I'm going to be 65 in Sept and I spent the day looking at medicare

[napi21]

supplemental ins. Do any of you have any info on your experiences with them? Geezz, there's catagories A thru L, Advantage plans, Fee for Service plans...my mind is spinning!

What did you do and why?

[Cleita]

1. I found out the hard way, don't do the privatized plans like Secure Horizons

where you sign off your Medicare benefits to them. Yes they promise you this wonderful coverage and drug benefits but the fact is that they underpay the providers, pay them late and most doctors don't take them except the desperate ones. Also, you are limited to the providers they approve and this is the killer they don't pay if you are out of the area they service and need ER care. They tell you that they do but unless you jump through their hoops you don't get reimbursed.

I get traditional Medicare part A with no premium and Part B with a premium deducted from my SS. I have a co-plan of private insurance that pays for what Medicare doesn't. I opted for AARP. They are the most reliable although, I don't like them much, but they come through. They have to take you and can't drop you even if you have a chronic condition. The co insurance gets more expensive as you get older, but you can see the doctor of your choice and your medical expenses are paid 100 percent except a $100 deductible every year. It doesn't pay for pills but Medicare part D is supposed to, however, I haven't figured out how this benefits anyone but the pharmaceutical companies.

On edit I forgot to tell you that most social workers recommend F for the copay insurance.

[Suich]

2. Try SHIBA.

http://www.doi.idaho.gov/shiba/help.aspx

They were a huge help to me...good luck!

[shraby]

3. We went with local agent

and got their supplemental coverage. It pays what medicare doesn't, no co-pay, no restrictions, no worries. If we ever have a problem, the agent is right here in town and we can go in and talk directly. No phone menus to wade through. So far we've had no problems.

[grasswire]

4. look into Medigap.

The provisions are spelled out by federal law; you know what you are getting; every Medigap F has the same provisions and exclusions no matter who you buy it from, whether it's BCBS or any other entity. You will get a comparative chart in the Medicare materials.

By contrast, the "advantage" plans may have provisions you do not expect or like. In studying those on behalf of a family member, I found some of them to be generally useless. They sound better than they are, and are heavily marketed to seniors.

Timing is important. In the first six months after eligibility begins, you MUST be accepted for a Medigap plan if that's what you choose. They cannot turn you down.

If you have been carrying health insurance, I don't believe any of that pre-existing condition crap comes into play. If you haven't, there may be a waiting period before benefits for a pre-existing on your supplemental, but again with Medigap it is regulated by federal law.

I urge you to study the Medigap plans. My family member chose Blue Cross Blue Shield supplemental Medigap and pays $175 per month for plan F. Example: an ER trip was billed out at nearly $4,000. She owed only $36 out of pocket for it after everything paid. Someone else here on DU said her hubby had brain surgery and paid nearly nothing, using Plan F Medigap.

[grasswire]

5. I should add...

...that part D is not a value for some people. My family member's meds are only $23 per month. It would make no sense to pay a part D premium. Injectable meds and IV meds are covered under Medicare itself.

[napi21]

6. I had to get suplemental Part D last year for y husband. He is still

working until I reached the medicare eligible age, but his drug plan at work was "noncorming" (I think that's the term they used! It's not too bad though. $16.12 per month. It seems to be worth it because he's on Lipitor, and 4 other meds. I'm fortunate that I don't take any meds, so I'm debating wether to spend the $16/mo for me.

I've been debating about going with Plan J which covers all the deductibles and things that Medicare doesn't pay. It's $171/mo and that's a BIG chunk out of our SS check! I saw several people here suggested Plan F and it would be $158.75/mo. Still a lot of $$, but I'll have to check the difference between the two plans.

Thank you all so much!

I was sceptical of those fee for service plans. Something just felt weird to me!

[grasswire]

7. it IS a lot of money for a SS recipient

It's a huge chunk for my family member. But the alternative is pretty scary; just one minor illness or ER trip can eat up what a whole year of premiums would cost and of course if there's a major problem the coverage is priceless. The peace of mind of knowing the coverage is there is worth something every month.

[napi21]

8. You're right of course., Two years ago I broke my ankle, and even

though we have good ins. through BCBS, our out of pocket expenses were $2,700! They make that 80%/20% sound like such a great deal...then you find out what it REALLY is like when you have to use the ins!

[Cleita]

9. It does take a chunk of your income but is worth it when you run

into unexpected expenses like getting MRIs.

[Alameda]

10. anyone have ideas about Kaiser Senior Advantage?

[Alameda]

12. I'd like to know about that too.

[trof]

11. I have United Healthcare through AARP.

Option 'F', I think.
I think it's around $35-$40 per month.
I'm not home now and don't have records available.