Medigap or Medicare advantage plan???

[saminmn]

Come on guys I need help.
Medigaps plans pay for everything but cost.
Advantage plans have copays. Some high some low most have a max out of pocket. The max out of pocket is nearly equal to what the Medigaps costs.

Seems like a crap shot. If you get Advantage and don't have any many hospital stays you are well ahead cost wise. If you get medigap and don't have any Hospital stays you paid a lot of money for nothing. If you have hospital stays your max out of pocket is the monthly Medigap premium.
However with Medigap you need part D for drug and that can cost a lot too.

Without going off track or changing the subject which plan did you go with and why PLEASE I'm looking for advice.

Ed,

I think one reason we have trouble answering the Advantage Plan vs. Supplemental question is that coverages can vary. In MN the Advantage Plans can be a great answer, if the plan has a good provider network. So, advantage plans like Blue Cross/Blue Shield and UCare that have wide networks of providers under contract in MN can offer low cost packages that are good.

We have some Advantage Plans that cost nothing, but they typically do not have Drs. under contract to provide their services at prices they would pay them. I believe you are not obligated to use a Dr. from a provider list, but finding out whether their terms and your Dr. could work together might be an issue. Sorry I don't really understand how they operate as I have no experience with them. I think there is a column in the government evaluation Web Page that indicates whether the plan requires using participating providers. For packages like BC/BS with wide doctor support, that is usually a none issue and in MN the way to go for high quality coverage. In MN I think I can change out of advantage plan during open enrollment, but this is a non-issue for me as I like my advantage plan option.

My choice in past 3 years has been UCare, but I need to go to government web site and re-evaluate for 2014. My UCare coverage includes drugs. I selected it over BC/BS based on cost given my known drug needs. Like I said, I need to visit Medicare plan finder and re-do with current prescriptions.

[Ed in Tampa]

Someone off line sent me a something to think about. With the drain of money from Medicare, the Advantage plans may soon not be free or low cost.
He believes they will be forced to increase prices until they match or surpass Medigap costs. Then many may want to switch to Medigap but will get caught up in under writing and be forced to stay in higher cost Advantage plans.
I don't like anything that does not allow freedom of choice and right now it appears I have freedom of choice but if I choose an Advantage plan I'm committed to what ever they end up doing. Not good!

[JPG]

Someone off line sent me a something to think about. With the drain of money from Medicare, the Advantage plans may soon not be free or low cost.
He believes they will be forced to increase prices until they match or surpass Medigap costs. Then many may want to switch to Medigap but will get caught up in under writing and be forced to stay in higher cost Advantage plans.
I don't like anything that does not allow freedom of choice and right now it appears I have freedom of choice but if I choose an Advantage plan I'm committed to what ever they end up doing. Not good!

My own 'perception' of Advantage plans is they be HMOs with 'territories'.

I do not like HMOs.

I do not like territories(Canadian type excepted).


So my only decisions are Part D, dental, vision.

I am sticking with standard medicare and AARP plan F.

[fjimp]

Come on guys I need help.
Medigaps plans pay for everything but cost.
Advantage plans have copays. Some high some low most have a max out of pocket. The max out of pocket is nearly equal to what the Medigaps costs.

Seems like a crap shot. If you get Advantage and don't have any many hospital stays you are well ahead cost wise. If you get medigap and don't have any Hospital stays you paid a lot of money for nothing. If you have hospital stays your max out of pocket is the monthly Medigap premium.
However with Medigap you need part D for drug and that can cost a lot too.

Without going off track or changing the subject which plan did you go with and why PLEASE I'm looking for advice.

As a retired health insurance agent my wife and I have Medicare and a Blue Cross Supplement with drug coverage. I do not like the advantage plans as one has to be very careful to find medical providers who are members of the particular advantage plan one belongs to. We travel a bit (within the USA) and need the option of seeing providers who may not subscribe to an advantage plan. Most of the Advantage plans are localized in nature. One thing to beware of is doing homework on the drugs you use as related to being covered by whatever plan you select. Part D is a huge pain and only going to get worse. Jim

[qtndas01]

I was planning between an all-in-one plan and supplemental. I know some that have no premium with 1200 deductible. I went with a Bankers Life Plan N supplemental due to two main reasons. I am on Hormone therapy for prostate cancer and the supplemental plan covers the entire U.S. A. in area and my son lives in a different state and I'm still covered in full if I'm out of state. With the all-in-one plan I would be Out of Ntwork in another state and might have to pay 35%. Also my hormone therapy costs close to $8000 and under the supplemental I only pay the Part B deductible. Otherwise I would have to pay a minimum of $2000 a year for just the one yearly treatment. Anything else would be additional. Each persons' situation is different so there is no hard fast rule. You have to check your own situation.
Another thing is that the all-in-one plans there is no guaranteed acceptance & can be cancelled in the future. The supplemental plans CANNOT

[Ed in Tampa]

Another thing is that the all-in-one plans there is no guaranteed acceptance & can be cancelled in the future. The supplemental plans CANNOT

I'm not sure about cancellations but I'm told by my insurance "experts" that supplemental plans can insist on under writing if you have been on an all in one plan and then want to come back. I'm also told you can move to any all in plan without underwriting.

[edflorence]

I'm not sure about cancellations but I'm told by my insurance "experts" that supplemental plans can insist on under writing if you have been on an all in one plan and then want to come back. I'm also told you can move to any all in plan without underwriting.

When I was pondering the decision of which way to go, Medigap or Advantage, I remember being advised by an insurance salesperson that the Advantage plan prices might not stay low after the Affordable Care Act took effect. That, plus the possible problem of getting into a Medigap after being in an Advantage plan, plus the loss of some ability to choose doctors, all seemed like enough reason to go with Medigap. I have not paid any attention to whether or not Advantage plan prices have been going up in the last couple of years, but I think that would be a good question to ask your insurance salesperson.

Happy Thanksgiving;

[Ed in Tampa]

[quote="edflorence"]When I was pondering the decision of which way to go, Medigap or Advantage, I remember being advised by an insurance salesperson that the Advantage plan prices might not stay low after the Affordable Care Act took effect. That, plus the possible problem of getting into a Medigap after being in an Advantage plan, plus the loss of some ability to choose doctors, all seemed like enough reason to go with Medigap. I have not paid any attention to whether or not Advantage plan prices have been going up in the last couple of years, but I think that would be a good question to ask your insurance salesperson.

Happy Thanksgiving]

Thanks so much for all of your feedback. You are confirming what everyone is telling me.

That is the decision I'm quickly coming to. I have talked to some people that should know and they say with the money the Congressional Affordable Care Act or CACA for short has siphoned out of medicare that most Advantage Plans are going to get real costly real quick. Or they are going to really increase their co pays.

Most Advantage plans I see already have a $295/per day copay for the first 5-7 days in the hospital. Anyone that has even major surgery lately knows they usually toss you out of the hospital before 7 days are up.

I don't know what exactly will happen, time will tell. But until then I think I'm going with Medigap to keep my self in a position I can go either way in the future. If the Advantage Plan prices don't go up in the next year to two I will then probably switch.