I think the tiers thing within a Part G plan is entirely a creature of your state law. So any advice needs to be state-specific.
I suspect it amounts to the same coverage at each tier, but with tiered pricing based on their payout experience. So call it “annual underwriting lite even if you don’t change plans”.
For those still undecided about a Medigap vs Advantage plan, I humbly offer this YouTube clip by John Oliver from a few nights ago. (YouTube clip from Last Week Tonight segment, 31 minutes long.)
Even given the comedic leanings he does bring up some good points.
tl;dr he’s pro Medigap, thinks the Advantage programs are a bad deal, and shows that the insurance lobby is not doing America any favors. Still, if you haven’t decided–or want validation on your Medigap decision–I think it’s worth watching.
This is what my friends are experiencing right now:
They are married and both retired. She retired about a year ago; until then, they were on her insurance through her employer. When she retired, they signed up for an Advantage plan.
He became real sick a few months ago. His diabetes became very acute, and he received a diagnosis of liver cancer. He just had his big toe amputated, which necessitated a stay in a physical therapy facility. Guess what? The Advantage plan will pay for 21 days; if he isn’t released by then, they’re on the hook for 220 bucks a day. With the help of the facility, she’s appealing that decision, but there’s no guarantee that her appeal will be granted.
Don’t buy an Advantage plan.
This is why I asked about my sister’s plan (in Louisiana). It’s an advantage plan, so it has a $0 deductible, but it covers everything like a supplement plan. I’m not about to move to Louisiana to get it, but it does tick me off that I’m paying over $3600 per year (including Part D) for something she gets for free.
My elderly mother (77 years old) keeps get daily calls trying to switch(buy?) a Medicare Advantage plan,
She tried them in the past but they were too much of hassle, She now just has straight Medicare/Medicaid.
But the calls keep coming…
We lost hubsters medigap plan some years ago. He has lots of issues so I believe underwriters would laugh, and stamp DENIED on an application for a new medigap. However, the advantage plan he is on now is ending 01/01/26. So he suddenly qualified for gauranteed issue again. As of the above date he will be covered under a medigap g again … thank dog.
You almost certainly have access to Advantage plans where you live, and many will be just as good as what you describe your sister as having.
No, the Advantage plans are not nearly as good here or, from what I understand, in most other states. I did such a deep dive into this in my state that the SHIP person I spoke with thought I was a broker. (Many thanks to John T and others!) If there were Advantage plans in all states as generous as the ones in my sister’s state, few people would ever get a Supplement plan.
She and I both paid about $200 for a TKR. The difference–besides the freebies she got–was that I’d paid over $2400 over the 12 months prior in premiums, while she’d paid $0.
There must be something different about the way Louisiana handles Medicare. I wish I knew what it is.