Medicare: figuring out what to do...

I have a friend in the same situation. He did get a $0 premium Advantage Plan and if that does not cover, the Tricare for Life will. Just a thought.
Do you (or anyone) know offhand how something like that works in terms of deductibles, co-pays, etc? Like do they go by the MA plan or Tricare?
 
This is curious; I was checking out the Part C thing and found out even if you have part C, you still have to pay the Part B monthly cost. ? What's the point of Part C then? Just getting little extras like visual and dental?
If you have Part C (an Advantage plan - beware) it will cover the 20% that Part B does not pay, unless you get denied care, which happens with Advantage plans. Medicare typically does not cover vision and dental but some Advantage Plans do. Advantage plans are private managed care, an HMO, so you can only go to doctors in their network. If you have a Medigap plan you can go to any doctor that takes Medicare.
 
If you have Part C (an Advantage plan - beware) it will cover the 20% that Part B does not pay, unless you get denied care, which happens with Advantage plans. Medicare typically does not cover vision and dental but some Advantage Plans do. Advantage plans are private managed care, an HMO, so you can only go to doctors in their network. If you have a Medigap plan you can go to any doctor that takes Medicare.
You can have Medicare Advantage PPO plans where you can go to any doctor in the PPO network. HMOs are alot more restrictive. Advantage plans cover "Fully" with minimal co-pay and with yearly maximum, no 20% co-pay. 20% co-pay is only for traditional medicare.
 
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Due to my military allowing me Tricare, I think my plan is clear: Medicare A and B plus Tricare should pretty much cover me, as that basically acts as my "Medigap." But I still found it kind of a maze and took more than a little reading and research, and realize others may be debating which way to go and thought it might be worth having a thread about it...
A and B plus plan G when it comes time
 
Due to my military allowing me Tricare, I think my plan is clear: Medicare A and B plus Tricare should pretty much cover me, as that basically acts as my "Medigap." But I still found it kind of a maze and took more than a little reading and research, and realize others may be debating which way to go and thought it might be worth having a thread about it...
I can relate our experience. Medicare A&Bare mandatory. Going to any of the Advantage plans just limits your options and flexibility. YMMV.

I added a GeoBlue Trekker policy and MedJet membership to cover yragrl
Medical.

Haven’t needed anything else.

We use military pharmacies, but depending on distance, that isn’t an option for some.
 
Due to my military allowing me Tricare, I think my plan is clear: Medicare A and B plus Tricare should pretty much cover me, as that basically acts as my "Medigap." But I still found it kind of a maze and took more than a little reading and research, and realize others may be debating which way to go and thought it might be worth having a thread about it...
I was very fortunate from a 2nd career post-USAF to be able to retire early and start serious sailing with my wife, and even took 2 grandkids a few years apart for 2nd & 3rd Grade aboard. No complaints on how TFL & Medicare A/B work together(other than excess paper!)
Suggestion, create an online account with both; link you & your spouses accounts so you both have full access & visibility; go paperless on statements; AND
Look at alternatives to using Express Scripts for medications unless you have very costly specialized meds - with the recent change to $13 each for refills by ExpScr we looked at our local CVS & WM Pharmacy for our 4 meds and get same refills for 2 of them for less than $1 each for 90 Days and 2 of them just under $2 each for 90 Days👍
 
I thought you either paid $13 for delivery or went to a military installation for meds?
 
Then how are you using CVS etc? Just paying for yourself?
 
My bad; I thought they didn't do retail, but looks like that's only for certain (and mostly not common) drugs.
 
Then how are you using CVS etc? Just paying for yourself?
Yes, we just have any prescription sent to our local CVS and then manage refills online and pay at pickup. Of our 4 meds, a 90 Day refill for any of them is under $2.... much better than the $13 Exp Scripts Cost..
 
Some great info on this thread. so far, thanks. I am wrestling with staying on the Aetna Advantage plan we switched to this year. Or returning to traditional Medicare. Here are my concerns with not switching. I would like to hear your experience and thoughts about my comments (If this seems like a hijacking of the OP thoughts, I will be happy to move this to a new thread:

  • My big concern with Advantage is the possible limitation of doctors. My experience to date is with the various procedures DW and I have required, only one was poorly executed. The doctor, head of the department, was highly recommended. He also had an alcohol problem others did not seem to know about. The procedure took place many years ago. Otherwise, for our few procedures, things went very well. Do you think it is true that for many/most procedures there is a choice of good doctors (typically recommended by the primary doctor and friends) of which one would likely be in the Advantage program?
  • Mayo Clinic, John Hopkins, perhaps others currently do not participate with Advantage plans. While we are fairly healthy and fit today is that enough to suggest the Advantage plan may not serve a person well when they need it most? Or, is that an over reach for making this decision?
  • Some health care providers are dropping MA. Is this a trend that you think will continue and you are concerned about? Or do you think the insurance companies will try to satisfy health care operators objections?
  • My MA plan seems gimmicky. Since we had no real medical issues, I think we made money this year with the $0 premium, quarterly allowances, payment for routine exams, etc. I guess while marketing consumer products, I made sure the products worked as promised but still had an off label. But for my health care, it just does not seem right. Is this a concern for you?
  • Other?
Thanks
 
Some great info on this thread. so far, thanks. I am wrestling with staying on the Aetna Advantage plan we switched to this year. Or returning to traditional Medicare.
No experience with Advantage. I see many red flags there. The BIGGEST red flag IMHO is the way it's being "hawked" on TV, radio, and the Net making me think there are hidden agendas, costs and issues with availability of drs. and services. I have no experience with it and I am sticking to traditional MC. Just one guy's (on the internet) opinion, so YMMV.
 
No experience with Advantage. I see many red flags there. The BIGGEST red flag IMHO is the way it's being "hawked" on TV, radio, and the Net making me think there are hidden agendas, costs and issues with availability of drs. and services. I have no experience with it and I am sticking to traditional MC. Just one guy's (on the internet) opinion, so YMMV.
Good point about the docs. AARP Bulletin, in a just received issue, reported that less than half of the doctors in a county are in the MA plans. From other reading, 'specialists' type health care, like the Mayo Clinic, do not participate in MA.

AARP also spoke about the 3 pricing programs. I am lucky to be in a Community-rated state which means policies charge the same amount to everyone in a geographical area. DW and I are still fairly healthy so we might be paying more than we could on a different approach. But, I like this one.

AARP does provide 4 examples of different sorts of medical needs (accident, sick while on vacation, etc) and their cost comparing MA to Original Medicare. The costs are pretty close with MA being lower on 3 out of 4. . Having said that, the lower monthly premiums of MA, make Original Medicare nearly twice as expensive for premiums with Medigap and part D.
 
Having said that, the lower monthly premiums of MA, make Original Medicare nearly twice as expensive for premiums with Medigap and part D.
I don't know about this statement. MA plans receive almost all the Part B premium. So it can't be an apples to apples comparison on premium costs. A $0 premium MA plan that covers everything Part B covers is not cheaper than Traditional Medicare - it's the same cost as Traditional Medicare.

But Medigap is expensive and that's where the comparison becomes apples to apples and MA is lower cost. But for that lower cost many have to accept the inability to see any provider they want, and the risk that the provider they want to see won't take Traditional, but will take MA.
 
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