My wife is retiring and I won’t have her insurance. Medicare, Medicare advantage, medigap, supplemental. Confusing. How are other USA PCA fighters doing their health insurance?
I have a few months to enroll in a supplemental despite pre-existing condition. I’m in NE Ohio.
From my reading it looks like Medicare with a supplemental (medigap) plan is best for PCA during the palliative years. $144 for Medicare and what? $200-$400 for supplemental. Maybe something additional depending upon income. Then there’s part D, drug plan. Is it worth the investment?
Thank you.
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kreg001
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You might want to speak with a medicare specialist who can give you informed suggestions based on your medical situation. One size doesn't fit all when it comes to navigating the Medicare maze. You might want to look into the following link that is a non-profit, state by state information center. shiptacenter.org/about-medi...
We were on Anthem Blue Cross Blue Shield. Spoke to one of their reps. Her recommendation is initially do Anthem Advantage which takes the place of Medicare with no additional cost; just the $144 from my social security. My current team and facilities are part of that plan. Then, before 12 months go by, so preexisting conditions aren’t considered, select a Supplemental plan. She says G as plan F will be discontinued in 2020. Supplementals require a plan D drug plan and she recommended the least expensive one. In addition to the $144 taken from my social Security I’ll be paying additional in the $200-$250 a month range.
I agree with SHIP but also you can find insurance brokers who don’t charge you. They are paid by the plans they sell but we learned a lot from them (and I was known as a Medicare expert for providers. ). I am not clear why the advice was to start with the MA plan. Be careful. The supplements are medically underwritten so her one year advice might be the only time you could switch. The MA plans will have more stringent rules on some things such as what providers you can go to. Problems perhaps with traveling. Btw we chose AARP supplement. Do get a drug plan if you go with Original Medicare. If you don’t and later want one you will pay a significant penalty. But you can easily switch drugs plans every year. You cannot switch supplements so easily. Medicare.gov has very good info for you
Original Medicare gives you more freedom, Medicare advantage is like an HMO. Original Medicare part A and B covers u well the supplement plan F covers u overseas. Original Medicare and a supplement is usually guaranteed renewable. Medicare advantage can drop u . Part D is the Rx part. With Medicare advantage it's all included Rx, doctors, and hospital.
My husband has Anthem Blue Cross Plan F. Yes we pay a little more BUT thru 1yr of PCA treatment (Zytiga, Jevtana, Radium 223, Lupron, etc) AND 2 major surgeries (w/hospital stays) we have paid NOTHING out of pocket!! I too have heard that Plan F will be going away, BUT IF you have the chance to get it, DO IT, as they can't take it away once you have it.
Supplemental plan F. It gives me the freedom to go to whatever specialist I want to see. Not locked into a network like Medicare Advantage. I think it also confers coverage when I travel within the USA.
Great question, it is quite an experience trying to decide!
I found that my Humana Medicare Advantage works best for me after my husband retired and I changed insurance, but as others have said, it's not one size fits all. I am female, obviously don't have PC, but do have other serious health issues.
I think @Fran2020 said it best!
Best wishes...🕊️🙏
Not enough information. It’s easy to tell you what I did, but..... Start with what plan your wife had. Is she going on Medicare? Does her employer off a supplemental plan? Even in retirement..... if so, she needs to contact an agent from her plan and sit down with you and her.
What was her plan? Say it was United Healthcare... they have a person through her company's Benefit Person. Set up an appointment. He will go over supplemental and Part D...... if ya’ll chose Advantage, it’s cheaper with drugs but locks you into certain treatment facilities and doctors.
In my case, it was a United Healthcare - AARP for supplemental and Plan F..... this was the most advantaged plan fir someone with metastatic prostate cancer. Anyway, start with your wife’s current plan before retirement...... if it worked for you...
Before I became disabled from this disease, I was an independent senior Medicare Insurance agent.
The best place to go for information on this topic is the government's website medicare.gov . It has a wealth of info, and you can do comparisons of plans.
To start with you need to choose either a Medicare supplement plan along with a Part D drug plan, or a Medicare Advantage plan which includes drug coverage. Generally, a supplement plus Part D will provide you with the most flexibility as you can go to any doctor that accepts Medicare. Whereas an Advantage plan typically limits you to a network of participating doctors.
Advantage plans have lower monthly premiums than supplement plans.
It is important to talk to you doctors to find out what plans they accept.
The plans and benefits are different in each state. One thing I can tell you is check the drug formulary for part D. Check what drugs you are currently taking. You don't have to get your part D from the same company that provides your supplement plan.
I choose standard medicare with a supplemental plan and Part D ten years ago. My supplemental plan is Plan J and was was discontinued some years ago but I am grandfathered in.I like that I can see any doctor that accepts medicare anywhere in the USA. Also there are no referrals required to see a specialist. Between medicare and my supplemental plan I have not been billed for anything and I have some big time medical issues. PCa, Multiple Myeloma and Heart Disease just to name some. My drug costs can be pretty high because of the speciality drugs I use. I wind up in catastrophic coverage most years.
As you may know, you can change your Part D plan each year during the annual open enrollment period Oct 15-Dec 7. Make sure to go to medicare,gov and perform a search of all your meds to make sure you are getting the most cost effective plan.
As with Plan J now Plan F is no longer available to new Medicare eligible seniors.
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