Medicare Advantage vs. Medigap vs. ?????

[CRLLS]

So do you think that Part B is being withheld from their SS check and that is why they think that they are paying zero?

https://www.ehealthmedicare.com/med...zero-dollar-premium-medicare-advantage-plans/

Yes. I don't think SS allows you to pay Medicare if you are collecting SS. Or maybe it is Medicare who doesn't allow it. They are both collecting SS. So Part B is paid via deduction from SS.

They are both intelligent people. I don't know why they ignore or dismiss the fact that they still pay the Part B.

 

[razztazz]

They are both intelligent people. I don't know why they ignore or dismiss the fact that they still pay the Part B.

I have known lots of people who brag about "not paying taxes" because when they do their 1040s they end up not owing anything or even get a refund. For some reason they're ignoring the money that was withheld and not refunded because that's what they owed. To them it's like not paying taxes.

 

[pb4uski]

I have known lots of people who brag about "not paying taxes" because when they do their 1040s they end up not owing anything or even get a refund. For some reason they're ignoring the money that was withheld and not refunded because that's what they owed. To them it's like not paying taxes.

Brings new meaning to the phrase "Ignorance is bliss".

 

[Katsmeow]

I think that many people who sign up for Medicare Advantage have heard about the advantages but not the disadvantages. When I was getting ready to go on Medicare I would get mail advocating for various plans. The vast majority were for Medicare Advantage. They didn't point out the disadvantages. I did a mailing from AARP UHC on their Medigap supplement but it was mostly MA. My doctor kept trying to get me to sign up for it. I told him I wouldn't and he was startled and wondered why? I pointed out the underwriting issue (if you want to go back to traditional Medicare) and he seemed surprised. Many people think you can freely go back to traditional Medicare if you don't like MA. You can, of course. But, you can't freely get a supplement and many people don't realize that.

 

[travelover]

............. My doctor kept trying to get me to sign up for it. I told him I wouldn't and he was startled and wondered why? I pointed out the underwriting issue (if you want to go back to traditional Medicare) and he seemed surprised. ............

No offense to doctors, but they don't seem to know much about how much anything costs, how it is paid for or what strategies exist to get the most value for your medical expense dollar.

My current doc is good, but I've had to fight with others in the past, for example, to get a paper prescription so I can shop it. "Gee, why would you do that?"

 

[audreyh1]

We have some neighbors who went with MA because they paid 0 premiums, they get a pair of glasses each year, and dental check-ups. Last year he got throat cancer, and while he is now cured and they were pleased with his care, it cost them around $10K, as they had to pay OOP for every scan, chemo, doctor visit, etc. They're regretting their MA decision.

They might have already saved $10K by paying $0 premiums for years?

Regardless, I wouldn’t go that route because I’m tired of max OOPs and limited networks and having a gatekeeper and getting insurance company approvals to see a specialist or get doctor ordered imaging (HMO crap).

 

[Bongleur]

Here's a table of the standardized supplement plans. ...
btw ......a YES in the table means it is covered.

https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies

What does N/A mean in the MOOP row?
1) potentially unlimited out of pocket
2) zero out of pocket

 

[pb4uski]

I think they mean 2... zero out of pocket... or more precisely, your out of pocket would be the deductibles and co-pays in the higher rows.... sort of awkward the wya the did it.

 

[Bongleur]

I think they mean 2... zero out of pocket... or more precisely, your out of pocket would be the deductibles and co-pays in the higher rows.... sort of awkward the wya the did it.

The footnote is equally opaque. What is the "out of pocket limit" for Medicare itself? Why not state that amount?

** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

The biggest unknown in the whole scheme seems to be the "Part B excess charge" - I guess you have to be an expert in your state laws to figure your worst case expense for that ?

And those who might want to go even to Canada or Mexico need to ask how much private insurance for "Foreign travel exchange" costs. But that probably won't be an every-year expense.

 

[Bongleur]

Seems like with the cost of medical care rising 5-6% a year, the increase in cost will be transparent with Supplement (Medigap) (a higher premium) but hidden with Advantage (reducing services or raising MOOP). So harder to compare providers with Advantage.

 

[Leroy Jones]

I've read through all the reply's on this topic. About a year ago I had heart surgery total cost $122,000. My out of pocket was $450. I have a Medicare Advantage Plan for which I pay no premium. I have to pay my Part B Medicare premium. Total expenses for me and the wife who is on the same plan was under $6000 including all premiums prescriptions and co pays. Wide network of Doctors covering all of Western NY. So far happy with the plan. All Hospitals are also in plan in Western NY

 

[frank]

I've read through all the reply's on this topic. About a year ago I had heart surgery total cost $122,000. My out of pocket was $450. I have a Medicare Advantage Plan for which I pay no premium. I have to pay my Part B Medicare premium. Total expenses for me and the wife who is on the same plan was under $6000 including all premiums prescriptions and co pays. Wide network of Doctors covering all of Western NY. So far happy with the plan. All Hospitals are also in plan in Western NY

would you mind telling which medicare advantage plan you use? Maybe I could learn something.

 

[Leroy Jones]

Univera

 

[RobbieB]

My max out of pocket will be 6700 / yr, sweet! Full west coast coverage plus Colorado, Hawaii, Virginia, Georgia and DC.

Not to mention I've been on Kaiser for 12 years now and I like it.

 

[golfnut]

My max out of pocket will be 6700 / yr, sweet! Full west coast coverage plus Colorado, Hawaii, Virginia, Georgia and DC.

Not to mention I've been on Kaiser for 12 years now and I like it.

Advantage or Medigap?

 

[RobbieB]

Kaiser Senior Advantage, HMO. Kaiser is big on the West Coast.