This article doesn't mention one fact that is important to anyone who has been diagnosed with prostate cancer.
After you make your initial choice of a Medigap insurer, you will likely never be able to change insurers. The Medigap insurers can discriminate against people with pre-existing conditions if you attempt to change insurers. Last I checked, they were not getting in line to sign up cancer patients.
So if you are choosing a Medigap insurer for the first time, you may want to pick carefully. You will likely have them for the duration.
Biggest problem is people dont know if you switch to a Medicare HMO, Kaiser for example, because you saw ads and 5 star ratings, and next year regret that decision and try to switch back to a Medicare PPO on your next open enrollment period, you cant. You are stuck with your Medicare HMO.
Dont get scammed by ads for zero copays on an HMO, or ads for 5 star ratings. If your PPO is good, better keep it. I am still blocking telemarketing calls every day asking me if I want to switch to an HMO. The calls are for over a year now. Might have to change my phone number to stop them.
I was lucky to get out of Kaiser when I moved from LA (SCAL) to Sacramento (NCAL). It was a qualifying distance move that allowed me to change everything. It qualified me to switch my insurance back to a Medicare PPO, and I can now go to Stanford and UC Davis for better care.
Agree. Government wants everybody on medicare advantage, and that is not good. They give incentives to Kaiser, award money to those HMO hospitals, and award 5 stars on surveys when they don't deserve it.
One time, one of my Kaiser oncologists 13 years ago said after my Lupron failed, "dont worry, Kaiser pays Hospice". Horrible doctor. Fired him and found another.
Medicare Advantage wants everybody on MA because they're ripping off the government for 15% more than regular secondary coverage costs. At least 10 years ago every company using Medicare Advantage was sending me brochures claiming
if I signed up with them there would be no premiums and they might give me some or all of what they take from my SS check- plus a gym program, glasses- in other words they were all scam artists. Ripping off the government is not something I'm going to do- unlike republicans who lie, cheat and steal from our government in every way possible- led by the trump crime family.
Cesanon: Remember that different medigap plans use different methods to determine premiums and WHEN those premiums increase. But the funny thing is that as I look back at the premiums I've paid vs. the 20% I would have paid, it's very close to a draw. Only in 2017 when I had triple bypass did I really "win".
Cesanon: First, eliminate those MEDIGAP plans that deny pre-existing conditions (in my case, that included AARP!). Second, determine whether premium rates are fixed for life (never!), go up on a yearly or multi-year basis regardless of age, go up on birthday anniversaries and, in all cases, is there a maximum premium or age cutoff. I guess you also need to be sure that the plan you select does not have limits on total or annual reimbursement (should follow/accept Medicare) and does not disappear when you reach a certain age. I guess another factor you need to consider is whether the plan you want can be transferred to other states (e.g., a move to Florida?). Sadly, neither Medicare itself nor any of the plans I know of cover out of the country medical expenses usually. Along the way, you should probably continue to examine Advantage plans and remember to factor in drug costs. Am I an expert on these matters? Far from it. Good luck.
Mark, please do your own investigation, even talk to one or more of those people who sell Advantage plans. When I signed on at 65ish, I never expected to be around at 82, but I am! On the other hand, considering the current political environment, who knows what or who will be around in a year, much less 15 yrs.
Given all this crap out there, probably the only safe strategy is to limit yourself to just a few of the largest insurers. AARP and Aetna are probably among them.
You can use Wikipedia to check size.
I chose Mutual of Omaha. I am not happy with that choice now that I have learned I can never move from them again.
Cesanon: just by living through my mistakes and asking "what if" questions. I'm sure you can also speak to people at Medicare/SS or even sit down with them. My prostate cancer voyage started at age 61, so I started on commercial insurance and knew I needed to have protection after I hit 65.
You can sort Medicare supplement plans by letter, Plan F is a common “pretty good” package, N is similar with some overseas coverage. Lotta fine print to wade through but the letter-named offerings are supposed to be mostly standard. As noted above the Advantage plans are mostly advantageous for the insurance industry.
It didn’t quite get answered above, and I’d really like to know, although one must stay with the same insurer, is it possible to change plans within that insurer’s portfolio? Or would pre-existing condition rule out even that? Anybody know?
If you have prostate cancer, you really should be choosing plan F or G.
If you are going to downgrade within a company to a lower plan level, I would not expect any problems.
You can rest assured, it is their game, and every time you give them an opportunity to make a decision, it will involve transfer risk from them in exchange for less money that that risk is worth.
I’ve been on AARP plan N since I turned 65 in 2011, I’d like to shift to F now that I’m battling PCa but fear the preexisting condition rule may prevent and motion.
Why don't you call them, ask if you need to go through an underwriting process to do so, and let us know what you find.
Why would they voluntarily increase their costs unless required by law?
The Repubs are doing so many mean things to non-medicare insureds, it is not plausible that these Medicare preexisting conditions problems will be fixed.
The sad part about this is that statistically probably 2/3 of the old white men here vote for the Repubs that are screwing us.
I was hesitant to call them so as to not open a can of worms, but hey they already know my condition so I did call this morning and to my surprise I can upgrade my plan without underwriting or pre-existing rules, provided I am already insured by them and am not just starting coverage nor seeking to change insurers. And I can do it now, I don’t have to wait for December enrollment window. Thanks for the nudge.
I live in Pennsylvania, which has a balance billing law that prohibits excess Part B charges. So for me the benefit of switching plans from N to F is the $183 part B deductible, plus office visit copays of $20 and ER copays of $50. Which looks to total somewhat less than the premium increase I would incur by changing from N to F. Perhaps that’s why there would be no problem “upgrading” my plan - United Healthcare would get more from upgraded me than the increase they most likely would need to shell out on my behalf. Hmmm.
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