I am confused on all of the plans available for medicare, can someone create a clear view of the options and what they represent. I am eligible next year 2025 and wanted to better understand all of the options and their cost.
Consider Medigap Plan G. Plan G has coverage of more out-of-pocket Medicare costs than any other Medigap plan type. Of course, that means higher premiums. Plan G is becoming the most popular plan. Plan F with similar benefits was the most popular but is no longer offered to new Medicare recipients.
Medicare.gov site has a chart comparing the Medigap plans. You can obtain more information by contacting your State Health Insurance Assistance Program
https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits
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2nd that. I was plan F and switched to plan G.
That’s assuming you don’t have Tricare, a federal service plan, or some other coverage that you can keep as the secondary payer to Medicare.
Did you ever consider High Deductible Plan G?
Thank you for the replies, Is plan G medicare advantage, or is it regular medicare?
Plan G is a Medicare Supplement (keep original Medicare). What state are you located in?
Hi westerlunda31! Its been a few years since doing this but when starting to learn it was DAUNTING so I feel ya.
This is main thing…
Medicare has a Part A and a Part B that everyone pays, sign up on Social Security.org. age 65, then comes the choices…
Theres Medigap which is “original Medicare” and theres different plans “A to N” ( or whatever the letters are). Read the various coverages for your use. With a Medigap plan you MUST pick up an additional Prescription Drug Plan or be penalized forever. In Wisconsin we have “SeniorCare” which is based on income but can be only $30/year! only. (We use this since we have no rx to speak of)
You pay a monthly premium with Medigap plans but in long run, considering copays as you get older, it may outweigh Advantage plans.
Advantage plans (can sometimes cost $Zero) and generally include the prescription drug plans and maybe dental and vision but there’s copays, limited to PPOs etc, and other things. Those expenses is what add up as you age.
If you choose an Advantage Plan you only have a short period of time to switch to a Medigap plan but you can always switch TO an Advantage plan.
FWIW, we chose the Medigap plan G + 2 different Riders through AARP with United Health Care and just pay Part B deductible. Premiums $ raise thru age 80, not by much, but theres a chart you can read.
Hope this helps (I’m by no means an expert)
I’ve been on Medicare for a couple of years now. I have a Medicare Advantage plan thru BCBS of Kansas City. I went with them because it is basically the same plan I had when I was working. It has prescription drug coverage and an allowance for dental, hearing and vision. I am very happy with my plan. I had a couple of ER visits that were seamless.
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When I first became eligible for Medicare, I worked with a medical insurance broker. He was very good at helping me navigate the various options available to me. He was able to provide me with information on multiple companies and together we determined what would work best for me. There was no cost to me for his service. I found the entire process very helpful and informative.
I would recommend you try to find a broker in your area who can work with you on options. I would also recommend you try to avoid responding to all the advertisement that is on TV, in the mail, etc.
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I know Clark does not like Advantage plans. There seems to be a couple of points missing in his article. If you think your plan stinks, the process to change to another plan is easy during the open enrollment period. I agree that a network only advantage plan is not a good way to go. There are Advantage plans that are basically PPO plans, much like many of the employer provided health plans. The plan provides access to doctors, hospitals, specialists, both in-network and out-of-network with no referrals needed. The out-of-pocket costs or deductibles are different with the various plans, so review everything thoroughly.
New York, Connecticut, Maine, and Massachusetts - these four States alone allow Advantage users to leave Advantage without medical underwriting. That was a tidbit of information that could be of use to someone.
Maybe if someone got in a pickle with Advantage they could have a temporary relocation ( = long summer vacation Down East) in NY New England, switch back to Original Medicare, then go back to their home State.
I guess it only works for most people if you can couch surf at a relative’s house (I have relatives in Upstate NY).
We retired a few years ago and was similarly confused with all the Medicare options.
We consulted with State Health Insurance Assistance Programs (https://www.shiphelp.org/) in our state at the time (Illinois). This is a free service and the gentleman spent over 2 hours with us explaining the various options. He was not a sales rep and did NOT recommend any particular vendor - he just provided information and answered all our questions. Extremely helpful (and FREE). Hope there is a SHIP representative in your state.
Once we decided on a plan (Plan G), we shopped for an insurance provider with our independent insurance broker. We have since moved to Arizona and have remained with our insurance provider.
I agree with Clark. We have traditional Medicare and Plan G supplement.
We have encountered several doctors who do not accept Medicare Advantage. My wife is a retired ICU nurse and extremely particular about our doctors. With tradition Medicare, we are able to go to any doctor and do not have to worry about in- and out-of- network providers. The down side is the it is more expensive. When we are sick, it is worth the cost to get the best medical care.
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After an enormous amount of time reading all I could find, I’m going with regular old Medicare A, B & D, and adding the High Deductible plan G (HD-G). It’s about $35/mo for each of us, and gives the full benefits for regular plan G once the deductible is met. It is very likely that we won’t hit that deductible very often for the next 10-20 years, and when we do, I don’t see the expense of that amount ever equaling the cumulative monthly cost of any of the Advantage plans. I agree 100% with Clark about those. The HD-G plan is more of a wealth protection plan to me. Catastrophic illness or injury will be covered, and our retirement funds won’t be over-taxed by paying a couple thousand out of pocket on the rare occasions when that becomes necessary. The savings from years when it is not necessary should more than offset those costs.
I understand that many people are used to expensive plans (often paid for by employers) that cover things as they go, but I’ve had HDHP for several years and put the $20k/yr savings into our retirement funds, including an HSA to cover those future deductible needs…
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Good idea. I’m thinking the same for me, my wife has a large current medical spend so hers won’t be High Deductible.