I wasn’t clear. They are free to the consumer and paid by the SHIP agency. And they are outstanding by all reports that I have ever heard. There is an equivalent thing for California Care (our ObamaCare) and they made it all easy. They even signed me up for everything once we agreed. I will use an advocate again in three years when I switch over to medicare.
Nope. This was Medigap, not drug coverage.
Looking at my county and age, Carefirst BlueChoice (level 1) is 180 a month. Carefirst BlueChoice (Level 2) is 269 a month (with attained age pricing). Level 3 is 358 a month. Nowhere does it explain what that means. When I input my ZIP code, the figures are a lot higher - not sure where those lower numbers came from.
AARP/UHC shows 152 a month for standard, 463 for Level 2. They are the only ones that offer community pricing though.
A while back, I played with a Part D estimator and found that the cheapest plans cost me far more in the long run.
There are a couple that offer issue age pricing - but they are companies I’ve never heard of. As are most of the others, to be fair! One even lists a “substandard” plan that costs MORE than the one that doesn’t say that. ‘da fuq???
My knee-jerk is that we’d stay with either UHC or Blue Cross (we currently have UHC and despite the bad press, they’ve been fine).
An AI response suggests that level 2 provides more comprehensive benefits - but they’re both listed under plan G, which I thought meant they had to offer the same benefits. I get the sense that you can be automatically forced into level 2 depending on health questions.
This. The SHIP counselor I worked with for my dad’s Medicare in CA said he was ultimately paid by the insurance companies, but he had no incentive to recommend one plan over another; they were all obligated to pay him the same.
The insurance companies as part of being allowed to do that kind of business pay into a fund that is used to pay the advocates. They are a step removed from one another.
For our current Part D plan, my wife and I are enrolled in Wellcare Value Script (managed by Express Scripts). Our premium this year was $0, and we paid $2.50 a month for one of my wife’s drugs. All of the other five drugs were $0, so we will pay a total of $30 this year for our prescriptions.
For 2026, however, Wellcare is raising their premiums to $9.60 per month for each of us, or $19.20 per month. Wife’s drug cost remains the same, so we’re looking at spending $230.40 more next year. Not a huge figure, but certainly more than $0.
In comparing plans on the Medicare site, I found Blue MedicareRx Essentials, which will cover wife’s drug with no co-pay, plus a $0 premium. I of course am very interested in this plan, which is a Blue Cross/Blue Shield plan. It would cost us nothing next year.
Anybody familiar with this plan? Any reason not to switch? I have switched plans before, and IIRC this switch was done with minimal difficulty.
Our advisor (who is an agent) definitely recommended the Supplement plans over the Advantage plans. She said for a few people, Advantage was better, but for most (and for us) it was not a good idea. She explained who would benefit from the Advantage plan, but I forgot the details.
I’m a few years away so fair to say my plans may change with shifting circumstance, but as it currently stands an Advantage Plan may well end up being my better option for a few reasons, but one stands out:
1.) It’s a better-than-average plan as Advantage goes - an employer plan in CA with a $1k MOOP, free wellness annual visit + all physicals ($15 on other visits like optometrist), free labs + x-rays and immunization, free ambulance + shuttle services, $50 ER (w/ no admittance), $15 outpatient surgery + chiropractor visits, $10 generic/$15 non-generic prescriptions (100 days), free medical equipment, free inpatient/$15 outpatient psych, free hospital of course and so on. My tax free retirement medical benefit should just about pay for all the monthly costs + Medicare B.
2.) It’s Kaiser and there is a hospital ten minutes from me and two more thirty minutes in either direction.
3.) Related to the above and most importantly I can actually get a GP.
It’s the last that by all anecdotal evidence is becoming increasingly problematic in my area. The fancy university research hospitals I would prefer if I got cancer are mostly not accepting new Medicare patients. My parent’s local clinic GPs have fucked off repeatedly for fancy concierge services where they are charging pricey premiums above Medicare and leaving behind very overwhelmed nurse practioners. My father (in his 80’s) has been trying to get a new GP for months with little progress.
I’m fine with Kaiser now in my 50’s, but I’d really rather prefer to be able to hit those advanced research hospitals as I climb into my mid-60’s and beyond. But I am assured of a doctor in the HMO system without paying an added premium and the plan might be “good enough” for a default. We’ll see - things may change.
That’s not a plan offered in my area, but I’ve been on Wellcare since CVS bought Aetna, and I couldn’t use them any more, and it has been fine. True the premiums vary without rhyme or reason (next year it is the same as yours, last year it was 17 cents a month) but two of my three drugs have no copay and one is $15 for a 3 month supply.
I’ve been with the AARP/UHC Medigap plan for 9 years with never a problem. When I was working my company would sometimes switch between UHC and Blue Cross - UHC was always better.
BTW, a new John Oliver on Medicare Advantage just dropped on YouTube here.
Excellent, of course.
Interesting.
We’re currently covered via UHC through my husband’s job. Mine would be through Blue Cross. We put the whole family on his because it seemed better cost-wise - this was at least 10 years ago. When I was still insured under Blue Cross (while husband and the kids were on UHC) I didn’t really have any issues either.
I have to say, I’ve had several surgeries this year and UHC has not quibbled at either, despite a theoretical lack of evidence (hysterectomy, done preventively due to BRCA1 mutation), and in the case of the breast surgery, they could have argued that it was cosmetic (preparatory to risk reducing mastectomy next year). On the other hand, they’ve TWICE dropped the preventive inhaler I was using, for “reasons”, and are refusing coverage for the preferred proton pump inhibitor I was taking for a while. Those may all be due to our plan, not the company as a whole.
We’re in open season right now and I’ll look at whether it would be beneficial to switch us all to my employer, or just me, or just stick with the status quo (the most likely option).
I worked for a really big company that was actually self-insured, with UHC just running the program. Maybe that made it better. My wife is a writer and did not have her own insurance, and whenever we switched to Blue Cross they asked several times whether I was sure she didn’t have insurance. I sent in the certification. Next time “are you really sure?” They paid everything, but annoying.
I do get the sense that once I pick a Medigap provider, I’m pretty much locked in.
Assuming there’s no qualifying event (moved, they stopped the plan, or whatever), I’d have to go through underwriting to make a change - and since I’ll be older and likelier to have health issues, there’s no guarantee anyone will touch me for anything I could afford.
Is that about right?
Is it similar if I wanted to switch to a Medicare Advantage plan (or from one MA plan to another)?
I’m planning on part G - which seems the most comprehensive and I’ve got a whole stableful of horses to deal with (but no zebras, so far….).
I’ve started doing some initial looking-around, and one thing that baffled me: virtually all the providers in my county have multiple levels / tiers, with very different premiums. It’s tough to find a good description of what those tiers mean, aside from possibly you get forced into a higher level if you’ve got certain health issues (which are, of course, secret). UHC for example: the standard tier shows as 152/month, but level 2 is 452 a month. CareFirst BlueChoice has 3 levels, from 180 to 358 a month (and it’s attained-age, so it could soar….).
And it’s not clear whether, if I got in on one at the lower tier, they’d force me up a level if I DID develop health issues later on.
Interestingly, there are two policies that are issue-age priced. Everence and TransAmerica.
And for the high deductible version: only one had premiums enough lower to make up for the deductible. That might be okay if you are someone who really has very few health issues, but that is NOT gonna improve as you age.
I switched my dad’s Medigap provider a few years ago during open season and it did not require underwriting. If you don’t choose Medigap at 65 and then decide you want it later, then I believe you are subject to underwriting.
I put my dad on a G plan, as the coverage seemed most comprehensive.
As has been mentioned several times above, I strongly recommend getting in touch with a SHIP counselor in your state. As you’re finding, there are lots of choices and it all gets pretty confusing.
I don’t understand this tiers thing. The Medigap options seem to be letters, and there is a single price for each, depending on the provider, of course. I got F (no longer available) and I’ve seen nothing that implies they can charge you more based on your usage. Do you have a cite? I looked on the AARP page, and didn’t see anything. If I hadn’t been lucky enough to have been born early, I would have taken G also.
Different Medigap options of course have different prices.
Also, if you switch from Medigap to Advantage and then want to switch back, that’s also subject to underwriting.
On the Part G plan listing, Anthem lists 3 levels. UHC / AARP lists 2. Several others do as well.
I am still having trouble finding ANY kind of description showing which “level” one gets put in, and why. The only link I can find is 15 years old and it says it’s based on health questions - and it MAY not be a factor for new enrollees.
Level 1 / Level 2 Plan Rates UHC/AARP | Insurance Forums
Of note: some states require all policies to be community rated versus attained age. I looked at my daughter’s ZIP code (in Vermont) and it did not include multiple plan levels, it had fewer providers, and the monthly cost was higher. The UHC offering was about midway between UHC’s level 1 and level 2 plans. This makes sense, of course, if my understanding of the levels is correct.
That’s my understanding as well, with exceptions for someone with creditable coverage - e.g. we still have coverage through my husband’s job even though we’re 66. Well, he will be in 3 weeks, I already am (I’m such a cougar).
I don’t know if part D requires such underwriting; I do know that part B and D come with a financial penalty if you don’t sign up “on time” (though again, creditable coverage means no penalty).
JohnT, is a Supplement plan better than an Advantage plan regardless of what state you live in? My eldest sister (age 77) in Louisiana has an Advantage plan that seems to have none of the downsides MA plans here in Washington state and elsewhere have. For instance, she had a total knee replacement a few years ago. Her total OOP was $200, and she got perks–an ice water machine, a digital bike–that neither I nor our brother (in IL) got with our TKRs. She pays $0 in monthly premiums, gets $200 in OTC meds free, and still has very, very low deductibles.
I’m on a Supplement plan and plan to stick with it, but day-um, that’s a sweet ride.
What makes Louisiana different?
Your link, and this is supported by a reddit thread I found about this, seems to say that you are in Level 1 unless you have health problems and have been in plan B for 3 years without being on Plan G. So, if you sign up for Medigap at 65, you will be in Tier 1, which is the cheapest, automatically. I certainly did not have to fill out any health questions when I signed up for Plan F.
None of the top level information, which assumes you are 65 and signing up for the first time, mentions tiers. I suspect Medicare for Dummies gives full details - might be worth looking at if you are in a bookstore or library.
BTW it seems option G is far the most popular, and I see why.
I used Age of issue pricing, which does not go up with age (only inflation.) It was the most expensive to start with, but I expected to live a long time so it would be worth it. So far, so good.
Yeah - I’ll be over 65 (I’m 66 now) but we have employer coverage for the moment. The possibility of losing that is always there, which is why I’m doing the research now.
The issue-age policies were indeed the most expensive, which is no surprise. I don’t know if I expect to live super long - both my parents died at 75, albeit of things I’m not susceptible to, but I have my own health issues. My husband’s parents have lived well into their 80s, and several grandparents were near 90, so he might outlast me.