But that’s why you get a supplement plan that pays the 20%. My husband had what could have been expensive treatment for stage 4 cancer. Medicare paid their 80% and his supplement paid the 20%, no questions asked. A supplemental plan can not “not pay” their 20%.
Never once did Medicare not cover my husband’s bills nor did the supplement. The two work together as coverage.
I have traditional medicare - plan G. My supplemental plan’s cost is $137.23 monthly and drug plan is $6.60.
I’m also turning 65 this year–hi, birthyear buddy! My understanding is that because I am on my husband’s insurance (over 100 employees in company) that I do not have to sign up for part B yet.
@blossom - I am ( gulp!) turning 70 in a few months and am still on My husband’s insurance. He just turned 65 a few months ago. Neither of us are on Medicare B
Why is that a surprise? That’s almost exactly what my husband’s G supplement costs, although his D is only $2. Basically no deductible or coinsurance. We are in Oregon but the cost is the same in other states for this company.
We have AARP United Healthcare Plan G supplemental. We are in the Bay Area and we pay $163/month. Deductible is $226/year. I think we have one of the highest healthcare costs in the country.
I’m in TX. My supplemental insurance is Philadelphia American.
Original medicare deductible (Part B) is $226 this year and once I’ve met that I’m done with deductibles and copay and bills.
I live within the world’s largest medical center and wanted no limits on medical care. I have had more that one friend or friend’s husband not be able to go to MD Anderson because their Advantage Plan wouldn’t cover it or wasted so much time getting approved to do so - time they didn’t have.
Anyway, that’s the line I drew in the sand. (And found out I get Silver Sneakers anyway.)
We also have original Medicare with AARP United Healthcare Plan G supplement.
Our premium is way more than yours-- $196/month each. It is expected to increase in June.
That is the community rate in our area; the rate is not based on age on enrollment or achieved age, as it is in some other areas. And this was the best rate available. Living in CT is expensive!
That being said, just in the first 2 months of 2023, my husband and I underwent a number of expensive medical tests and procedures. I also had surgery a few weeks ago. Yet for all this, we will each only have to pay the $226 Part B deductible for 2023-- which we have already met.
My parents had the AARP supplement and were happy with it. They choose it over USAA but can’t remember the details. But for expensive stuff, my dad went through the VA because he had trouble getting stuff covered with traditional medicare and the AARP supplement.
It doesn’t matter which supplement you get - according to more than one of the insurance agents with whom I talked. Supplements pay the 20% that Medicare doesn’t - period. If Medicare approves the treatment and pays, then the supplement pays its part. If Medicare doesn’t approve treatment then neither does the supplement - period. It isn’t something to negotiate. The supplement has no power to either approve or disapprove anything. If the company you choose decided not to provide supplement insurance anymore, you can choose another without having to be approved. Existing conditions don’t matter. You should have no fear about which supplement you’ve picked. However, that’s only if the insurance agency quits their gap policy. Otherwise, a change in gap policy allows a yes or no from the company. I’ve liked my policy - they pay the 20% and cost me less than some of the more expensive ones.
I asked why some supplements cost more - my husband’s cost about $70 more a month than the one I chose and we got exactly the same coverage. My insurance agent said that his spent more on advertising and my husband helped pay for it.
Anyway, double check me. But all supplement gap policies cover 20% of the medicare approved costs - no more no less and no right to approve or disapprove the treatment.
Vision insurance is the biggest rip off. Unless it’s fully paid by the employer, we don’t get it. One eye exam yearly and $100 towards glasses every two years is something we can self-insure. Want to point out that if you require a medical procedure performed by an ophthalmologist, that would be medical, not vision. Ditto some dental surgery.
Dental plans don’t pay much. $1,000-$2,000. Year negates premiums paid. One important reason to have dental insurance is to get the in network rates. Unless you can negotiate cash rates.
Community rated (or no age-rated): Your premium isn’t based on your age and may only increase due to inflation or other factors. Everyone, regardless of age, is charged the same premium.
Issue-age rated (or entry age-rated): Your premium is based on your age when you buy the policy and won’t increase as you grow older. Your premium may only increase due to inflation or other factors.
Attained-age-rated: Your premium is based on your age and can increase as you grow older and due to inflation and other factors.
There’s a belief that MA plans attract the healthier types, leaving sicker to Original Medicare, and thus, MA plans are more costly on a risk-adjusted basis. Add to that, those that believe in single (federal) payor for all, and MA is going in the opposite direction.
Laws differ by states. Some have “guaranteed issue” which allow switching plans without underwriting (eg. approval). When you’re allowed to switch and whether you can change plan type (eg. N to G, etc) have further variation by states that have guaranteed issue.
When I was a provider (before retirement) some supplemental payers seemed to pay faster than others. Medicare automatically sent the claim on to the supplemental (which for the mostpart I remember them being AARP/UHC, Mutual of Omaha and a few others) - just cant recall uf any had USAA and want to be sure doctor are paid promptly.