Talk of The Villages Florida

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-   -   Big Decision to Make re: Medicare (https://www.talkofthevillages.com/forums/medical-health-discussion-94/big-decision-make-re-medicare-311866/)

Miguel 1952 10-10-2020 08:38 AM

Quote:

Originally Posted by Ytepsick (Post 1845246)
You're going to be fine. Your research and thoughts are accurate. Find an independent agent, one who is reputable and been doing this for a while. They can walk you through the whole process quite easily. That person would have to evaluate your current drug list in addition to the supplement. Good luck!

This is exactly on point!
Independent agent is not obligated to just one insurance company, but can shop around.
There are many YouTube talks on Medicare, supplemental and Part D prescription. You can learned many things about Medicare so you know what questions to ask. My best!

Pommom91 10-10-2020 08:40 AM

I have Traditional Medicare with a blue cross supplement. I can go to any doctor in any state in the US if they participate in Medicare. I think the Villages Health care PCP’s are missing out by not accepting Medicare.

Chi-Town 10-10-2020 08:44 AM

Quote:

Originally Posted by Dontee (Post 1845234)
Kathy,
I turned 65 in July and started Medicare. The government charges 144.00 a month. I took BC/BS plan G so I could see any doctor I wanted with a cost of 177.99 a month. I also had to find a company selling prescription plans and I selected SilverScript for 25.20 a month. Every doctor takes Medicare and plan G and I’m saving 200.00 a month from my private health care which had a 5000.00 deductible.

Very similar to my choices and couldn't be happier.

chrisinva 10-10-2020 08:53 AM

I understand your concerns. Ours were similar when we moved here 1.5 yrs. ago. We're both on Medicare. We went to a SHINE meeting for clarity. http://floridashine.org/ and they cleared up everything. We still have my fed gov retiree coverage & Aetna instead of a supplemental Medicare plan. Works great - we never pay co-pays, can go to any doc, & pay very little for a few meds. Coverage is nation-wide.
Good luck - be sure to check out SHINE. Their in-person counseling is cancelled due to covid but they host virtual classes now.

Eg_cruz 10-10-2020 08:53 AM

Quote:

Originally Posted by kathyspear (Post 1845161)
I am currently insured through my husband's employer. Because it is a small company (30 - 40 employees?) my coverage is pricey. Also, like most people with private insurance, my deductible has quadrupled in the last few years. I have been reluctant to switch to Medicare but am currently investigating my options.

It looks as if I can save $200-300 per month on my premiums if I sign up for regular Medicare, a Plan G supplement, and a drug plan. In addition, if I am understanding what I read about Medi-gap plans, I will save several thousand dollars in annual out-of-pocket costs if I dump hubby's coverage.

Assuming that is correct (and please correct me if it is not!), my primary concern is: Will I have trouble finding doctors who accept my new coverage? Right now I can go to any doctor I want. If he/she is out of network I pay a larger percentage but I can still see that doctor.

I gather I will need to find another primary care dr if I make the switch because I have been seeing someone with TVHS. I have no attachment to that person, though, and have no problem with going elsewhere. BUT I'm terrified that something BAD will happen, everyone will say, "Oh, you MUST see Dr. So-and-So, he is the expert on that problem!" But Dr. So-and-So won't take Medicare patients.

Advice? Comments?

Thanks in advance.

kathy

If you go with AARP United Health Plan F you will see it is about the same price as Plan G. The difference is the part B deductible in Plane G you have to pay it and in Plan F you don’t.
If you are pretty healthy you may want to consider Plan N. Plan N it usually $50.00 less a month then the G and F. With N you have to pay the Part B deductible which is less than $200 a year and you have up to $20 co-pay to doctors. When it comes to Part A all three plans have the same coverage which is your hospital and short term nursing home.
With the N Plan you would have to go to the dr about 20 times a year before you reach the same out of pocket cost of G and F.
If you have other questions you can email.....FYI I do not sell any of the Medicare plans I have just worked in this market for 20 yrs. Happy to help

condomom22 10-10-2020 09:08 AM

Just this week I was told by a Medicare specialist (broker) that the Medicare/medigap (supplemental) policies allow for the greatest flexibility in doctors and hospitals (including Mayo) as these all accept Medicare. Additionally, the broker pointed out that with Advantage plans you are frequently directed to use only certain hospitals in their network for your surgery, whereas with Medicare/medigap you can select the hospital you wish to use.

HappyRetired 10-10-2020 09:23 AM

Plan F for supplemental insurance is no longer offered. If you have it, don't change. There are Advantage plans that are PPO (you can pick your doctor), not part of an HMO. However, some doctors don't take those plans. Add in costs of dental and eye care if they are not covered by supplemental. Some Advantage plans include some (limited) benefits. You must have drug coverage even if you don't use it or there is a penalty to pick up later. SHINE should be able to help. Also, set up an online account at Medicare.gov for lots of information on plans and Medicare in general. Do the same for Social Security because there are lots of questions answered there.

sswitenki 10-10-2020 09:24 AM

My husband and I came from MN with Medicare and BCBS Suppliment plans. My husband has had hospital stays at West Marion, ER trips to Villages hosp (never again), Leesburg hosp, Prostate Surg in Ocala, And total hip replacement At Mayo. He had PT and home health care after hip surgery. And a week stay in transitional care at Villages Rehab. All since Jan 1, 2019. We have paid zero copays, and Mayo only billed us about $100. Very happy with our plans. We have not had trouble finding mds but most have been specialists. Maybe general primary care is more difficult. Hubby needs internal med to help manage his needs

sk450 10-10-2020 09:30 AM

I don't think you can get plan G while still on privet insurance. If you were on Medicare you can use you husband's as a secondary. Your in or out of Medicare.

airstreamingypsy 10-10-2020 09:31 AM

It looks as if I can save $200-300 per month on my premiums if I sign up for regular Medicare, a Plan G supplement, and a drug plan. In addition, if I am understanding what I read about Medi-gap plans, I will save several thousand dollars in annual out-of-pocket costs if I dump hubby's coverage.

Kathy,

I have plan G. It's amazing. I have a one time deductible, under 200.00, and it's clear sailing after that.

sk450 10-10-2020 09:47 AM

Check with Mutual of Omaha with drug plan my total 132.00 per month.

Bridget Staunton 10-10-2020 09:57 AM

Just a note for all, Medicare is income driven. Love reading all the advise from everyone

llmcdaniel 10-10-2020 10:08 AM

My daughter is a PA for a large medical practice in Ohio. Every year during their annual discussion of financial strength a dr will suggest dropping Medicare pts, and everyone else dismisses that suggestion very quickly. It will never happen in most practices.

kathyspear 10-10-2020 10:13 AM

A big thanks to all who took time to respond. I really appreciate the info.

For those who asked, I am 69. At 65 I was automatically signed up for Part A and B but declined B as I was eligible to continue on hubby's work plan. At that time my deductible was $500; it is now 4k. My monthly premium is currently ~ $800 month and will likely go up (along with the deductible) in December or January.

Because hubs is still working full-time (and then some!) I will have to pay more than the typical $144 month. (I have already looked at the chart on the Medicare site which shows the premiums based on 2018 income to determine what my monthly payment will be.) I will also have to pay a surcharge for any drug plan. Even with those extra charges, it looks like I will come out way ahead.

As I said, my concern is my ability to see the doctors of my choice. I could have chosen a less expensive plan from hub's employer but I would have had a smaller pool of doctors in the network. Didn't want that restriction. I understand that some Advantage plans cover "extras" but I don't wear glasses (had cataract surgery with multi-focal lenses implanted), I currently pay as I go for dental (and I'm fine with that), and I know myself well enough to know I would never take advantage of a health club. :)

Again, thanks a million for the help.

k.

Bridget Staunton 10-10-2020 10:18 AM

Did you go to Shine presentation here in The Villages, thanks to advising others


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