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Honored Social Butterfly

YOUR MEDICARE PLAN CHOICES

Why did you choose either Traditional Medicare or a Medicare Advantage Plan as your choice in how you want to get your Medicare benefits?

 

If there was no such thing as a Medigap plan (Medicare Supplemental policy) would that change your decision in how you receive your Medicare benefits?

 

Came back to edit and ask another question -

How high do you think Part B premiums could go and are you prepared to pay them for the long haul?

 

OR perhaps your state or your MA insurers pays all or part of these Part B premiums - was that a factor in picking your choice of a Medicare plan?

 

 

It's Always Something . . . . Roseanna Roseannadanna
Regular Contributor

Here is something interesting:

It is called "Plan G-Innovative" from Physicians Mutual.  It is a modified high-deductible plan for the first three years, then the deductible decreases to a normal Plan G deductible after that.  The premiums are lower than a typical Plan G, but higher than a Plan G-HD.

 

This is not available in every state - I think Physicians Mutual says it is available in 21 of 50 states.

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I am not retired yet, but will be in the next 12 months or so.  I've decided to go with Medigap rather than Medicare Advantage.

 

In answer to your question about if there were no Medigap, would that change my decision about how I receive my Medicare benefits? It obviously would since my current choice is Medigap.

 

Keeping in mind that I am not a Medicare expert, my interests are tailored specifically for me in my particular situation, and what follows in this post is are my own opinions/thoughts and each person should do their own research and come to their own conclusions:

 

Medicare Advantage (MA), despite it's zero premiums, has a very high maximum-out-of-pocket in my state (on the order of $7500 in 2023) and by far had the highest cost potential in the event of a catastrophic illness. It was also the least predictable in terms of budgeting for health events.  In the news, there are inquiries about whether MA companies are using pre-authorization to deny care and increase profit.  For myself, I have no intention of turning my health decisions over to an insurance company (or a network of incentivized health practitioners) who have a profit motive to keep me alive as long as possible, while doing the least to keep me healthy and free of pain, and saddling me with as much of the cost burden as possible, using Artificial Intelligence (AI) technology.  Looking at my 90 year old mother, and my wife's 86 year old mom, they would be helpless to defend themselves against this sort of thing, and I have no doubt that MA companies take that into consideration.

 

Medigap Plan G (the best plan available to me) is very predictable, but has much higher premiums which are guaranteed to go up substantially over time.

 

Medigap Plan G-High Deductible (G-HD) has the lowest premiums but is less predictable for budgeting  because of the high deductible.  Also the deductible is tied to the annual inflation rate and will go up substantially over time.  I read that you have to keep a closer eye on what is being charged to your G-HD plan because of the high deductible.   Looking at my 90 year old mother, I'm not sure I will have the ability to do that should I live that long.

 

Plan N is a medium between Plan G and Plan G-HD and is not that much more expensive than G-HD.  It does not cover everything Plan G does, and it has trivial co-pays, but the premiums are substantially lower than Plan G, and the budgeting costs seem to be highly predictable, like on Plan G.

 

I'm going with Plan N (health) and a low cost Plan D (drugs). I will use a self-paid dental plan.  I know this is not the cheapest set of options, but it works for me. (Update: I've decided NOT to go with Plan N because it has no maximum-out-of-pocket on excess charges.  Probably will go with Plan G-HD, or with Physicians Mutual Plan G-Innovative.)

Regular Contributor

After a little more research, Medigap Plan G-HD is back in contention again for me.  Still agonizing between the two. Some people speculate that Excess Charges on Plan N will become more prevalent in the future.  A person could put aside a chunk of money for Plan G-HD deductible (in case of an emergency) and increase it each year for inflation.  In the forums, one person thought that Medicare negotiated rates are much lower than retail rates, and then you only have to pay 20% of that, so most G-HD incremental costs would be similar to the Plan N co-pays.  It makes sense to me.

 

A great resource for information BTW are the bogleheads.org forums under "Personal Finance (not investing)".

Periodic Contributor

I am lost just reading about this. It seems like I would have to be a scholar to learn all of this information.

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