Medicare - H E L P ! !

[mitch5252]

..
Sarah, what were the differences that made you choose Medicare Advantage over Original Medicare?

Here's a question I never thought of before now - once you choose either option (Advantage or Original), can you switch at open enrollment, or is it a choice to which you held forever?

..

[chalet05]

If you are traveling, you do not want an HMO. Arizona winter friends had to return to their home states for treatment.

Birdie is correct about the Zip Code. My original Advantage plan was not available in all Washington counties. LeRoy and I had the same plan, but his was much cheaper - even had the premium drop while my sky rocketed!

Mitch, I think you can switch from one type to the other - guess I'll be finding out.

[etexlady]

Typically you can only change your coverage during the annual Open Enrollment period but, yes, you can change from one plan to a different one. There are some situations which can trigger a "Special Enrollment Period" that allows a person to change their plan outside of the Open Enrollment period (an example is a person changes their residence to a location where their current plan is not available, etc.) People who qualify for the Low Income Subsidy (sometimes called "Extra Help" for those with very low income) can change their plan at any time.

[chalet05]

I have been researching - especially AARP. Being lazy here and instead of calling them, I wonder if Karen or JudyJB could answer. Does the plan completely cover annual visit, mammogram, bone density, colonoscopy? I assume they are all covered under diagnostic but want to be sure. This plan is about $50 more a month than what I have now. As far as I can see AARP has no maximum out of pocket? Thanks in advance!

[mitch5252]

I have been researching - especially AARP. Being lazy here and instead of calling them, I wonder if Karen or JudyJB could answer. Does the plan completely cover annual visit, mammogram, bone density, colonoscopy? I assume they are all covered under diagnostic but want to be sure. This plan is about $50 more a month than what I have now. As far as I can see AARP has no maximum out of pocket? Thanks in advance!

..
Wouldn't no max out-of-pocket be a deal breaker for you?
It would me...

I didn't read this all, but might give you an idea?

https://www.medicareinteractive.org/get-answers/medicare-covered-services/preventive-care-services/medicare-coverage-of-preventive-care-services

..

[chalet05]

Mitch, that out of pocket max is one of my big concerns - I've been doing just fine with my advantage plan plus I have 50% dental.

In 2003, for Steven's last medical, out-of-pocket was $2400! When I signed on for Medicare the plan was $3600, then $6400 and now $10,000!!

[JudyJB]

You really need to go to this UNited Healtcare site: https://info.aarpmedicareplans.com. You enter your zip code and then click the county, if the zip code covers more than one.

In my case, it gave me three advantage plans, nine Medicare Supplement plans, and three drug prescription plans. I next clicked on Medicare Supplement Plans. There are Plans A, B, C, D, etc. Rates run from $83 to $148 per month, but yours may be different, and remember that these costs are beyond what you pay for Original Medicare. It also gives you a very simple table of what is covered under each plan.

I chose Plan F because it pays 100% of everything in the U.S. and even 80% of foreign emergency care. It has paid every penny of annual visits, mammograms, bone density, colonoscopy, plus some serious tests and recent procedures ($25,000 worth). IN other words, I have absolutely NO out of pocket costs. BUT THAT DOES NOT MEAN EVERY PLAN THEY OFFER COVERS THOSE THINGS! So you really cannot be lazy ,and you do need to check.

I have had some major things happen to me in the past, like a $140,000 stay in the hospital 8 years ago for pancreatitis. I also have recently been diagnosed with something that will mean huge bills in the future. (Don't worry, I'm NOT dying anytime soon and don't expect this to affect my life expectancy!!!) My point is that I chose the most expensive plan that covers 100% of everything so I don't have to worry about medical bills. For me, the extra $60 per month is well worth it. But you have to look at your costs and make decisions based on your expectations and worry-rate, so please don't make your decision on what someone else has done.

However, I do not have any dental coverage at all.

I don't know what plan Steven has, but you need to find out what it was and how it is different from these offered by AARP/United Healthcare. I suspect he does not have a Medicare Part C supplemental plan, which is what United Healthcare is offering. Most Advantage Plans, however, do have out-of-pocket costs, to my understanding.

The cheapest way to get coverage is to get a Medicare Advantage Plan, but for those of us who travel and want a choice of where we get treatment, that is not possible. For example, if I had had an Advantage plan from Ohio, I could get emergency care anywhere, but would have had to return to Ohio to get annual medical exams, and routine tests such as colonoscopy, mammograms, and the hand surgery I had twice in the past two years. This way I can get it in Ohio and in California or wherever I decide to be when I get treatment. So you have to decide where you want to be able to get coverage.

[chalet05]

Thanks, Judy. Yes, that site is what I have been looking at and wanted to make sure I was reading everything completely. Having the information you gave about the basics is a big help.

As far as Steven, I wasn't clear - he is my late husband and was not on Medicare - just an illustration of how max out-of-pocket has changed in 13 years.

[Liz]

I have BCBS Plan F and also have no deductible or out of pocket costs. It is good anywhere in the US. However, I am fortunate because my husband's retirement plan pays half of the premiums which makes it more affordable.

[mitch5252]

I was looking into AARP Plan F plans and found that the site's quick comparison chart shows is NO benefit differences between Plan F and Plan Select F, except the Select F is $30 or so cheaper than Plan F.

Had to look into it further.

The difference is the NETWORK - Plan Select F has a limited network - it is NOT nationwide.

You can read about it here:

https://www.senior65.com/medicare/article/medigap-plan-f-vs-plan-f-select

I clicked on "APPLY" just to review the process and it shows that you MUST be a member of AARP. I am not. But I will be.