So, someone flagged 1poorlady about Medicare Part C. Not that we’re eligible yet, but 1poormom is on Medicare and has dental issues (i.e. bad teeth, but she still has the teeth). She was told Part C covers it. Mom was already on Medicare before she got dementia, and just had A and B. So I never really thought about it. Looking up Part C, it appears to be where you can get “Medicare Advantage” policies. I’ve been warned seven ways from Sunday to avoid Medicare Advantage plans because they generally cost more, and are more restricted, than traditional A and B with a medi-gap policy.
Just thought I would re-verify that this is generally the case. It’s just a money-maker at the expense of the senior citizen, yes?
Asked this on the Discord, but didn’t get any nibbles.
TIA,
1poorguy
1poorguy,
It’s just a money-maker at the expense of the senior citizen, yes?
Yes. I’ve learned on TMF that Advantage puts more money in the pockets of the insurance co than helps most people. Everyone is different, of course, but Medicare Advantage is A LOT of insurance that you pay for whether you use it or not.
If you have the ability to pay for some of these procedures out of pocket, then you can save yourself the Advantage costs.
I recently signed up for Medicare and chose Parts A and B with MEDEX Core as a supplement. This caps my out of pocket expenses across hospitals and doctor office services. I pay for the dentist, eye exams, and other smaller costs - like prescriptions.
Hope this helps,
'38Packard
Most Medicare Advantage plans have annual limits on how much they provide for dental care. Maybe over 1000 bucks a year but not too much more. Routine cleanings, x-rays now and then, etc.
If you are thinking of going that route, check real carefully each plan, the doctors offered, how large the network is, whether they provide for ‘nursing home’ care if needed and how much and what percent, the meds covered and co-pays, the services provided and co-pays.
Medicare Advantage is like Hotel California. You can easily check it. If you have serious medical issues - you can’t check out. You are stuck in a Medicare Advantage Plan. (You likely have to take physical and complete analysis of healthcare spending before anyone will take you back to regular Medicare.)
I’ll stick with Medicare. I can choose by doc, actually 3 of them - GP, Heart guy, ear guy, and dentist…
Now where my GP is (large group) they will only take Medicare Advantage for those turning 65. I got in as ‘legacy patient’ when they decided to do that. That restricts you to THEIR heart doc, ear doc, etc.
Not all MA plans include dental.
t
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It does. Thanks.
Which plan did you sign up for? I understand the “G” plan is no longer available (and was supposed to be the best). I think “F” is supposed to be the best available now?
1poorguy
I switched to AARP United Heathcare Medicare advantage last year. Saving abt $2k per year compared to Medicare A, B, D. Dental care, glasses, hearing aids included. Plus $300+/yr in otc expenses. Much lower premiums. All my doctors and hospitals in plan. Drug coverage has no deductible and reasonable copays.
So far satisfied with the plan.
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My MAPD plan has no monthly premium and guaranteed issue if I move to a supplement since I’ve been with the company 24 months. Includes dental.
5
I understand the “G” plan is no longer available (and was supposed to be the best). I think “F” is supposed to be the best available now?
I think it’s the other way around, “F” is no longer available and “G” is the best plan.
We went with traditional Medicare part B and a “F” supplemental and are very happy. Everyone takes us as patients, and since we travel, we’ve had service in at least 4 states.
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DW and I have a separate dental policy through Mutual of Omaha -pricey at $96/month for the
two of us but she has dental issues that made us go for some added coverage. I have used
the insurance coverage for broken tooth repair and the service helped - covering about 50%
of my dentist charges. Mostly the service covers cleaning twice a year and some of the
regular dental work.
Advantage plans may be worth while if your doctors are in the plans and the remainder of the
specialists are in the plan and if you do not travel much. All things in life have advantages
and disadvantages. Also, everything costs money. Everyone gets upset about insurance costs
but like the service and help when the plans work well. Everyone has their own circumstance
that determines what is “best” - and generally it is not what everyone tells you they
are happy with.
Howie52
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PG WroteWhich plan did you sign up for? I understand the “G” plan is no longer available (and was supposed to be the best). I think “F” is supposed to be the best available now?
G is available in Georgia and has the distinction of being both the the most expensive and the least expensive! We have two versions of G. One is just the normal G plan - I assume what the other 49 states have. But if one asks persistently the call center people will get off their backsides and read. By taking a 15 or 20 minute recorded health interview one can get those same G benefits but at a much lower premium. This is something the Georgia Insurance Commission negotiated at least with the AARP/United Healthcare group. They exclude people for many high cost related behaviors and conditions - things like smoking, coronary artery disease, cancer, etc.
My wife has that plan. I asked and was denied because I got one of those heart X-rays and they found some calcium in an artery. I was not aware of the x-ray results and said “no” to the coronary artery disease question. The investigation of my health turned up that excluding condition a few days after the phone interview.
An example of the kinds of things many people do not think through is demonstrated with plan N. Plan N has exactly the same coverage as G, but includes co-pays. $10 for your PCP and $20 for specialists - cardiologist, ophthalmologist, etc. I assume 50% of my visits to my PCP and 50% at the higher co-pay. I would need to double my number of doctor visits to make the plan N total costs equal plan G.
Many supplemental plans have additional monthly premiums to your Medicare fee which is usually deducted from your Social Security check.
Most Medicare advantage plans have no additional fees.
Of course large national plans with in network services everywhere are better than small regional plans. This matters if you travel or spend time in other states.
International coverage might be something to look into.
GWPotter posts,
<<PG WroteWhich plan did you sign up for? I understand the “G” plan is no longer available (and was supposed to be the best). I think “F” is supposed to be the best available now?>>
G is available in Georgia and has the distinction of being both the the most expensive and the least expensive! We have two versions of G. One is just the normal G plan - I assume what the other 49 states have. But if one asks persistently the call center people will get off their backsides and read. By taking a 15 or 20 minute recorded health interview one can get those same G benefits but at a much lower premium. This is something the Georgia Insurance Commission negotiated at least with the AARP/United Healthcare group. They exclude people for many high cost related behaviors and conditions - things like smoking, coronary artery disease, cancer, etc.
My wife has that plan. I asked and was denied because I got one of those heart X-rays and they found some calcium in an artery. I was not aware of the x-ray results and said “no” to the coronary artery disease question. The investigation of my health turned up that excluding condition a few days after the phone interview.
An example of the kinds of things many people do not think through is demonstrated with plan N. Plan N has exactly the same coverage as G, but includes co-pays. $10 for your PCP and $20 for specialists - cardiologist, ophthalmologist, etc. I assume 50% of my visits to my PCP and 50% at the higher co-pay. I would need to double my number of doctor visits to make the plan N total costs equal plan G.
Here on Washington State, I’m paying $44/month for a high-deductible Plan G – that’s $44/month whether you’re age 65 or 105.
I just looked at the Georgia Insurance Commissioner’s website. It looks like premiums vary with age (higher as you get older.)
Also, plan N benefits are fixed nationwide by Federal law. If AARP/United Healthcare told you they negotiated some kind of “special deal” with the State of Georgia on plan N, they’re lying to you.
intercst
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I concur w/JonathanRoth. Have had the same plans since 2011 & very happy too. ~$40,000 lithotripsy, w/overnite hospital stay. My portion $0.0… and saw no other bills related (be it doctor, anesthesia, floor sweeper, etc) either. But, the current closest equivalent would be Supp Plan G.
I have had traditional medicare plus supplement “F” since 2009. I can’t remember the last time I saw a medical bill, and that includes any doctor I go to, multiple surgeries, lots of rehab, ER visits, etc. I also have a separate prescription drug plan which is very low cost.
This plan is no longer offered, but plan “G” is a close cousin.
This is not be the lowest insurance, but IMO, the most comprehensive. I can’t remember any longer if the premium always increases every year, but It does after a certain age. It also varies by zip code.
Regardless of which plan you take, keep track of all the mileage for all medical related visits, as well as the portion paid via Social Security or supplement or whatever you pay for drugs, vision, dental, etc. You may be able to use this for itemized deduction on your taxes.
Just clearing up something I have seen posted several times in this thread. You can still get Plan F under certain conditions. I became eligible for medicare in 2016 and will get Plan F when I eventually get off my group plan.
https://eligibility.com/medicare/supplement-plans/medigap-pl…
Medigap Plan F will have limited availability. Beginning in 2020, Plans F and C, which cover the Part B deductible, are no longer available to people newly eligible to Medicare after January 1, 2020. If you became eligible for Medicare in 2019 or earlier, however, you can still enroll in Plan F in 2020 and beyond.
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Just thought I would re-verify that this is generally the case. It’s just a money-maker at the expense of the senior citizen, yes?
No, just at the expense of the citizens.
The Fed subsidized Advantage to make it cheaper than traditional Medicare Supplement plans. That makes it more profitable for the insurance companies, but not more expensive for the seniors that use those plans.
You can have more coverage with an advantage plan than a normal supplement, but there are trade-offs with that expanded coverage such as a much smaller network.
https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medica…