Classic Medicare & Medigap vs. Medicare Advantage

[SteveL]

Since I retired, my former employer changed how our health insurance was handled a number of times. Sometimes I have had GHC, sometimes BCBS, sometimes a different plan. You have to go to what they offer you. Currently have BCBS. Yesterday, I called them to ask about their Medicare Advantage plan and whether or not they have doctors you can go to in Palm Desert, for example. The answer is yes. So, for BCBS (BS here in WA) if you do Med Ad, you can travel in the US. The person I spoke to said to check because they don't have docs everywhere.

Regarding GHC. When we were down there in 2009, I hurt my shoulder at the gym, and wanted to see a doc. Was trying to avoid the $300 em room ded with GHC. Here in the Seattle area, GHC has urgent care at many of their offices that you can go to on the weekend, and avoid the em room. Well, Kaiser has limited facilities in the Palm Springs/Palm Desert area. They have some contract docs in various places, but no urgent care. After I went through the nonsense to get a Kaiser #, I tried to get an appointment, but it would have been a week wait to see a gp. Alt. I could drive to Riverside to get urgent care, or go to the emergency room. I still ended up paying the $300.....

Still, it has been two years since my experience. Perhaps GHC and Kaiser have done more to meld their computer systems since my experience. GHC has great care if you don't travel much. Very easy, very efficient, great on-line experience. They have a Med Ad plan, but being gone for four months each year makes that choice questionable to me.

[Zero]

SteveL, thanks for sharing that information and your experiences. I'm still on company retiree insurance with 3 years to go before Medicare. I have a choice of HMO or PPO and I chose PPO from the get go. I never looked back. I love BCBS PPO.

Now, that is not to say I wouldn't have loved an HMO just the same, BUT, as I go toward the age 65 decision, my current thinking is taking our company subsidized Med Advantage PPO option because of exactly what you mentioned. Travel.

I have a college buddy/cardiologist at Weill-Cornell in NYC and I go to him for yearly checkups and BCBS pays regular as rain. I go to San Diego doctors for most other things and no problems with payments. I chose the doctors, I can refer myself to specialists and I really like those aspects.

But I really wonder if Medicare + Medigap is the answer or whether Medicare Advantage really does have an advantage. That's hard to noodle out.

[SteveL]

Currently on BCBS of MA PPO. It works well, and you can find docs via their web site most places. Unfortunately, this ends later this year when we switch to Medicare. We can continue retiree med, but the plan goes from BCBS to Aetna, and there will no longer be a list of Docs who accept the plan. Coverage stays the same in terms of copays and deducts, but you have to find docs who will accept medicare. My alts are Medicare with a Medigap supplement, or Med AD plans avail here. With the Retiree Med, you can get it with drugs or w/o if you want your own D plan. We are paying $700 month for medical now. Looks like the cost will be much the same between paying for Med B, and whatever options we choose. I have to look into the MAdvantage plans a bit.

Looks like the govt. will be gradually phasing out the extra subsidy for MAd plans.

One of the good things about staying on Ret Med, is if you want to change later, you can switch to a medigap/plus d later on with no penalty.

There is a group of clinics here (Virginia Mason) that accept medicare and we already use them.

Haven't decided what to do. Lots of other retirees here from my co. and they have all done different things, but most seem happy with their choice, so not sure if you can go wrong.

[Brat]

We had Kaiser for years until moving out of their service area. I agree it is much easier to use if you are in their service areas. I haven't had occassion to use urgent care out of their service area for 55 years (my parents were subscribers) and I recall that the office tried to give Mom the run-arround but backed off when they found that I was hospitalized after I returned.

I am a Fed retiree so have GEHA as an option (Medicare is always primary if you have that). My issue after moving from the Seattle area to Portland has been finding a primary care physician who accepts Medicare. Kaiser is more expensive than GEHA so my wallet was determinative.