I’ve been shanghai-ed into helping my 90 yo MIL pick a Medicare supplement plan for the upcoming year.
She got a visit from a Humana salesperson and is now hopelessly confused about all the options. Including the options that AIUI amount to opting out of Medicare entirely :eek:.
She has been remarkably healthy the last decade. But she admits she’s starting to fail and may not have more than another good year in her before major subsystems start to really fall apart. Which means we can’t use her prior history and expenditures as a good guide to the near future. The good news is the premiums even on the fancier plans are not burdensome vs her income and assets.
As a Depression-era baby the only thing she *really *understands is that cheaper is always better :smack: As for me, I can spell “Medicare” most days and that’s about the end of my quality knowledge.
My going in assumption is now is not the time to switch from a quality full coverage plan to the cheapest thing she can find. But I admit that assumption is based on my experience with non-Medicare insurance. IME, you don’t always get what you pay for; but you never get what you don’t pay for.
I can probably win an argument to get her to renew her current plan by shear force of will. But I would not want to be treated that way and I don’t want to do it to her.
She’s got about a 1" stack of Humana brochures for me to read. Which I will. But I’d like to get educated on all the various Medicare sections (Part A, Part F, ??? ) and the various options at a conceptual level first. I’d also like to find a comparison site that can cut through the marketing BS, slanted comparisons, and outright lies and give me true apples to apples comparisons between brand X and brand Y.
So I’m asking y’all for a couple things:
References to good sites for explanations and plan comparisons.
Useful anecdote or rules of thumb for stuff to want in a plan and stuff to avoid.
Any personal experiences plus or minus with plans specifically here in South Florida where we all are.
I can Google as well as the next person; I’m hoping somebody here has recently done this research and can recommend sites based on that. I know we’ve got some insurance gurus on here. Or input from somebody like **WhyNot **who’s got practical experience working with the practical results of people’s insurance-buying decisions.
Many thanks in advance for any assistance. MIL thanks you too.
I recently went down this rabbit hole.
The Gap/Supplement plans are standard - every insurer pays the same and covers the same.
I went with ‘Plan F’ - the most complete coverage available.
Medicare only pays 80% - which, with US costs being what they are, can leave a huge hole in your wallet real quick.
Here are starters.
Humana is a huge company - check their record. I went with Blue Shield 30 years ago and have stuck with them. It is a non-profit. https://www.mymedicare.gov/
If she is getting older and has a group of physicians she likes, a Medicare Advantage Plan might be the way to go. They cover far more than regular Medicare, and it often doesn’t cost anything out of pocket.
ETA: Both Humana and Blue Cross are in Florida and have good networks there. I worked for the Blues for years, and a friend has worked for Humana for years.
I don’t know if there is a site to compare plans against each other. My parental units all have Medicare with Federal Employee Retiree BCBS as their “gap” policy. It’s like having a Platinum card for healthcare, and I admit to envy.
If she doesn’t already have a Supplement (Medigap) plan, she might not get past underwriting (Unlike the ACA plans, Medigap providers can choose to not sell her a policy if she is deemed a poor risk).
If she has one, hold on to it for dear life - at her age it will be well worth it.
I view Advantage plans as another type of government outsourcing - one that puts an insurance company into the Dr - Patient relationship. Also, the insurance companies are paid a premium to administer your treatment - and make a profit from it.
There is a window when you first became eligible for Medicare where you can sign up for a Supplemental Plan w/o any underwriting, but after that’s passed it can be very hard to get one depending on your. And as someone who works with Medicare Advantage plans (from the insurance side) I’d recommend everyone who’s getting Medicare for the first time go with the Supplemental Plan & standalone Rx plan route instead getting an MAPD plan; it’ll pay off in the long run (unless of course you like having to deal with crap like provider networks, referrals, prior authorizations, etc).
With a Supplement plan, you and your Doctor determine what to do without having to get approval from an insurance company or use only their approved networks,
My wife is about to start Medicare and I have noted that out of the deluge of offers she has been getting in the mail, every single one was for an Advantage plan. If they have the money to market plans that heavily, it tells you something about the profitability of Medicare Advantage.
We have both signed up for a Medigap Supplement plan while we could do it without underwriting and possible refusal.
(Slight hijack) If a retiree is covered by a Federal Employee Health Benefit plan and Medicare B, is there any point to either a supplemental plan (which I assume the FEHB plan is) or an Advantage plan?
For drugs (I’m on track to hit a $2500/week drug), I got a BS plan which uses Medicare Part D as a base and sits on top of it.
Medicare was not intended to cover drugs - which is why there are separate drug plans.
But: Unless you come from a long, long line of hale and hearty stock who die instantly (and avoid the medical bills), you are really, really better off buying coverage you don’t end up using.
Almost always better to have and not need than to need and not have. depression-era babies can appreciate that viewpoint.
:eek:.