Medicare Open Enrollment Period Almost Here: Medicare Advantage vs. Original Medicare, Which Is Better Plan for You

Category: Health Issues

September 26, 2017 — The Open Enrollment Period for Medicare Part D and Advantage Plans starts soon; it runs from October 15 to December 7. Since this is your window to make changes in your plan or sign up for new coverage, it is an excellent time reconsider if Medicare Advantage or Original Medicare is your best option, as well if you have the right Prescription Drug coverage plan (Part D). We gained a new appreciation for how complex this topic is as we wrote this article. It will provide you with some basic background information to start thinking about this issue, but do not make any important decisions like this without careful thought and research.

Signing up for Medicare and Medicare Basics
You have 7 months to sign up for Medicare in all its forms when you turn age 65 with no penalties. That 7 month period starts 3 months before your 65th birthday and ends 3 months afterwards. Thereafter there are open enrollment periods when you have the option to change plans and coverage.

As a refresher, original Medicare includes Part A (hospital coverage) and Part B (doctor services). Almost everyone eligible for Medicare gets Part A at no cost, but Part B requires you to pay a premium ($134/month for most people, higher income taxpayers pay more). Medigap policies are available from private insurers and provide coverage on top of original Medicare. Part D is Prescription Drug coverage (you pay a premium). Part C is the Medicare Advantage program, which is offered by a list of government approved companies. Your Part C premium will which vary by type of plan and provider – sometimes it is $0 for certain “skinny” plans.

More about Medicare Advantage
According to the Kaiser Health Foundation about 28% of people on Medicare have Medicare Advantage plans, and that percentage is climbing. If you join a Medicare Advantage (MA) Plan you’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare. The government pays your MA provider a fee every month, and if you need services the MA pays them. However, each Medicare Advantage Plan can charge different out-of-pocket costs. They can also have different rules for how you get services, like whether you need a referral to see a specialist, or if you have to go to doctors, facilities, or suppliers that belong to the plan. Most Medicare Advantage Plans offer extra coverage like vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). You usually pay a monthly premium for the Medicare Advantage Plan, which might or might not include your Part B premiums.

If you have a Medicare Advantage Plan you should receive a notice prior to the Oct. 15 enrollment period from your insurance company notifying you of changes in the plan for the coming year. It is important to review those changes to decide if: you want to stick with that company, shop around, or switch to original Medicare plus Medigap. Medicare Advantage has a separate Disenrollment period from Jan. 1 to Feb. 14 – this is when you can drop Part C and choose Original Medicare – but not vice versa.

Which Plan is better for you – Original Medicare (Parts A and B, plus optional Medigap coverage) or Medicare Advantage (Part C)?
There are two options for the people who want supplemental coverage beyond Parts A and B. You can opt for original Medicare Part A and B and add on a Medigap policy, or you can opt for Medicare Advantage for your supplemental coverage. Garrett Ball was interviewed in an informative article on the SquaredAway Blog about the advantages and disadvantages of Medical Advantage vs. original Medicare plus Medigap plans. Approximately 10% of his clients end up with Medicare Advantage vs. 90% who elect Medigap coverage. Ball is an insurance broker and the owner of Secure Medicare Solutions in North Carolina (his website, 65medicare.org has some great resources on this complex issue).

Some pros and cons of Original Medicare vs. Medicare Advantage
There are “advantages” and “disadvantages” to both types of plans.
Original Medicare
– A big advantage of Original Medicare is you get out of network coverage. This is usually very important if you live in two places, travel frequently, or have to be able to access a wider network of medical providers or use services not authorized by your MA provider
– If you have a Medigap policy on top of your original Medicare, coverage on that cannot change (at least as long as we have Obamacare)

– Prescription drug coverage is a separate plan (and added expense)
– You probably need to consider adding a Medigap plan to pick up uncovered expenses and co-pays.

Medicare Advantage (MA)
– A big advantage is lower premium costs (even $0), since this is more of an HMO type approach to health care. However the lower the premium the higher your co-pays and deductibles might be
– MA plans might pick up deductibles and co-pays not covered by original Medicare
– MA plans offer the convenience of 3 plans in one – Medicare, prescription drug, and supplemental insurance
– Emergency and urgent visits are covered everywhere in the U.S.
– Prescription drug coverage and sometimes vision and dental are normally part of MA plans, while those are an extra expense and more providers to pay with original Medicare

– A disadvantage is that you must stay within a network of medical providers; going outside the network can be expensive
– You might be charged more if you later decide to switch from Medicare Advantage to a Medigap plan, since the latter can ask about (and charge you more for) pre-existing conditions.
– Doctors can come and go in networks. For that reason you need to check to see if your doctors will still be in your Medicare Advantage network
– You might have to get a referral to get approval for some services, which might not be covered by the plan.
– Congress has targeted the extra expense paid to Medicare Advantage providers in Obamacare repeal efforts, so in the future these plans might not be as attractive as they are now

What can I do in the Oct. 15 – Dec. 7 Enrollment Period
So, back to the upcoming Medicare enrollment period. Here are the things you can do during this 7 week period:
– Change from Original Medicare to a Medicare Advantage Plan.
– Change from a Medicare Advantage Plan back to Original Medicare.
– Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
– Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
– Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage.
– Join a Medicare Prescription Drug Plan.
– Switch from one Medicare drug plan to another Medicare drug plan.
– Drop your Medicare prescription drug coverage completely.

Bottom line
Whew! There is a lot to think about here. The big thing is to confirm that you have the right kind of plan for your needs, and that it will still do that next year. If it looks like your lifestyle or health is changing, or if your insurer is changing the plan or providers in a way that doesn’t fit you, this enrollment period is your chance to make things right. If you are shopping for a Medicare plan, go to https://www.medicare.gov/find-a-plan/questions/home.aspx and medicare.gov.

Comments? Do you questions or war stories about deciding to use a plan from original Medicare or Medicare Advantage? Please share your thoughts in the Comments section below.

For further reading:
Medicare Shopping: 10 Rules
Kiplingers: Medical Advantage Plans Can Cut Premiums and Hassle
Medicare.gov – How Do Medicare Advantage Plans Work
Medicare Advantage Plans Cover all Medicare Services
So You’re Turning 65: Here is Your Medicare 101 (a 3 part series)




Posted by Admin on September 25th, 2017

50 Comments »

  1. It should be noted that Original Medicare pays 80% and it is up to you to pay the 20%. Not all Medigap plans are created equal. Not all Medigap plans are offered in every State. Medicap prices vary from State to State. Also, consider, Plan F which pays all deductibles for hospital and doctors and pays the 20%. This leaves you, in most cases, no bills. Plan F is one of the most expensive Medigap plans. There is also, in some States, a high deductible Plan F. Also, be aware, Plan F will no longer be offered after 2020 but those who have it will be grandfathered and can keep it.
    Another thing people may not be aware of is that Medicare Part A (Hospital) has a benefit period of 60 days and a deductible that applies to each benefit period (rather than a calendar year deductible like Part B). As of 2017 the deductible was $1316 (per benefit period of 60 days). So if by some terrible chance you were admitted to the hospital 6 times (6 benefit periods) your deductible could be $1316 X 6 =$7896. That would be pretty unlikely but you never know. My Hub has Plan F and has undergone radiation treatments. The bills so far have exceeded $156,000. Medicare approved costs were something like $146,000 and we would have had to pay around $8,000. However, we have Plan F and have not received one bill so far. What a relief that is.
    Examine all the Medigap plans for what they offer. Each is very different in what they pay. Each is different in what they cost.

    by louise — September 26, 2017

  2. I’m nearing the point where it’s time to sign up for Medicare. I’m 99% certain that I want original Medicare but I’m undecided between Plan F and Plan G for a supplemental. I’d be interested to know what others think about taking Plan G (with a lower premium) over Plan F Higher premium but pays all of the deductibles).

    by Timothy Brew — September 27, 2017

  3. I am confused. It is mentioned above that:
    Medicare Advantage has a separate Disenrollment period from Jan. 1 to Feb. 14 – this is when you can drop Part C and choose Original Medicare – but not vice versa.

    What can I do in the Oct. 15 – Dec. 7 Enrollment Period
    So, back to the upcoming Medicaid enrollment period. Here are the things you can do during this 7 week period:
    – Change from Original Medicare to a Medicare Advantage Plan.
    – Change from a Medicare Advantage Plan back to Original Medicare.

    Isn’t Part C a Medicare Advantage Plan? Appreciate any further explanation of this.

    Editor’s Note: Part C IS Medicare Advantage. We mistakenly said Medicaid in the para above when we should have said Medicare. Sorry for the confusion.

    by Joan — September 27, 2017

  4. Question: I signed up for Medicare at age 65, and at age 67 am still working FT. I plan to leave my job at the end of this year or early in 2018. I am currently enrolled in Plan A, but because I have employer health insurance and pay into that system, I have not started to pay Plan B or have a Medigap or Medicare Advantage plan. Will all these options open up to me since I will no longer be covered by my employer’s health insurance plan? Anyone know? Thank you.

    by Elaine Cubbins — September 27, 2017

  5. What about the “F” plans for people with health issues?

    by Steve C. — September 27, 2017

  6. There is a confusing typo in the above article. The lines:

    “What can I do in the Oct. 15 – Dec. 7 Enrollment Period
    So, back to the upcoming Medicaid enrollment period. Here are the things you can do during this 7 week period:”

    Notice that it reads: “the upcoming MEDICAID enrollment period”, but should read: ” the upcoming MEDICARE enrollment period”.

    Editor’s Comment: Thanks Thomas for the correction. We were afraid we would make that mistake after we caught ourselves doing just that. Now corrected!

    Medicare and Medicaid are very different things!

    by Thomas Tomaszewski — September 27, 2017

  7. As long as you can prove continuous coverage you should be able to switch to a Medigap or MA plan with no problem.

    by MARY WILEY — September 27, 2017

  8. Elaine, good question. These options are available to you when you leave your FT employment. I recommend you evaluate your current employer health insurance plans as well as Medicare plans when you retire. Sometimes you can continue with your existing health care plan as a retiree. Each plan is different and each of our health care needs is different. Best of luck to you!

    Terese

    by Terese — September 27, 2017

  9. Because of pre-existing conditions we have been turned down by Medigap plans to supplement Medicare A/B. Therefore we are “stuck” with Medicare Advantage Plans. Mind you, that isn’t a bad thing. We have been very happy with “most” of the Medicare Advantage Plans. Where we live now there is only one Medicare Advantage Plan, which so far meets our needs.
    Fair warning here: sign up with Medigap plans when you first are Medicare elgible. After the fact your chances of being qualified for Medigap plans approach zero.

    by Charles A Bradbury — September 27, 2017

  10. My mothers Medicare Advantage once covered the 20% that Medicare would have not. Then they added Vision, Dental, and Hearing Aids BUT also you are no longer covered for the 20% in most instances. So it is actually worse than Medicare for the possible costs. You cannot buy MediGap with an Advantage plan. The original point for the Medicare Advantage was to have the 20% covered. She has the highest option (which is a waste of money) and pays a lot each month. She pays essentially no doctor visit copays and the closer you read the plan the more you are on the hook for some big expenses. So I suggest you read the entire plan NOT just the summary. Nothing I can do to her make change. And some doctors in the plan were terrible and I (a surprise to them) fired some of their asses as we could do so since we could pick from a list. The local group were funneling patients to those MDs they liked or had some deal with.. At this point we have all good doctors and know how to deal with the system. The dentists are pretty much losers and the vision covered is a loss to the centers so they wish you go away and do not give you options that have to give if desired if they loose money on the deal.This is the normal way vision places work because around here they have to take all the insurance as a bundle not be able t pick and choose which they accept. Overall for me I would never step foot into that Advantage plan. It is the low cost option for a reason.

    by Drew — September 27, 2017

  11. I have had a advantage plan since January and have no issues with it. I made sure my GP was on the plan which was the most important to me. Additionally, the dentist I regularly use is also on the plan. I pay a premium of $66 monthly and $134 to Medicare, so a total of $200 a month. I have no co pays for well visits each year but $5 copay to see my GP, specialists are $15. I went to an ophthalmologist and had a complete check up including various tests and only paid $15. The doctor was excellent. So I guess the area you live in might contribute to how you feel about this plan. Additionally, I am very healthy, so this plan suits my needs perfectly. If my health deteriorates, I will probably change to regular medicare and a medigap plan since they cover more services. My mom pays almost $500 a month for all her coverage but never has a copay. She has had several surgeries and never had to pay anything. BTW my mom is 96.

    by Staceky — September 27, 2017

  12. Not all Medicare Advantage plans have strict provider networks. My wife and I are on her teacher’s retirement program benefit plan using Medicare Advantage via United Healthcare. We can use any doctor within or outside of their network without penalty. The combined cost of Medicare Part B and the MA premium are quite low compared to what I see for people with original Medicare plus a supplemental plan as some of those have steep premiums. I am sure we are enjoying some benefits simply due to the size of the teachers plan.

    by Michael — September 27, 2017

  13. My husband and I have used an Advantage plan for the 10 years we have been retired. Out of pocket medical expenses have been minimal, especially since we used a no premium HMO. Keep in mind the premium for a Medigap policy could run at least $2500 a year, plus you need a Drug policy. For a two person household that is an expense of around $5000 + a year that you MUST pay, whether you need a lot of medical or not. So, for the 10 years, we feel we have saved close to $50,000.

    My husband had back surgery,I mean major back surgery, L1 thru L5, by one of the best surgeons in the country. Take a look at the HMO Networks offered in your area. There are some great Doctors available in these networks. Look up the Doctors available in the different fields….it doesn’t mean you are getting the bottom of the barrel Doctors/medical care!

    by Linda — September 27, 2017

  14. Elaine,
    I used to be a SHIP counselor (never sold insurance but had to get my license just to counsel). Prior to quitting your job, sign up for Part B with Social Security. Have it start the month you no longer are working. It will automatically start on the first of that month (can’t start mid month etc). By signing up for Part B, you can then get a Medicare supplement without being denied for pre-existing. You will also have to get a D or RX plan. That is the only plan you will have to review each year. You do NOT have to review the Medicare Supplement yearly. That plan goes anywhere you do which is great for snowbirds. Have the medicare supplement And the D plan start the same date as your B starts. That way you won’t have to go without any insurance once you quit. Your local SHIP (see the phone number listed on the back of your Medicare & You Book) can help you with medicare supplement publications and guidance choosing one. They can also help pick a D plan. The reason these places are so important is because SHIP does NOT want to sell you a product, they are there to explain them to you.

    by Tracy — September 27, 2017

  15. Some answers:
    Staceky: you won’t be able to go from a medicare advantage to original medicare and a medicare supplement because the supplement WILL look at pre-existing and may very well deny you from getting coverage for that 20%. Some ways you can get into a medicare supplement is by moving out of the advantage area or if the medicare advantage leaves your area or quits on you.
    Timothy Brew: Sign up for the most coverage you can because they can deny you extra coverage in the future. I suggest getting the most coverage when you first sign up.
    Drew: totally agree
    Michael: Sounds like you are describing a Retiree Group plan, very different than a Medicare Advantage plan that most people have access to.
    One side point I want to mention is that getting a medicare supplement WITH ALL OPTIONS runs an average of $150/mo for someone @ 65 y/o. Quite a bargain for those who want to go anywhere and NOT see bills. However years ago Paul Ryan didn’t like how the medicare supplements were paying for everything and not having the customer “have skin in the game” so in 2020 he implemented a change coming to medicare supplements that to me is appalling. If the consumer wants to pay for the right to have everything covered, they should be able to. Info below:
    Beginning in 2020, Section 401 of the Medicare Access and CHIP Reauthorization Act 2015 (MACRA) will prohibit the sale of Medigap policies that cover Part B deductibles to newly eligible beneficiaries.

    by Tracy — September 27, 2017

  16. When looking at Medicare Advantage plans that may have a 20% copay in some situations, remember that there is also a maximum out-of-pocket cap (MOOP). So if you have a major surgery for which the total bill is $200,000, some might think you’d owe $40,000 due to the 20% copay. But that’s limited by the MOOP. The MOOP on my Medicare Advantage plan is $6,000, which is the maximum I’d generally be required to pay towards medical costs in any one year. Always check with a qualified, reputable Medicare insurance sales agent to determine the best plan for your particular situation.

    by Clyde — September 28, 2017

  17. Tracy, Who or what is SHIP? signed “lost and confused!”

    by amy — September 28, 2017

  18. Has anyone used, or had a parent use, a Medicare Advantage Plan while in an assisted living/nursing home. I guess I would be nervous that the assisted living/nursing home would not be careful to use “in network” Doctors for my care and I would be responsible for a slew of “out of network” expenses.

    by Linda — September 28, 2017

  19. I will be retiring in 2018, but I will have my regular insurance that I have a work now as a supplementary insurance. so should I get medicare advantage or medicare regular?

    by Patsy Jones — September 28, 2017

  20. Amy click this link to find a SHIP program in your state. STATE HEALTH INSURANCE PROGRAM
    Content Researched & Assembled by the Staff at http://www.SeniorsResourceGuide.com and http://www.SeniorsEGuide.com

    What is SHIP?
    SHIP is a free health benefits counseling service for Medicare beneficiaries and their families or caregivers. SHIPs mission is to educate, advocate, counsel and empower people to make informed healthcare benefit decisions. SHIP is an independent program funded by Federal agencies and is not affiliated with the insurance industry.

    SHIP Counseling is FREE of charge
    State Health Insurance Assistance Programs (SHIPs) provide free help to Medicare beneficiaries who have questions or issues with their health insurance. You can call a counselor or attend a workshop/presentation in your area

    http://www.seniorsresourceguide.com/directories/National/SHIP/

    by louise — September 28, 2017

  21. Amy this is the link that should have been first to look up SHIP in your State: http://www.seniorsresourceguide.com/directories/National/SHIP/

    by louise — September 28, 2017

  22. Louise, it’s highly unlikely that anyone would have as many as 6 Medicare Part A benefit periods in a year because a person must be out of the hospital for more than 60 days to start a new benefit period. For example, a person could be in the hospital January 1-10. After a person pays the deductible, he/she pays nothing for inpatient hospital stays for up to 60 days. If the person returned to the hospital more than 60 days after Jan 10, a new benefit period starts, the deductible is again due, but the person gets a new 60-day period. If the person discharged on Jan 10 returns to the hospital on Feb 15, less than 60 days later, it would count as Day 11 and no deductible is due, Doctor charges fall under Part B whether a person is in the hospital or not.

    by Jean — September 29, 2017

  23. Yes, Jean, if you reread my post I said it is probably unlikely someone would be admitted to the hospital 6 times in one year. But some people could be admitted to the hospital several times a year. My point is that a lot of people don’t realize that the deductible for Medicare Part A is not a once a year deductible, the deductible is good for a 60 day benefit period.

    by louise — September 29, 2017

  24. Many thanks for the helpful info on SHIP!

    by amy — September 29, 2017

  25. Tracey: That $150 amount for everything is certainly not in New York City. My mom pays around $500 a month for Medicare, AARP medigap and drug coverage. The plans that she has would cost her half the amount in GA. So you really need to consider the state that someone is in.

    by Stacey — September 29, 2017

  26. Medigap, Plan F is $240 a month in CT but like Tracy says, in some other States I have checked Plan F is around half the price. Every State’s insurance provider charges a different amount for Medigap plans.

    by louise — September 29, 2017

  27. My question is this. I have been retired for some years now. I have been on my employers retiree health plan sense my retirement and this plan also covers my wife. This was good as her employer didn’t offer any health after wife’s retirement.
    Now she retired when she was 62 and started her SS right away. We were both born in the same month one year apart. So next year I will turn 65 and go on Medicare leaving employer plan behind. At this time my wife will be turning 64. Will she be able to get medicare also ? She has collected SS for 24 months at age 64 so does this qualify her ? She is not disabled.

    by Marty — September 29, 2017

  28. Marty, I am not an expert but very doubtful your wife is eligible for Medicare. I am 64 and waiting for age 65 to get on Medicare. I am on Obamacare and cringing on the new price increase for 2018. My Hub is also 1 1/2 years older than me and we were both on Obamacare till he was eligible for Medicare at age 65 which started this March. I can start this coming August 2018. Since I am on SS my Medicare card will come automatically about 3 months before age 65. They offer Medicare B at the same time which costs $134. You can opt out if you wish. That is the Doctor part of Medicare. Unless you continue to work to have insurance for your wife, I am assuming Obamacare is what your wife will need. It is based on your family income in regard to receiving a subsidy. You might want to puts some figures on paper to see what your income will be to see if you can get a subsidy thru Obamacare. You might also consider working one more year till your wife turns 65 and is eligible for Medicare. Obamacare is not cheap! My Silver policy, which offers a subsidy, costs $950.54 and the subsidy pays $440 so my part to pay is $510.54 per month! Good luck!

    by louise — September 29, 2017

  29. Forgot to say Medicare B is $134 per month!

    by louise — September 29, 2017

  30. Louise,, Thanks for your input and info. I know everybody is in different circumstances when it comes to medicare. Right now I pay about the 510 a month you talking about but it covers both of us. The way I am understanding it I have to go on A at 65. I have talked with the company I retired from. They say I will take part A and B. I get a sentimental medicare policy with includes the drug plan i am on now from them. The drug plan qualifies under medicare rules. Plus they the company will pay me an amount in lump sum bases once a year to help with things not covered by Parts A and B.
    Being that I am already retired I did not ask about being able to keep plan for extra year through them to cover her.

    Now with all this being said I read the rules about taking medicare before your 65. It stated you could under these conditions, it listed. Disabled, Some kind of end stage disease, have been collecting SS for 24 months, one other I do not remember at this time.
    But the thing was it did not say (and) anywhere in that list. So I was thinking 62 to 64 is her 24 month period that she has been on SS.
    I was hopping someone else could confirm this. Or that they tried and failed to do it under his rule.

    by Marty — September 29, 2017

  31. I’ve been told lately by two people that their employer’s COBRA plans were significantly cheaper than buying insurance in the marketplace. Since COBRA can last 18 months, that could help some people reach the Medicare Supplement marketplace. It’s worth shopping around: call your insurance agent, check sites like AARP, AAA and Costco, and see what is else might be available! In anticipation of leaving employment in 2017, one acquaintance intentionally signed up for her employer’s high-deductible plan to get a lower COBRA payment.

    I’ve heard that there is also a form that you can submit if your Medicare premium is based on higher earnings when employed, in which you can request a reduction of premiums after retirement due to a lower retirement income. I’m trying to track down that form.

    by Kate — September 30, 2017

  32. I live in Georgia and have Plan F through Mutual of Omaha. The monthly cost is $170.00 for me and $152.00 for my wife. This plan does not include Part D.

    by Jim C — September 30, 2017

  33. Hi Marty,
    I am a SHIP counselor in California. “Have been collecting SS for 24 months” refers to people on Disability. After they have qualified for Disability and have waited 24 months, they are eligible for Medicare. Other than this and the other exceptions you list, there is no way to get Medicare before age 65. As a suggestion, if you haven’t already done so, you may want to compare the costs of your Retiree plan with the costs of Medicare before you switch over to Medicare. Include the costs of the Part B premium, co-pays or a Medigap premium, and especially the costs of drug premiums and co-pays. If you decide to keep your Retiree plan, you may also be able to continue to include coverage for your wife. It is worth asking about.

    by Karen W — September 30, 2017

  34. MARTY, my father retired thru GM and after his passing my mother is still receiving his pension, SS and his Blue Cross health insurance. SHE only pays $121 monthly for everything. I tell her how lucky she is. Is there a reason you can’t keep both??

    by mary11 — September 30, 2017

  35. I have the option of a Cobra plan when I retire and it is $700 per person in the family for 12 months. Renewable one year later. This option will enable me to retire before 65 yrs, to a part time job and wait for Medicare to take over. As long as the company doesn’t cut that from our benefits, that is.

    by William DeyErmand — October 1, 2017

  36. First thanks to all you for your responses.
    I have talked with past employer about this. They are the ones that help you switch over from their insurance plan to Medicare at age 65. They help you in this because you get your “gap plan” through them. The plan that helps or picks up what medicare doesn’t and also provides your drug plan so no need for Part D. On top of that you get a yearly stipend of 2000 to help with over non covered medical charges. Good deal I think.
    The question I didn’t ask was what about the wife that has been on my plan for the last 30 some years. So that is what I am trying to figure out.
    So Monday I will call them again ask these questions. Can I keep my insurance for another year to keep her covered ? Will my gap and drug plan through them cover her after she goes on medicare ? If this does cover her can I use it while she is on the open market plan for a year ? Is there a cobra plan that would cover her for the year ? I do not believe there is a cobra plan. I had a cobra plan for dental only after I retired but is was only good for like six months. I can not be the first to go through this and I am sure they can tell me if they can help out in anyway.
    I live in New York State and they run their health care through the state. Checking that it would work out to about 5 – 6 hundred a month for about the level of coverage I have now. No financial aid with that. I will let you know how my phone calls go tomorrow.

    by Marty — October 1, 2017

  37. I live in South Fl and I’m 65 can anyone recommend a good drug program that won’t break the bank? I’m on a total of five different med. three generic and two not generic. I’m on part A and B Medicare. There are too many different plans and I’m confused what is in my best interest not the person selling me the plan. Help!

    Any good suggestions would be appreciated.
    Skip from Florida

    by Skip P — October 2, 2017

  38. Skip – Check out https://www.consumerreports.org/cro/2014/10/best-medicare-drug-plans/index.htm for a plan of attack. You will have to do some of you own foot work because all plans don’t cover all drugs. Then you can go to a broker if you wish, but you’ll at least be informed. Or you can just sign up with a provider online. You can always change next year. I would suggest a broker because a single line agent can only sell his own book.

    by Peder — October 2, 2017

  39. How is Humana Medicare Advantage? They do a lot of advertising I noticed.

    Jennifer

    by Jennifer — October 3, 2017

  40. @SKIP – This page has a step-by-step instruction sheet to comparing Part D plans on Medicare’s website: https://65medicare.org/compare-part-d-plans/. You can compare plans on Medicare’s website very easily and sign up on Medicare’s website directly. It is crucial to do that as different plans cover different medications, use different pharmacy networks, have different co-pays, etc. – if you are on a few medications, there can be differences of thousands of dollars a year from one plan to the next.

    by Garrett Ball — October 3, 2017

  41. Jennifer, I have Humana’s plan. I’ll soon find out how good it is. I just ran up a $7,000+ ER bill from a fall after Hurricane Irma. Needed a CT scan for a head injury and stitches. If it’s as advertised, my cost will be the $75 co pay.

    by Jennifer — October 3, 2017

  42. Are you an inpatient or an outpatient? Here is an article to explain hospital status. Seems having a medigap plan is a good idea. I went thru this in and outpatient thing with my Mother and it is not something you need when a loved one is so sick. https://www.gomedigap.com/blog/inpatient-vs-observation-status/

    by louise — October 4, 2017

  43. On a slightly different note, I have to say that I am being driven absolutely crazy by the calls I am getting from companies trying to sell me Medicare supplemental plans and information (not to mention the junk mail from insurance companies, financial planners and others). I will turn 65 in about 5 months. Yesterday I had 8 pieces of Medicare mail and six Medicare calls (3 today so far)r). Being on the “do not call registry” does nothing. Blocking the numbers doesn’t help. I get calls from my current state, the state of my cell phone’s area code, and calls from other states. I can’t ignore them since unknown numbers could be someone calling from my company, which has offices all over the country. I hope this harassment tapers off after I turn 65!!!

    by Kate — October 4, 2017

  44. Kate: I agree. They are so relentless that it makes me believe there must be a lot of profit in those plans.

    Phones have become as much an annoyance as a useful tool. I only answer calls on my landline and mobile phones if the numbers are familiar. I get messages from people who know me, but not from the sales people.

    Telemarketers hang up immediately upon realizing that their autodialing machine reached my voice mail machine. Computers seem to dislike talking to one another.

    by JCarol — October 4, 2017

  45. Call your telephone provider to see if NOMOROBO can be installed on your phone. I have a landline and my phone was ringing non stop all day long with robo callers. I was ready to tear my hair out. I am on the do not call list which only works for most legitimate companies. Most of these robo callers are dirtbags trying to scam you out of something. NOMOROBO has reduced my incoming nuisance calls to a few a day now. Problem is that these scammers keep changing their numbers so even NOMOROBO can’t keep up with it. Intermittently I will check on the computer to see who may have called and if they appear to be scammers I go to NOMOROBO website and plug in those numbers for them to check and hopefully put them in their reject system! Just the other day I got a phone call from the WINDOWS guy trying to scam me again for the 20th time that ‘they observed problems on my computer’. I told the guy he was a scammer and hung up. GRRRRR!!!

    by louise — October 4, 2017

  46. Follow up on my Humana plan experience with a visit to the emergency room. Don’t know why my post said it was from Jennifer. I don’t think I’ve changed my name, but who knows, I’m getting old and forgetful.

    Anyway, got the final bill from the hospital today. Of the $7,000+ bill, Humana took care of everything but the $75 co pay for ER visits. Hooray! How do people who have no insurance deal with such huge bills???

    by Linda — October 4, 2017

  47. Linda: Does your Humana plan have a specific name and wondering what your monthly charge is for this plan? Is it a Medicare Advantage plan or Medigap? Also, what state do you live in. Thanks

    by judy — October 5, 2017

  48. I admit, I haven’t read all the posts so I may not be giving new information. When I first started getting Medicare, I signed up for an Advantage plan – happy with the $0 premium but not so happy with the co-pays. While they weren’t awful, I was afraid of what they could become if I had a serious illness. Because the renewal period was less than 12 months after I signed up, I could have switched to Original Medicare and a Plan F. While searching for the best premium (it definitely pay to shop), Mutual of Omaha suggested Plan G. The coverage is identical to Plan F but you pay the Medicare deductible, currently $183. This brought down my premium significantly – currently $129.62. I was able to cover the deductible in 4 to 5 months compared to the premium for Plan F. You do, however, have to qualify medically for Plan G. If it wasn’t already stated, if you sign up for Plan F in the first 12 months of receiving Medicare, they must accept you.

    by Louise H — October 5, 2017

  49. I failed to mention that you still need a drug plan. I haven’t been too happy with Humana Walmart plan. My maintenance drugs are very inexpensive and the premium is around $18, but if you need a brand drug, good luck.

    by Louise H — October 5, 2017

  50. Judy, I live in Florida. There is no premium for my Humana plan. It’s a Medicare Advantage Plan. It’s called Humana Gold Plus. When I lived in Minnesota I also had a Medicare Advantage Plan with UCare. The premium there was $60/month. It had no vision and dental coverage. And they disallowed things like a postoperative biopsy of a lump removed from my arm to see if it was cancerous. Wasn’t too happy with them. Now I’m $720 ahead each year, so I can afford to pay some deductibles.

    Each state has different plans, so you need to do your homework. And, yes, the volume of stuff they send you is unbelievable! I was still working when I turned 65, so I just threw it all out. Then I suddenly got laid off at age 66 and had to scramble to find something to replace my employer plan. Good luck!

    by Linda — October 6, 2017

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