Medicare Supplemental Insurance

[+ Kufrol]

I will file for Medicare soon (I'll turn 65 in September), and despite all the (unsolicited) 'helpful' advice I've received via the phone on almost a daily basis, often several times during the day, I still don't know which supplemental insurance plan to buy. I don't have many prescriptions, but I want a program that could accommodate future prescriptions if that happens, and I want a plan that will cover any medical emergency wherever I travel. Thanks in advance for any suggestions you might have.

[+ pepa_e_mango]

you may want to get this..

Medicare Survival Guide® Advanced (Paperback) http://tonisays.com/index.php/product/medicare-survival-guide-advanced-paperback/

[+ Avalon]

I will file for Medicare soon (I'll turn 65 in September), and despite all the (unsolicited) 'helpful' advice I've received via the phone on almost a daily basis, often several times during the day, I still don't know which supplemental insurance plan to buy. I don't have many prescriptions, but I want a program that could accommodate future prescriptions if that happens, and I want a plan that will cover any medical emergency wherever I travel. Thanks in advance for any suggestions you might have.

 

For Medicare Part D Prescription Coverage I recommend United Health Care. And for mail order prescriptions I recommend Optum RX.

[wklucas]

For Medicare Part D Prescription Coverage I recommend United Health Care. And for mail order prescriptions I recommend Optum RX.

 

I've done a lot of research for both my parents & some other aging relatives.....with Original Medicare for a supplement I recommend a Plan F (or Plan G) with United Health Care - endorsed by aarp notwithstanding.....for a stand alone Part D Prescription Plan - Aetna Medicare Rx Saver - comprehensive formulary / low monthly premium / great service for either - pharmacy network or mail-order home delivery......Blue Cross / Anthem Supplemental plans also might be worth a look......depending on where one lives & a couple other factors, premium comparisons between UHC & BC might reveal the better choice while offering the same coverage.....generally speaking though, if one can afford it - Original Medicare + separate Supplemental + standalone Part D drug plan gives much more freedoms of choice & coverage than any combined Medicare Advantage plans.....or HMOs or PPOs if those still even exist.

[+ Billsboy4]

For supplemental, I recommend a Plan F from one of the insurers ....it pretty much covers everything for doctors and hospitals, that Medicare doesn't pay for (which is 80% and this covers the other 20%, so your out of pocket is 0). AARP recommends United Healthcare, I use Blue Shield, but it depends on which state you live in. You can also get a Medicare Advantage Plan, but it works more like an HMO and I like to choose my own doctors. Always use doctors that are Medicare participants. When I first started on Medicare, I tried to collect for a non-participating doctor.....forget it, they never approve it (I subsequently found out from my State's Insurance Commission, that I was wasting my time), therefore I always ask the doctor's office.

 

As far as Part D (prescription), I use Humana, which I found to have cheaper premiums than United Healthcare and have been happy with them. I don't have alot of prescriptions and have found them good for my needs. They participate with most of the national chains and have their own mail order.

 

Medicare makes all this stuff confusing and difficult to understand until you get the hang of it.

[+ Avalon]

United Health Care Part D Prescription Coverage current monthly premium is $94.50

 

Medicare Part D does have co-pays and the "donut hole".

[+ azdr0710]

if you're military and able to use USAA.....

 

https://www.usaa.com/inet/pages/insurance_medicare_supplement_insurance_standard?akredirect=true

 

would happily jump off a cliff if USAA told me to.....

[+ WilliamM]

I will file for Medicare soon (I'll turn 65 in September), and despite all the (unsolicited) 'helpful' advice I've received via the phone on almost a daily basis, often several times during the day, I still don't know which supplemental insurance plan to buy. I don't have many prescriptions, but I want a program that could accommodate future prescriptions if that happens, and I want a plan that will cover any medical emergency wherever I travel. Thanks in advance for any suggestions you might have.

 

I received a lot of advice too, but only you can make the decision that works for your needs,

[Rudynate]

United Health Care Part D Prescription Coverage current monthly premium is $94.50

 

Medicare Part D does have co-pays and the "donut hole".

 

And if your prescription drugs cost more than a few thousand dollars per year, which is common place in today's market, you WILL encounter the donut hole. I stay out of the donut hole by buying most of my prescription drugs off shore.

[+ sync]

I went with United Health Care's plan F, which is pricey, but I decided the peace-of-mind it gives me is worth the budgeting. I've been in the plan since 2014 and no complaints concerning prescriptions or regular doctor's visits. Thankfully, I have not yet had to deal with any hospital charges.

Edited June 4, 2018 by sync

[+ Funguy]

I have United Health Care, F, also.

Because of my chemo I have already been in and now out of the donut hole. Now down to $750 a month for my copay.

 

I will be looking at other plans closer to end of the year to see if it is a bit less for the 1 med I really need. It's Tier 5 I think so nothing may help.

[Rudynate]

I have United Health Care, F, also.

Because of my chemo I have already been in and now out of the donut hole. Now down to $750 a month for my copay.

 

I will be looking at other plans closer to end of the year to see if it is a bit less for the 1 med I really need. It's Tier 5 I think so nothing may help.

 

 

There's so much at stake that you're stuck.

[+ Kufrol]

Thanks for the replies; they've all enlightened me as I sort through the perplexities of insurance (I'm covered via a COBRA arrangement until I turn 65). I guess the plan I want, one that will pay for any and all services or expenses not covered by Medicare, doesn't exist. I hadn't heard of the donut hole until reading these posts. I'm glad my deadline is three months away.

[+ Avalon]

Thanks for the replies; they've all enlightened me as I sort through the perplexities of insurance (I'm covered via a COBRA arrangement until I turn 65). I guess the plan I want, one that will pay for any and all services or expenses not covered by Medicare, doesn't exist. I hadn't heard of the donut hole until reading these posts. I'm glad my deadline is three months away.

 

And that donut hole is based upon the actual price of the prescription and not the co-pay. If a person has expensive meds they can reach the donut hole quickly.

 

Obamacare did a lot of good like allowing coverage without regard to pre-existing conditions but I wish that it had done away with the donut hole!

[+ tassojunior]

...or HMOs or PPOs if those still even exist.

 

I'm in Kaiser so they very much exist. Kaiser is only in California and a few other parts of the country. Everyone praises Kaiser (and they get the best reviews), until they're in it. Then you end up constantly complaining about it. I have no other Medicare reference to compare it to. I guess my Part D is through Kaiser also. With Kaiser you don't have to make choices or decisions. There are none. I've been in HMO's for 40 years so it would be scary to switch.

 

Isn't the donut hole supposed to go away? I don't know if I have one in Kaiser since I have few meds.

[+ Kufrol]

I belonged to Kaiser when I worked in Oregon and have friends who have their supplemental insurance. They've experienced no hassles as Washington (state) residents who have had minor and somewhat major out of state emergencies, using non Kaiser facilities and physicians ... I'd go with them if I could.

[+ Funguy]

My experience overall with Medicare has been A+. I have only paid my yearly deductible of $100 and no more.

 

My only problem has been Rx chemo - $3300 the first month put me into and out of the donut hole in one fell swoop! Now my copay is 750 per month and I will be screening the plans specifically for this medication. Unfortunately, it is what it is.

 

Otherwise, goodrx.com can save a lot of mo

[+ Avalon]

This says that the donut hole is going away

 

https://www.aarp.org/health/medicare-qa-tool/does-the-doughnut-hole-go-away/

[+ tassojunior]

I belonged to Kaiser when I worked in Oregon and have friends who have their supplemental insurance. They've experienced no hassles as Washington (state) residents who have had minor and somewhat major out of state emergencies, using non Kaiser facilities and physicians ... I'd go with them if I could.

 

 

 

Ive been in HMOs for 40 years....3 of them....they're all kind of the same. You do get rushed through visits and the clinics are big and full.

Edited June 4, 2018 by tassojunior

[craigville beach]

I live in Mass and have Tufts Medicare . the only problem I have had is I usually hit the doughnut hole about September of every year.

[+ Pensant]

For Medicare Part D Prescription Coverage I recommend United Health Care. And for mail order prescriptions I recommend Optum RX.

UHC and OptumRx are part of the same company.

[+ newatthis]

I will file for Medicare soon (I'll turn 65 in September), and despite all the (unsolicited) 'helpful' advice I've received via the phone on almost a daily basis, often several times during the day, I still don't know which supplemental insurance plan to buy. I don't have many prescriptions, but I want a program that could accommodate future prescriptions if that happens, and I want a plan that will cover any medical emergency wherever I travel. Thanks in advance for any suggestions you might have.

Assuming you do traditional medicare + a Part B supplement ("medigap") + a drug plan ("Part D"), there are some important points which may reduce your anxiety.

 

1. For Part D (drugs), medicare has a personalized search at https://www.medicare.gov/find-a-plan/questions/home.aspx?AspxAutoDetectCookieSupport=1 which allows you to input the medications you currently use and then spits out a list of plans in your area sorted by lowest total annual cost. This can and should be done every year during open enrollment, since the drug plans change. In my case, my standard meds are all tier 1 generics and my plan, which costs about $17/month, covers them free of any charge. Of course, this helps only with the drugs you already take.

 

The interface is a little clunky, but well worth the time to learn to use it.

 

2. All medigap policies come in standard packages (A, B, ...., G) and all plans with the same letter designation have exactly the same benefits no matter who the insurer is. The most comprehensive is "F"; "G" is the same as "F" except you have to cover the yearly Part B deductible (currently around $180) out of pocket. In the plans I looked at, the annual premium difference between "F" and "G" was more than the deductible, so I went with "G".

 

Your choice of insurer thus comes down to how financially solid the insurer is and the quality of their customer service. See #3.

 

3. You are guaranteed acceptance into a medigap plan without a physical exam only in the first 6 months of eligibility; you are locked into your choice after that (I'm glossing over some exceptions and details here). I found that frightening. In the end, I worked with an insurance broker (they are paid by the companies, not you) who was very knowledgeable about the various companies. Most importantly, he knew that in my area, Blue Cross/Blue Shield (one of the most expensive plans) had guaranteed acceptance, period, which meant I could always switch to them if my first choice didn't work out. So I went with the cheapest medigap plan offered by a financially stable company and so far they've been fine.

 

4. Finding a good insurance broker might not be so easy, but it's worth the search -- they also handle all of the paperwork for you. I found mine through recommendations from friends. I did cold call a few I found online, but my initial interactions with those did not inspire confidence.

[Rudynate]

There's an important "gotcha" with the premiums- they're means-based, so if you are on Medicare and still working, you may have to pay a higher premium. I feel like I'm paying three times for Medicare-I've been paying into it for my entire life, a portion of my self-employment tax goes to medicare and I pay an increased monthly premium because of my income.

Edited June 4, 2018 by Rudynate

[JayCeeKy]

Newatthis has some excellent advice.

 

As "newatthis" has stated, the Medicare Part B deductible is $183 and the difference in premiums for Plan F (which has no deductible) is greater than just paying the deductible of Plan G (which does not cover the $183 deductible). That is why I have Plan G.

 

I went to a private Insurance broker and purchased a policy from a company that you have never heard of but is highly rated by Consumer Reports and by a cursory review of online comments. I have only had a couple of instances of using my Medicare Supplement and have had no problems with this company.

 

One consideration in getting a Medicare Supplement is that there are three ways in which the premiums are figured: 1)Community Rated; 2)Issue-Age policy; 3)Attained-Age policy. My policy is "Community Rated" which means that I pay a higher rate (everyone in the plan pays the same rate regardless of age) but will not see drastic increases as I get older. You could get a policy that is "Attained Age" which would be lower initially but would see much higher rates as you age.

 

For a good explanation of these three ways in which premiums are set see:

 

https://www.medicare.gov/find-a-plan/staticpages/learn/how-insurance-companies-price-policies.aspx?AspxAutoDetectCookieSupport=1

[wklucas]

2. All medigap policies come in standard packages (A, B, ...., G) and all plans with the same letter designation have exactly the same benefits no matter who the insurer is. The most comprehensive is "F"; "G" is the same as "F" except you have to cover the yearly Part B deductible (currently around $180) out of pocket. In the plans I looked at, the annual premium difference between "F" and "G" was more than the deductible, so I went with "G".

 

There's also some other "wrinkle" coming possibly in 2020, I think - something about the insurers are going to stop offering supplemental Plan "F" to new enrollees......folks already with "F" can keep it but because of no more new enrollees entering that plan, monthly premiums might skyrocket.....for that reason alone, many are simply now signing with Plan "G" first or switching over from "F" into "G" if that's an available option with their carrier / in their area.....like I said, I have my parents & other relatives with "F" for now.....I've simply been too lazy or don't care about a premium increase enough yet to have taken some action & consider recommending to them to change from one to the other.....before this change kicks in though, the total costs to the insured (patient) between "F" (having the deductible covered) & "G" (paying the deductible but with lower premium) - that difference albeit still beneficial with "G" should have been relatively minimal.....

 

& also for Part D, I recommended Aetna RX Saver plan....good formulary / good premiums.....but selecting an actual plan can get more complicated / involved than just those 2 factors.....every individual needs to look at a plan's co-pay structure.....for current meds, easy to incorporate into one's calculations....if new meds are initiated during any calendar year, a new evaluation of one's plan might need to be done & might mean changing plans.