Do you have experience and lessons from deciding on Medicare plan/provider?
- Thread starter compiler
- Start date
- 703
I chose a Medigap plan as I want to know my costs, want to avoid networks, no prior authorizations, and my plan doesn't change evry year.
Medicare A and B are not things you need to decide about. You eitherhave them or not based on your work history and regardless of the rest of your medicare choices you pay for B (and A is free unless you don't meet criteria for work quarters). Your choice is advantage plan vs original medicare with a supplement.
Advantage plans have networks, some don't pay for out of network (some do but at a lower rate), most have high maximum out of pocket costs. Some have vision dental and hearing coverage but it will vary between plans as will the conditions of use. A few offer transportation to doctor visits and some offer cash cards of varying amounts (fewer do this year). Some offer meds and some don't. If they don't you need to buy medicare D (those choices are on medicare.gov). If you go on medicare.gov (you don't need to sign in or create a account to see the information) you can see your choices in your zip code and what they offer. Out of pockets often run $3500-9000 with most of them in the $4500- 6000 range.
Original medicare you can be seen anywhere in the country at any facility that accepts medicare (so no network limitations). Depending on the supplement you choose (each alphabet letter is required to offer the same benefits although a few of them add "extras") your out of pocket may be as low as the medicare B deductable. You will need to buy D to pay for some of your drugs. Failure to buy it in a timely manner and you pay a life long penalty on premiums. You can see your choices on medicare.gov (be sure to put in your drugs, choose pharmacies and you will see the costs. If you do not buy a supplement you will have unlimited out of pocket copays and you will have to pay the Medicare A deductible every time you are hospitalized.
If you are low income (includes spouse income) you may be eligible for medicaid which dictates some of your choices but then medical care (you still need to have A, B and an advantage plan (this state, others may allow you to couple it with a supplement as there are some state difference but this one won't) but then medicaid picks up almost all of the rest of your costs.
Or you can talk to an agent about your choices about your choices and the pros and cons of them, they can answer questions and guide you through the process. If you want someone to educate you more about the medicare in general then you can look for your state's SHIP office. Those volunteers are trained to educate you about Medicare.
I, personally, for me would choose supplement G but then I have a lot of health issues and know I'd be hitting the higher out of pocket that advantage plans have. Also I'd want the freedom to be seen out of state as there aren't network issues, you don't need insurance to approve referrals, and when you first sign up you don't need to pass medical underwriting to get it (there are additional rules about this and exceptions).
Advantage plans have networks, some don't pay for out of network (some do but at a lower rate), most have high maximum out of pocket costs. Some have vision dental and hearing coverage but it will vary between plans as will the conditions of use. A few offer transportation to doctor visits and some offer cash cards of varying amounts (fewer do this year). Some offer meds and some don't. If they don't you need to buy medicare D (those choices are on medicare.gov). If you go on medicare.gov (you don't need to sign in or create a account to see the information) you can see your choices in your zip code and what they offer. Out of pockets often run $3500-9000 with most of them in the $4500- 6000 range.
Original medicare you can be seen anywhere in the country at any facility that accepts medicare (so no network limitations). Depending on the supplement you choose (each alphabet letter is required to offer the same benefits although a few of them add "extras") your out of pocket may be as low as the medicare B deductable. You will need to buy D to pay for some of your drugs. Failure to buy it in a timely manner and you pay a life long penalty on premiums. You can see your choices on medicare.gov (be sure to put in your drugs, choose pharmacies and you will see the costs. If you do not buy a supplement you will have unlimited out of pocket copays and you will have to pay the Medicare A deductible every time you are hospitalized.
If you are low income (includes spouse income) you may be eligible for medicaid which dictates some of your choices but then medical care (you still need to have A, B and an advantage plan (this state, others may allow you to couple it with a supplement as there are some state difference but this one won't) but then medicaid picks up almost all of the rest of your costs.
Or you can talk to an agent about your choices about your choices and the pros and cons of them, they can answer questions and guide you through the process. If you want someone to educate you more about the medicare in general then you can look for your state's SHIP office. Those volunteers are trained to educate you about Medicare.
I, personally, for me would choose supplement G but then I have a lot of health issues and know I'd be hitting the higher out of pocket that advantage plans have. Also I'd want the freedom to be seen out of state as there aren't network issues, you don't need insurance to approve referrals, and when you first sign up you don't need to pass medical underwriting to get it (there are additional rules about this and exceptions).
Similar threads
