OT: Medicare Advantage

[atab]

I will (most probably) be joining medicare starting 2020 and now is the enrolling time. I am researching on Medicare Advantage plans. I don't have medical problems other than sleep apnea and Barrett's Esophagus which requires an endoscopy once every two years. Currently I don't take any prescription medications. I know there are people who are experienced medicare subscribers here. Can someone please advise on selecting a plan?

atab

[Okie bipap]

Have you turned 65 yet, or are you going to turn 65 next year. If you are not 65 yet, you do not need to make a choice at this time, but it doesn't hurt to start thinking about the various plans. Medicare advantage plans vary greatly depending on where you live. Plans offered by companies vary from state to state, or even with a state.

[atab]

Have you turned 65 yet, or are you going to turn 65 next year. If you are not 65 yet, you do not need to make a choice at this time, but it doesn't hurt to start thinking about the various plans. Medicare advantage plans vary greatly depending on where you live. Plans offered by companies vary from state to state, or even with a state.

Thanks for the response. I am 69. Still working. So far had employer's medical insurance. Switching to Medicare in case I decide to retire next year. I live in Connecticut.

[Pugsy]

You will need to check the plans available in your area because plans can vary state by state and even county by county within a state.
Medicare Advantage plans will usually follow what Medicare does but not always 100%.
Like my Advantage plan no longer follows the 13 month capped rental for a cpap machine like Medicare does.
Mine is a perpetual monthly rental and of course I don't want to be paying 20% forever for a machine. They won't ever be buying me a machine with that copay.

The Evidence of Coverage is usually available online for most of the Advantage plans so pick out the ones that look interesting to you in your county and compare the pros and cons with each. There are regular Advantage plans and HMO Advantage plans and PPO Advantage plans.....compare them and figure out which one makes more sense for your situation.

And remember...if you end up with a plan you don't like you can always change to something else next open enrollment period.
We changed my mom's last fall...she was paying $49 a month for her plan and her prescription drug coverage wasn't so great. One medication was costing her nearly $50 a month and the others were $9 a month....and with the change there is no monthly cost to her and the expensive medication now costs her $6 a month and the others are now $3.....and her potential total out of pocket is less than with her old plan.
Win win for her. I changed to same plan last year too but because the facility co pay fees were less and I didn't have to have a 3 week wait to have a procedure done. That was the real driving force behind my change...I was having some procedures done as an out patient and having to wait 3 weeks. Annoyed the hell out of me. Medicare didn't require the wait...just that particular advantage plan rule.

They don't always follow Medicare's guidelines. That can be a pro and a con.

[chunkyfrog]

We take advantage of the free senior insurance consultation--EVERY FALL.
In my state, it is SHIIP.
First timers can go in any time, even though renewal time is in the fall.
They will compare plans available in your area, along with your current medications.
Sometimes, delaying medicare will cost you penalties.

[Okie bipap]

I am 69. Still working. So far had employer's medical insurance. Switching to Medicare in case I decide to retire next year.

I worked until I was 71, but started my Medicare at age 65. I had to start Medicare in order for my Tricare for Life to kick in. Prior to that, I was using regular Tricare with a Tricare supplement that only cost me $120 a month instead of paying $400 a month for medical insurance through the company.

[SDBud]

Have you turned 65 yet, or are you going to turn 65 next year. If you are not 65 yet, you do not need to make a choice at this time, but it doesn't hurt to start thinking about the various plans. Medicare advantage plans vary greatly depending on where you live. Plans offered by companies vary from state to state, or even with a state.

Thanks for the response. I am 69. Still working. So far had employer's medical insurance. Switching to Medicare in case I decide to retire next year. I live in Connecticut.

If you DIDN'T enroll in Medicare when you turned 65, you'll have to pay 10% more for each year you waited. Cost is now already over $100 a month at 65.

But you need to research YOUR State, each is different. Here in California, the basic Advantage plans are free and offer lots of things
you don't usually get otherwise.

[atab]

You will need to check the plans available in your area because plans can vary state by state and even county by county within a state.
Medicare Advantage plans will usually follow what Medicare does but not always 100%.
Like my Advantage plan no longer follows the 13 month capped rental for a cpap machine like Medicare does.
Mine is a perpetual monthly rental and of course I don't want to be paying 20% forever for a machine. They won't ever be buying me a machine with that copay.

The Evidence of Coverage is usually available online for most of the Advantage plans so pick out the ones that look interesting to you in your county and compare the pros and cons with each. There are regular Advantage plans and HMO Advantage plans and PPO Advantage plans.....compare them and figure out which one makes more sense for your situation.

And remember...if you end up with a plan you don't like you can always change to something else next open enrollment period.
We changed my mom's last fall...she was paying $49 a month for her plan and her prescription drug coverage wasn't so great. One medication was costing her nearly $50 a month and the others were $9 a month....and with the change there is no monthly cost to her and the expensive medication now costs her $6 a month and the others are now $3.....and her potential total out of pocket is less than with her old plan.
Win win for her. I changed to same plan last year too but because the facility co pay fees were less and I didn't have to have a 3 week wait to have a procedure done. That was the real driving force behind my change...I was having some procedures done as an out patient and having to wait 3 weeks. Annoyed the hell out of me. Medicare didn't require the wait...just that particular advantage plan rule.

They don't always follow Medicare's guidelines. That can be a pro and a con.

Thanks you very much, Pugsy for advise. Very useful. I was actually trying to compare plans offered on my county. They are somewhat confusing. Plans that charge more seem to have less benefits. It is a relief to know that we can switch every year. I was am considering taking straight Medicare (without advantage) for the first year. Then again there are MediGap plans. You have to get those the first time. Otherwise, they can increase premium/deny if you get sick later on.

atab

[atab]

We take advantage of the free senior insurance consultation--EVERY FALL.
In my state, it is SHIIP.
First timers can go in any time, even though renewal time is in the fall.
They will compare plans available in your area, along with your current medications.
Sometimes, delaying medicare will cost you penalties.

Thank you ChunkyFrog. Good point: I will find out whether there is a consultant in Connecticut and call them to get a clear idea.

Atab

[atab]

Have you turned 65 yet, or are you going to turn 65 next year. If you are not 65 yet, you do not need to make a choice at this time, but it doesn't hurt to start thinking about the various plans. Medicare advantage plans vary greatly depending on where you live. Plans offered by companies vary from state to state, or even with a state.

Thanks for the response. I am 69. Still working. So far had employer's medical insurance. Switching to Medicare in case I decide to retire next year. I live in Connecticut.

If you DIDN'T enroll in Medicare when you turned 65, you'll have to pay 10% more for each year you waited. Cost is now already over $100 a month at 65.

But you need to research YOUR State, each is different. Here in California, the basic Advantage plans are free and offer lots of things
you don't usually get otherwise.

Thanks SDBud. The fine applies if you did not have employer insurance after 65. I did.

Atab

[bwexler]

Here in Southern California many Advantage plans put on presentations touting how wonderful they are.
Some agents present multiple plans they represent.
The local medical center brings in a group of agents to present how wonderful the various plans are.
I attend several of these meetings each year and then I build a spreadsheet where I guesstimate how many doctor visits and procedures I might have in the coming year and my prescriptions.
I compute the total cost for each company.
Since I am relatively healthy, some plans wind up under a few hundred dollars for the year and others are over a thousand. At that point it only takes a few more seconds to choose the best and rule out the rest.
It is necessary to do this every year, because the best last year may be among the worst this year.

[atab]

Here in Southern California many Advantage plans put on presentations touting how wonderful they are.
Some agents present multiple plans they represent.
The local medical center brings in a group of agents to present how wonderful the various plans are.
I attend several of these meetings each year and then I build a spreadsheet where I guesstimate how many doctor visits and procedures I might have in the coming year and my prescriptions.
I compute the total cost for each company.
Since I am relatively healthy, some plans wind up under a few hundred dollars for the year and others are over a thousand. At that point it only takes a few more seconds to choose the best and rule out the rest.
It is necessary to do this every year, because the best last year may be among the worst this year.

The problem with this approach is time. I am still working and quite busy. I have an impression that these presentations contain 90% marketing fluff and 10% facts. Time-wise, it is rather expensive way to get this information. When I retire, this will be a good way to do it. I am in the process of collecting parameters of each plan on a spread-sheet. But there are many differing factors and a direct comparison is impossible. There are also difficult to quantify parameters such as customer support, available doctors/facilities.

Atab

[SDBud]

Have you turned 65 yet, or are you going to turn 65 next year. If you are not 65 yet, you do not need to make a choice at this time, but it doesn't hurt to start thinking about the various plans. Medicare advantage plans vary greatly depending on where you live. Plans offered by companies vary from state to state, or even with a state.

Thanks for the response. I am 69. Still working. So far had employer's medical insurance. Switching to Medicare in case I decide to retire next year. I live in Connecticut.

If you DIDN'T enroll in Medicare when you turned 65, you'll have to pay 10% more for each year you waited. Cost is now already over $100 a month at 65.

But you need to research YOUR State, each is different. Here in California, the basic Advantage plans are free and offer lots of things
you don't usually get otherwise.

Thanks SDBud. The fine applies if you did not have employer insurance after 65. I did.

Atab

I'm covered by the VA, but that apparently doesn't count for Medicare. SO I skipped Medicare.

Worked out fine for me, so far.

[katebrownell86]

I want to take medicare advantages. How to start or join?

[atab]

I want to take medicare advantages. How to start or join?

If you are already on Medicare or you are starting at age 65, now (until Dec 7) is the enrollment period. Go to the website medicare.gov. There, after providing your zip code, you can find all the Medicare Advantage plans available to you. Comparing is tricky. That is why I asked this community for guidance. Make sure your doctors and hospitals are included in the plan you select.

Atab