Medicare with Medigap or Medicare Advantage?

[ZZman]

I am now collecting SS early but not Medicare eligible yet. Been doing a lot of reading on Medicare and plans. It appears to me that if you are a healthy person an advantage plan might be the way to go. However if you have health issues and forsee lots of tests, labs, doctors visits or hospital stays a Medigap would be the better choice.

What kind experience have BITOG members had?

 

[HowAboutThis]

I am now collecting SS early but not Medicare eligible yet. Been doing a lot of reading on Medicare and plans. It appears to me that if you are a healthy person an advantage plan might be the way to go. However if you have health issues and forsee lots of tests, labs, doctors visits or hospital stays a Medigap would be the better choice.

What kind experience have BITOG members had?

I'm a couple decades from learning, but I know I've heard or read that you want to be careful you don't think "I'm healthy now, I'm going with the cheap one" because if you end up getting sicker as you age it can really hit you hard financially to save a few bucks early.

Super vague, but maybe others that know more can expand on what I poorly tried to convey.

 

[Donald]

There are differences in Medicare Advantage plans although they must cover a lists of mandatory things.

I retired (well from one company) and my employer provides two slightly different flavors of a Medicare Advantage plan. So I either go with one of the two options or go off on my own.

From my reading it seems the Medicare Advantage plans hawked on TV to individuals may be lacking but the ones offered to groups (retired employees of a company) are much better.

And large health insurance companies like United Healthcare probably offer hundreds of plans. The devil is in the details.

Don't forget to consider dental.

 

[HowAboutThis]

There are differences in Medicare Advantage plans although they must cover a lists of mandatory things.

I retired (well from one company) and my employer provides two slightly different flavors of a Medicare Advantage plan. So I either go with one of the two options or go off on my own.

From my reading it seems the Medicare Advantage plans hawked on TV to individuals may be lacking but the ones offered to groups (retired employees of a company) are much better.

And large health insurance companies like United Healthcare probably offer hundreds of plans. The devil is in the details.

Don't forget to consider dental.

My parents didn't go dental because of the cost. After some decent sized, recent repair bills out of pocket I haven't asked if they're regretting or still think it's cheaper. So yeah, you'll at least want to price current cash prices at your dentist and compare to what they charge and then roll the dice, or not.

 

[rekit]

We have Medicare and a Supplement with Plan G. No co-pays, no referrals, go to any Dr or Hospital. There is a Deductible but we have had several $$ surgeries and never paid much if anything for that. Before we retired I thought health insurance was gonna be a big problem, but this is better that the Cigna we had at my Refinery. We have some friends with Advantage Plan and now that they got Really sick they can't change plans w/o a physical I believe.

 

[Passport1]

Do you travel?

 

[chemman]

Think of Medicare Advantage plans as being really restrictive HMO types of coverage. Many of the so called perks appear to be available only to lower income retirees and those who also qualify for Medicaid as well as Medicare. If you want to see a specialist that is not in the Medicare Advantage plan for your area and the insurance company providing the coverage, then you get to pay out of your pocket to see that specialist.

Then there are the special needs Medicare Advantage plans (SNAP Plans) for people with specific disabilities. If you have a disability, but it is not for one of the specific disabilities on the list for a SNAP plan, well, you do not get in. My wife has MS and unfortunately, there are no SNAP plans on our area that includes MS as a qualifying disability even though she had been on Social Security Disability.

Lastly, I read something that compared the average cost to Medicare for an individual covered by Medicare and a regular supplemental coverage plan versus the cost to Medicare for an individual covered by Medicare and a Medicare Advantage plan, and the people enrolled in the Medicare Advantage plans cost the system significantly more than those who had the regular supplemental plans like a Part G.

Needless to say, both my wife and I have regular Medicare plus a Plan G supplemental plan because the hassles associated with a Medicate Advantage Plan are just not worth the restrictions and the headaches. Additionally, if we travel someplace, we do not have to worry about finding in network providers if any are even available out of our area.

 

[JeffKeryk]

I have Medicare Advantage; my Doctors and hospitals are Stanford or Stanford affiliated. Great insurance. I have a broker agent who represents all the options in the Santa Clara Valley. His pay is through the providers; he has helped me tremendously.

 

[BHopkins]

I've talked to my Medicare agent about this very subject. He has spent a lot of time reviewing all the different plans. His opinion is Medicare Advantage is a much better option.

One argument for Medicare, is that you can go to any doctor or hospital that you choose. That could be important as you get older, and if your health gets bad. But that is a big if. I know plenty of older people that live their older years without becoming seriously ill, and needing constant medical care.

I recently had a simple prostatectomy. On my Medicare Advantage Regence plan, the copay is $400. That's it. I looked into Medicare, and I would have had to make, I believe, a $2000 deductible before Medicare paid anything. And I don't have to pay for Plan G. Or Plan D, as that is included with most Medicare Advantage plans.

 

[Nukeman7]

You can learn a lot about the pros and cons of Medicare Advantage vs. Medigap plans in 10 minutes by watching this video. The speaker talks kind of fast, so you may want to watch it more than once and pause it to review on-screen info that he displays. Pay particular attention to the medical underwriting stipulation if you select an Advantage plan initially but need to transition to a Medigap plan at a later date.

 

[Nukeman7]

I recently had a simple prostatectomy. On my Medicare Advantage Regence plan, the copay is $400. That's it. I looked into Medicare, and I would have had to make, I believe, a $2000 deductible before Medicare paid anything. And I don't have to pay for Plan G. Or Plan D, as that is included with most Medicare Advantage plans.

The deductible was $226 in 2023 and is $240 in 2024. That is all you would have to pay out of pocket for the entire calendar year if you subscribed to a Medigap G plan, even if you had $5 million worth of treatment. No other charges or copays after the meeting the $240 Part B annual deductible.

 

[ZZman]

Do you travel?

Not much. Visit daughter in Colorado once a year or so

 

[sopususer]

Both of my parents had Medicare with Medigap Plan F (this is no longer offered) Plan G is the closest thing that is available now. My dad opted not to sign up for a Medigap plan nearing his initial sign up period; however, he was looking at prospective cataract surgery and decided to purchase his plan. Less than a month later he was diagnosed with cancer. Over the next twelve years of his life .(thankfully he responded well to treatment) his Medigap paid multiple thousands of dollars of bills. He always said it was the best decision he ever almost didn't make. Every healthcare professional I spoke to in his declining years as well as my mom's declining years described Medigap plan F as the Cadillac of plans. As I understand it, plan G is only different from the non-existent plan F in that it doesn't pay the annual part B deductible-so it is basically the same thing. Old expression: "the cheap often comes out expensive." I'd think long and hard as medical expenses are what will clean out a bank balance, retirement fund etc more quickly than any other life event.

 

[LDB]

You want to decide before you're 65 and can sign up for either one with no stipulations. If you are healthy and get supplement it costs more but if you get sick you're better off. If you get less costly advantage and later become sick it costs MORE. I went with plan G supplement. It costs more. But when my arm falls off and it costs $xxx,xxx to put it back I'll be glad I'm not paying 20% of the bill like with advantage.

 

[walterjay]

I have Medicare and plan G as the supplement. Recently had bypass surgery to the tune of about 74K. Everything paid for by insurance. I have not been billed a penny. It may work different in your state.

 

[AZjeff]

People think "I'm healthy now, I'll save money with an Advantage plan, who cares what the co-pay is". Then they're not and there's no going back to plan G. And you need a physical to go to a different Advantage plan as I understand it.

 

[jetman]

I am now collecting SS early but not Medicare eligible yet. Been doing a lot of reading on Medicare and plans. It appears to me that if you are a healthy person an advantage plan might be the way to go. However if you have health issues and forsee lots of tests, labs, doctors visits or hospital stays a Medigap would be the better choice.

What kind experience have BITOG members had?

Not!
My wife has worked in the industry for 30+ yrs.
Advantage plans want/make you die sooner so they make more money
I'm 66, healthy, on medicare A & B & D & G my wife tells me.

 

[k1xv]

At age 76, with Medicare and Medigap Plan C, I have not had a hospital , lab or doctor's bill since age 65. And that included several surgeries and hospital stays, including,a hospital stay of 2 weeks.

I call the alternative Medicare Disadvantage. I don't trust anything pitched by Joe Namath or Jimmy JJ Walker.

 

[Pablo]

There is a lot of untruths in this thread people. Watch out!

 

[Pablo]

You can learn a lot about the pros and cons of Medicare Advantage vs. Medigap plans in 10 minutes by watching this video. The speaker talks kind of fast, so you may want to watch it more than once and pause it to review on-screen info that he displays. Pay particular attention to the medical underwriting stipulation if you select an Advantage plan initially but need to transition to a Medigap plan at a later date.

That is a decently fair comparison.

First of all, yes it is a fairly personal decision and a LOT depends on your state and what insurance carriers are available.

No you don't need a physical to change to a different Medicare Advantage plan. You can even go back to the original Medicare.

No you won't get stuck with 20% of a $XXX,XXX bill if your arm falls off.

Again up to you, but if you go Medigap G, you will need D, so make sure you compare the true costs.

In WA state Advantage is the way to go if you are reasonably healthy, and since it's just like private insurance, my same docs take it, and some of them didn't take Medicare. The dental is pretty basic, but works fine. Eyecare even. No extra premium.