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Don't be tempted. The reason they are flooding the market with baits for Advantage is that it's cheaper for them, and it can really cost you - not them - in case anything happens to you (illness or accident).
The woman I talked to (a salesperson who checked to see if I'd received the latest changes regarding my meds and whether I had any questions), even said that it's a gamble taking Advantage.
When my brother heard what happened to me, he finally decided to get a Supplemental Plan. It is SO worth it. Anything can happen at any time: severe illness, terminal illness, catastrophic accident - not to mention the myriad things that come up for seniors. I used to be so incredibly healthy except for my lung issues. Now? I have so many appointments I wouldn't be able to keep up with the co-pays let alone if something happens and I end up in the hospital like I did 3 times 12 years ago. I have a $42/mo dental/vision/hearing plan that works just fine for me.
I guess some people don't mind gambling, especially if they have plenty of other resources. Those are the only people for whom Advantage works, in my opinion.
By the way, my understanding is that premiums are based upon the state you live in, not your income. I have a California plan and can switch (during the annual switch period) to a cheaper plan where I live now. I just leave it alone because it works for me and I may end up back in California some day.
Agree. We got a plan G and in the first year my husband was on it he was diagnosed with prostate cancer. Even though the doctor said he could wait and see as it was slow growing, he didn't want to and chose to have Proton Therapy after researching it and talking with others who had it done. If he was on an advantage plan he probably wouldn't have been covered for Proton Therapy and either would have to have traditional radiation or have it removed. The advantages of Proton vs Traditional is that with proton it is directed at the tumor and avoids damage to other organs surrounding the prostate. It is also used in other cancers like brain and breast. The biggest thing with radiation and breast cancer is possible damage to the heart. With brain you can imagine what else could potentially be affected. He has been happy with his decision. It wasn't easy or comfortable, especially inserting the markers to direct the proton but it worked.
I will be 80 years old in December. I am still working part time as a tax preparer and book keeper. I am a reasonably educated person who raised 3 children on my own for 15 years. I have had many life experiences and am reasonably proficient in business matters. I am astounded at the amount of misinformation I am reading on this thread.
I know doctors who will not take new patients with Advantage plans. People can take in the information posted on this thread, there is good info here but, there is contradictory info, as well. Take the knowledge gained here, terminology, questions to ask a Medicare coach, and then make your decisions. Please do not base it just on these boards. Knowledge is power and this is one of the most important decisions in your life. Know your options then, act. Some of the info stated here is irreversible, some isn't. Know the difference and good luck.
It would be helpful if you would state specifically what is untrue in this thread. I would not be offended. I have shared that I don't know everything, and researched only what I needed at age 65 after being royally screwed by Medicare Advantage. I never asserted that everyone would be screwed, only that it is a gamble which I believe is reasonable to assume for many - not all - folks.
I went straight to a broker the last days of the month before I turned 65. My Supplemental plan went into effect on the 1st day of my birthday month.
I started this thread because it was my impression from the agent that people are able to switch, and they are free to do that for one year even after being on Supplemental.
The agent stated that this is a rule that not every agent tells people, so many people don't know about it. Again, that's why I started this thread.
I plan to call the agent on Monday and confirm what she said, and ask other questions. Because, like I said, she told me that I am free to switch over for a year to see if it would work for me. Why would she mislead me?
Last edited by pathrunner; 10-07-2023 at 12:46 PM..
Reason: typo
Because I’m curious I went to the Medicare website and all I could find about being guaranteed to switch to a medigap plan after being on a advantage plan is that you can only do that for the first 12 months after you initially go on Medicare. So for many of us that ship has sailed.
Again, I switched my mom after about 10 years of her being on an Advantage plan.
— Medicare open enrollment runs from Oct. 15 thru Dec. 7.
— You can switch from Original Medicare to a Medicare Advantage plan, or vice versa.”
I believe the 12 month window is when you are guaranteed to get any Medigap policy without needing an exam/underwriting. My mom didn’t need one though but it was quite awhile ago. She wouldn’t have had any problem passing it though as her only health disorder was chronic Lymphedema in her legs.
If you use your Trial Right for Medicare Advantage and then switch to Traditional Medicare, Plan N is not one of the Medigap Plans available without underwriting. (However, there are a few states, such as New York, that do not allow underwriting at all.)
Following a Trial Right, Plan G (or G-HD) would be available without underwriting.
FWIW,
the separation of the emergency department from the “hospital’s network” could be in itself a result of mind-boggling amount of uninsured or undocumented who use it as their de-facto healthcare providers as EDs are legally required to take them all.
So it is the networks loss leader of sorts.
Sounds like we need to look at how to remedy that for patients as well as insurance companies and healthcare system.
Why healthcare should be for profit? Nobody wants cancer or surgeries… I would cancel all so called non-profits “charities” - we have literally millions of them getting money and not paying taxes.
Their CEO’s salaries in multi millions
Divert all of it to healthcare?
As it stands now - the Medicare Supplement is just another tax on people - some of them? most of them - are lower if not completely low income.
No wonder that the citizens who paid that Medicare tax all their lives have to resort to using some bogus disadvantage plans to avoid monthly fees… while their taxpayers money go to line up the pockets of the insurers..
Sometimes the choice is not truly theirs and yes… it is a gamble.
Correct. My choice was a gamble and I lost. I could not, at that point, have taken a job to pay the Supplement rate of $350+ and that was in 2011 (under age 65 disableds pay more). I could barely walk, needed a hip replacement and my lungs blew up 3 months after Medicare kicked in so I couldn't have worked anyway, not for at least 6 months due to hip replacement. I know of seniors who are working just so they can pay their spouse's Medicare Supplement premium.
Agree completely with the first bolded text above, and churches should be taxed as well - especially bogus churches that are actually a cult. All monies should be funneled to the thing that America claims it was built on.
As to the second bolded text, yes, I pay $228/mo with a SS income. I'm fortunate to get more than many people do, I'm probably a bit above midpoint on the scale.
Medigap rates are not adjusted for each individual's current health status and usage each year.
Once you have your policy, the premium may be adjusted annually based upon your age and sex, depending on the pricing methodology used by the insurance company.
To further expound, if one individual had no medical expenses last year and another individual developed cancer and had $1 million of medical expenses last year, they will both have the same subsequent premium increase. The individual with cancer will not see a big spike in their premium because of their medical condition.
Indeed. It's called risk pool. Which is why how a Medigap supplement is priced is important. Open risk pools dilute the increases, whereas closed risk pools can lock an insured into a much higher price.
Upthread someone said their insurance agent said UHC pricing was just like other plans. IT IS NOT. In most states, UHC provides community-rated pricing (open risk pool), which as one ages, can be very advantageous.
For those who are unfamiliar with Medigap supplemental pricing, please read this:
You might want to consider looking at other Medigap insurers, since California has a Birthday Rule that allows you to switch to another Medigap plan (of equal or lower benefits) around your birthday each year without underwriting.
She no longer lives in California. Purchasing a plan in her new state may require health underwriting.
Quote:
Originally Posted by Riley.
Thanks...I am also going to call them and get further info. What I don't understand is, I had regular Medicare with my Fed BC/BS. Got 'talked into' rolling the BC into the advantage plan. I am paying co-pays now that I didn't pay when I just had the Fed BC/BS as 'back up,' as in $40 for my PT (shoulder issue) when last year, before advantage, I had no co-pay for a different issue. I'm not sure what the 'advantage' is to the Advantage plan.
I consider myself reasonably intelligent but when I start talking about this stuff, I am confused. I thought I was doing the right thing, switching.
Edit: I pay my Medicare premiums and I still pay for my BC/BS coverage monthly out of my fed retirement, which ain't alot.
If you are on BCBS Advantage through FEHB, possibly they will allow you to switch back. BCBS has allowed its Advantage enrollees to switch to its Medigap supplemental in some states without underwriting. Or, did you enroll in a BCBS Advantage outside of FEHB? Generally, FEHB plan offerings will provide better coverage than those outside of FEHB. If you are still in the FEHB system, look into changing plans.
Quote:
Originally Posted by pathrunner
Thanks, I already mentioned upthread that I'm not willing to switch. I'm in the middle of a bunch of treatments and I just don't want the hassle of switching everything over with each doctor. If next year things have calmed down, I'll consider switching. I will admit that I don't trust companies and rising costs. Or coverage. For example, if I switch to the company I mentioned upthread, why is it so much less expensive and would I really get the same level of benefits? Even though they say they will, will they really?
If you are in a state outside of California, the birthday rule doesn't apply. Depending on your current state of residence, you will be subject to health underwriting.
There are several reasons you can switch at any time. One is within the first year if you decide it is not working out for you or anytime if you move outside the plans coverage area or the plan ceases to cover the area you live in. You can switch any year to any other plan including regular medicare plus Part G every October for the next year. So, if you think you made a mistake you can always wait until the next enrollment period (October) to make that switch.
This is absolutely not true. The ability to switch is state specific. See:
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This is the 6-month period that starts the first day of the month you're 65 or older and signed up for Part B. After this period, your options to buy a Medigap policy may be limited and the policy may cost more.
Quote:
Originally Posted by ocnjgirl
Again, I switched my mom after about 10 years of her being on an Advantage plan.
— Medicare open enrollment runs from Oct. 15 thru Dec. 7.
— You can switch from Original Medicare to a Medicare Advantage plan, or vice versa.”
Incomplete and misleading information from nerdwallet. Yes, you can go back to Original Medicare. HOWEVER, the ability to purchase a Medigap supplement without health underwriting depends on your state rules or whether your situation qualifies for either Trial Right 1 or 2.
See above links.
****
I, too, am alarmed at the misconceptions voiced on this thread - especially the belief that one can easily switch between Advantage and Medigap supplemental without health underwriting during fall open enrollment. This is not true. As repeated all over this board and also numerous times on this thread, the guaranteed-issue right to a Medigap supplemental is state specific. The link has been provided numerous times, but here it is again:
— Medicare open enrollment runs from Oct. 15 thru Dec. 7.
— You can switch from Original Medicare to a Medicare Advantage plan, or vice versa.”
I believe the 12 month window is when you are guaranteed to get any Medigap policy without needing an exam/underwriting. My mom didn’t need one though but it was quite awhile ago. She wouldn’t have had any problem passing it though as her only health disorder was chronic Lymphedema in her legs.
I like many seniors can’t pass medical underwriting which is what I am trying to warn people about. I got tachycardia at 50 which is perfectly controlled with a beta blocker for the past 19 years and is not a serious condition. The only reason I was able switch from a F plan to a G was because Nevada has the birthday rule. The insurance broker told me any heart issues at all automatically fail medical underwriting. Your mom was lucky she could pass.
Yes, that was the bill I mentioned but I mistakenly called it surprise billing not sure what the right name is. I still don't trust that it has really eliminated the issue, but I was happy to see it passed.
She never had to undergo it though, I don't know why. No questions about her health were asked at all.
I'm confused about the costs of Advantage plans. I see them referred to as free or $0 premium, yet my mom pays for hers. Do some people get them free?
Yes that’s why so many people take them.
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