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Medicare Supplemental Insurance variation by location?
Old 04-03-2020, 06:01 PM   #1
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Medicare Supplemental Insurance variation by location?

Hi all:

I have not researched Medicare much, as it is still 2.5 years away, but now I am starting to read and plan. My only exposure to Medicare was 5+ years ago with my parents, who had an excellent supplemental retiree policy and almost every cost of their care was covered either by Medicare or by the retiree supplemental plan.

However, I won't have a retiree benefit, so I will need to purchase either Medicare Advantage or a Medicare Supplemental policy of some sort.

The bain of my FIRE ACA existence has been the huge variation by state and by county in policy premiums and quality (coverage, networks, etc). In fact, as a nomad, I "moved" from Polk County TX to Sumter County FL so that I could buy much better insurance.

QUESTION: is there a similar phenomenon with Medicare supplemental policies? Will the quality and price of what I can get vary dramatically by state/county?

I've started to think about this as I consider where I might finally settle aged 65+ (NM, AZ and OR are current contenders). Do I need to thrown cost/quality of Medicare Supplemental policies into the decision mix?
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Old 04-03-2020, 07:02 PM   #2
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In the mountains of NC, DW had a few choices for a Plan G supplement at around $95 a month. Lowest cost Part D plan was about $14. Medicare Advantage plans up here do not have a big network. I hear the Advantage networks are much better in say, central Florida.

So, I don't think prices differ a great deal by location but plans do. At least in my experience. YMMV

You can go online to various BC locations and put in various birthdates to find out the current cost. Have you tried that?
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Old 04-03-2020, 07:35 PM   #3
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Thanks. I am still sorting through the alphabet soup of D, C, G, F, ....

So far I haven't found a decent online reference which discusses Parts and Plans. The official Medicare site is opaque at best. If someone can give me a link/URL to a good guide to Medicare, I'd appreciate it.

My understanding is that how good a Medicare Advantage plan is will be VERY location dependent. If you travel around the US quite a bit, you should stick to traditional medicare with much larger networks .
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Old 04-03-2020, 08:50 PM   #4
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Originally Posted by BarbWire View Post
Thanks. I am still sorting through the alphabet soup of D, C, G, F, ....

So far I haven't found a decent online reference which discusses Parts and Plans. The official Medicare site is opaque at best. If someone can give me a link/URL to a good guide to Medicare, I'd appreciate it.
https://boomerbenefits.com/new-to-medicare/

Some say the above link will answer your questions. Boomer Benefits has many explanations and will work with you. No, I do not have a financial relationship with them.
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Old 04-03-2020, 09:12 PM   #5
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There is a good search engine here if you use the Google option. You'll find that this has been discussed many times.
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Old 04-04-2020, 05:24 AM   #6
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Quote:
Originally Posted by BarbWire View Post
The bain of my FIRE ACA existence has been the huge variation by state and by county in policy premiums and quality (coverage, networks, etc). In fact, as a nomad, I "moved" from Polk County TX to Sumter County FL so that I could buy much better insurance.

QUESTION: is there a similar phenomenon with Medicare supplemental policies? Will the quality and price of what I can get vary dramatically by state/county?

I've started to think about this as I consider where I might finally settle aged 65+ (NM, AZ and OR are current contenders). Do I need to thrown cost/quality of Medicare Supplemental policies into the decision mix?
No. MediGap is much simpler. The price for the MediGap varies some around the country, but no matter where you live when you enroll, the network is the same - all the providers in the US that accept Medicare.

Quote:
Originally Posted by BarbWire View Post
Thanks. I am still sorting through the alphabet soup of D, C, G, F, ....

So far I haven't found a decent online reference which discusses Parts and Plans. The official Medicare site is opaque at best. If someone can give me a link/URL to a good guide to Medicare, I'd appreciate it.

My understanding is that how good a Medicare Advantage plan is will be VERY location dependent. If you travel around the US quite a bit, you should stick to traditional medicare with much larger networks .
Not sure if you’re asking about MediGap or Medicare Supplemental. There have been hundreds of threads on this, close to one hundred just in the past year. Just browse the health forum and look for Medicare in thread title. Here are a few

https://www.early-retirement.org/for...ath-94740.html

https://www.early-retirement.org/for...vs-101032.html

https://www.early-retirement.org/for...re-101383.html
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Old 04-04-2020, 06:57 AM   #7
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Simply stated, to meet your main concerns about limited access to providers, stay away from the various Medicare Supplement (aka MediGap) plans that have the word "Select" in them. Those plans have "in-network" providers.

All plans with the same "letter" have the same minimum benefits. For instance, a Plan G from company 1 will have the same benefits, copays, etc as a Plan G from company 2, 3, &4. The only difference is premium and possibly service in correcting errors in billings. Some plans such as AARP Plan G have some extra benefits like gym membership. Those plans may (?) vary from location to location, but only on those "added benefits". The federally mandated Medicare benefits cannot change.
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Old 04-04-2020, 07:14 AM   #8
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Thanks you for the quick overviews and for the links pointing me in the right direction.

Just to give you an idea of my level of confusion, MichaelB wrote: "Not sure if you’re asking about MediGap or Medicare Supplemental" which seems to suggest -- to me -- that they are are different, but CRLLS wrote "Medicare Supplement (aka MediGap)" which makes it sound like two names for the same thing. I have a lot to learn.

I tried using the search engine here with "Medicare" and "Supplemental" and "Medigap" and was overwhelmed with the number of threads returned.

MichaelB: can you please tell me the Google search terms/phrase you used to come up with the three threads you provided? they hit the nail on the head. (Yes I know -- I am not a very sophisticated Google searcher. Another skill I need to improve.)

Thanks again. This will give me quite a bit to read during lockdown...
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Old 04-04-2020, 07:24 AM   #9
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If you will move around or just travel a lot you will want to stay away from Advantage plans and their local networks. A lot of people that don't travel much will advise staying away from Advantage. I do have Advantage and have not had any major issues, but I am relatively healthy and don't travel much.
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Old 04-04-2020, 07:27 AM   #10
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IMHO, one of the best threads on the subject of Medicare/Medigap

https://www.early-retirement.org/for...ath-94740.html
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Old 04-04-2020, 07:30 AM   #11
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Spend $15 on this book'

https://www.amazon.com/Medicare-Dumm...s%2C190&sr=1-3
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Old 04-04-2020, 07:56 AM   #12
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MichaelB: can you please tell me the Google search terms/phrase you used to come up with the three threads you provided? they hit the nail on the head. (Yes I know -- I am not a very sophisticated Google searcher. Another skill I need to improve.)
One option is to visit the Health Forum and look for theads 1) with Medicare in the title and 2) lots of posts. https://www.early-retirement.org/forums/f38/

Another is to use the Forum search function, look for “Medicare” only in the title, and then open the threads with lots of posts - more than 25. https://www.early-retirement.org/forums/search.php
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Old 04-04-2020, 08:00 AM   #13
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Again, thanks all! Time to start reading. Glad I have two years to figure this out!
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Old 04-04-2020, 08:04 AM   #14
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One other recommendation is to search for posts by member MBSC. He is an expert on health insurance and his posts regarding Medicare are always informative.
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Old 04-04-2020, 08:12 AM   #15
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One other recommendation is to search for posts by member MBSC. He is an expert on health insurance and his posts regarding Medicare are always informative.
Very good idea.
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Old 04-04-2020, 09:55 AM   #16
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Thanks you for the quick overviews and for the links pointing me in the right direction.

Just to give you an idea of my level of confusion, MichaelB wrote: "Not sure if you’re asking about MediGap or Medicare Supplemental" which seems to suggest -- to me -- that they are are different, but CRLLS wrote "Medicare Supplement (aka MediGap)" which makes it sound like two names for the same thing. I have a lot to learn.

I tried using the search engine here with "Medicare" and "Supplemental" and "Medigap" and was overwhelmed with the number of threads returned.

MichaelB: can you please tell me the Google search terms/phrase you used to come up with the three threads you provided? they hit the nail on the head. (Yes I know -- I am not a very sophisticated Google searcher. Another skill I need to improve.)

Thanks again. This will give me quite a bit to read during lockdown...
Barbwire, to hopefully clarify this one thing for you, I'll quote the Medicare.gov website:
Quote:
What's Medicare Supplement Insurance (Medigap)?


Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies
They are one and the same. Now for figuring out what is your best choice with all the options available, that will take more reading and investigating on your part. We are here to help. Ultimately it will be your decision.
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Old 04-04-2020, 05:58 PM   #17
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Now for figuring out what is your best choice with all the options available, that will take more reading and investigating on your part. We are here to help. Ultimately it will be your decision.

Yep, the buck stops with me! Fortunately I've got a couple of years to dig through and digest this all and weigh my options.

Being an optimist, I tell myself decoding Medicare is much less complex than evaluating ACA policies is!

Again, thanks to all for pointing me in the right directions to begin my studying!
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Old 04-05-2020, 05:59 AM   #18
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I've started to think about this as I consider where I might finally settle aged 65+ (NM, AZ and OR are current contenders). Do I need to thrown cost/quality of Medicare Supplemental policies into the decision mix?
Medicare supplement (Medigap) premiums can be attained-age, issue-age or community-rated. Attained-age premiums change each year for both age and inflation.

Medigap policies written in AZ are issue-age. The age 65 premium will be higher than age 65 attained-age rates in the other states because the age adjustments are already built into the initial premium. However, the issue-age policy only increases for inflation, not age so it tends to balance out over the long term.

The Mayo Clinic location in AZ does not accept most Medicare Advantage plans. More info: https://www.mayoclinic.org/patient-v...re-on-medicare

The Mayo Clinic in AZ is not a Medicare participating provider. This means they can charge 15% above the Medicare approved amount for Part B physician services. Medigap Plan G pays this excess charge but has a higher premium. Plan N does not pay the excess amount but the premium savings can be applied toward this amount should the need arise. Their Florida location has developed this document explaining the billing impact: https://www.mayoclinic.org/documents...u/doc-20078770

Oregon has a "birthday rule". Each year, you can switch to another Medigap plan with equal or lessor benefits without medical underwriting. For example, if you choose Medigap Plan G you can move to another company's Plan G if their rates are lower next year. If all Plan G's become too expensive, you can downgrade to Plan N.

CMS Guide to Choosing a Medigap: https://www.medicare.gov/Pubs/pdf/02...igap-guide.pdf

2020 Medicare & You booklet: https://www.medicare.gov/Pubs/pdf/10...re-and-You.pdf
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Old 04-05-2020, 06:40 AM   #19
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Not to repeat what others are saying, each state has a State Health Insurance Assistance Program (SHIP). Here in NC it is called SHIIP. State Health Insurance Information Program. What happens is that the state and local agencies train volunteers to advise people like you. Your search engine of choice will find the local office. These volunteers will meet one on one with you and answer all of your questions. I am one of these volunteers.
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Old 04-05-2020, 11:49 AM   #20
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Medicare supplement (Medigap) premiums can be attained-age, issue-age or community-rated. Attained-age premiums change each year for both age and inflation.

Thanks so much and ....Oy! this makes my head hurt!

I am now soooo glad that I have two years to study and figure this out. I remember my scramble during Open Enrollment in 2015 as I tried to quickly sort out the ACA plans open to me because my pre-ACA grandfather plan had been discontinued.

This forum -- and especially your posts -- were invaluable.
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