some pushback on that statement.
I agree with that. Personally I'm on medigap plan G, but there are some very intelligent, and probably richer people than me here with MA.
It is actually richer people who should get less insurance, because they can better afford to self-insure.
cashmoney
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Re: Deciding on Medigap vs Medicare Advantage

Post by cashmoney »

Northern Flicker wrote: Fri Mar 24, 2023 1:52 pm
cashmoney wrote: IMO the biggest reason to choose original medicare with a medigap is not financial protection but to avoid managed care and have complete flexibility on providers.
Except it is not complete flexibility on providers. This may just apply to people who live in an area served by Kaiser, but Kaiser is an example of a large provider that does not accept original Medicare. A Medicare recipient who wishes to receive care from Kaiser has to choose a Kaiser Advantage plan.

There are other providers who do not accept Medicare.

Generally, I think MA plans run by insurance foundations associated with large care providers, which generally are large provider organizations in urban areas, can be good medicare choices. People who live in smaller communities may lack access to good MA plans, and even in urban areas, there are bad MA plans.


You are right that some Medicare providers are exclusive to a Medicare organization with a risk contract but overall from what i have seen its not that prevalent -yet .One place where i do see some of this is at The Villages in Florida.

Explaining Medicare rules and then the exceptions to those rules reminds me of what the Dude in the Big Lebowski said:

"This is a very complicated case, Maude. You know, a lotta ins, a lotta outs, a lotta what-have-yous. And, uh, a lotta strands to keep in my head, man. Lotta strands in old Duder's head."
cashmoney
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Re: Deciding on Medigap vs Medicare Advantage

Post by cashmoney »

JAZZISCOOL wrote: Fri Mar 24, 2023 5:28 pm
dagsboro wrote: Fri Mar 24, 2023 4:24 pm Advantage plans are great until they are not and I have been reading about many cases when they are not.
+1

A friend with a MA plan is having a serious problem with his PCP in terms of getting a referral for a very painful condition. It is taking weeks to even move closer up the "algorithm" to get a referral to a specialist despite severe pain for which PT etc. is not helping at all. Until this recent event, he and his wife have been generally happy with the plan.

The NYT and other publications have written about these types of issues as mentioned above. YMMV.

The majority of the times ( which believe it or not is not very often) when i get calls from HMO MA members who are having a referral issues the delay is because the PCP has not processed the referral request or submitted incorrectly. The MA carrier referral approval time once the request is received is usually between immediately to 72 hours depending how the request was submitted. There can also be a delay from the time the specialist gets the referral approval and the time they call the member to schedule the appointment. ( this delay can happen even if you have a ppo or original Medicare when you see a new specialist) If you know who the specialist is call their office and they will tell you if request has been received or call the insurance company to confirm referral was submitted. There can be a big difference on how efficient the referral dept is between different PCP offices.


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JAZZISCOOL
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Re: Deciding on Medigap vs Medicare Advantage

Post by JAZZISCOOL »

cashmoney wrote: Fri Mar 24, 2023 9:59 pm
JAZZISCOOL wrote: Fri Mar 24, 2023 5:28 pm
dagsboro wrote: Fri Mar 24, 2023 4:24 pm Advantage plans are great until they are not and I have been reading about many cases when they are not.
+1

A friend with a MA plan is having a serious problem with his PCP in terms of getting a referral for a very painful condition. It is taking weeks to even move closer up the "algorithm" to get a referral to a specialist despite severe pain for which PT etc. is not helping at all. Until this recent event, he and his wife have been generally happy with the plan.

The NYT and other publications have written about these types of issues as mentioned above. YMMV.

The majority of the times ( which believe it or not is not very often) when i get calls from HMO MA members who are having a referral issues the delay is because the PCP has not processed the referral request or submitted incorrectly. The MA carrier referral approval time once the request is received is usually between immediately to 72 hours depending how the request was submitted. There can also be a delay from the time the specialist gets the referral approval and the time they call the member to schedule the appointment. ( this delay can happen even if you have a ppo or original Medicare when you see a new specialist) If you know who the specialist is call their office and they will tell you if request has been received or call the insurance company to confirm referral was submitted. There can be a big difference on how efficient the referral dept is between different PCP offices.


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Good to know. Thanks.
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JAZZISCOOL
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Re: Deciding on Medigap vs Medicare Advantage

Post by JAZZISCOOL »

cashmoney wrote: Fri Mar 24, 2023 9:59 pm
JAZZISCOOL wrote: Fri Mar 24, 2023 5:28 pm
dagsboro wrote: Fri Mar 24, 2023 4:24 pm Advantage plans are great until they are not and I have been reading about many cases when they are not.
+1

A friend with a MA plan is having a serious problem with his PCP in terms of getting a referral for a very painful condition. It is taking weeks to even move closer up the "algorithm" to get a referral to a specialist despite severe pain for which PT etc. is not helping at all. Until this recent event, he and his wife have been generally happy with the plan.

The NYT and other publications have written about these types of issues as mentioned above. YMMV.

The majority of the times ( which believe it or not is not very often) when i get calls from HMO MA members who are having a referral issues the delay is because the PCP has not processed the referral request or submitted incorrectly. The MA carrier referral approval time once the request is received is usually between immediately to 72 hours depending how the request was submitted. There can also be a delay from the time the specialist gets the referral approval and the time they call the member to schedule the appointment. ( this delay can happen even if you have a ppo or original Medicare when you see a new specialist) If you know who the specialist is call their office and they will tell you if request has been received or call the insurance company to confirm referral was submitted. There can be a big difference on how efficient the referral dept is between different PCP offices.


disclaimer licensed agent
Good to know. Thanks.
kd2008
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Re: Deciding on Medigap vs Medicare Advantage

Post by kd2008 »

kd2008 wrote: Fri Mar 24, 2023 8:46 am
cashmoney wrote: Thu Mar 23, 2023 11:21 am
There probably is data on this somewhere in the CMS data. I am more aware of the members hitting MOOP because they are more apt to bring it up. From my antidotal observation from speaking to many MA consumers the ones who do not have a hospital stay in the year with the typical number of doctor visits , diagnostic test ,out patient services etc may spend 200- 700.000 annual .The biggest reason one hits the MOOP is the 20% for chemo and dialysis however many middle class retirees can get help with this co insurance through different programs/foundations s

On the flipside of this the same person who has plan G may see the Medicare supplement G has paid out claims of 150-350.00 annual in this typical year. IMO the biggest reason to choose original medicare with a medigap is not financial protection but to avoid managed care and have complete flexibility on providers. This year i have had more of my medicare supplement clients call me and want to switch to MA plans. This has been a trend as medicare supplements premiums have been increasing and MA plans have been improving- in Florida especially. In fact as of 6/1 the biggest medicare supplement provider and long time rate leader in Florida UHC had their biggest increase ever up about 7% on plan G and 8.5% on plan N. What has really surprised me recently is the number of long time Mayo clinic patients who had Medicare supplements be willing to give up access to Mayo to get a MA plan-that never use to happen.

Of course all of this depends on where you live because some states like florida have high medicare supplement rates and very good MA plans and some states may have low medicare supplement rates and not so great MA options .

disclaimer licensed agent-not recommending any plans.
This post has so much wisdom and insightful information that I have looked but not found elsewhere. Thank you from the bottom of my heart.

When my DH goes on Medicare, we will most likely choose plan G for the reasons you listed. But we have options of MA plans - UHC plan and a local network called Community Care that may work out as well for most part and we will be ok and be cheaper.

Medical Savings Account (MSA) plans are an interesting wrinkle. They are a MA plan. $0 premiums. One can use any Medicare accepting provider nationally. $2000 per year in the savings account. $5000 deductible. $2000 can be used for vision and dental as well. The money is yours to use later on medical care if you don't spend it.

There is an option of $3000/yr savings account contribution plan with $8000 deductible.

Others Options I was thinking (not for us but in general):

1. Use this plan 65-70 and bank $10,000. Then go onto a traditional MA plan. Works if you are healthier. (Lucky few)

2. Use traditional MA plan and save on costs. If need be, go on to this plan if you need wider network. (Harder to do this when you need it and are sick, and need to be somewhat affluent to pay the deductible)

The deductible here is a true deductible, and not the faux deductible of plan G-HD where 80% is paid by part B.

Of course, waiting for Annual enrollment for MA plans is a hurdle.
I was explaining the tradeoffs to my DH. He was like G-HD seems to balance them well. You are going into a self selected pool of healthier cohort, it is acting like a true insurance with a backstop against high expenses, and it doesn't impede network availability. Plus it complements our HSA funds as they can be used for deductible costs.

He also raised concern about the evergrowing share of Medicare advantage plans (now about 40% or so. It was around 15-20% around 2008?). This means the pools for medigap plans are shrinking as well as aging, resulting in more expensive premiums. At some point there is going to be a runaway effect or death spiral for these plans.

Good thing we can go to an advantage plan during annual enrollment if that happens (albeit with lesser network).
ModifiedDuration
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Re: Deciding on Medigap vs Medicare Advantage

Post by ModifiedDuration »

First, I wouldn’t worry about a death spiral of Medigap plans due to decreasing enrollment, as enrollment in Medigap plans has actually increased from almost 10 million in 2010 to almost 15 million in 2022.

There were an awful lot of Baby Boomers becoming eligible for Medicare over that time frame, so even though the percentage on Medicare Advantage has been increasing the number of people with Medigap policies has also actually been growing.

Second, I wouldn’t worry about more expensive premiums for the high-deductible plans. Using F-HD as a proxy for G-HD (since F-HD has been around for so long), the high-deductible plans tend to have little or no annual premium increase over time.

The real increase in cost for the high-deductible plans is the annual increase in the deductible, now $2,700. This increase is tied to CPI-U.

As an example, the F-HD premium for my insurance company in my state has not increased in over 15 years. In fact, the premium has actually declined by over 40% over that time period.
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Re: Deciding on Medigap vs Medicare Advantage

Post by vested1 »

kd2008 wrote: Sat Mar 25, 2023 9:07 am

Good thing [for the insurance company that} we can go to an advantage plan during annual enrollment if that happens (albeit with lesser network).
Sorry for the unasked for edit. In my opinion, nothing about the privatization of Medicare is good for Medicare recipients. Having a lower premium, or none at all is simply camouflage, and hiding what is really going on. Ask your healthcare provider what they think of it. If they're honest you'll get an earful.

But hey, the insurance companies love Advantage programs. $1,000 to $1,200 a month of taxpayer money for every enrollee, and a dusting off of the old denial button that's been gathering cobwebs? What's not to love?
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Re: Deciding on Medigap vs Medicare Advantage

Post by book lover »

Want to know about behavior? Look at the incentives. An insurance agent makes about $750 selling an Advantage Plan and $250 selling a Medicare Supplement Plan. Whose pocket does the $500 come from when the agent is paid their commission? Provider choice is paramount for me in the event of a severe illness to my wife or me, so I will stick with Traditional Medicare with Supplemental Plan G.
kd2008
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Re: Deciding on Medigap vs Medicare Advantage

Post by kd2008 »

I agree with the cost of advantage plans to the taxpayers. But that is what CMS is choosing to do based on law. They are saying paying $1200 per month per enrollee is de-risking us from the catastrophic costs that sometimes pop up. You can't really blame insurers for taking advantage of that opportunity. Consumers are gaining dental, vision, hearing aid benefits. But they do not understand the tradeoffs or are ok with it because the future is unknown. Insurers play games for sure, but not everyone is affected the same otherwise the seniors would raise deluge of complaints.

Remember is it small tiny fraction of population that ends up using healthcare far in excess of median. That is why it is insurance.

My deceased FIL (RIP) had nearly dozen hospital stays, multiple surgeries etc while on Medicare advantage plan for 20 years and he was still considered "low usage" enrollee. So it is important to assess the reference point and understand relative frame of reference.
kd2008
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Re: Deciding on Medigap vs Medicare Advantage

Post by kd2008 »

vested1 wrote: Sun Mar 26, 2023 8:37 am
kd2008 wrote: Sat Mar 25, 2023 9:07 am

Good thing [for the insurance company that} we can go to an advantage plan during annual enrollment if that happens (albeit with lesser network).
Sorry for the unasked for edit. In my opinion, nothing about the privatization of Medicare is good for Medicare recipients. Having a lower premium, or none at all is simply camouflage, and hiding what is really going on. Ask your healthcare provider what they think of it. If they're honest you'll get an earful.

But hey, the insurance companies love Advantage programs. $1,000 to $1,200 a month of taxpayer money for every enrollee, and a dusting off of the old denial button that's been gathering cobwebs? What's not to love?
They are not denying care willy nilly. Let's bring in a realistic perspective here. I agree denial of care is wrong. But that is essentially a feature of advantage plans and not a bug. It is a tradeoff that many make unwittingly.
vested1
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Re: Deciding on Medigap vs Medicare Advantage

Post by vested1 »

kd2008 wrote: Sun Mar 26, 2023 4:27 pm
vested1 wrote: Sun Mar 26, 2023 8:37 am
kd2008 wrote: Sat Mar 25, 2023 9:07 am

Good thing [for the insurance company that} we can go to an advantage plan during annual enrollment if that happens (albeit with lesser network).
Sorry for the unasked for edit. In my opinion, nothing about the privatization of Medicare is good for Medicare recipients. Having a lower premium, or none at all is simply camouflage, and hiding what is really going on. Ask your healthcare provider what they think of it. If they're honest you'll get an earful.

But hey, the insurance companies love Advantage programs. $1,000 to $1,200 a month of taxpayer money for every enrollee, and a dusting off of the old denial button that's been gathering cobwebs? What's not to love?
They are not denying care willy nilly. Let's bring in a realistic perspective here. I agree denial of care is wrong. But that is essentially a feature of advantage plans and not a bug. It is a tradeoff that many make unwittingly.
Agreed, which was my point, and not a challenge to your prior comment.
HikerJ0y50
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Re: Deciding on Medigap vs Medicare Advantage

Post by HikerJ0y50 »

My Dad was diagnosed with pancreatic cancer in November 2022. Prior to that, I had no knowledge of my parents' choice regarding Medicap vs. MA. Needless to say, I have learned a lot about there choices in the past several months. They chose Medigap G (Blue Cross) and I just wanted to mention that the lack of stress specific to medical insurance/coverage has been a blessing, so far at least. I'm grateful for their choices because the stress of a terminal illness is its own beast. Not having to stress about MA-related coverage hurdles has allowed us to focus more of our time and energy on appreciating what little shared time we have left. There is no one size fits all "right" choice. Wishing everyone the best with their choices. :happy
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Re: Deciding on Medigap vs Medicare Advantage

Post by biscuits »

I chose traditional Medicare for many reasons, but among them are: I want to be covered when I travel within the US and I want the option to travel for specialty care out-of-state without begging some insurance board to grant me the privilege. You may think you have the time and energy to make that case now, but you might not if you are sick. I believe that Medicare Advantage plans restrict coverage beyond your state lines. My BCBS plan also includes a $50,000 lifetime benefit for coverage out of the US. That's not a lot, but it's better than nothing, which is what I think the Medicare Advantage plans offer.

And many physicians will not accept Medicare Advantage patients because the reimbursement is so low.
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Re: Deciding on Medigap vs Medicare Advantage

Post by Dregob »

biscuits wrote: Mon Mar 27, 2023 6:42 pm I chose traditional Medicare for many reasons, but among them are: I want to be covered when I travel within the US and I want the option to travel for specialty care out-of-state without begging some insurance board to grant me the privilege. You may think you have the time and energy to make that case now, but you might not if you are sick. I believe that Medicare Advantage plans restrict coverage beyond your state lines. My BCBS plan also includes a $50,000 lifetime benefit for coverage out of the US. That's not a lot, but it's better than nothing, which is what I think the Medicare Advantage plans offer.

And many physicians will not accept Medicare Advantage patients because the reimbursement is so low.
Advantage plans cover emergency medical care. I do wonder about the network argument against Advantage plans when I lived with that for my 40 years of employment?!
kd2008
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Re: Deciding on Medigap vs Medicare Advantage

Post by kd2008 »

Dregob wrote: Mon Mar 27, 2023 6:57 pm
biscuits wrote: Mon Mar 27, 2023 6:42 pm I chose traditional Medicare for many reasons, but among them are: I want to be covered when I travel within the US and I want the option to travel for specialty care out-of-state without begging some insurance board to grant me the privilege. You may think you have the time and energy to make that case now, but you might not if you are sick. I believe that Medicare Advantage plans restrict coverage beyond your state lines. My BCBS plan also includes a $50,000 lifetime benefit for coverage out of the US. That's not a lot, but it's better than nothing, which is what I think the Medicare Advantage plans offer.

And many physicians will not accept Medicare Advantage patients because the reimbursement is so low.
Advantage plans cover emergency medical care. I do wonder about the network argument against Advantage plans when I lived with that for my 40 years of employment?!
For some people it is a real hardship to find an in network specialist on short notice when on advantage plan. Especially in rural areas or small towns.

In large urban areas and in senior heavy areas like Florida it may not be much of an issue.
Agent 99
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Re: Deciding on Medigap vs Medicare Advantage

Post by Agent 99 »

OP mentioned they live in NJ but here is a troubling development out of TN. Vanderbilt Hospital will stop accepted Humana Advantage plans in April. The impact to those enrolled in Humana must be stressful. Perhaps this is a negotiating tactic and just a local problem.

The trickle down of this on others includes my brother who is a research scientist in the medical school. His department has slashed support budgets based on this problem.

From Vanderbilt: https://www.vumc.org/main/accepted-insu ... anges-2023

Health systems like Vanderbilt Health continue to face higher costs for personnel, supplies, equipment, and medications needed to provide high quality care.

We rely on fair partnerships with insurance companies that help us cover these increased costs. We can't continue to partner with insurance plans that don't reimburse us adequately.
biscuits
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Re: Deciding on Medigap vs Medicare Advantage

Post by biscuits »

Agent 99 wrote: Tue Mar 28, 2023 11:37 am OP mentioned they live in NJ but here is a troubling development out of TN. Vanderbilt Hospital will stop accepted Humana Advantage plans in April. The impact to those enrolled in Humana must be stressful. Perhaps this is a negotiating tactic and just a local problem.

The trickle down of this on others includes my brother who is a research scientist in the medical school. His department has slashed support budgets based on this problem.

From Vanderbilt: https://www.vumc.org/main/accepted-insu ... anges-2023

Health systems like Vanderbilt Health continue to face higher costs for personnel, supplies, equipment, and medications needed to provide high quality care.

We rely on fair partnerships with insurance companies that help us cover these increased costs. We can't continue to partner with insurance plans that don't reimburse us adequately.
Yes. A friend's 96yo mother is enrolled in Medicare Advantage and her provider (Lovelace) just pulled out of Medicare Advantage--I assume due to low reimbursements, but I don't know for sure. Now at 96, in the middle of a health crisis, she needs to find a new primary care doctor. The family is competent and attentive, but they are having a hard time finding her a new doctor.

Regarding specialists: I live a small, largely rural state. I saw 5 docs here for a tricky problem, with no diagnosis. Finally went out of state to a major medical centre, saw a great specialist, and am continuing my care there. My traditional Medicare and BCBS supplemental cover this care seamlessly.
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