I’m still working. All the premiums are automatically deducted from my bank account
Swimscatmom. I would have done the same. It’s so easy being on Medicare
@thumper1 Yes, there are many different Medicare advantage plans- some (like the one our state employees have here) seem good. But many, especially HMO based plans, are not advised. As was mentioned by @scmom12, many providers are not on the HMO Advantage plans. The large group retiree Advantage plans are typically not the problematic HMO plans. http://time.com/money/4396394/medicare-advantage-enroll-health-care/
Yes, exactly.
I called them because my husband was fretting. I should receive a bill next month then will figure out if I want to pay quarterly or set up direct deposit. Inclined to stick with quarterly as I’ll be taking SS next year as soon as I am eligible.
Thanks 
Part D is problematic because you choose your plan based on the meds you know you are taking when you sign up. There is no way to know how the plan covers some new med your doc might prescribe in July. You do have the option to change plans every year.
I chose a Medicare supplement rather than a Medicare advantage plan because around here the advantage plans have very narrow networks; you can only go to one ophthalmology group, for example.
I think folks need to research the different types of Medicare Advantage Plans in THEIR area. There are different levels from no premium to ones with higher premiums.
The types of things covered vary as well…for example, my Anthem BS/BS Medicare Advantage Preferred Plan doesn’t include RX…for my group (teachers retired). RX is still through Express Scripts.
Like everything else related to health insurance…the Medicare Advantage options vary.
https://www.medicare.gov/Pubs/pdf/11474.pdf
This is a good publication that explains Medicare Advantage and regular medigap.
As with anything…you need to understand the type of policy you are getting.
H and I are both in a Medicare Advantage plan.
Pros:
Only one plan to worry about dealing with.
We happen to be in a plan with no monthly premium, so we just pay Medicare and that’s it.
The PCP copay is only $20, specialist copay is $45.
We also get a dental plan, worth up to $1,000 a year, for no additional cost.
We get Silver Sneakers – membership at certain fitness clubs – for free.
Cons:
Our specific plan is an HMO, so we need a referral from our PCP before we see a specialist.
If we travel out of area, only emergencies are covered.
My BC/BS Medicare Advantage Plan is a preferred provider plan with a large network of doctors. Every hospital on our state also participates.
Our plan has.
$5 copay for any doctors…PCP or specialists…well care, preventative or other.
There is no gatekeeper. We don’t need a referral from a PCP to see a specialist.
My total payment for my other than Medicare insurance is $135 a month…but that includes Express Scripts for RX, a dental plan, vision, and hearing.
Maximum out of pocket is $2000 a year.
We also get Silver Sneakers and that saves me about $70 a month.
Ours is a plan that has a huge network of in network providers in all 50 states, and covers emergency or urgent care out of the country.
You can see…all Medicare Advantage Plans are NOT the same.
My mother, who is now 100 years old, has a Medicare Advantage Plan. I only know this because my brother & I have been very actively managing her care since she was diagnosed with dementia about 18 months ago.
I suggest if one lives near a major medical school or teaching hospital, see what plans are accepted there. Her plan covers treatment through UCLA medical. Her PCP, whom she has seen for years, has been excellent, as have all the specialists whom we’ve had contact with. She has not received a bill for any premium until this year, which is less than $25/month. I don’t recall ever seeing any invoices for prescriptions. And, no co-pay for office visits. There might have been a co-pay for an ER visit. If so, it mustn’t have been much, otherwise I’d remember the cost.
I just want to say…I’m not telling anyone they should or shouldn’t get a Medicare Advantage Plan over a medigap Plan.
This most definitely is a personal decision, as health insurance is for everyone.
There is such variation in all kinds of policies. You need to get what works for you and your health needs.
Must admit I did not look at Medicare Advantage - mainly because I don’t really understand what it is and I don’t think I know anyone who is on it. Maybe because of where I live. I may have a look at it though.
My parents had Medicare Advantage thru Kaiser (in NorCal) and it was excellent.
Medicare Advantage basically replaces plain old Medicare and a Medicare Supp plan for you. You get all your coverage from one company, just like you did when you were getting employer-based care. You pay Medicare, but Medicare sends those premiums to the Medicare Advantage company. The MA company has a real incentive to keep you healthier than average so they make money, not lose money, on you. That’s why you might get goodies like Silver Sneakers. They also might send you reminders about tests you should be having.
For those who care about accuracy, I just realized that in my Post #47 I made a mistake: My PCP copay is $0.
My understanding is that it’s important to have a Medigap or Medicare Advantage plan because otherwise there is NO cap on your out of pocket copays.
I have never explored the details because my folks have insurance and we have insurance from former employers that my dad and H retired from which take the place of a Medigap or Medicare Advantage plan, plus provide better coverage than Medicare D.
Your state office on aging in your state Dept if health should have someone that can help explain your instate options at no charge.
@VeryHappy Yes, it is also my understanding that Advantage plans ‘replace’ parts A and B in that you deal with one company. Most Advantage plans work like HMO’s with a more limited network than supplemental plans. There are currently NO Advantage plans available in my county.
I had a great session with a volunteer Medicare advisor/counselor. I learned a number of things, the most surprising is how the gap policies function. Guaranteed issue of the supplemental policy is only for a limited time once you become eligible. Whatever level of supplemental policy you pick (A-F) is your baseline forever (at least that’s how it works now). In other words, if you pick a lower premium, lower cost supplemental option (say a C policy) you are only guaranteed to be able to keep that level of coverage. If you later decide you want a higher level policy (F) you will be required to go thru a qualification process. Chances are very high you won’t qualify.
So pick those supplemental policy levels carefully. FWIW, our long time insurance broker recommends the AARP offering.
When its time to take Medicare B, I will probably get my supplemental through USAA. For those who don’t know, Medicare C and F supplements are going away in 2020. Those who have it I believe will be grandfathered in, but it will no longer be available to new subscribers. Not sure if they are planning to offer something in its place, but there are other options (D, G and there are also plans K, L M, N that I haven’t looked at. I am attending a Medicare presentation in early June and will see what I can find out. Personally, I will still avoid any Medicare Advantage HMO plan.
I did not know about the F going away - good to know. It has certainly been a good plan for my husband with all his medical problems. Hope you are right about the being grandfathered in!
^^ the theory is that F rates will start to climb quickly, however, as the young 'ens (new 65’s) will not be able to join. Thus, the cohort in F will continue to get actuarily older and sicker than the replacement G, jacking up premiums in F.
Another reference is Phillip Moeller’s book, Get What’s Yours for Medicare.
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Interesting - guess we will have to look into G come the time.
They make health insurance for older people way too complicated. My Mum would never have been able to cope with all that (she did not live in the US so did not have to but I am sure there are many in the same boat). My husband helps every November with Medicare D sign ups at the local vo tech and senior center. He’s no spring chicken himself at 76 but some of the older and not computer savvy people have a really hard time with it. I was lazy and just let him check out the Med D plans for me despite his attempts to educate me.