# 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:** 8
**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 18, 2022, 1:36pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/141 "2022-10-18T13:36:10Z")
> [@Mean\_Mr.Mustard](#): > > 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 Sorry, somehow missed this, my friend: 1. Yes 2. Yes 3.a. only with medical underwriting OR within 6 months after you turn 65 3.b. Yes 3.c. Yes. Most make you wait until the enrollment periods ---
**Author:** ![ratatoskK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ratatoskk/32/2987_2.png) [@ratatoskK](https://boards.straightdope.com/u/ratatoskK)\ **Post date:** [October 18, 2022, 1:52pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/142 "2022-10-18T13:52:45Z")
> [@abcdefghij](#): > > At some point in the last few years, somebody talked him into an Advantage plan. It was barriers to care all the way down. Was your Advantage plan an HMO or a PPO? I’m in an Advantage PPO plan and love it, and have never had any problems. Maybe a lot of the complaints in this thread about Advantage are referring to an HMO? ---
**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 18, 2022, 1:53pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/143 "2022-10-18T13:53:38Z")
> [@JohnT](#): > > only with medical underwriting I wasn’t exactly clear on what this meant, so I did a quick Google search. Here’s what I found: From [ehealth](https://www.ehealthinsurance.com/medicare/enrollment/can-i-switch-from-medicare-advantage-to-medigap/): > your insurance company may require medical underwriting before it sells you a plan. During medical underwriting, the insurer looks at your past medical history and current health status. If the company determines the risk of covering you is too high, it can refuse to sell you the plan you want, or it may charge you much higher premiums for the coverage. So while you may want to switch, you may not be able to switch, at least not without financial penalty. ---
**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 18, 2022, 2:00pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/144 "2022-10-18T14:00:44Z")
I definitely need to look into what happens when you move. The in-laws have a supplement, one sponsored by AARP, because they are (not unreasonably) concerned over having access to whatever care they need, versus whatever care an accountant thinks they deserve. It’s not out of line to think that one or both would have died, given what I hear about MA plans these days. Anyway, the tentative plan is that at some point we will need to move them into assisted living - ideally near us rather than near where they live, because I sure as hell don’t want them in a place where the staff can tell that nobody will look in on them regularly. Which of course might entail switching plans, or a different cost for the same plan. ---
**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 18, 2022, 2:10pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/145 "2022-10-18T14:10:02Z")
I am positive that this is not going to be a problem, my issue is that I do not know the mechanism by which this occurs, so I cannot give you any advice. They may not even have to switch. ---
**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 18, 2022, 2:52pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/146 "2022-10-18T14:52:02Z")
My mom moved into assisted living a few years ago, and absolutely nothing changed regarding her insurance. During her two-year stay there, premiums and coverage were just as they were before the move, both with her supplemental and prescription plans. ---
**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, 3:28pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/147 "2022-10-18T15:28:33Z")
> [@ratatoskK](#): > > Was your Advantage plan an HMO or a PPO? He had an Advantage HMO, and I agree that that’s a significant element of the problem. Non-Medicare HMOs suck, too, ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [October 18, 2022, 8:05pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/148 "2022-10-18T20:05:10Z")
> [@Railer13](#): > > My mom moved into assisted living a few years ago, and absolutely nothing changed regarding her insurance. During her two-year stay there, premiums and coverage were just as they were before the move, both with her supplemental and prescription plans. Yes. But did your Mom move to a different state when she entered assisted living? That is the question @Mama_Zappa is trying to get answers to. Since all supplements and advantage plans are state-level administered, not Federal, there just might be some wrinkles to changing states late in life. ---
**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 18, 2022, 8:19pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/149 "2022-10-18T20:19:06Z")
> [@LSLGuy](#): > > But did your Mom move to a different state when she entered assisted living? No, she moved to a different wing of the building in the senior-center complex. I didn’t catch that the move would be to different state. My apologies. And, yes, plans might certainly be different in another state. Heck, I’ve found that prescription plans vary by county where I live. ---
**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 19, 2022, 1:20am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/150 "2022-10-19T01:20:31Z")
> [@JohnT](#): > > I am positive that this is not going to be a problem, my issue is that I do not know the mechanism by which this occurs, so I cannot give you any advice. They may not even have to switch. > [@Railer13](#): > > My mom moved into assisted living a few years ago, and absolutely nothing changed regarding her insurance. During her two-year stay there, premiums and coverage were just as they were before the move, both with her supplemental and prescription plans. Hopefully their plan is indeed a nationwide one - it’s sponsored by AARP. I would not be surprised if there was a rate change - since as noted, there will be a STATE change. They live in Florida. The time or two I’ve tried pricing plans just plugging in their location and ours, rates seemed to be higher where they are now. I don’t know if that has to do with a higher elderly population down there, or what (as otherwise, we are in a MUCH more expensive part of the country). ---
**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 19, 2022, 1:41am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/151 "2022-10-19T01:41:53Z")
MZ, you may want to find the local SHIP and ask them: > **[About](https://www.shiphelp.org/about-us)** > > The SHIP TA Center helps members of the general public understand, locate, and access SHIP services in their state, territory, or commonwealth. ---
**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 19, 2022, 3:21pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/152 "2022-10-19T15:21:00Z")
> [@Mama\_Zappa](#): > > Hopefully their plan is indeed a nationwide one - it’s sponsored by AARP. I would not be surprised if there was a rate change - since as noted, there will be a STATE change. My AARP plan is run by UHC, who sends me the statements that they paid everything. There is an AARP portal into their site, but it is just to brand the coverage. Who administers yours? I’m in California. ---
**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 20, 2022, 12:55am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/153 "2022-10-20T00:55:47Z")
> [@Voyager](#): > > Who administers yours? I’m in California. Not sure - though I think it MAY be United Healthcare. Theirs is in Florida. ---
**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:** [October 20, 2022, 1:27am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/154 "2022-10-20T01:27:30Z")
> [@Mama\_Zappa](#): > > Hopefully their plan is indeed a nationwide one - it’s sponsored by AARP. This is where I get confused. Because I was disabled, before I turned 65, I had a nationally available Medicare Advantage plan, Humana Gold. The premiums were $0, but there was a hefty deductible. A doc told me that here in WA state, Humana Gold is basically one step above Medicaid. Most medical practices here don’t accept it. When I turned 65, I switched to a Medicare Supplement plan. My older sister lives in Louisiana. She also has Humana Gold, too, but while she also has a $0 premium, her plan is accepted at most places, she has a low deductible, and her plan covers as much as my MS plan does. She had knee replacement surgery and paid less than $200 total. How can the same national plans vary so much state to state? ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [October 20, 2022, 1:31am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/155 "2022-10-20T01:31:30Z")
Because they are not national plans. They are customized state-level plans offered by nationwide providers using a common branding scheme for all their products. Until her death a few months ago I managed my late MIL’s affairs. Mom had Humana Gold. Which came in 30 different “flavors” here in Florida alone. Plus gosh knows how many other flavors in gosh knows how many other states. ---
**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:** [October 20, 2022, 3:11am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/156 "2022-10-20T03:11:46Z")
I figured it must be something like that. What I still don’t get is why they vary so much from state to state. There was only one flavor available here and my sister said the same about her choices, though I think her late husband did the selecting. I’m curious as to why this is. Is it that state insurance boards have different requirements so that WA, for instance, lets HG get away with having cruddier plans, while LA state does not? Or does it have to do with average income by state, or what? My sister has long raved about Humana Gold, and as I said, she had a pricey knee replacement and paid almost nothing. I paid almost nothing for back surgery in March, but I pay well over $300 per month for my Medigap policy. When I had HG, I couldn’t find docs that would take it, and I had to pay a hefty deductible. ---
**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 20, 2022, 1:51pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/157 "2022-10-20T13:51:21Z")
As a former resident of Louisiana, my only thought is that the HG execs there are incompetent and don’t know whose palms to grease. But the markets do change. The MA plans offered in my area now are a lot better than offered when I signed up for Medicare, not that I’m going to sign up for any of them. ---
**Author:** ![Maserschmidt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/maserschmidt/32/18829_2.png) [@Maserschmidt](https://boards.straightdope.com/u/Maserschmidt)\ **Post date:** [October 20, 2022, 3:21pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/158 "2022-10-20T15:21:41Z")
> [@Voyager](#): > > As a former resident of Louisiana, my only thought is that the HG execs there are incompetent and don’t know whose palms to grease. For context, three Louisiana Insurance Commissioners in a row went to jail for (respectively) extortion, accepting illegal donations, and perjury. ---
**Author:** ![tim-n-va](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tim-n-va/32/3001_2.png) [@tim-n-va](https://boards.straightdope.com/u/tim-n-va)\ **Post date:** [October 20, 2022, 6:31pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/159 "2022-10-20T18:31:52Z")
Let me echo the thank you for this thread. I’m six months from turning 65 so in the call deluge phase. I have TRICARE so I plan to enroll in Medicare A & B. My understanding is that because I’m already drawing SS I will be automatically enrolled in those. I’ll verify that it has happened in a few months. At 65 I’ll have Parts A and B, TRICARE for Life and dental and vision thru my wife’s plan. She will retire herself in the next six months and will pay for those out of her FERS pension. If anyone sees something I’m missing, especially those currently on TRICARE, I would welcome corrections to my plan. Because we were only married for 18 years that coincided with active duty, if we divorce my wife will lose TRICARE after one year. ---
**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 20, 2022, 6:44pm UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/160 "2022-10-20T18:44:52Z")
Be sure you are getting advice from a professional about your plans at all times because you do NOT want to lose that Tricare. And if you should pass away prior to your wife, she can keep it as long as she doesn’t remarry… and that’s about all the advice I can give re: Tricare. [Previous page](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146.md?page=7) [Next page](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146.md?page=9)