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Conversationalist ⭐
September 23, 2026

Are large Group Medicare Advantage plans generally superior to individua MA plans?

  • September 23, 2026
  • 5 replies
  • 48 views

Since the day I learned that my Medigap Plan G premiums were going up 35% in 2027, I’ve been obsessing about Plan G vs. HD-G and running “the numbers” for best case vs. worse cases scenarios. Somethings been nagging me: While I love obsessing about insurance and wouldn’t mind the paperwork associated with the HD-G, my dear wife has absolutely no interest or patience in tracking provider visits, charges, Medicaid allowable charges, deductibles, etc.  Meanwhile I am eligible for a zero-premium large group Medicare Advantage plan from my former employer, the State of North Carolina. And if I added my wife (with a premium of $68) and predeceased her, she could continue at the spousal rate forever - worry free. What a gift that would be. (Ever heard “Don’t let better be the enemy of good?” Reports I’ve gotten from former colleagues suggest that our group plan may be better than individual M.A. plans available to the general public. I would love to hear about your experience.

5 replies

Community Champion ⭐
September 25, 2026

To be fair, Advantage plans are similar to employer-provided plans, which are the gold standard for people under 65.  In fact, that’s a selling point--you’ve had at-least-somewhat managed care for your whole life, and this is just more of it.

I assume the reason employer-provided retiree plans might be be richer than Advantage plans available to the public is that they’re trying to continue coverage similar to what the retirees had when employed.  

To be honest, I’m kind of glad my choices are somewhat limited.  A health plan for retired state employees is probably pretty darn good, but it’s not going to be unfettered like Original Medicare.  I’m actually glad I don’t have it in my decision matrix.  Because also, it might be great right now, but that’s no guarantee of what it will be like in the future.

FWIW, I’m like your wife.  I detest dealing with any medical billing.  I’ve posted before about a check for over $100 Medicare sent me last year.  I read all the footnotes and looked at all the numbers and still have no idea why I got it.  It came after I’d satisfied my Part B deductible of $257, but I ended up being out of pocket only about $150 because of that check.  This sort of thing drives me crazy, even when it’s in my favor.  Because this one is in my favor, but what about other ones?  

So far, paying the Plan G premium doesn’t affect my lifestyle.  It hurts, especially because I’m 5 years into Medicare and have had almost no claims.  Usage wise, I’m a perfect candidate for a high-deductible plan.  But temperament wise?  I would suffer.  I could deal with it if it becomes necessary, just as I could deal with an Advantage plan if that were my only option.  In the meantime, I view my Plan G as an investment in my mental health, and thank my lucky stars I can swing it, so far.

ETA:  Ultimately, what type of over-65 medical plan to get is extremely individualized, so we all just have to figure out our own best course of action.  I find that incredibly annoying, and almost cruel.  But it’s what we’ve got.

 

 

Conversationalist ⭐
September 25, 2026

After further reconsideration, I’m sticking with my plan to go with a HD-G plan starting 1/1/2027. Group MA plans may be better than regular MA plans but in the end, they’re all STINKING MA plans.

Community Champion ⭐
September 24, 2026

I don’t have any personal experience, but I read a lot about Medicare.  The general consensus is that Advantage plans through employers are often better than the ones available to the general public.  To the point that even people who are generally anti-Advantage say it could be a good choice, depending on the specifics of the plan.

Conversationalist ⭐
September 24, 2026

Thanks for sharing your observations. From reading your previous comments, I know your thoughts matter.

Community Champion ⭐
September 24, 2026

Well that’s a very nice thing to say.  Although your zeal for dealing with medical billing makes me think there’s something seriously wrong with you. 😀