Talk of The Villages Florida - Rentals, Entertainment & More
Talk of The Villages Florida - Rentals, Entertainment & More
#1
|
||
|
||
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!
__________________
South Philadelphia PA, Wildwood NJ, Riyadh-Saudi Arabia, Upland CA, Colorado Springs CO |
|
#2
|
||
|
||
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. |
#3
|
||
|
||
Quote:
|
#4
|
||
|
||
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. |
#5
|
||
|
||
No, about 1/3 go with Advantage Plans. The number might be different in The Villages.
Quote:
|
#6
|
||
|
||
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.
|
#7
|
||
|
||
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.
__________________
Pennsylvania, for 60+ years, most recently, Allentown, now TV. |
#8
|
||
|
||
Quote:
Quote:
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. |
#9
|
||
|
||
Quote:
|
#10
|
||
|
||
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.
|
#11
|
||
|
||
Quote:
The Villages 2 plan adds coverage for areas where there are no in-network providers, albeit at a reduced rate (e.g. instead of insurance paying, say, 80% for an in-network provider, it might only pay 45%). The $80/month also buys you some reduced copays versus the Villages 1 plan. -- bc |
#12
|
||
|
||
Quote:
|
#13
|
||
|
||
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.
Even though it is more difficult to find a Dr in TV who accepts medicare plus suppliment, We would never consider an advantage plan. Outside the bubble I would believe most doctors accept medigap. That makes it much less of a concern when traveling. Concerning The Villages hospital I have spent 5 days there plus emergency room visits and my medicare plus BCBS medigap supplement covered all costs 100%. Of course if the budget is tight going with an advantage plan is understandable. I justify the monthly premium as protection against catastrophic expenses. As an added benefit I don't have get a referral to see a specialist. |
#14
|
||
|
||
I started off with a supp plan when i retired and still lived in georgia. For whatever reason, the county i lived in did not have the passport / advantage plan. Moving to the villages has allowed me to drop down to the advantage w passport with a relatively low out of pocket max at $80 / month. I did quite a bit of research and found most of the places out side the villages that i might go w serious issues were covered as in network. I'll be giving the villages health system a try. If you switch from supp to advantage you can switch back within a year w no problems.. Also, since wife has decided to continue working, I might suspend medicare and go under her corporate plan, saving $$$ from IRMAA
|
#15
|
||
|
||
Quote:
|
Closed Thread |
|
|