Medicare Advantage or Medigap/Supplemental

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  #16  
Old 08-09-2019, 11:41 AM
Dan9871 Dan9871 is offline
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Originally Posted by rustyp View Post
Just to be clear - you can switch back at reup time always. .
I think what you are talking about is what medicare "Guaranteed Issue Right". Switching from Advantage to regular Medicare is not a problem.

What might be a problem is picking up a Medigap, i.e. supplemental, policy. If you have the Guaranteed Issue Right then any insurance company that offers a Medigap policy must accept you without any conditions.

Here is the Medicare page that explains when you have a Guaranteed Issue Right:

https://www.medicare.gov/find-a-plan...otections.aspx

Even if you don't have a Guaranteed Issue Right an insurance company may accept you anyhow, but they don't have to and may charge you extra over their regular rates.
  #17  
Old 08-09-2019, 01:03 PM
Tom52 Tom52 is offline
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Just to be clear - you can switch back at reup time always. You are not locked in forever. There are extenuating circumstances that you can switch in mid year. I do remember seeing something about the first year switch but can't remember what it was. I am long past the first year. There is something about you may pay a higher supplemental with medicare and supplemental because they can charge the supplemental based upon your age Vs if you had been in from day 1.
I just read online that if you have had an advantage program for over a year you will be subject to medical underwriting if you wish to change to a more comprehensive medigap policy. There are a few exceptions but this can be risky. I would link to this information but I don't know how to do it.
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Old 08-09-2019, 02:35 PM
rustyp rustyp is offline
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I just read online that if you have had an advantage program for over a year you will be subject to medical underwriting if you wish to change to a more comprehensive medigap policy. There are a few exceptions but this can be risky. I would link to this information but I don't know how to do it.
OK now I am confused. What is the difference between Medicare with a supplemental and medigap?
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Old 08-09-2019, 02:54 PM
Tom52 Tom52 is offline
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OK now I am confused. What is the difference between Medicare with a supplemental and medigap?
Medigap is the supplemental insurance policy which picks up some or all of the costs that medicare does not cover. It does not cover prescription drugs. That requires a separate part D drug plan.
  #20  
Old 08-09-2019, 03:29 PM
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I just read online that if you have had an advantage program for over a year you will be subject to medical underwriting if you wish to change to a more comprehensive medigap policy. There are a few exceptions but this can be risky. I would link to this information but I don't know how to do it.
Talk to SHINE, we were almost in this position, found out you have to change back to Medicare after 50 weeks or less (if my memory is correct) and are guaranteed supplemental coverage WITHOUT medical questions, etc., after that you can get back to medicare, BUT you may be subjected to medical questions, and possible additional charges for supplemental due to preexisting medical conditions. SHINE was very helpful in this area.
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  #21  
Old 08-09-2019, 03:55 PM
petsetc petsetc is offline
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FYI - Plan F is probably going away for new Medicare recipients in 2020. Suggest you Google for exact details.
  #22  
Old 08-09-2019, 04:10 PM
Tom52 Tom52 is offline
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FYI - Plan F is probably going away for new Medicare recipients in 2020. Suggest you Google for exact details.
It is true plan F is going away but plan G is nearly identical. Only difference is plan G had a $185 yearly deductible. After the deductible is paid everything else is covered the same as plan F. On the plus side the monthly premium for a current plan G is lower than the current comparable plan F.
  #23  
Old 08-09-2019, 06:04 PM
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OK now I am confused. What is the difference between Medicare with a supplemental and medigap?
The supplement plans are sometimes called medigap plans, i.e. they cover the "gap" not covered by Medicare - the deductible and copays for hospital and doctor charges. As has been stated, prescription drugs are covered by a separate Prescription Drug Plan, aka Medicare Part D.
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Old 08-09-2019, 06:27 PM
rexxfan rexxfan is offline
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Yes I agree the passport is available with both 1 and 2. However it is my understanding the $1900 and $7500 OOP is part of the 2 plan only ($80/mo). I've been wrong before.
That's my understanding as well. The $80/month gets you the out of network coverage plus a few other perks as compared to Villages 1.
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  #25  
Old 08-09-2019, 06:41 PM
rexxfan rexxfan is offline
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I never understood the idea that if you are healthy an advantage plan might be better because you save some money. Your health can change very quickly for the worse. Maybe their crystal ball works better than mine. Just based on both my parents experience, they had significant hospital bills, well in excess of $500,000 each in perhaps the last five years of life. They had BCBS F medigap plans and they paid absolutely zero beyond their monthly premium.
Are you saying that if someone has an Advantage plan and their health changes for the worse that the Advantage plan won't pay for it? I thought the big difference between Medicare+Supplement and Advantage was that the latter restricts you to in-network providers, but other than that, both provide similar coverage. No?
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  #26  
Old 08-09-2019, 06:42 PM
rexxfan rexxfan is offline
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I just read online that if you have had an advantage program for over a year you will be subject to medical underwriting if you wish to change to a more comprehensive medigap policy. There are a few exceptions but this can be risky. I would link to this information but I don't know how to do it.
I've read the same.
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  #27  
Old 08-09-2019, 06:48 PM
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Originally Posted by villagetinker View Post
Talk to SHINE, we were almost in this position, found out you have to change back to Medicare after 50 weeks or less (if my memory is correct) and are guaranteed supplemental coverage WITHOUT medical questions, etc., after that you can get back to medicare, BUT you may be subjected to medical questions, and possible additional charges for supplemental due to preexisting medical conditions. SHINE was very helpful in this area.
I suspect all this is going to change anyway, especially if Medicare For All becomes a reality. If that happens, I wouldn't be surprised if Advantage plans went away altogether (and if so, I can't imagine that everyone on an Advantage plan being forced back onto MFA would be penalized in any way, it'd be chaos).
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  #28  
Old 08-09-2019, 08:02 PM
Dan9871 Dan9871 is offline
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Originally Posted by rexxfan View Post
I thought the big difference between Medicare+Supplement and Advantage was that the latter restricts you to in-network providers, but other than that, both provide similar coverage. No?
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Yes, by law an Advantage Plan must provide all the services that regular Medicare does.

Medicare Advantage Plans cover all Medicare services | Medicare
  #29  
Old 08-09-2019, 08:47 PM
JGVillages JGVillages is offline
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We have had Florida Blue Advantage PPO for 7 years. My wife has had stomach cancer surgery, and her knee and hip replaced. Our choice of specialists though limited to preferred providers, has been excellent. Her choice of Moffitt Cancer Center in Tampa is in the Network, while not in the UHC Advantage Network. Her knee surgeon choice and hip choice we also in Network. Monthly premiums have varied a bit each year, but currently are $42. I investigated The Villages UHC Plans and system but found them to be ever changing and seeming to have a difficult time finding a satisfactory identity. Now I understand TV Healthcare Plan will be accepting Florida Blue Advantage. Not sure why now and not earlier. I have a Primary GP and have had him since before going on Medicare. Most of my friends that have had TV UHC Plans have had issues. Originally they accepted supplemental plans, then they didn’t. Primary Physicians have left frequently leaving them to change and change hoping to find one they like. My experience is to date TV Healthcare has not been able to solidly find it’s identity, at least for me. It certainly is a great concept and I wish them future success.
  #30  
Old 08-10-2019, 03:34 PM
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My Wife had Federal Bluecross/Blueshield for years but turning 65 this year made her eligible for Medicare. With her on Medicare we decided to drop her Federal Bluecross/Blueshield because of the cost. We met with an independent Health Insurance Representative outside of The Villages and discussed different supplemental plans. We chose Unitedhealthcare, they have two options, one is no cost and the other is $80.00 a month. With that said at the moment the Villages Health Clinics are only accepting Unitedhealthcare to be seen at there clinics. There are doctors and specialist outside the clinic that are preferred providers. Because she turned 65 this year we are eligible to change again during this open season and I am looking at other options.
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supplemental, plans, bc/bs, advantage, medicare

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