# America's Elder Crisis, Medicare Edition **URL:** \ **Category:** Miscellaneous and Personal Stuff I Must Share\ **Created:** [March 4, 2021, 5:55am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146 "2021-03-04T05:55:49Z")\ **Posts on this page:** 20\ **Page:** 7
**Author:** ![davidm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/davidm/32/225_2.png) [@davidm](https://boards.straightdope.com/u/davidm)\ **Post date:** [December 6, 2021, 6:22pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/121 "2021-12-06T18:22:48Z")
> [@JohnT](#): > > So you just had Original Medicare? > > Still, doesn’t matter. You had that Initial Enrollment Period when you turned 65, and if you had an insurance agent guiding you in all this, they should have explained this to you and signed you up for the MS (or a MA) plan. > > Of course, if you have Medicaid as well, this advice may be different (as noted). I did not have an insurance agent guiding me. After I had received disability for two years, I was automatically placed on Medicare. I did not speak with an agent. ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [December 8, 2021, 7:45pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/122 "2021-12-08T19:45:50Z")
> [@Voyager](#): > > Wait until you hit 65. You’ll need a shovel to dig yourself out of the mail. Yeah - my brother (just turned 68) still gets loads of mail. We haven’t gotten much (any?) despite being within 3 years of Medicare eligibility. ---
**Author:** ![nelliebly](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nelliebly/32/5422_2.png) [@nelliebly](https://boards.straightdope.com/u/nelliebly)\ **Post date:** [January 21, 2022, 10:25pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/123 "2022-01-21T22:25:21Z")
I just came back to thank @JohnT again, especially for this bit from the OP > [@JohnT](#): > > You know how you talk to your grandma who says she got her knee replaced and it didn’t cost her a cent? She had a Med Supp plan, guaranteed I found out yesterday that I have to have back surgery. Today the ortho clinic where I’ll have the surgery sent me my estimated expenses for that surgery: $1, 014. Turns out they hadn’t factored in my Medicare supplement policy. My estimated expenses are, in fact, $0. I’m SO glad I went with a Medicare Supplement plan. ---
**Author:** ![carnut](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnut/32/3531_2.png) [@carnut](https://boards.straightdope.com/u/carnut)\ **Post date:** [January 22, 2022, 12:01am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/124 "2022-01-22T00:01:10Z")
> [@nelliebly](#): > > I’m SO glad I went with a Medicare Supplement plan. I’m glad you responded with this info. I will definitely be relying on this thread in a couple of years. I’m trying to hold out on all the surgeries I need until 65. Fingers crossed. ---
**Author:** ![nelliebly](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nelliebly/32/5422_2.png) [@nelliebly](https://boards.straightdope.com/u/nelliebly)\ **Post date:** [January 22, 2022, 12:03am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/125 "2022-01-22T00:03:30Z")
Mine are crossed for you as well! I should probably have mentioned that without Medicare or insurance, the surgery would cost close to $5,000. ---
**Author:** ![JohnT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnt/32/15048_2.png) [@JohnT](https://boards.straightdope.com/u/JohnT)\ **Post date:** [January 22, 2022, 12:04am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/126 "2022-01-22T00:04:00Z")
🥲 Thank you. ---
**Author:** ![VOW](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/vow/32/3043_2.png) [@VOW](https://boards.straightdope.com/u/VOW)\ **Post date:** [January 22, 2022, 1:05am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/127 "2022-01-22T01:05:11Z")
I’m dancing for @nelliebly ! ~VOW ---
**Author:** ![nelliebly](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nelliebly/32/5422_2.png) [@nelliebly](https://boards.straightdope.com/u/nelliebly)\ **Post date:** [January 22, 2022, 1:08am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/128 "2022-01-22T01:08:08Z")
Hey, after my back surgery, I’ll join you! Thank you! ---
**Author:** ![Mean\_Mr.Mustard](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mean_mr.mustard/32/3865_2.png) [@Mean\_Mr.Mustard](https://boards.straightdope.com/u/Mean_Mr.Mustard)\ **Post date:** [October 14, 2022, 11:10am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/129 "2022-10-14T11:10:44Z")
I am resurrecting what I consider the most useful Dope thread of all time because my Medicare days are on the horizon. I’ll direct my questions to @JohnT , who has been so generous with his knowledge, but others, of course, are welcome to engage. Today’s questions: JohnT: Has anything changes since you opened this thread a year and a half ago that would alter any advice you have given? In particular, do you still stand firmly in the Medigap camp, assuming one can afford the monthly premiums? Is this something that you can change yearly (Medigap vs. Medicare Advantage), or are you stuck with your choice until the end of time? Thanks! mmm ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 14, 2022, 3:32pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/130 "2022-10-14T15:32:59Z")
> [@Mean\_Mr.Mustard](#): > > Is this something that you can change yearly (Medigap vs. Medicare Advantage), or are you stuck with your choice until the end of time? Judging from the piles of mail I get even at 70 wanting me to change to a Medicare Advantage plan, I think you can change. I’ve been extremely happy with Medigap, but we can afford the premiums. I’m not sure we’re ahead financially, but the flexibility and the lack of variation in healthcare expenses has been a plus for us. ---
**Author:** ![Railer13](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/railer13/32/9742_2.png) [@Railer13](https://boards.straightdope.com/u/Railer13)\ **Post date:** [October 14, 2022, 3:45pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/131 "2022-10-14T15:45:39Z")
[Here](https://www.investopedia.com/articles/personal-finance/010816/pitfalls-medicare-advantage-plans.asp) is an article from Investopedia. I am no expert, but this article appears to answer a lot of questions. Hopefully @JohnT will weigh in. Investopedia says that you can change back from Advantage to Medigap, but with strict limitations: > If you decide that the Medicare Advantage Plan isn’t for you, you have the right under federal law to purchase any Medigap plan if you switch to Original Medicare within 12 months of the date that you joined a Medicare Advantage Plan for the first time. > You may also switch from your Medicare Advantage Plan to Original Medicare during the annual Open Enrollment Period or if you qualify for a Special Enrollment Period. However, you may not be able to purchase a Medigap policy (if you switch after the aforementioned 12-month limit). If you are able to do so, it may cost more than it would have when you first enrolled in Medicare. > [@Voyager](#): > > I’ve been extremely happy with Medigap, but we can afford the premiums. I’m not sure we’re ahead financially, but the flexibility and the lack of variation in healthcare expenses has been a plus for us. I am in 100% agreement with this statement. ---
**Author:** ![JohnT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnt/32/15048_2.png) [@JohnT](https://boards.straightdope.com/u/JohnT)\ **Post date:** [October 14, 2022, 4:18pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/132 "2022-10-14T16:18:53Z")
> [@Mean\_Mr.Mustard](#): > > JohnT: Has anything changes since you opened this thread a year and a half ago that would alter any advice you have given? > > In particular, do you still stand firmly in the Medigap camp, assuming one can afford the monthly premiums? > > Is this something that you can change yearly (Medigap vs. Medicare Advantage), or are you stuck with your choice until the end of time? 1. Yes: I am no longer in the industry. But still licensed! 2. Yes, I still recommend supplement plans UNLESS you live in FL, CA, or maybe AZ, which have Advantage plans comparable to supps. 3. With supplement plans, if you change, you may be health-rated if not out-and-out denied. You can switch Advantage plans every year, though. ---
**Author:** ![Mean\_Mr.Mustard](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mean_mr.mustard/32/3865_2.png) [@Mean\_Mr.Mustard](https://boards.straightdope.com/u/Mean_Mr.Mustard)\ **Post date:** [October 14, 2022, 5:26pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/133 "2022-10-14T17:26:47Z")
So, if I understand correctly: 1. If you go with Advantage, you can switch plans yearly without penalty. 2. If you go with a supplement plan, you’re probably going to stay with that plan. 3. Can you jump from Advantage to supplement? Supplement to Advantage? Are there limits to how often you can switch? (thanks for the quick responses) mmm ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [October 17, 2022, 7:47pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/134 "2022-10-17T19:47:19Z")
> [@Voyager](#): > > Judging from the piles of mail I get even at 70 wanting me to change to a Medicare Advantage plan, I think you can change. My understanding is that going from Medigap to Medicare Advantage is easy. Going the other direction is not as easy (and may be impossible). Others can weigh in better than I can, but I believe part of the problem is you may have to go through medical underwriting if you go from MA to Medigap. That’s where things get tough. > [@JohnT](#): > > With supplement plans, if you change, you may be health-rated if not out-and-out denied. You can switch Advantage plans every year, though. How does it work if you move from one state to another? Is there anything like a “Get Out of Medicare Advantage Free” card? Or, just if you have a supplement in one state, and move to another - is underwriting a concern? At some point we may move the in-laws from their state (Florida) to ours (not Florida) when they need assisted living. ---
**Author:** ![JohnT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnt/32/15048_2.png) [@JohnT](https://boards.straightdope.com/u/JohnT)\ **Post date:** [October 17, 2022, 7:58pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/135 "2022-10-17T19:58:08Z")
> [@Mama\_Zappa](#): > > How does it work if you move from one state to another? I genuinely do not know exactly how this occurs, sorry. ---
**Author:** ![Railer13](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/railer13/32/9742_2.png) [@Railer13](https://boards.straightdope.com/u/Railer13)\ **Post date:** [October 17, 2022, 8:50pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/136 "2022-10-17T20:50:23Z")
> [@Mama\_Zappa](#): > > My understanding is that going from Medigap to Medicare Advantage is easy. Going the other direction is not as easy (and may be impossible). This is also my understanding. And once you’re sick, you’re going to pay dearly to go from Advantage to Supplemental. My sister’s SO sold policies for a while. His advice was: if you’re healthy, Advantage is better. If you’re sick, go with Supplemental. If you’re on an Advantage plan, don’t get sick. ---
**Author:** ![JohnT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnt/32/15048_2.png) [@JohnT](https://boards.straightdope.com/u/JohnT)\ **Post date:** [October 17, 2022, 9:08pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/137 "2022-10-17T21:08:16Z")
> [@Mama\_Zappa](#): > > My understanding is that going from Medigap to Medicare Advantage is easy. Going the other direction is not as easy (and may be impossible). This is correct. All of it. Best time to get the supplement is when you enroll for MA/MS (usually age 65). Second best time is when you get a MA plan on initial enrollment and, within the first 90 days, decide you want a supplemental plan, so you switch. To both of the above, you do not have to do a physical and your premium is based upon a complicated formula which I can’t recall (the average premium for new enrollees in your county or something), as these scenarios fall within your initial enrollment period (IEP). Any changes made AFTER the IEP may require you to take a physical and, if done incorrectly, may result in you being cast from the original supplement, leaving you to accept an Advantage plan. ---
**Author:** ![carnut](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnut/32/3531_2.png) [@carnut](https://boards.straightdope.com/u/carnut)\ **Post date:** [October 17, 2022, 10:56pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/138 "2022-10-17T22:56:37Z")
> [@Railer13](#): > > My sister’s SO sold policies for a while. His advice was: if you’re healthy, Advantage is better. If you’re sick, go with Supplemental. If you’re on an Advantage plan, don’t get sick. He is correct. Because I already have health issues and because I have done a lot of work for health insurance companies, I will be avoiding Medicare Advantage, even though it is less pricy as long as you are healthy. ---
**Author:** ![abcdefghij](https://avatars.discourse-cdn.com/v4/letter/a/43a26b/32.png) [@abcdefghij](https://boards.straightdope.com/u/abcdefghij)\ **Post date:** [October 18, 2022, 11:50am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/139 "2022-10-18T11:50:38Z")
My father set up supplemental when he turned 65 (he’s now 80 with definite physical and mental health issues). At some point in the last few years, somebody talked him into an Advantage plan. It was barriers to care all the way down. Moreover, they didn’t cancel his supplemental (both Medicare and his supplemental plan were ticked about that), so he got to pay for both, even though he couldn’t use the supplemental when the Advantage plan refused to pay. At the last open season, I was able to switch him to a different supplemental plan with somewhat better terms than his original one and kill off the Advantage plan. There was no medical evaluation and the only obstacle was needing to wait for open season. I don’t know whether the fact that his supplemental was never canceled has anything to do with it, but neither Medicare nor the Medicare advisor I worked with ever raised it as an issue. Based on what I’m reading here, I definitely wouldn’t count on being able to switch from Advantage to supplemental, but other than needing to wait for open season and the stress of some Advantage parasite calling him while I was waiting for it to all go into effect and needing to cancel that, too, it all worked pretty smoothly. Definitely glad I’d been put in touch with the Medicare counselor. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 18, 2022, 1:15pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/140 "2022-10-18T13:15:09Z")
> [@Railer13](#): > > My sister’s SO sold policies for a while. His advice was: if you’re healthy, Advantage is better. If you’re sick, go with Supplemental. If you’re on an Advantage plan, don’t get sick. In other words, Advantage wins if you plan on being healthy right up to the day you fall over dead. Kind of like how the free market in health care assumes you can shop for emergency heart surgery before you need it. They’d have to pry my supplement plan from my cold dead fingers. [Previous page](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146.md?page=6) [Next page](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146.md?page=8)