I have not decided but I am so far following you. I might go back but in WA Advantage choices are now more limited.
My medication plan is free but my few new drugs are not. But the meds are cheap so it’s not terrible
I’m waffling here
I love researching this stuff and hours upon hours and more I am "waffling" between which plan I will take in 2026
However I kind of enjoy this stuff. As you know I had a lot of need for my health plan this year which makes me wonder if just a little bit ... "what if" This is why for sure, I will not settle for a high out of pocket Advantage and thankfully there is still one considered very low out of pocket (3,100) that is actually a very good plan with Humana.
Then, I could step it up just a little bit to BCBSNC (4,100) which isnt "free" meaning it's the cost of Part B plus an additional $40 a month. No big deal and with that extra cost even though the out of pocket is higher by a little bit that I will never hit anyway what is comforting with BCBSNC is unlike I think your state and also the Northeast. Here once in an Advantage plan you are stuck in Advantage unless you go through underwriting. With that said in my state, this one company BCBSNC markets themselves as "Blue to Blue" so with this company I can switch back and forth Advantage to Medigap without underwriting. That is a thought for me, because until I get past the next 18 months or so it's impossible to know what the next year or two may bring. But honestly not much more they can do anyway, except drug therapy at that point.
Last but not least is BCBSNC offers another advantage plan with similar amounts above and no $40 a month in exchange for a higher out of pocket of around $5400 and I dont want to go down the road to higher out of pockets. Principle, what is the purpose of the insurance then?
Which then brings the thought of just skipping a supplemental plan all together then. Keep A, B, and D then pay 20% of Medicare approved amounts which is a fraction of the actual amount charged. The danger here is once you go without a supplement or Medigap if you want to get back in you may have to go to underwriting. Impossible to say any particular state and I am not knowledgeable in anything more than this. But I think to go this route would be insane.
The thing is, without a supplement plan the costs are not as high as we think. Hospitals are covered 100% (after the deductible) and this is completely at no cost. Then you have Part B that you are covered 80% of medical costs. You much pay the 20% of the APPROVED medicare cost which is stupid low compared to the retail charge.
This is the medical part of one radiation treatment
SO if I didnt have Medigap Plan N I would have had to pay that 20% of the approved amount = $8.49 since I have Medigap Plan N it was paid by BCBSNC
Ok, here is an actual treatment as outpatient for a little less than a month of radiation however this is Part A 100% (out patient and I dont understand all this part but I think a Part A co/pay being outpatient )
SO if I didnt have Part N Medigap I would have owed $865.16 a far cry from $30,000 ... anyway... just talking. I think, way, way, way too much. My plan N paid it
This years bills will easily be well over 100k I think, and as much as we complain, wow, I paid less then 2k. Plus $329 a month in premiums Part B and Plan N combined.
Full disclosure
Anything I post in here is my personal thoughts and experiences. I am not a licensed agent in anyway. I do think anyone can educate themselves if they choose to by going to medicare.gov and then if unsure of themself at least have the knowledge to have an intelligent conversation with a licensed agent.
ha ha!
