Another Medigap question - which insurer

[Sue J]

Thank you. Living in the world of deductibles in the $6,000 range a Part B deductible of $166 looks spectacular! 80/20 also looks great but I can see where not having a dollar limit leaves you with a lot of risk in the case of a very expensive diagnosis and treatment.

I'm trying to learn about this before we get there in 2020. We are currently opted out of DHs retiree health plan but he can opt back in at Medicare age and receive an HRA allowance but must select his supplemental plan through their Towers Watson Connector system. The transition in the past year has been frustrating, confusing and upsetting to many participants. I follow the progress on a blog for retirees. Hopefully by the time we get there it will be running smoothly.

I expect Medicare costs to change by 2020 and wouldn't it be nice if there was a maximum out of pocket like the ACA plans!

Thanks for the response.

 

[molly312]

Make sure to check with your state rules regarding Medigap. Some states allow you to change Medigap insurers on your enrollment date. That is the way it is in Missouri. In some some few states you can go from Advantage to Medigap.....again, state rules. Usually, going from Advantage to Medigap requires underwriting and if you have a health issue - forget it.

You can easily go from Medigap to Advantage as long as you are satisfied with the doctors and hospitals available - think HMO. In most states - going from Medigap to Advantage is a one-way street, unless you move to a new area that doesn't cover your current Advantage plan.

 

[MichaelB]

Deeply disappointed with the Sunday South Fl newspaper. The issue had a special 16 page supplement titled "Medicare. Your 2017 Guide". It included articles, advice, descriptions, and information on more than 100 individual plan offerings. That is, Medicare Advantage offerings. Across the entire section there was only one mention of Medicare Supplemental Insurance, this

Another option is to buy a Medigap policy, private supplemental insurance that picks up co-pays and costs not covered by traditional Medicare.
However, insuring yourself through traditional Medicare combined with a Medigap policy can be more expensive than Advantage coverage.
To search for Medigap rates and more information: go to the Florida Office of Insurance at floir.com/choices. Or call 850-413-3140.

The section was clearly prepared by the state insurance lobby, but that was not mentioned anywhere. A real disservice IMO.

 

[Huston55]

The section was clearly [-]prepared[/-] paid for by the state insurance lobby, but that was not mentioned anywhere.

FIFY

 

[gayl]

Maybe I need an example -

Let's say I have an office visit. Billed at $150, adjusted to $120 by my insurer. On a non Medicare HDHP plan I'd pay $120 as my deductible. On a non HDHP plan that would be a $30 co-pay.

If I have Medicare this would be part B, correct? Without a supplement, what would I pay? If I had a supplement and had not met the deductible, what would I pay? How about if I had already met the deductible?

Medicare B adjusts bill down so you pay 20% of insured amt $120 = $24. No insurance = $150

If I have a medical test billed at $5000 my insurance adjusts it to $1500 and with a bronze plan I pay the $1500 as part of my deductible. How is this different with Medicare? How does a supplement cover this?

Medicare B = $1200
Supplement = $300