Should I switch from Medicare Advantage to regular Medicare?

[Rainger99]

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.

[retiredguy123]

If you are healthy, I wouldn't switch. You will definitely need a drug plan and a Medicare supplement plan, which will cost more than $200 per month. Why switch? My opinion.

[villagetinker]

If you have been on an Advantage plan for more that 1 year, you can be subjected to underwriting when going back to traditional Medicare. IMHO, I would contact SHINE and have a discussion with them. So, to answer your question it depends on how long you have been in an Advantage plan. We were on for 5o weeks and were able to switch back without any penalty, but we just made it.
SHINE has 800 number and LOCAL meetings in TV, and we have found them to be very helpful. If you get the Daily Sun, the weekly advertisement for healthy living usually has their contact info.

[MplsPete]

If you have been on an Advantage plan for more than 1 year, you can be subjected to underwriting when going back to traditional Medicare. .

To help the OP, in simple English, underwriting means that supplement plans will want you to have a physical exam by a doctor.
If you are not very healthy, they will reject you.

[ElDiabloJoe]

Pittman Law Offices in The Village JUST did a video on this two days ago. Pittman Law Office often contributes to videos by the Newcomers, Jerry and Linda.

It sounds like you are usually unable to switch after one year, if I heard it correctly. I recommend you invest the 11 minutes in what might be a very costly decision:

https://www.youtube.com/watch?v=HAP1liGSCo4

[tophcfa]

If you want to switch, do it now while you’re healthy. If you wait, and have the misfortune to come down with an expensive medical condition, it will be too late. For us, a supplemental plan is a no brainer since we own homes in two far away states and like to travel. We find the national network of traditional Medicare to be very appealing.

[tophcfa]

To help the OP, in simple English, underwriting means that supplement plans will want you to have a physical exam by a doctor.
If you are not very healthy, they will reject you.

It will also involve a review of your complete medical history/records, so you can’t hide a pre-existing condition.

[Rainger99]

Pittman Law Offices in The Village JUST did a video on this two days ago. Pittman Law Office often contributes to videos by the Newcomers, Jerry and Linda.

It sounds like you are usually unable to switch after one year, if I heard it correctly. I recommend you invest the 11 minutes in what might be a very costly decision:

https://www.youtube.com/watch?v=HAP1liGSCo4

I watched the video. Are his numbers correct? He says medigap is about $175 a month plus about $25 a month for prescriptions or about $2400 a year. Add the $240 deductible and the most you would pay would be $2640. But that doesn’t include dental or vision.

It seems that the most you pay with Medicare supplement would be about $2700 a year. But you pay that every year-whether you go to your primary care doctor once a year or if you have open heart surgery and chemotherapy the same year.

At this point I am paying less than $500 a year. I assume that will go up as I get older. But until then I am saving about $2000 a year.

[biker1]

Supplemental costs vary by age, sex, smoking history, the company, where you live, the plan (F, G, N, etc.), and whether you switched to an Advantage Plan and then switched back in less than a year. Prescription drug plans vary and can be as low as $0 per month. The numbers you presented are ballpark.


I watched the video. Are his numbers correct? He says medigap is about $175 a month plus about $25 a month for prescriptions or about $2400 a year. Add the $240 deductible and the most you would pay would be $2640. But that doesn’t include dental or vision.

It seems that the most you pay with Medicare supplement would be about $2700 a year. But you pay that every year-whether you go to your primary care doctor once a year or if you have open heart surgery and chemotherapy the same year.

At this point I am paying less than $500 a year. I assume that will go up as I get older. But until then I am saving about $2000 a year.

[Michael 61]

Traditional Medicare vs Medicare advantage is a MAJOR decision when one turns 65. I’m still a few years away from 65, but doing my research now. I think the mistake many make is that they look at their current health at 65 and make a decision based on how healthy they are currently. It’s important to look into the future, and consider what your health costs could be, as well as access to specialists, under each program should you need extensive health care, hospitalization, surgeries, rehab, etc. There is no “one size fits all” here. But it’s important to remember it can be very difficult, if not impossible, to switch from advantage to traditional Medicare when you are in your 70s or 80s if you have been diagnosed with serious health issues.

[Rainger99]

Traditional Medicare vs Medicare advantage is a MAJOR decision when one turns 65. I’m still a few years away from 65, but doing my research now. I think the mistake many make is that they look at their current health at 65 and make a decision based on how healthy they are currently. It’s important to look into the future, and consider what your health costs could be, as well as access to specialists, under each program should you need extensive health care, hospitalization, surgeries, rehab, etc. There is no “one size fits all” here. But it’s important to remember it can be very difficult, if not impossible, to switch from advantage to traditional Medicare when you are in your 70s or 80s if you have been diagnosed with serious health issues.

As far as I can tell, the main objection to advantage is that you are limited to in-network doctors while Medicare allows you to see any doctor. But in reality, can you see the best doctor in the USA or the best doctor in Florida? You can probably see the best doctor in Sumter County. I don’t think a doctor can see more than 32 people a day and that is probably generous. So your doctor is limited even with Medicare.

However, you are probably saving a lot of money every year with advantage.

And does the doctor make a difference? I have seen very wealthy people that have the best medical care in the world die from cancer or other diseases. And I have seen middle class people go to a regular doctor make miraculous recoveries.

Does anyone have any facts on whether people live longer under Medicare as opposed to those who have advantage?

[Rainger99]

Study comparing Medicare to advantage plans.


A Review of 62 Studies Finds Few Big Differences Between Traditional Medicare and Medicare Advantage on a Variety of Measures | KFF (https://www.kff.org/medicare/press-release/a-review-of-62-studies-finds-few-big-differences-between-traditional-medicare-and-medicare-advantage-on-a-variety-of-measures/)

[daniel200]

As far as I can tell, the main objection to advantage is that you are limited to in-network doctors while Medicare allows you to see any doctor. But in reality, can you see the best doctor in the USA or the best doctor in Florida? You can probably see the best doctor in Sumter County. I don’t think a doctor can see more than 32 people a day and that is probably generous. So your doctor is limited even with Medicare.

However, you are probably saving a lot of money every year with advantage.

And does the doctor make a difference? I have seen very wealthy people that have the best medical care in the world die from cancer or other diseases. And I have seen middle class people go to a regular doctor make miraculous recoveries.

Does anyone have any facts on whether people live longer under Medicare as opposed to those who have advantage?

In Medicare Advantage your provider must write/agree a referral for a specialist. If you see a specialist without this they will deny coverage. They use this to limit their costs.

A person who is enrolled in Original Medicare does not need a referral from a primary care doctor to see a specialist. However, you must check that the specialist is Medicare-approved and currently accepts Medicare assignments.

[Rainger99]

In Medicare Advantage your provider must write/agree a referral for a specialist. If you see a specialist without this they will deny coverage. They use this to limit their costs.


I don’t need a referral to see a specialist in my UHC advantage plan.

And when I was working and before I had Medicare, I had to get a referral to see a specialist. It wasn’t a problem. My primary care doctor would always refer me.

[bionorse1]

When I signed up for Medicare my broker advised me to marry my supplement and date my drug plan. My $200 a month supplement pays for everything that Medicare doesn't. Ex. If a visit costs $100 and Medicare pays $10, my supplement pays the remaining $90 however if Medicare pays nothing neither does my supplement. As a plus, I can go to any hospital, doctor or specialist anywhere in the US without a referral!! I have Welcare for my drug plan. The monthly premium is $0 and generic drugs are $0 for a 90 day supply. I can change my drug plan once a year with no penalty.

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.

[rsmurano]

All advantage plans are very bad. There is a reason why they throw everything under the sun in them to entice you.
You might be healthy now but tomorrow you might not be. If you have been on an advantage plan for over a year, all the supplement plans can refuse you.

Have you investigated any advantage plan? If you have, you would have never joined 1. All advantage plans can refuse medical service because the insurance company are the 1’s that approve medical service to you, not Medicare. Medicare does not refuse any medical service, if a dr thinks you need help, you always get it. Why are advantage plans been talked about in congress for years? Because of the 60% refusal rate of coverage by advantage plans.

Also, your supplement plan covers everything that Medicare covers, there is no right of refusal of medical service from the supplement company.

Also, have you been seeing in the news that more and more hospitals are not accepting advantage plans? Right now your local hospital might cover your advantage plans, but don’t count on it tomorrow. I have Humana prescription plan and the salesman last year tried to get me to get their advantage plan so I asked him a couple of questions: do you refuse medical service even if a dr prescribes it? He said yes they can. A year ago, I had a medical device installed in me and the 1 I picked was $20,000 more than the cheaper device, so I asked the salesman if they would allow me to get their advantage plan device I wanted and he told me they would have recommended the cheaper unit if it did the job. Remember, these are insurance companies that make money when they don’t have to pay out.

What I don’t get is hearing about people taking a cheaper advantage plan that has many deficiencies to save a couple hundred $$$ when getting a much better supplement plan g/n/?? When overall you are saving hundreds of dollars a month compared to what you were paying when you were working with possibly better coverage.

[bowlingal]

SHINE.....Serving Health Insurance Needs of Elders. These are Medicare people, NOT insurance people. The best option for information. They meet at Eisenhower Rec Center, Lake Miona Rec Center, Chula Vista Rec Center and Lady Lake library. All at different days/times. No appointment needed. SHINE - Home (http://www.floridashine.org)

[jojo]

My mother had one of the upper end Advantage plans which was ok until she started needing rehab or worse skilled nursing after a hospital visit. We were limited to 2 facilities and both were nightmares. i have neighbors and friends who have recently discovered that their Advantage plans greatly limit their choices in rehab and skilled nursing. The facilities prioritize supplement plans in making intake decisions.

[RoseyRed]

As far as I can tell, the main objection to advantage is that you are limited to in-network doctors while Medicare allows you to see any doctor. But in reality, can you see the best doctor in the USA or the best doctor in Florida? You can probably see the best doctor in Sumter County. I don’t think a doctor can see more than 32 people a day and that is probably generous. So your doctor is limited even with Medicare.

However, you are probably saving a lot of money every year with advantage.

And does the doctor make a difference? I have seen very wealthy people that have the best medical care in the world die from cancer or other diseases. And I have seen middle class people go to a regular doctor make miraculous recoveries.

Does anyone have any facts on whether people live longer under Medicare as opposed to those who have advantage?
Good Point! May also want to consider quality of life vs longevity!

[HJBeck]

I always thought that if an office visit cost $100 and Medicare says the office visit is only worth $50, Medicare will pay 80% of the $50 or $40. Your supplemental plan only pays the balance of what Medicare didn’t pay on the $50 that Medicare said the office visit was worth or $10. The medical provider has to eat the unpaid portion of the original office visit cost.

[GizmoWhiskers]

To help the OP, in simple English, underwriting means that supplement plans will want you to have a physical exam by a doctor.
If you are not very healthy, they will reject you.
Hmmmm didn't they make healthcare required to no pre-existing conditions?? A quick google search reveiled info on that. Seems "Medigap" and a handful of states have the pre-existing on Medigap and certain enrollment periods as well as open enrollment times.

Medigap purchasing details: enrollment periods, guaranteed issue, and more - Medicare Interactive (https://www.medicareinteractive.org/get-answers/medicare-health-coverage-options/supplemental-insurance-for-original-medicare-medigaps/medigap-purchasing-details-enrollment-periods-guaranteed-issue-and-more)

[retiredguy123]

I always thought that if an office visit cost $100 and Medicare says the office visit is only worth $50, Medicare will pay 80% of the $50 or $40. Your supplemental plan only pays the balance of what Medicare didn’t pay on the $50 that Medicare said the office visit was worth or $10. The medical provider has to eat the unpaid portion of the original office visit cost.
You are correct.

However, one rare exception is if the provider has totally opted out of Medicare. In that case, the provider can charge whatever they want.

[biker1]

When you become eligible for Medicare, you have an opportunity to enroll in a supplemental plan with no underwriting. They have to accept you regardless of your health situation. If you want to switch later on from an Advantage plan to a supplemental plan then you might be subject to underwriting. You can initially try out an Advantage plan for a year and then switch to a supplemental plan without underwriting.

Hmmmm didn't they make healthcare required to no pre-existing conditions??

[Rainger99]

When you become eligible for Medicare, you have an opportunity to enroll in a supplemental plan with no underwriting. They have to accept you regardless of your health situation. If you want to switch later on from an Advantage plan to a supplemental plan then you might be subject to underwriting.

Does anyone have any figures on what percentage of people are rejected by underwriting?

[Bkosloski]

I am 79 and paying $173 for Medigap Plan N. My partner, with many medical issues, pays about $245 for plan G, no deductibles, copays, etc and can go anywhere they accept Medicare. Has been to Shands, inpatient rehab 3 times, etc. and hasn’t paid a dime. We pay $0 this year for our drug plan, but drug plans are changing for everyone next year.

Medigap is the way to go when you get older. My opinion.

[Bay Kid]

Why is the government so tricky on health coverage?

[beckylou152]

We researched this extensively, and decided upon traditional Medicare with a supplement. A great resource is The Medicare School. Medicare advantage can refuse to approve care, and Medicare cannot if you go to a provider that accepts it. Here is a good video to start. I know people are very happy with their advantage plans but I also know people who have their care choices limited or denied. My husbands Medicare part D is free and he has yet to pay for any meds. https://youtu.be/5OmK94JRerc?si=d_AATncnyQvKmFNB

[retiredguy123]

We researched this extensively, and decided upon traditional Medicare with a supplement. A great resource is The Medicare School. Medicare advantage can refuse to approve care, and Medicare cannot if you go to a provider that accepts it. Here is a good video to start. I know people are very happy with their advantage plans but I also know people who have their care choices limited or denied. My husbands Medicare part D is free and he has yet to pay for any meds. https://youtu.be/5OmK94JRerc?si=d_AATncnyQvKmFNB
Not exactly. Medicare can refuse to cover some treatments or drugs.

[msilagy]

Underwriting at Mutual of Omaha supplement meant answering health related questions when I had that supplement. No medical exam. However keep in mind it all depends on what you want concerning your health care. I have traditional medicare and a supplement and last year I broke my leg with surgery and rehab, had a macular hole in my eye w/treatment at Mayo Clinic in Rochester Mn. I had breast cancer with surgery and radiation. All paid 100%. I never ever considered an advantage plan no matter if it cost initially less.

[kendi]

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.

We steer clear of advantage plans because we don’t want an insurance company making our healthcare choices for us.


If you switch from an advantage plan you will need medigap which is supplemental and plan D also which is the drug plan.

As far as what it will cost you it depends on what plans you pick. But you will likely pay more than what you are now.

Go to Medicare.gov and you can find all the plans along with details. One thing to watch out for are plans that increase in cost based on your age. USAA is the worst.

Happy hunting

[PoolBrews]

If you have been on an Advantage plan for more that 1 year, you can be subjected to underwriting when going back to traditional Medicare. IMHO, I would contact SHINE and have a discussion with them. So, to answer your question it depends on how long you have been in an Advantage plan. We were on for 5o weeks and were able to switch back without any penalty, but we just made it.
SHINE has 800 number and LOCAL meetings in TV, and we have found them to be very helpful. If you get the Daily Sun, the weekly advertisement for healthy living usually has their contact info.

Can you share your reasons for switching back? I'll be going on Medicare next year and want to understand reasons for and against an Advantage plan.

[kendi]

All advantage plans are very bad. There is a reason why they throw everything under the sun in them to entice you.
You might be healthy now but tomorrow you might not be. If you have been on an advantage plan for over a year, all the supplement plans can refuse you.

Have you investigated any advantage plan? If you have, you would have never joined 1. All advantage plans can refuse medical service because the insurance company are the 1’s that approve medical service to you, not Medicare. Medicare does not refuse any medical service, if a dr thinks you need help, you always get it. Why are advantage plans been talked about in congress for years? Because of the 60% refusal rate of coverage by advantage plans.

Also, your supplement plan covers everything that Medicare covers, there is no right of refusal of medical service from the supplement company.

Also, have you been seeing in the news that more and more hospitals are not accepting advantage plans? Right now your local hospital might cover your advantage plans, but don’t count on it tomorrow. I have Humana prescription plan and the salesman last year tried to get me to get their advantage plan so I asked him a couple of questions: do you refuse medical service even if a dr prescribes it? He said yes they can. A year ago, I had a medical device installed in me and the 1 I picked was $20,000 more than the cheaper device, so I asked the salesman if they would allow me to get their advantage plan device I wanted and he told me they would have recommended the cheaper unit if it did the job. Remember, these are insurance companies that make money when they don’t have to pay out.

What I don’t get is hearing about people taking a cheaper advantage plan that has many deficiencies to save a couple hundred $$$ when getting a much better supplement plan g/n/?? When overall you are saving hundreds of dollars a month compared to what you were paying when you were working with possibly better coverage.

I know someone who died due to her advantage plan denying the specialty facility she needed to go to. Very sad

[MX rider]

All advantage plans are very bad. There is a reason why they throw everything under the sun in them to entice you.
You might be healthy now but tomorrow you might not be. If you have been on an advantage plan for over a year, all the supplement plans can refuse you.

Have you investigated any advantage plan? If you have, you would have never joined 1. All advantage plans can refuse medical service because the insurance company are the 1’s that approve medical service to you, not Medicare. Medicare does not refuse any medical service, if a dr thinks you need help, you always get it. Why are advantage plans been talked about in congress for years? Because of the 60% refusal rate of coverage by advantage plans.

Also, your supplement plan covers everything that Medicare covers, there is no right of refusal of medical service from the supplement company.

Also, have you been seeing in the news that more and more hospitals are not accepting advantage plans? Right now your local hospital might cover your advantage plans, but don’t count on it tomorrow. I have Humana prescription plan and the salesman last year tried to get me to get their advantage plan so I asked him a couple of questions: do you refuse medical service even if a dr prescribes it? He said yes they can. A year ago, I had a medical device installed in me and the 1 I picked was $20,000 more than the cheaper device, so I asked the salesman if they would allow me to get their advantage plan device I wanted and he told me they would have recommended the cheaper unit if it did the job. Remember, these are insurance companies that make money when they don’t have to pay out.

What I don’t get is hearing about people taking a cheaper advantage plan that has many deficiencies to save a couple hundred $$$ when getting a much better supplement plan g/n/?? When overall you are saving hundreds of dollars a month compared to what you were paying when you were working with possibly better coverage.

I would disagree with you saying "all plans are bad". Like anything, some are better than others.
We did our research and even talked to some people with serious medical issues on our plan, UHC Advantage HMO/POS. We can go anywhere in their large nationwide network, with no pre-approvals needed.

We even checked many specialists, hospitals and doctors and the majority were in the network. We also have used the dental, vision and wellness benefits. We're satisfied with our desision.
Btw, SHINE said it was a good option.

Painting with a broad brush on this is foolish.

[Mrprez]

I would disagree with you saying "all plans are bad". Like anything, some are better than others.
We did our research and even talked to some people with serious medical issues on our plan, UHC Advantage HMO/POS. We can go anywhere in their large nationwide network, with no pre-approvals needed.

We even checked many specialists, hospitals and doctors and the majority were in the network. We also have used the dental, vision and wellness benefits. We're satisfied with our desision.
Btw, SHINE said it was a good option.

Painting with a broad brush on this is foolish.

Agreed, the OP will not get an unbiased opinion here. Best thing is to go talk to the people at SHINE and get the facts.

[Marine1974]

[QUOTE=Rainger99;2372914]I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

I have regular Medicare $174 a month taken out of my social security. My supplemental is with AARP United Healthcare $166
Per month . ( up from $146 a month in 2023) . My deductible is $240 for the whole year after that I pay $0 . No referrals needed I can go anywhere. My drug plan Medicare part d premium is $0 some drugs I regularly take our $0 others $15, prescriptions I don’t regularly take range from $15 to ? . I also have VA healthcare but due to my income I’m put in a tier where I pay a copay for primary care $15 specialist $50 but if I see 3 specialist in the same day it’s still one charge of $50!.
I’m on my dentists dental plan $375 a year . 2 cleaning, X-rays free . 20% off other procedures .
Never had Medicare advantage but my wife does . She’s healthy but pays copays .

[LuvNH]

Agreed, the OP will not get an unbiased opinion here. Best thing is to go talk to the people at SHINE and get the facts.

You NEED professional information which you can get from SHINE. From experience I would tell anyone to buy the best insurance you can afford. Your healthcare needs are not the same at 65 as they will be at 85 .

[RoboVil]

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.
If you travel within the US at all then regular Medicare has you covered everywhere. With Advantage programs, you could get hit with a big bill if you need care outside of their network. We currently travel outside of TV to visit family and don't have to worry about whether network services are available. Also, join AARP and price their regular Medicare plans (via United Health) and obtain Medigap coverage too. As for pricing, it just depends on what plan you chose and where you live.

[Rainger99]

Everyone says you don’t need referrals for Medicare.

How does that work? If I want an MRI of my knee, I just show up and it is covered?

[sully1]

Switch now while you still can.There is nothing greater than piece of mind. Spend the few extra bucks and be worry free. You can’t take it with you my friend. Did you ever see a hearse with a u- haul trailer behind it?

[biker1]

Radiology typically works by having a Dr. make a referral. I doubt you would find a provider who will entertain a patient calling directly for an MRI. The provider will verify your insurance before any procedure.

Everyone says you don’t need referrals for Medicare.

How does that work? If I want an MRI of my knee, I just show up and it is covered?

[retiredguy123]

Everyone says you don’t need referrals for Medicare.

How does that work? If I want an MRI of my knee, I just show up and it is covered?
You can see a specialist, like a dermatologist or a surgeon, "IF" they will see you. But, even some specialists will not see a patient without the patient first seeing a primary care provider. But, Medicare will not require a referral, when some Advantage plans will. For an Xray, like an MRI, you would definitely need an order from a medical doctor or other authorized provider.

[Rainger99]

Radiology typically works by having a Dr. make a referral. I doubt you would find a provider who will entertain a patient calling directly for an MRI. The provider will verify your insurance before any procedure.

So if I twist my knee playing pickleball, and I go the ER and ask for an MRI, the doctor has to order it? And he makes the decision to order an x-ray rather than an MRI?

[biker1]

Drs will typically follow a protocol appropriate for the injury. This may involve an x-ray and physical therapy and a subsequent MRI if the problem persists. It depends.



So if I twist my knee playing pickleball, and I go the ER and ask for an MRI, the doctor has to order it? And he makes the decision to order an x-ray rather than an MRI?

[retiredguy123]

So if I twist my knee playing pickleball, and I go the ER and ask for an MRI, the doctor has to order it? And he makes the decision to order an x-ray rather than an MRI?
As a patient, you cannot demand an MRI if the doctor disagrees. But, personally, I think the medical profession is pretty stingy when it comes to ordering an MRI. Just my opinion.

[Joeint]

I don’t need a referral to see a specialist in my UHC advantage plan.

And when I was working and before I had Medicare, I had to get a referral to see a specialist. It wasn’t a problem. My primary care doctor would always refer me.

You may not need a referral but you will definitely need an approval which may or may not happen. You need to get approval for a rehab stay if you need one. (dis)Advantage plans are fine if you're healthy not so much when you get older and need more care.

[Janie123]

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.
Medicare Advantage is great if you are healthy like you are, We personally went with an advantage plan G as we have a cancer history in the family and for example, the Mayo Clinic, one of the top 5 cancer hospitals in the country does not accept Advantage. Wife is a pancreatic cancer survivor because of the Mayo Clinic. It wasn’t just the treatments (chemo, radiation, surgery) but the order that they did it in. We have different opinions on her treatment and the Mayo was very different and they gave statistics on why they do what they do it the way the do. Plus places like Mayo have all the services under one roof. The docs just picked up the phone and called a different building to talk to other docs. My SIL is extremely healthy and on an advantage plan and had breast cancer just pop up out of nowhere and she had to go to various places for various opinions and that took weeks where we went to the Mayo on a Monday and by the following Thursday 10 days later, we started chemo…

You can switch now as underwriting will see you as healthy, once you are not healthy, you cannot switch…. IMO, never skimp on your healthcare

I would look at YouTube videos on advantage vs supplemental to do your homework… .

[MX rider]

You may not need a referral but you will definitely need an approval which may or may not happen. You need to get approval for a rehab stay if you need one. (dis)Advantage plans are fine if you're healthy not so much when you get older and need more care.

Just another uninformed poster painting with a broad brush. Medicare is not a one size fits all, as some of you are saying. Everyone should do their own research and do what's best for them. SHINE is a good resource

As I said in a previous post, not all MA plans are the same. As a matter of fact, some are much better than others. We know, we did the research.

You can go to the Medicare website and check ratings for all the MA plans, it's just another tool you can use to make an informed decision.

[frostola]

I have an advantage plan and I am very pleased. I was recently diagnosed with breast cancer, I have had the best care at MOFFITT. My recent hospital bill was $30,000 and I only had to pay $150. I also had thousands of $$ in bills for tests and procedures prior to surgery and only paid $120.
I have great dental and vision coverage. Florida Blue worked with me to get into doctors ASAP. I have a $20 copay for specialist, but didn’t have to pay a copay at MOFFITT. Just wanted to share a positive view on Advantage plans.

[schrdr]

I switched from std Medicare and supplements. Along with drug coverage to Florida Blue. Saving $1000 per month. That's $12,000 saved per year over std Medicare. 2 years ago I had over $500,000 in surgery and hospital bills all covered by Florida Blue Advantage plan. I would never go back to Std Medicare

[dougjb]

I strongly urge you to go and speak with a SHINE representative.

They are not salespeople and only provide unbiased information. They are exceedingly helpful. In my case, they really helped me analyze which plans were available and what they cost. If they could not give me that info, they directed me to a place that had such information. As a result, I saved hundreds of dollars a year while getting the best original Medicare and Medigap policy for my health conditions. They schedule routine meetings at various locations throughout the Villages.

Please be aware, if you are currently on a Medicare Advantage plan and you wish to switch to original Medicare, the plan may or may not (most likely, will) underwrite you to see if you qualify for their plan. If you have any significant pre-existing health conditions, it is unlikely you will be able to switch easily. SHINE can help provide you with more information as to that.

The important thing to remember is that insurability for pre-existing health conditions is not a right as a matter of course. Unlike the ACA which provided for this very necessary arrangement, Medicare does not. So, please keep this in mind. You can not just change for the sake of change or for a matter of economics. Your health serves as the basis for change.

As for me, I am grateful to SHINE. I went with Original Medicare with a (now unavailable) Plan F. It is the best health insurance I have ever had. But, it does cost. But, the savings compared to my pre-Medicare is very substantial. I love Medicare!

[Mrprez]

I would avoid YouTube as a source of reliable information about MA plans. Most of that content is put out by people whose business is selling Medigap policies.

[Rande]

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.

The first year on Medicare I had an advantage plan in NJ as did my husband. This was 7 yrs ago. After the first year I switched to a supplement plan. My husband had Prostate cancer that required 45 radiation treatments and various visits to specialist, Urology and Radiology. All at $50 a treatment/visit. That adds up quickly. That’s when I made my decision to switch my plan. If you really get sick, it can be costly in copays.

There are hospitals that do not except advantage plans. I understand Moffit is one of them.

[jimjamuser]

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.
Yes, you should switch.

[Mrprez]

The first year on Medicare I had an advantage plan in NJ as did my husband. This was 7 yrs ago. After the first year I switched to a supplement plan. My husband had Prostate cancer that required 45 radiation treatments and various visits to specialist, Urology and Radiology. All at $50 a treatment/visit. That adds up quickly. That’s when I made my decision to switch my plan. If you really get sick, it can be costly in copays.

There are hospitals that do not except advantage plans. I understand Moffit is one of them.

Your understanding is wrong. Moffit does accept MA plans. Also, an MA plan will have a maximum out of pocket coverage depending on the plan. Some are more than others that’s why it pays to read the details or get professional non biased assistance.

[MX rider]

I have an advantage plan and I am very pleased. I was recently diagnosed with breast cancer, I have had the best care at MOFFITT. My recent hospital bill was $30,000 and I only had to pay $150. I also had thousands of $$ in bills for tests and procedures prior to surgery and only paid $120.
I have great dental and vision coverage. Florida Blue worked with me to get into doctors ASAP. I have a $20 copay for specialist, but didn’t have to pay a copay at MOFFITT. Just wanted to share a positive view on Advantage plans.

OMG!! You're coming here with real world factual information about MA plans. Don't you know they're a scam?

You can't do that. You need to have a post that starts with " I heard" or "all ma plans are bad" or "someone told me" or "I read an article" or "never sign up for ma".

LOL!!

We too are happy with our MA plan. It's great to have options, that's a good thing for everyone.

SHINE is a good place to start for the OP.

[bill4952]

You can switch if you are getting younger.

[Rainger99]

You can switch if you are getting younger.

As far as I can tell, you can switch if you are in reasonably good health.

I called a company that sells medigap. He said plan G and plan N are the two most popular medigap policies. N is quite a bit cheaper than G. As far as I can tell, the main difference is that G does not have a copay when you visit the doctor but N does have a copay.

He said I could get G for about $205 a month and N for about $152. Drugs are about $75 a month.

I also asked him about the difficulty in switching from advantage to Medicare. He said it is pretty easy unless you have significant pre-existing conditions such as dialysis, severe heart problems, diabetes, or advanced cancer. He estimated 95% are approved.

[CoachKandSportsguy]

For those interested in a Medigap plan, its also expensive. My mom is 97, only has medicare, never has had a supplement, and she just had her first major surgery, hip replacement, and the total uncovered medicare bill was $2,000.

am thinking that all those years of savings, and she cancelled her dental eye plan as a seldom used plan, but very high premium. If you have plenty of savings, i would skip the medigap and have a good chunk of cash, $10,000 for out of pocket emergency surgery.

Any other major surgeries uncovered by medicare expenses for comparison?

[tophcfa]

For those interested in a Medigap plan, it’s also expensive.

It’s all relative and situation dependent. A Medigap plan can be very expensive relative to both an advantage plan and just basic Medicare without a Medigap plan, under the huge assumption that the insured remains healthy and doesn’t require expensive medical care for a long time. On the other hand, after being on Obamacare for the last several years, a Medigap plan looks like an absolutely incredible bargain in comparison.

[DAVIDW5084]

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.

Please contact Shine for details on Medicare plans. As one post stated there are counselors available now in The Villages. Search for Florida Shine in you browser for locations and times in Sumter and Lake counties

[Frodo]

We have to remember that Medicare advantage is a for-profit business. Whenever they can deny you a service they make more money. On the other hand, if you would like to see a specialist and you have regular Medicare you call up and make an appointment. You don't have to go through a thousand steps trying to get approval from your managed care insurance provider.

[Rainger99]

We have to remember that Medicare advantage is a for-profit business. Whenever they can deny you a service they make more money. On the other hand, if you would like to see a specialist and you have regular Medicare you call up and make an appointment. You don't have to go through a thousand steps trying to get approval from your managed care insurance provider.

Aren’t Medigap companies a for profit business?

[Frodo]

We have to remember that Medicare advantage is a for-profit business. Whenever they can deny you a service they make more money. On the other hand, if you would like to see a specialist and you have regular Medicare you call up and make an appointment. You don't have to go through a thousand steps trying to get approval from your managed care insurance provider.

[retiredguy123]

Aren’t Medigap companies a for profit business?
Yes, they are. But, they operate significantly different from advantage plans. Medigap plans are designed by the Government to pay the 20 percent copay that original Medicare doesn't pay. They have very little flexibility when paying claims. Basically, if Medicare covers it, they must pay for it. They cannot deny coverage of a claim approved by Medicare. The only flexibility they have is in how much they charge in premiums. So, they are basically a piggyback plan to Medicare, and they are heavily controlled by the Government.

[westernrider75]

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.

We currently have a supplement which costs us about $250 a month (for both of us) but are considering switching to an advantage to potentially save some dollars. My biggest concern is being able to get necessary services through an advantage plan. For instance, my sister in law has been ha i get back problems for about 6 months. She finally got in with a surgeon who ordered an MRI to try to determine exactly what was happening. It was denied. That would not happen with a supplement.

[MX rider]

We have to remember that Medicare advantage is a for-profit business. Whenever they can deny you a service they make more money. On the other hand, if you would like to see a specialist and you have regular Medicare you call up and make an appointment. You don't have to go through a thousand steps trying to get approval from your managed care insurance provider.

Obviusly, all MA plans are not the same. Mine doesn't require approvals. This person likes their plan as well. But don't let her facts get in the way of your story.

"I have an advantage plan and I am very pleased. I was recently diagnosed with breast cancer, I have had the best care at MOFFITT. My recent hospital bill was $30,000 and I only had to pay $150. I also had thousands of $$ in bills for tests and procedures prior to surgery and only paid $120.
I have great dental and vision coverage. Florida Blue worked with me to get into doctors ASAP. I have a $20 copay for specialist, but didn’t have to pay a copay at MOFFITT. Just wanted to share a positive view on Advantage plans."

[Arlington2]

...My biggest concern is being able to get necessary services through an advantage plan. For instance, my sister in law has been ha i get back problems for about 6 months. She finally got in with a surgeon who ordered an MRI to try to determine exactly what was happening. It was denied. That would not happen with a supplement.

Many of us would be interested to know the MA plan your sister has. Some MA's seem to be notorious for denials. I have UHC and have had many similar tests with no denials. I do know a person with UHC that had a knee denial, but it turns out it was a problem with the procedure coding. I am 100% pleased with UHC. I believe most Fl Blue folks have the same positive experience.

[biker1]

Which plan do you have (insurance company and plan letter)?


We currently have a supplement which costs us about $250 a month (for both of us) but are considering switching to an advantage to potentially save some dollars. My biggest concern is being able to get necessary services through an advantage plan. For instance, my sister in law has been ha i get back problems for about 6 months. She finally got in with a surgeon who ordered an MRI to try to determine exactly what was happening. It was denied. That would not happen with a supplement.

[Emkay56]

Sounds to me like you have a great advantage plan. I've had an advantage plan since I started Medicare, 3 years... I'm healthy so it works great for me. Why pay $200/mo for a supplement plan? To me it's a no brainer to keep what you have.

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.

[Thomy]

Not exactly. Medicare can refuse to cover some treatments or drugs.

Rarely....

[retiredguy123]

Rarely....
That is because most mainstream Medicare providers know in advance what Medicare will and will not cover. But, there are thousands of medical treatments and drugs that Medicare does not cover. For example, many people travel overseas and pay a lot of money for stem cell treatments.

[SusanStCatherine]

Rarely....

I'm on just a few prescriptions. One is NP thyroid which has been around since before FDA approval so it is never covered by any insurance. It's rediculous. So I found a mail order pharmacy to minimize my cost to $60 for a 90 day supply.

I'm also on a new generic. It is on a high tier on my part D plan. They want $177/mo through Part D. I got an exception through and it still costs the same and after I meet my deductible then I pay 50% because of the tier. I was able to get it filled at CVS and used a GoodRx coupon which brought the cost down around $70/mo from the start. CVS found me even a better discount than GoodRx. And my doctor did not think they would fill a 90 day supply, but CVS did and that was even less expensive.

I pay $0 for my plan D and what I pay on these two prescriptions do not count toward my $545 deductible. But I probably won't reach that anyway. I looked at all the available part D plans and spending more would make no difference whatsoever due to my particular prescriptions.

Everything depends on your own individual case. Also things can change.

[retiredguy123]

Think about it. If Medicare covered everything, quacks and snake oil salespeople would be coming out of the woodwork to sell treatments and collect money from Medicare.

[lawgolfer]

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.

Unless money is a serious problem and the "free" teeth-cleaning and eyeglasses are extremely important to you, switch to regular Medicare as soon as you can and purchase a Supplemental plan from one of the private insurance companies (AARP gets you United Health).

Should you have a serious medical condition, your choice of doctors will be limited to those in the Advantage plan. They may, or may not, be the best available. Getting permission to use a doctor outside the Advantage plan will be as hard as pulling your own teeth.

With regular Medicare, you can be treated by any doctor you choose, provided the doctor accepts Medicare and accepts as payment in full what Medicare and your supplemental insurer pays.

If you don't care who cuts into your chest to place several bypasses on your heart or cuts into your brain to remove a tumor, stay with your Advantage plan.

[Rainger99]

According to the Wall Street Journal, about 7.1% of Advantage enrollees will have to find another plan next year because theirs is being terminated, up from 0.4% to 1.5% during the past four years.

[rjm1cc]

Look at this site SHINE - Home (https://floridashine.org/)
In my area we can also set up one on one appointments with a Shine person. I think this is what you need to do.

[mrf6969]

Reading through the comments here, I have not seen any comments about doctor choice. We choose Medicare Supplement over Advantage because we are not locked into just a pool of doctors. We can go to any doctor, anywhere in the country. Love that freedom.

[Rainger99]

We can go to any doctor, anywhere in the country. Love that freedom.

I always hear that as an argument for Medicare. Can everyone on Medicare (about 30 million people) really go to the top heart doctor in the country? I would think it would be very hard to get an appointment.

[mrf6969]

I always hear that as an argument for Medicare. Can everyone on Medicare (about 30 million people) really go to the top heart doctor in the country? I would think it would be very hard to get an appointment.
You missed the point. Advantage has a much smaller pool of "heart doctors" to choose from.

[Rainger99]

You missed the point. Advantage has a much smaller pool of "heart doctors" to choose from.

I agree that it is smaller. However, UHC has over 1.3 million physicians and care professionals nationwide. I am not limited to Sumter County or even Florida.

[Aces4]

I don’t need a referral to see a specialist in my UHC advantage plan.

And when I was working and before I had Medicare, I had to get a referral to see a specialist. It wasn’t a problem. My primary care doctor would always refer me.

I believe Medicare Advantage is the pathway for private insurers to take over and Medicare itself to disappear. All the goodies were thrown in there for seniors to be enticed into the Advantage Plan and then slowly be taken away.

A friend went to the ER after suffering chest pain and it was determined he needed stents and the surgery was scheduled. Imagine his surprise when he received notice that upon further examination of his test results, they think medication should work. Yikes! Yes, he has Medicare Advantage and it's not impressive to us. You have to make your own decision.

CNN has an article from October 14th, 2024 regarding the changes coming to Medicare Advantage as open enrollment starts. And it begins...

[MX rider]

There's no right or wrong. We were on the same UHC MA plan for 24 in Indiana. But since we moved here we switched to The Villages UHC MA plan yesterday. Before you make a decision, make an appointment with a insurance agent that is with UHC and check out their Medical facilities.

[MX rider]

I agree that it is smaller. However, UHC has over 1.3 million physicians and care professionals nationwide. I am not limited to Sumter County or even Florida.
Exactly. We're on UHC Advantage and have had no trouble finding good doctor and specialists that take it.

[MX rider]

I believe Medicare Advantage is the pathway for private insurers to take over and Medicare itself to disappear. All the goodies were thrown in there for seniors to be enticed into the Advantage Plan and then slowly be taken away.

A friend went to the ER after suffering chest pain and it was determined he needed stents and the surgery was scheduled. Imagine his surprise when he received notice that upon further examination of his test results, they think medication should work. Yikes! Yes, he has Medicare Advantage and it's not impressive to us. You have to make your own decision.

CNN has an article from October 14th, 2024 regarding the changes coming to Medicare Advantage as open enrollment starts. And it begins...

MA plans differ greatly. We know, we did lots of research before we chose UHC. We just renewed with The Villages UHC Advantage plan.
They have their own doctors and facilities and only take advantage plans, no medicare. But we're also free to go to any provider in the nationwide UHC network if we choose. Plenty of good doctors, specialists and hospitals take UHC.

Plus we have $2500 in dental and $300 in vision benifits, which we use. We also like the wellness benefits. Since we're very fit and take care of ourselves, the free gym membership is something we really like. Genesis gym at Brownwood is an excellent, top notch gym. My wife takes 2 classes a day there.

And yes our plan did change, for 2025 we both get back $16 a month on our SS check. Other than that very minor changes.
Anyone looking at MA plans should do their research. Check ratings, talk to SHINE and try to talk to people on the plan if possible.

Btw, SHINE said it was a very good option

[JRcorvette]

If you care about your health and ability to get the services and care you might need and can afford the extra cost then definitely YES!

[Laker14]

The really big elephant in the room is that you are making decisions now, based upon what the choices are now, and the conditions now, but they will change. Just because someplace like Moffit takes my UHC Advantage plan NOW, doesn't mean they'll take it in 3 years,. Likewise, however, with the Supplemental plans. That is also a shifting landscape.

[Dusty_Star]

As far as I can tell, you can switch if you are in reasonably good health.

I called a company that sells medigap. He said plan G and plan N are the two most popular medigap policies. N is quite a bit cheaper than G. As far as I can tell, the main difference is that G does not have a copay when you visit the doctor but N does have a copay.

He said I could get G for about $205 a month and N for about $152. Drugs are about $75 a month.

I also asked him about the difficulty in switching from advantage to Medicare. He said it is pretty easy unless you have significant pre-existing conditions such as dialysis, severe heart problems, diabetes, or advanced cancer. He estimated 95% are approved.

I think you may be right about it being easy to switch when you are in fairly good health. However, the Medicare Supplement Plans differ in cost depending on which one you choose.
I am currently in Plan G with Florida Blue & it is $221, but my Plan D drug premium is zero dollars a month, so about $58 less than you were told. I chose those plans. There are MediGap Plan G High Deductibles with premiums ranging from $52 - $97 (this is Sumter County). You can look through your options at the Medicare.Gov website. You do not have to belong to look through the options. Choose to 'continue without logging in'. Find a Medicare plan (https://www.medicare.gov/plan-compare/#/?year=2025&lang=en)

(One of the reasons I liked the Florida Blue plan was it is one of the ones that say they will not raise premiums as we age. I also agree with the advice of one of the earlier respondents: marry the supplement, date the drug plan. Pick a good plan for life, but review drug plans each year to meet your potentially changing needs).

[Dotneko]

Reading through the comments here, I have not seen any comments about doctor choice. We choose Medicare Supplement over Advantage because we are not locked into just a pool of doctors. We can go to any doctor, anywhere in the country. Love that freedom.

Can you use the doctors at the Villages Health??

[Mrprez]

Can you use the doctors at the Villages Health??

No, they can’t see a PCP. Specialists only.

[Dusty_Star]

Can you use the doctors at the Villages Health??

Currently if you have Medicare + Medigap you can see specialist doctors at Villages Health.