@jimbohretired wrote:
Wondering if u all are being hit by significant increases in medical premiums and if so have you considered switching to any of the advantage programs.
We have Medicare as our primary and United as our secondary. We both are seeing about a 20% increase in costs this year.
Also our long term care insurance increased approximately 65% this year with my premium going from about $1850 to $3100. WOW
Our secondary hospital / Doctor increased approximated 20%. Our overall medical premiums including medicare is now over $9000 a year. With my long term care insurance total out of pocket is over $12000 per year not includind our out of pocket for medical/medication copays.
Anyhow would be interested in hearing from those using medical advantage
plans - are u satisfied with your care as pricing is significantly less.
The one concern I would have is qualtiy of care if one of us has a significant medical issue. As an example, my wife has had a kidney transplant at the Mayo which would not have been covered aat that facility with an advantage plan.
Anyhow am interested in any input u have.
Medigap cost can vary greatly and from year to year depending
LTC insurance plans are also subject to increases based on many factors depending upon your policy details. Age, coverage amounts, amounts being paid out of the total plan. Insurers have actually found that LTC policies are not a good product for them so many insurers are writing no new policies,
A Medicare Advantage plan covers the same benefits as Medicare BUT IN A DIFFERENT WAY.
The premiums are NOT for just "gap" coverage (as a Medigap plan is) - they are complete coverage Medicare insurance. Although premiums may be low to even none, there are co-pays, co-insurance, deductibles to be covered - your out-of-pocket cost. So when doing your comparison between traditional Medicare wit gap coverage and a Medicare Advantage plan, consider what you will be paying in all out of pocket cost. It usually works out better when you are relatively healthy - less so as more and more covered and necessary medical services are needed.
I believe one of the problems beneficiaries make when picking a Medigap plan at the initial enrollment period is that they pick the very best coverage plan because that is time when the premium cost is most reasonable - the lowest. But because original Medicare is a plan with few cost controls, gap premiums increase sometimes to the point where they may be unaffordable to many of them. There are several other Medigap plans available where there maybe some out-of-pocket cost and have lower premiums but they should not be discounted if the beneficiary can afford these OOP cost - if they cannot afford these out of pocket cost, they may not be able to afford the escalating premiums of the other more cost inclusive Medigap plans later on.
https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
So If I were you - I would consider checking the other Medigap plans available with your insurer and see if that is feasible for you in your situation and that you can change plans (to a lesser coverage one) but underwriting might also play into this.
Medicare Advantage plans control their cost by managing care with geographical area confines, network of providers, sometimes step therapies, more pre-approvals perhaps, co-pays, co-insurance and deductibles - sometimes with an included Part D formulary coverage. About 1/3 of all Medicare beneficiaries have choses this type of coverage - mainly because it does fit their pocketbook.
As to your LTC coverage - you can always check your policy and with the insurer to see if your benefits can be reduced and acceptable to you for a reduction in premiums - But IMO, cost in these types of policies are gonna continue to rise - we are all getting older and many will need more hands on daily care later in life - this type of care will become more expensive juat because it is labor intensive and the folks supplying it will demand higher pay, their liability and employment insurance will rise.
Remember that you and your wife are different in your health care needs so what might be best for one of you, may not be good for the other - picking a plan should be a personal choice, not a couple thing.
Also remember, that original Medicare WITHOUT a Medigap plan (any of them) does open you up to a lot of out of pocket medical cost if the situation arises - original Medicare has NO annual or lifetime limit on these out of pocket cost - Medicare Advantage plans do have a annual limit.
Seems like you know the big differences in original Medicare and Medicare Advantage - I don't think there is any right or wrong answer because it just depends on the person, their health, their finances - and as is the case of all insurance, it is money paid for protection - it is always a guess as to what, if any, situation might arise.
It's Always Something . . . . Roseanna Roseannadanna
