Choice A:

The government will provide you with reasonably priced healthcare. You can see most any doctor you want, at any time, without our approval. We'll pay for any recognized treatment you want, for any ailment you have. For about $150/month, you can buy additional coverage that will cover most deductibles and ancillary costs.

Choice B.

A private, profit-making company will manage your healthcare, within the bounds of what they think is reasonable, to insure they make a profit. They'll give you a free gym membership (that everyone wants, of course) and maybe 2 dental cleanings. In exchange, you save about $100/month on medical cost. In exchange for that $100, most Dr visits will be handled by a nurse or PA. You can't see any other Doctor, unless the Nurse/PA/Dr says you absolutely need to. If you need any special procedures or treatments, send them a message and they'll let you know if it fits into their business/profit model.

For the price of Cable TV, you can get the best healthcare available in the world or you can opt to save yourself $150/month.

Tough choice.

Supplement plans IMHO are for those with chronic illness. Heart disease, high blood pressure, overweight, etc. I assume they do not have to be medically underwritten. If you are in good health, Medicare Advantage is fine
The medicare supplement plans start at $150 per month. Plus you may need to purchase a drug plan too.
Florida Blue for example Monthly Cost $178-$660
Doesn't include:
$185.00 Standard Part B premium

MA is being hugely over-billed. If someone wants to look at government benefit cheats, start there.....

The Part B premium is $185 per month, unless you are under IRMAA, in which case the monthly premium can be more than $600 for the exact same coverage.

You have to go through your primary care doctor and they get referrals sent out for you for specialists and tests that are required.

Traditional Medicare does not require a referral, but some specialists may. If you have an advantage plan, the plan may require a referral before going to a specialist. That is the difference.

Also, with traditional Medicare, you may be able to get 2 or 3 second opinions without a referral, but your advantage plan may not allow a second opinion at all.

There's nary a person in the United States of Medicare age, that isn't overweight, has high blood pressure, heart issues or all 3.

There's hardly a 65 year old in America, who's not taking medication of some sort, on a regular basis.

There's one and only one reason for have a Medicare Advantage Plan and that's COST.

Everyone is entitled to get whatever kind of Medicare or Insurance plan they want, but the folks who come on here and promote Advantage Plans because they're a "better plan", are simply disingenuous.

People are entitled to make a value decision, based on a cost/benefit analysis ... that's their right. Anyone who argues Medicare Advantage Plans offer better healthcare, are simply rationalizing their cost saving decision.

LOL! that belief will work until it doesn't! anyone can develop a chronic illness between 65 and whenever, after they chose a plan, through no fault of their own Anyone can get into an accident requiring lots of medical care, though no fault of their own. .

Thinking if you are healthy today and will stay that way forever is hopium. . so do healthy people who believe that then know how they will die?
will it be a golf cart accident? someone else's fault? a tree falling? a lightning bolt? dementia/Alzheimers, which can result in a long life needing assisted living or in home care?
but never needing any thing else but an annual physical and a gymn membership?

That is my understanding as well.

I have a Plan F sup. I go to an ER they take me, no bill.
My wife had 3 ER visits and 2 admissions, 3 cardiac procedures and a pacemaker. No bills.
My plan has 50,000 in out of country coverage.
We were lucky when we ran away from TVH 10 years ago because we passed the screening to change to BCBS TM sup Plan F.
Now they would have rejected us for medical reasons.
If you have a MA plan you might not be able to switch if you are ill.

That post didn't end where I first thought it was headed (I guess I was hopeful). I thought you were going to say what I'll go ahead and add.

THE BEST health insurance costs very little. It is simply this:
-- Eat primarily high-quality and healthy food (Mediterranean diet is still the best)
-- Get regular exercise with stretching and keep your weight in check
-- Quality sleep and enough of it is important
-- Have people in your life who routinely cause you stress? Ditch them. Not kidding, you want to be healthy or not? Eliminate stress.

Brian, there are many people of young Medicare ages that are healthy and who very intentionally take care of themselves. I'm one of them and know others. They don't have need to see Doctors because they live like the above. So, some of them choose Advantage plans because why wouldn't they? Over a decade it's quite a lot of money saved (for a couple probably $40,000+). Plus they can switch plans every year in the 4th quarter.

Of course, those healthy people could be in a bad car accident or get a serious disease -- guess what will happen then? They will get medical care.

I hear and read a lot of justification from people about the premiums they pay for traditional Medicare - which I find interesting. If it's worth it to them, that's all that matters. But, I think some are convincing themselves that they're getting more than they actually are and they seem to need to convince others too.

I’ve been on Medicare Advantage for over ten years (Careplus each year) and do you know how much I’ve saved over regular Medicare? Over that ten years I’ve paid a total of less than $3,000 out of pocket for my health care. I’ve had one major surgery, a sleep study with a CPAP machine prescription, the usual prescriptions for fairly routine issues, and great doctors, nurses and support. I really love my Medicare Advantage. Maybe I’ve been lucky, but I don’t see where traditional Medicare with a supplement plan could have been any better for me.

Gym membership
 

All my gym memberships, through the local YMCA’s and Lifetime, are free with my Medicare Supplement Plan. Mine is Renew Active. There is also Silver Sneakers.

The main objection to MA seems to be that MA denies necessary medical coverage while TM provides it with almost no questions asked.

Has anyone with MA been denied treatment? If so, what were the circumstances? If MA denied treatment, did they provide alternative treatment?

Did the patient suffer adverse medical consequences as a result of the denial?

Did you appeal? Bring a lawsuit?

Never denied anything in 5 years.

Mass has had to propose new / change laws to bring MA into reasonable behavior due to their delaying / denial behavior. The hospitals were complaining because it was costing them money and backing up beds, resulting in delayed healthcare due to lack of beds

My exact sentiments- I’m 63, so two more years from Medicare age, but have done extensive research and homework in preparation of making the very important decision TM vs MA. I have also met with the folks at Shine - great resource.

I’m amazed how many my age haven’t done any research on the topic, and have an almost “cavalier” approach as to what to do when they turn 65. Many, unfortunately, appear that cost and freebies will be the deciding factor as to what they choose.

I feel it’s so important not to just to assess your current health conditions/situations, but look down the line 20-30 years from now, and determine what type of coverage would suit you best if diagnosed with a serious or terminal illness or if in need of rehab.

Everyone’s situation is different - and one plan may work better for some than others. For me, I’m going with TM + Medigap. Even though I’m healthy and prescription-drug free at this time in my life, it will help me sleep better knowing I have the best coverage available if needed. It’s the same as house or auto insurance, I don’t go with the cheapest premium necessarily, but for what is the best actual coverage in the event I need to make a claim. (I’m a retired insurance claims manager).

Had dinner with high school / college friends/couple where one is a doctor. She would never take MA, too many rejections from a doctor's point of view. The point to remember, which I would wager that most don't realize, that MA private insurers,don't make procedure decisions on medical need/basis, they make their decisions based on corporate policies.

good luck with that . .

Smart. Wait until you get about 5 months before turning 65 and have two files handy, one very large file labeled “Medicare Advantage” and another much smaller one labeled “Medicare Supplement”. You will begin to get a steady avalanche of mail right up until your 65th birthday. You will be absolutely amazed at how much marketing stuff you get for Medicare Advantage plans, relative to information brochures related to Supplemental Plans. The amount of MA marketing materials you will get from AARP in conjunction with United Healthcare alone will practically fill up your large file. Take all that for what it’s worth, but it was easy for me to interpret it.

of course, the doctor makes a big salary and can afford the supplement. The average person chooses MA.

I’m an “average” person, and I won’t be going MA.

I’m 63, and am paying almost $1000 a month for a solid health insurance policy. So, once I turn 65, and only paying for traditional Medicare + Supplement, I’ll be saving quite a bit in monthly health cost premiums.

I understand those on tight, fixed incomes may have no other alternative than to go with MA. But I think most Villagers have a few extra dollars to invest in obtaining the best possible medical coverage available.

It isn’t always about money. Some people have existing health issues that prevents them from passing through the underwriting.

Yes, it is necessary to go through medical underwriting if after the age of 65, one wishes to move from MA to TM, however, there is no medical underwriting to initially enroll in TM at age 65.

That is why it’s so important to make the correct decision when turning 65.

I would highly recommend reading this book to anyone getting close to turning 65. I ordered it on Amazon, and after reading it passed it along to two of my good friends. We all signed up for the exact same plans (except for part D) after reading this book. Good luck to everyone navigating this very important decision.

True, unless you buy your policy from Connecticut, Massachusetts, Maine, or New York. Note, one of those states has to be your primary residence in order to purchase your policy there.

So if getting on TM were crucial, someone could move to one of those states for three months and then move back to the villages?

Never thought of that, but I suppose. You would have to establish that state as your primary residence before the annual enrollment period. Would probably take more than three months, and then you would have to pay state income tax in that state and you would lose your Florida homestead exemption.

At the time I was covered on my wife’s Federal health care. Over the years the self plus one became too expensive.

54% of Medicare beneficiaries are enrolled in Medicare Advantage plans. I enrolled in Medicare Advantage because I wanted to be able to see Villages Health primary doctors. I was not impressed with any local primary doctors who where not part of Villages Health. IHMO, MA is perfect for those without chronic illness or conditions. High blood pressure, obese, heart condition, obese etc. You will see how expensive a gold Medicare supplemental plan is and then you will decide for yourself.

Don't forget about the required Medicare premium which will probably be over $200 when you are enrolled.

For those with a medigap plan, how much does it cost? And how much does it usually go up each year?

$189 per month for UHC Plan N. How much it goes up varies. The premium varies with age and some other factors.

What is a "gold Medicare supplemental plan" ?

Plan G in most states for new enrollees. In Massachusetts it’s called Supplement 1A. It basically pays for 100% of everything not covered by Traditional Medicare, after about a $250 annual deductible. I have the Blue Cross and Blue Shield Sapphire Supplement 1A plan with a monthly premium of $189. It’s absolutely the best Supplemental plan available.

All premiums go up because of inflation. It depends on the state you purchase your policy from if/how much your premium will go up every year based on age. Some states use attained age ratings, some use issue age ratings, and other states use community age ratings. My state of primary residence uses community age ratings, so my policy doesn’t increase as I get older because of my age. That being said, I pay more when I’m younger than in many other states, but less as I get older.

I didn’t know age was so variable.

Attained Age Ratings premiums are based on the policyholder's current age at the time of renewal or premium calculation.
- Premiums increase as the policyholder ages, reflecting the higher risk associated with older age.

Issue Age Ratings Premiums are based on the policyholder's age at the time the policy is purchased.
- Premiums remain constant based on the issue age and do not increase as the policyholder gets older, though they may rise due to inflation or other factors.

Community Ratings Premiums are the same for everyone in a specific geographic area or "community," regardless of age or other individual risk factors like health status.
- Premiums may vary by location or plan type but not by individual age or health.

In Sumter County, most insurers use attained age.

It's a stupid rule to charge extra if you have higher income. The medicare premium should be zero for all.

The best plan with the most coverage.

Note that the "surcharge" is added to the standard $185 rate. The actual rates are:

Part B IRMAA:

Single:
$106,000 or less: $185.00 (standard premium)
$106,001 - $133,000: $259.00
$133,001 - $167,000: $370.00
$167,001 - $200,000: $480.90
$200,001 - $500,000: $591.90
Over $500,000: $628.90

Married Filing Jointly:
$212,000 or less: $185.00 (standard premium)
$212,001 - $266,000: $259.00
$266,001 - $334,000: $370.00
$334,001 - $400,000: $480.90
$400,001 - $750,000: $591.90
Over $750,000: $628.90

Every time this thread is restarted, it degenerates into the same few folks defending their decision to stay with TM, for reasons easily debunked, such as doctor availability and costs. I think people just tend to defend their choices, regardless of what they are. So I'm going to defend mine, right now.

We've been on Medicare Advantage since we became elgible, and have never had anything we needed rejected, including my wife's week in the hospital from a stoke last year, or any of the dozens of tests that followed.

Yes, I complain about the lousy primary care doctors that are available here in-network, but I'm not convinced that paying an extra $1000/month between the two of us would improve our choices much in this healthcare desert, 45 minutes from the nearest city. We had great in-network doctors in Houston on the Kelsey-Seybold Medicare Advantage plan.

Our current Humana "Giveback" PPO plan is free and even refunds the Social security deduction for Medicare. It includes Moffit Cancer Center in Tampa in-network. Even our great Kelsey plan in Houston didn't include MD Anderson, in-network. But either way, since we always choose a PPO, we can see any doctor we want if we don't like the in-network doctors, and it still covers 80%. That's the same as my old employer's United insurance, that cost me $500/month.

I confess, I don't understand how MA stays in business giving insurance way for free. I suspect it has something to do with those $500 office call visits they bill the gooberment, that used to only cost me $25, back before doctors started billing insurance companies instead of patients. But after paying 3% of my wages for 50 years on a promise to get some back if I lived to 65, I see no reason to shell out $1000/mo of my life savings at the back end of this scam, for the same thing I can get for free.