Medicare + Part D + Medigap...or Medicare Advantage?

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There are plenty of insurance brokers who have been blowing up my phone since the beginning of the year, but quite frankly, I trust the advice of the people on this board above some stranger out for profit.


I will be eligible for Medicare in December but understand I can apply in September. The health issues I have are issues I have to live with: fibromyalgia, high blood pressure, arthritis and stress from caring for bedridden hubby I see my PCP once a year, have a few cursory blood tests and that’s it. I haven’t been in the hospital for 6 years and that was elective surgery. Been 9-1-1-ed once, 10 years ago. I take a total of 2 meds that cost me $6.00, granted that’s with drug coverage.


For years and years I’ve dutifully written out checks for ridiculous amounts of money for health insurance I never use. We are in a terrific money crunch now. I added up hubby’s supplemental and drug costs and it’s over $200 a month. Plus we still pay a good buck for what Part D doesn’t cover.


Medicare Advantage holds a real appeal for me right now. People have said it’s great until you want to use it and then you pay through the nose with co-pays. But, I don’t use it! If I go for my yearly physical, what I’d have to pay would still be less than what the monthly fees for Medicare +Supplemental would be. To me, it’s like flushing money down the toilet. Money we need to use for other things...like food. I had a regular plan with CareSource a few years ago and wound up paying 1/2 the costs of my physical, x-rays, and blood tests anyway. Can’t be worse than that!


Help, help! Counting on you guys! Thanks!

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Medicare A, B, D, and UHC/AARP Plan F (F will only be available to new enrollees through the end of 2019 and then grandfathered to those with it, but not available to new members. At that time, Plan G will be the 2nd best.

Avoid Medicare Advantage.
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Reply to Myownlife
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Think of it this way--if you are paying money for insurance you are "not using", it's probably a sign that you are remaining healthy. I'm 66 and in excellent health, but I realize there will come a day on which I need care whether it's at age 69 or 89. I chose the Medigap plan G because it is very comprehensive.
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Reply to jacobsonbob
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RayLin: Thank you!
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Reply to Llamalover47
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Sorry, didn't read everyones responses but want to put my 2cents.

Thankfully husbands former employer handles our supplimental, DH paying a small fee for me. We have BC/BS. Neither husband or I have any health problems. Most years we don't even meet the deductable. By the time we do, its almost the next year, We also have a "share" amount we r responsible for.

Medicare pays 80% of what they consider reasonable leaving 20% you are responsible for. This s/b picked up by ur supplimental. With me and my Mom (AARP United Health Medigap) that 20% was split in half, I am responsible for the other half. When I had to look for a supplimental for Mom, the state of NJ only had 3 that I could chose from. Medicare Advantages used to be HMOs. I think now they are PPOs. Meaning that you probably can keep ur doctor but will get lower deductibles and copays if you stay within their network (their doctors and services).

You really have to weigh the cost of the insurance plus deductables and copays to determine if having the insurance will save you anything. Find out what your doctor excepts and hospitals in ur area.

By the way, if you are already getting SS, Medicare is automatic.
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Reply to JoAnn29
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Ahmijoy Aug 31, 2018
thanks, JoAnn. I’ve been looking at the Medigap Plan F high deductible. I’m not sure how it’s different from Advantage. The deductible is just about as high, though. There’s a lady on Facebook and also has YouTube videos and she has kind of a mini-course on Medicare and Medigap plans. You can call her and she’ll help you for free. I also checked out the SHIP webpage as the other poster suggested.

I know any insurance is a gamble and we have to have it. It’s just frustrating to have to pay all that money every month and never use it.
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Hello! Licensed Social Worker that counsels older adults on Medicare choices on a daily basis.  I suggest anyone struggling with making any Medicare decisions contact their local Area Office on Aging, their states SHIP (Senior Health Information Program) and/or Senior Center.  They are a wealth of impartial information about Medicare/Medicaid and the differences of Supplement and Advantage plans.  I have found some agents will strongly encourage folks to take Advantage plans which may not be the best one for you and then run into problems when the plan will not cover all of the costs of care or medications.  Make sure you do a benefits check-up every year because plans do change medications they will cover.  I am in Ohio and we have one of the best SHIP Programs in the country,  I am partial of course! While it may seem like your "pouring money down the toilet" with a Medicare Supplement, you will have very few costs later.  With a Medicare Advantage you have co-pays all along the way.  I refer to them as Pay it Now or Pay it Later.  It all depends on your own financial situation.  We all are used to paying for insurance we may never need, think about the insurances you have on your house, car, etc.  I hope my house never burns down but am glad I pay for it up front, same for car insurance, I hope I do not get in a wreck, but am glad I have had it for the times I have needed it. Good luck with your decision but remember you can always change it every year if it the one you chose does not work for you.
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Reply to sutree
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Istucany, hubby has Medicare, AARP, (which I think is United Healthcare). He has dental and eye through his union.

Jacobsonbob, his finger looked very bad. We have seen the Urgent Care doctor before and I trust him. I believe he got to see the specialist sooner because he did go by ambulance. I also think the doctor thought I would take him home and not go to the ER because I complained about the long wait time the last time I was there. Remember this was a table saw accident and the doctor thought nerves and tendons were damaged.

This is from my cell phone I hope it gets through ok.
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Reply to MaryKathleen
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Ah: You;re welcome!
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Reply to Llamalover47
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I was rereading my post,
I realized that I wasn't clear. It sounded like I haven't had any health issues. That is not true. I meant the insurance companies have paid off with no problem.

Ahmijoy one major illness can cost thousands. My husband cut his finger badly on a table saw recently. We went to urgent care. The doctor said he needed a hand surgeon and insisted be go by ambulance to the hospital about 1/2 mile away. It cost $1,400. Just for ambulance. Insurance covered all. Haven't seen anything from urgent care , ER or doctor.
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Reply to MaryKathleen
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lstuscany Jul 28, 2018
Hello Mary,

Hope me you’ve been well. You were one of the first people to respond to me when I signed up some months ago.

With your reference to the urgent care, cut finger, ambulance and specialist. What insurance was the primary. Medicare then a secondary?
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As Llamalover47 says, use an agent.

I went to the Medicare site when it was time for me to carry insurance and it even states there, get an agent.

You don't pay the agent - they earn small commissions. An Advantage Plan will cost you more money and still has limits. My DH had a "oldie but goodie" plan that is no longer offered so we kept it. No limits on it back then.

I opted for a policy that I pay the deductible because it saved me more than the deductible in paying the premiums. A good agent will give you the time to figure it all out - have a calculator and pen & paper handy. It took me a few minutes to see that paying the deductible out of pocket really did save me money over the premiums.

I never met my agent - talk to friends and family, that's how I found my agent. He has me call him every November to see if there is a better plan for me. He's changed my insurance companies twice and my drug plan twice. Since I take no drugs, I can always get the cheapest plan he can find. Same with the Health Insurance, I've never been hospitalized for anything.
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Reply to RayLinStephens
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Ahmijoy Jul 28, 2018
Thanks, Raylin. I can’t quite pull the trigger on the Advantage plans. I do understand what everyone is saying. It’s a gamble, and with the way my life has gone over the past decade, it’s a guarantee I’d lose.

I did get a letter from a local agent and I will call him when I become eligible in September. I remember my mother also used an insurance agent and her plan was always changing, but her insurance premiums didn’t seem to cause her hardship. I may even have this agent look over hubby’s supplemental and drug plan.

thanks again!
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You would be wise to use a qualified insurance agent when you sign up for Medicare Supplemental as it can be difficult to understand which plan letter to sign up for, assuming you're going purchase Medicare Supplemental. What also comes into the decision in your own health history.
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Reply to Llamalover47
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Ahmijoy Jul 28, 2018
Thanks! I am going to use an agent. I realize it’s just the intelligent thing to do.
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