[FLoriginal]

Looking for recommendations for a medicare supplement plan. My husband receives Medicare benefits, beginning in March, 2017 and needs a supplement to go along with. He does have some health issues, RX needed, etc. What are your recommendations for plans that cover The Villages and Marion County physician and hospitals?

[jnieman]

Originally Posted by FLoriginal

Looking for recommendations for a medicare supplement plan. My husband receives Medicare benefits, beginning in March, 2017 and needs a supplement to go along with. He does have some health issues, RX needed, etc. What are your recommendations for plans that cover The Villages and Marion County physician and hospitals?

For the prescription part go to Medicare.gov: the official U.S. government site for Medicare. They have a form you can fill in and list your medications and doses. It will take your info and present you with a variety of plans in your area who will pay the most for your prescriptions.

[villagetinker]

We have United Health care, and no problems with the specialists. Had to change primary care doctors, but found a new one in Leesburg also with no problem.

[Investment Painting Contractors]

Originally Posted by FLoriginal

Looking for recommendations for a medicare supplement plan. My husband receives Medicare benefits, beginning in March, 2017 and needs a supplement to go along with. He does have some health issues, RX needed, etc. What are your recommendations for plans that cover The Villages and Marion County physician and hospitals?

My wife and I have United Health Care Plan F and J we travel a lot and can use any doctor in the US who accepts Medicare. No Co-Pay. Mayo Clinic also treats us pretty good. Len & Mary

[retiredguy123]

It is my understanding that a Medicare supplement plan is different from a Medicare Advantage plan. A Medicare supplement plan covers the 20 percent out-of-pocket co-pay expenses when you use regular Medicare Part B. In my opinion, these supplement plans are a waste of money if you can afford to pay the co-pay. Pay the 20 percent co-pay yourself and you will save a lot of money. Why do you think these supplement plans are advertised every 10 minutes on television? All the insurance company needs to do is to wait for Medicare to pay a claim, and then they pay the co-pay. It is a very low cost, low risk business because they have all of the historical Medicare claim data with which to price their premiums. They let the Government do all the work to evaluate and pay the claims. They don't need to independently evaluate any claims. They only pay the claims that are approved by the Government. I could run the whole insurance program on a laptop with no employees.

[Investment Painting Contractors]

I had Linx surgery for acid reflux Medicare said it was experimental and didn't want to pay, a little over $25,000. Mayo Clinic and United fought the case, for me. My final bill after Medicare and my supplement was $8.00. . At $152 a month I feel I'm ahead of the game. I get a physical every year, Flu shot, Treatment for sinuses, Eyes checked, Cortisone shots, Chest X Ray, Etc. At $1,824 a year with no additional out of pocket I feel that I'm ahead of the game.

[villagetinker]

Originally Posted by retiredguy123

It is my understanding that a Medicare supplement plan is different from a Medicare Advantage plan. A Medicare supplement plan covers the 20 percent out-of-pocket co-pay expenses when you use regular Medicare Part B. In my opinion, these supplement plans are a waste of money if you can afford to pay the co-pay. Pay the 20 percent co-pay yourself and you will save a lot of money. Why do you think these supplement plans are advertised every 10 minutes on television? All the insurance company needs to do is to wait for Medicare to pay a claim, and then they pay the co-pay. It is a very low cost, low risk business because they have all of the historical Medicare claim data with which to price their premiums. They let the Government do all the work to evaluate and pay the claims. They don't need to independently evaluate any claims. They only pay the claims that are approved by the Government. I could run the whole insurance program on a laptop with no employees.

Yes, but if you have a major expense, it is worth it: pacemaker replacement $124,000+, our cost, with supplemental $325, without supplemental, our potential cost $25,000. It is all a matter of your level of risk. If you are healthy, a case can be made to go without, just like going with MA, if however, you have medical issues, IMHO, supplements are well worth it. This one instance will cover both of our costs for almost 10 years.

[retiredguy123]

Yes, in some cases, a few people can come out ahead with the supplemental insurance. But, most people do not. These insurance companies have a hugh profit margin, with very low risk. That is why they spend millions and millions of dollars on advertisements. If you can afford the co-pays, you are statistically better off without the insurance. Also, if you are lucky enough to have time to schedule an expensive procedure in advance, you can buy the insurance in the calendar year before the procedure and take advantage of the insurance. Overall, the vast majority of people who pay for the insurance for 15 or 20 years, will lose money.

[FLoriginal]

Thank you for the information.

[rivaridger1]

Originally Posted by retiredguy123

Yes, in some cases, a few people can come out ahead with the supplemental insurance. But, most people do not. These insurance companies have a hugh profit margin, with very low risk. That is why they spend millions and millions of dollars on advertisements. If you can afford the co-pays, you are statistically better off without the insurance. Also, if you are lucky enough to have time to schedule an expensive procedure in advance, you can buy the insurance in the calendar year before the procedure and take advantage of the insurance. Overall, the vast majority of people who pay for the insurance for 15 or 20 years, will lose money.

I think you will find most of the advertising dollars are spent on Medicare Advantage plans, not Supplement plans. In addition, the rates for Medicare Advantage and Supplement plans are regulated and while the companies providing this insurance are entitled to a profit the regulators do all in their power to insure it is not excessive. I'd also think you find that medical risk is not exactly " low ". If it was, the Affordable Health Care Act insurance providers would not be going broke as one example. The fact is medical risk is " low " for young healthy adults and the exact opposite for seniors. When you drive around The Villages and for that matter anywhere in Florida do you see any shortage of doctor offices or other medical facilities ? Also, do disbelieve the expert's predictions that the Medicare system is economically unsustainable in the long run ? Some senior somewhere must be sick.

Scheduling expensive medical procedures in advance and then buying insurance seems to me to be some akin to listening to meteorological forecasts a year in advance and deciding whether you want to buy Homeowners insurance including hurricane coverage for that year. Try scheduling a heart attack and a quadruple by-pass a year in advance.

I'd like to see the statistics supporting the comment " the vast majority of people ( presumably seniors ) who pay for medical insurance for 15 to 20 years will lose money " in light of the fact the Medicare system is basically insolvent. For crying out loud, most seniors are going to die from something medically related in 15 to 20 years.

With respect to the original poster rolling the dice as a senior on your health and likely medical expenses does not really seem to make much sense to the majority of people.

If you do not buy an Advantage Plan, depending on your economic circumstances give thought to a Medicare Supplement Plan. The best and most costly one is Plan F which will shortly be no longer available to new Medicare subscribers. There are other which will allow you to participate in your medical expenses for reduced premiums.

[retiredguy123]

My comment about low risk refers to the insurance company's risk and only applies to supplement plans. Supplement plans are different from Advantage plans. For supplement plans, the insurance company uses historical Medicare claims data to price the plan. They depend entirely on Government to evaluate and validate the claims before they will pay any benefits. When it comes to any insurance, I would rather self insure myself if I can afford to do so, but some people may need the insurance. Maybe I watch too much television, but I sure see a lot of ads for Medicare supplement plans. These ads seem to imply that you are getting more coverage, when, in fact, they are only providing the co-pay for claims that are approved by the Government.

[Miguel 1952]

Please do your research by calling the experts as this is a very important and potentially costly decision. I have original Medicare with a supplement. I chose plan F- HD (high deductible). I am paying $75.65 per month and the high deductible is $2200. All supplements are regulated by the government, meaning all Plan F are the same, but not all the premiums will be the same. Why pay more to an insurance company when all Plan F are the same? These plans are regulated by the government.

There is a lot of good information on YouTube so you can get an idea and be more knowledgeable. Try these videos, very helpful (medigapseminars.org). Full disclosure, I have no business interest in these videos except as a learning tool so I could make a decision.

Remember, how do you plan for a heart attack, a stroke, a car accident, etc. ahead of time! The 20% is going to be very expensive out of pocket for your family. My best to you in this very personal choice. Good luck!