Medicare Advantage or Medigap/Supplemental

Medicare Advantage or Medigap/Supplemental

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Medicare Advantage or Medigap/Supplemental
  #1  
Old 08-06-2019, 11:56 AM
RalphM RalphM is offline
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Default Medicare Advantage or Medigap/Supplemental

We are about to retire, thus we will no longer have our Highmark BC/BS employer coverages. We have spoken to consultants about both the Medicare Advantage and Supplemental plans. We are leaning toward a BC/BS supplemental plan. This decision is based on our experience with our current employer BC/BS plan.

We've also been told by SHINE that Village Healthcare and the Village Hospital accept the advantage plans but not supplemental. They also informed us that there are very good medical services surrounding the Villages who do accept supplemental plans.

We would appreciate thoughts and recommendations for general practitioners. Thank you!
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  #2  
Old 08-06-2019, 01:44 PM
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billethkid billethkid is offline
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Traditional medicare plus supplemental.

Most importantly no restrictions on what doctors/specialists to use, locally or when traveling.

We have not had to reach into our pocket for anything these past 15 years....including some very major events like breast cancer, significant cardio vascular repair/replacement treatment and follow up care.
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  #3  
Old 08-06-2019, 02:18 PM
retiredguy123 retiredguy123 is offline
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Quote:
Originally Posted by RalphM View Post
We are about to retire, thus we will no longer have our Highmark BC/BS employer coverages. We have spoken to consultants about both the Medicare Advantage and Supplemental plans. We are leaning toward a BC/BS supplemental plan. This decision is based on our experience with our current employer BC/BS plan.

We've also been told by SHINE that Village Healthcare and the Village Hospital accept the advantage plans but not supplemental. They also informed us that there are very good medical services surrounding the Villages who do accept supplemental plans.

We would appreciate thoughts and recommendations for general practitioners. Thank you!
Can you keep your employer plan after you retire? If so, you may not need to sign up for Medicare at all. I retired from the Federal Government, and I still maintain my Federal Blue Cross insurance as my only health insurance. It has a $5,000 annual catastrophic limit which I can easily afford, if necessary. I just cannot justify a $265 per month Medicare Part B premium plus another $200 or so per month supplemental premium plus $85 per month for drug coverage.
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  #4  
Old 08-06-2019, 04:48 PM
gatorbill1 gatorbill1 is offline
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You pay $$$ for supplemental - you do not pay for most advantage plans, some give you money back from your monthly medicare charge.
Most people go with advantage plan - I think about 70% of people with Medicare. Most doctors take advantage plans. I have never found one that did not.
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  #5  
Old 08-06-2019, 05:21 PM
biker1 biker1 is offline
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No, about 1/3 go with Advantage Plans. The number might be different in The Villages.

Quote:
Originally Posted by gatorbill1 View Post
You pay $$$ for supplemental - you do not pay for most advantage plans, some give you money back from your monthly medicare charge.
Most people go with advantage plan - I think about 70% of people with Medicare. Most doctors take advantage plans. I have never found one that did not.
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  #6  
Old 08-06-2019, 07:49 PM
bob47 bob47 is offline
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We were advised that as a rule of thumb, if you have or expect significant medical issues, you are better off with a Medicare supplemental plan. If you have few medical issues, you may save money with an advantage plan. I believe this to be true.
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  #7  
Old 08-06-2019, 08:48 PM
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villagetinker villagetinker is offline
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Be sure to check for coverage if you travel, when we looked at this a few years ago, the entire state of Colorado WAS NOT COVERED by any of the advantage plans that were offered at the time, that was a deal breaker. Then we found out that several of the specialists my wife was already using would not accept the advantage plans, the was a deal killer, we stayed with Medicare and supplemental.
Also, if you go with an advantage plan, there is a very limited time where you can go back to medicare and NOT be subjected to underwriting, be sure you understand this.
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  #8  
Old 08-06-2019, 09:48 PM
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champion6 champion6 is offline
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Quote:
Originally Posted by RalphM View Post
<snip> We are leaning toward a BC/BS supplemental plan. This decision is based on our experience with our current employer BC/BS plan. <snip>
If you a leaning this way, then shop around. Everyone's Plan F is the same, for example. Why pay a higher premium for the same coverage?

Quote:
Originally Posted by RalphM View Post
<snip>We've also been told by SHINE that Village Healthcare and the Village Hospital accept the advantage plans but not supplemental. <snip>
I don't think this is exactly true. Here's my take:
1. Village Healthcare (The Villages Health) accepts specific advantage plans (not all advantages plans), but not Original Medicare with a supplement.
2. The Villages Regional Hospital accepts most all insurances.
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  #9  
Old 08-07-2019, 05:59 AM
rustyp rustyp is offline
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Quote:
Originally Posted by villagetinker View Post
Be sure to check for coverage if you travel, when we looked at this a few years ago, the entire state of Colorado WAS NOT COVERED by any of the advantage plans that were offered at the time, that was a deal breaker. Then we found out that several of the specialists my wife was already using would not accept the advantage plans, the was a deal killer, we stayed with Medicare and supplemental.
Also, if you go with an advantage plan, there is a very limited time where you can go back to medicare and NOT be subjected to underwriting, be sure you understand this.
The Villages Medicare Complete 2 advantage plan has a passport system. This allows one to go to areas outside of their local coverage and find an in network doctor or facility and be charged the same as in network.The $80 / month covers (amongst other items) an In Network Out Of Pocket max of $1900 and an Out of network Out Of Pocket max of $7500. True not all areas of the U.S. are covered under the passport plan but a large percentage is. Example all counties in New York State are covered. FYI I recently needed a short trip to emergency in New York the bill was $2500(highway robbery) and my total part was the $90 deductible. For those areas not covered like Colorado (I assume - did not look it up) you are still covered but at out of network rates with a max out of pocket of $7500. This would probably work for most people if traveling to Colorado is a vacation short term but probably not the right plan for you if you are a Colorado snowbird.
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  #10  
Old 08-07-2019, 07:24 AM
collie1228 collie1228 is offline
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Quote:
Originally Posted by bob47 View Post
We were advised that as a rule of thumb, if you have or expect significant medical issues, you are better off with a Medicare supplemental plan. If you have few medical issues, you may save money with an advantage plan. I believe this to be true.
In my experience this is true. My doctor and I discussed the relative advantages of Medicare Advantage vs. Medicare with a supplement, and he convinced me that since I am very healthy, an Advantage plan is best for me, as it costs me nothing (other than the basic Medicare premium paid by everyone on Medicare), and it includes many benefits not provided by standard Medicare (some dental, some vision, pays full cost of my gym membership, etc.) However, Medicare Advantage is restrictive, and to get full benefits you must stay within the program network, which means you can't go to any provider you want. If you think you might need specialty care outside the network, you should probably avoid Medicare Advantage.
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