I got the distinct impression you were telling the OP and others Medigap is the only way to go and far superior. Not sure why I thought that.Nothing changed. I just typed more than usual.
I got the distinct impression you were telling the OP and others Medigap is the only way to go and far superior. Not sure why I thought that.Nothing changed. I just typed more than usual.
This thinking is incorrect. You're choosing to suggest you are going to have $500,000 procedures every year and hit that $3,450 out of pocket.From AARP so presumably well informed and accurate.
Does Medicare Advantage have out-of-pocket limits?
Yes. If you choose to have coverage from a private Medicare Advantage plan instead of original Medicare, you’ll have a maximum out-of-pocket spending limit. Federal law requires Medicare Advantage plans to have an out-of-pocket limit of $8,300 or less for covered in-network services in 2023; $12,450 or less for covered in-network and out-of-network services combined. Those numbers rise to $8,850 and $13,300, respectively, in 2024.
Using their link and checking my own zipcode the plans show a minimum out-of-pocket of $3450 based on checking the first 20 results, several having that same figure. That is $287.50 monthly against my $145 monthly, or basically double the monthly premium. Those plans also have copays I do not have. Also restrictions on provider choices I do not have. Choose a doctor not on their A list and the OOP double or greater.
And for some people it is the perfect choice. Based on their needs/wants/preferences. I'm satisfied with my $145 a month, all done, and make any choice I want at any time I choose.
Well.This thinking is incorrect. You're choosing to suggest you are going to have $500,000 procedures every year and hit that $3,450 out of pocket.
This is my problem with posts, we are making incorrect assumptions, then I let myself get caught up spending time writing a book in these threads *LOL*
1. Your premiums will go up with age regarding the Medigap insurance
2. Your $145 monthly does not include, dental care, eye care, hearing and over the country products plus the many other perks should you choose to take advantage of them and you are not paying $145, you are paying $320. which will go up every year.
3. How to do you think you will hit $3,450 if you had an Advantage C plan? How can you assume you will? What formula are you thinking about? Ending up in nursing care for months? I dont think you understand "out of pocket'? Out of pocket is not a deductible. So you do not spend $3,450 unless extremely sick every year.
My bills in 2022 were $130,000 (one hundred thirty thousand) my cost was $850, that was all.
IN that cost UHC also paid my $1,200 yearly gym bill, my dental bills, my eye care bills and contact lens and $400 in over the counter items, plus my medications.
All told, they paid me to take their plan, not I them. All this for the $175 automatically already taken out of the SS check.
In case you dont know, your Medigap insurance and Part D drug policy is private medicare too.
Pick your plan, choices are great! No one size fits all, choose what you are comfortable, it's great to hear thoughts from various people but some are misleading. The best source is your own research for your area and then of course listen to what others have to say to help you think and confirm what you read.
Never mind other posted stories, those reading these posts can use the following links to see their costs in their area. This is just a sample there are many other companies out there. I believe the first three are among the largest. I like large, more so if an Advantage C plan. It's why I chose United Heath Care and recently last month switched to Aetna health care because both are all over the country as many others. I just like big. I liked UHC a lot, they are the biggest, but Aetna in my case is putting more money in my pocket, I look at it as almost free coverage with all the perks. What I love about the Advantage plans is I can shop and switch every year as many years as I want and I like shopping! *LOL*
With these links you can look at the costs for Medigap Insurance (dont forget Drug Part D coverage and Advantage C plans. Pick and choose what you are comfortable with not what I say or anyone else. We live in the greatest country in the world and the Medicare system works no matter what you choose.
Medicare Coverage Options from UnitedHealthcare
When it comes to Medicare coverage, it's important to know which coverage is the best fit for you. Learn about Medicare plans offered by UnitedHealthcare.www.uhc.comAetna Medicare
enroll.aetnamedicare.comShop 2024 Medicare Insurance Plans | Humana
Find 2024 Humana Medicare insurance plans, including Medicare Advantage and Part D prescription drug plan options. Learn more.www.humana.comMedicare | Wellcare
Medicare is a federal health insurance program. Select your state to find details about your particular WellCare program.www.wellcare.com
and the mother of all sites, straight from your Government, an incredible resource to help you prepare and learn what is available to you.
Welcome to Medicare
The official U.S. government website for Medicare, a health insurance program for people age 65 or older and younger people with disabilities.www.medicare.gov
I didnt know you played and only recently thought I saw you reference it.Well.
You do go into detail.
I wasted time this AM typing some of that, also pointing out comparing a MAX to a PREMIUM is apples v. oranges. Then I deleted it all and used my own example.
PS Sick of being snowed in! I went into Playtime and found a PB venue a new place, not far. Only two signed up so far. This late afternoon. Can you catch a flight?
Really, nothing I wrote was misleading. I was primarily responding to/clarifying for Pablo. A "premium" is ...a premium. They pay a premium for their Advantage plan. Not implying anything. I agree that comparing total costs of your different options is wise. No one is disputing that. My other post was to just to provide some insight that sometimes your total monthly cost/perks/etc. may not be the only thing to consider when making your Medicare decisions. Again, choice is great!Huh?
and what is that "premium"? I can tell you right now,
This is misleading whatever you are implying.
Anyone can check what their Advantage C plan would cost right here without me going off the rails *LOL* with another insane long post.
Medicare Coverage Options from UnitedHealthcare
When it comes to Medicare coverage, it's important to know which coverage is the best fit for you. Learn about Medicare plans offered by UnitedHealthcare.www.uhc.com
Ps, one thing I did learn from this thread is I just put in my old town on Long Island NY where costs for everything is insane and found out how much less expensive even medial care is here. An example is MAX out of pocket cost for the same Advantage C plan here in the Carolinas is $3,000 less than Long Island NY and some of their plans up north do have a small premium from $0 to $50 a month.
I would suggest most lower cost areas outside NY Metro areas and places in CA would be like I have here, stupid cheap.
I agree, choice is great.Really, nothing I wrote was misleading. I was primarily responding to/clarifying for Pablo. A "premium" is ...a premium. They pay a premium for their Advantage plan. Not implying anything. I agree that comparing total costs of your different options is wise. No one is disputing that. My other post was to just to provide some insight that sometimes your total monthly cost/perks/etc. may not be the only thing to consider when making your Medicare decisions. Again, choice is great!
You are correct though one important point.Be careful if you think you can switch back to original Medicare from an Advantage Plan. The answer is that yes you can switch back to original Medicare, however you can be denied Medigap policies based upon preexisting conditions.
There are a handful of States that require guaranteed issue of Medigap policies, others require underwriting
Do your homework!
Wife has PPO Humana AP and she had a lump. After huge 10's of thousands of dollar medical bills that Humana paid for she's now Cancer free. It would've bankrupted us if we'd not had some coverage. Happy with it so far. She even gets the $125 healthy benefits card monthly but I've heard from a couple salesmen that some other companies give out more than that a month for groceries etc.For some none believers this is a small screen shot of a family member for 2023 and the Advantage C plan by Humana. Im just showing you 2023, this person had roughly $800,000 in bills the year before (2022) that his Advantage C took care of.
Ok, so 2023 here is the proof $544,554.70 retail cost in medical bills for 2023 and this person did not even hit his out of pocket expense of $2,500
I honestly do NOT care if someone rather have Medigap G (or like) Plus D coverage over an Advantage C plan. I have another family member that loves it and could care less about the extra costs of everything.
I just HATE the misinformation spewed out that are completely false about Advantage C plans. This persons bill contains some of the most advanced amazing medical treatment in the world and the year before that was even more expensive included the most advanced equipment known to man inside his chest, a literal computer with internet access controlling electrical impulses in his heart and reporting any events to his health care network that the computer corrects automatically. All at almost no cost to him.
Its times like this, more so with a loved one that you thank god you live in the USA and have the health system we do.
BTW- this person lives a normal life. You wouldn't know he has this stuff if you met him.
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That is awesome, your experience kind of hits home with my wife, over a decade now and she is cancer free. She still has company health ins though.Wife has PPO Humana AP and she had a lump. After huge 10's of thousands of dollar medical bills that Humana paid for she's now Cancer free. It would've bankrupted us if we'd not had some coverage. Happy with it so far. She even gets the $125 healthy benefits card monthly but I've heard from a couple salesmen that some other companies give out more than that a month for groceries etc.
Thank you very much & to the same for your wife. What in the world would we do w/o them.That is awesome, your experience kind of hits home with my wife, over a decade now and she is cancer free. She still has company health ins though.
Forget salespeople or at least if you listen to them do your own investigating>
I have researched these Advantage C plans for years now. I find they pretty much pay out the same but shuffle around the "perks" to what they think will better sell for the public. SO for me, #1 lowest cost and out of pocket rules. Using the lowest out of pocket then REALLY eliminates the dozens of plans and options>
Once I do that, keeping the lowest out of pocket as a top priority I then choose by the perks what puts the most in my pocket.
I find let's say, in your case, someone says there are better healthy benefits, then look further to see what part of the plan has less of.
Meaning it's normally a shuffling of the perks, you may find some things are higher, MRIs co-pays for specialists or less dental and vision perks. I love this about these plans because I tailor which one works best for me.
Im glad your wife is ok, as mine is, freaking cancer is such a nefarious sneaky disease.
Im trying to understand if I am answering what you are looking for.Interesting discussion, read all four pages.
What I don't see here is people really laying out their situation and making a decision based on their pre-retirement spend. My stuff is pretty expensive (corp family plan) so all of this seems really cheap, even the Medigap G plans, compared to where I am now. My out of pocket premium plus my pre-tax flex spending account and then the spending when we run out of that flex money, is usually pushing $10K/yr. The out of pocket max on my current family plan is $12,500 a year, but of course I'm including my premiums when I talk about my total cost, whereas the insurance company wants $12500 after I pay the premiums. Before my prior spouse passed away at 46 of cancer, was the only time I hit that max and the insurance company paid everything 100% past that.
Dental insurance is a necessity, I just had to have a crown re-done and it was about $550 out of pocket, that's with the higher option PPO dental insurance. The medigap plans don't cover dental? That is a consideration.
False, by not signing up for either a Medigap plan or an Advantage C plan you very well can be ruined financially and owe up to 20% of all your medical care except for hospital.You know the joke about lawyers? That 98% of them are crooks that give the rest a bad reputation?
I think it's much the same with Advantage plans. Instead of 98% of them being bad, it may only be 20%, but if you sign up with a member of that 20% it could ruin you financially. I suggest a lot of research with a qualified trustworthy insurance
Not sure how you came up with that. What is this mechanism? Where are your backing statistics?I think it's much the same with Advantage plans. Instead of 98% of them being bad, it may only be 20%, but if you sign up with a member of that 20% it could ruin you financially.
So you just popped in here to give us some "wisdom". Amazing.I do not have a dog in this fight, being retired military.