Thanks. I need to find out if he is eligible and if any are available.
I’ll take all the help I can get.
And a mid-thread thank you to everyone. This has been faster, more reliable, and more reassuring than anything that AI would have put up. I’m only a sometime contributor to this community but I’ve never been more grateful for it than I am now. Thanks.
Agreed.
Part B of “original Medicare” covers doctor office visits, labwork, outpatient procedures, etc. but has a 20% “coinsurance” for most of what it covers (i.e., Medicare pays 80%, the patient is responsible for paying the remaining 20%). 80% sounds like a lot, until you start piling up five-digit doctor bills. Medigap covers that 20% gap.
I have not read this whole thing. But Hubster’s advantage plan ended so he had the option to have Medicare and guaranteed issue for a medigap plan. We jumped on it and thank dog we did. He became very ill and ended up in a hospital for two weeks and is now in a rehabilitative hospital which he may end up being in for quite some time. If he’s still had advantage it would have cost us thousands of dollars. Because of your dad’s age he would be eligible for medigap part F. It overs virtually everything and hospital stays cost nothing Advantage plans are crap for a senior with health issues they only advantage the the insurance companies. They have to accept him regardless of his health or medical history No you don’t get 0 dollar premiums. But if you get good advice you could get an affordable one. It will be much more affordable than months of rehab and hospitalization. You can also find a good part D with low or zero premiums. It is well worth looking into. Been there done that.
When you are looking at the Part D Rx plans check to see that all of his medications are listed on the formulary that you want.
The drugs included on the formulary change annually so that is something to keep in mind for next year.
Tell me more? I don’t know anything about Part F. Is he automatically eligible? What if he never signed up before?
Based on the number of companies abandoning Advantage plans, it doesn’t seem like the insurance companies are making out. I suspect the insurance companies thought they’d make a fortune but what happened is they couldn’t get their rates at hospitals down to the low rates that Medicare pays, so they just wound up paying higher fees to hospitals and medical providers and shortchanging care for patients. So the hospitals won and everyone else lost.
Thanks. I’ll get a list of his drugs from my niece. Can you easily change your Part D provider from year to year?
Advantage plans are a lot better for the insurance companies when the clients are younger. The disadvantage is exactly what happened to your father. Also, the Advantage plans have people trying to deny coverage, and you have in-network problems.
I’ve been on traditional Medicare with Medigap and Plan D for almost 10 years, and have never had a problem.
The aforementioned John T works in the industry and gives excellent advice. There is a fairly long thread about it, when you have time to give it a look. It has a lot of good basic information.
When I was about to go on Medicare, I found that Medicare for Dummies was an excellent source for all the intricacies. Don’t buy it used since the rules change.
A Medicare Advantage plan might be easier for him to deal with, but I’m not sure it is better overall.
I just started on Medicare/Supplemental/Part D this year.
I was told that you can easily change your Part D every year. In fact I was told I will need to check my prescriptions with the available formularies every year and switch accordingly.
I wish you all the best navigating this. It can be overwhelming.
I hope he pops in but everyone has been so helpful, I at least have some better sense of control.
I’m sufficiently whelmed, at least.
It’s not Part F - there are a number of different Medicare supplement plans , each of which has different coverage. They are identified by letters (why not confuse people) but each company’s Plan F has the same benefits. There are a couple of plans not available for new enrollees.
Generally, yes. During the Annual Enrollment Period (AEP), which runs from October 15 - December 7, one can make changes for the next calendar year. But, there are some rules around signing up for certain types of Medicare coverage, and if you don’t choose it by a certain age, you’re blocked out of it. I don’t think that Part D plans are part of that.
I think that Plan F is one of these, but Plan G is similar.
F is being phased out. Hubster was eligible because of his age.
Another example of why Medicare plus medigap: Hubster went into the same rehabilitation hospital a couple years ago. At that time he had Blue Care Network advantage of some sort. Anyway the hospital and doctor spent almost a week saying he needed to be there and being denied. They finally said yes on the third or fourth (can’t remember for sure) and he went. This time there was no dancing around and denying, he needed to go. He’d been in the hospital two weeks, and the doctor said he needed to go and that was it he went.
Even if @JohnT doesn’t make an appearance here in time, you may find it helpful to read some of their distilled wisdom at:
It’s a huge thread, but there are a couple of summary posts near the start that give you at least the background of what you need to know.
Rules are a bit different when you’re changing plans midstream, so take what is written therein with a grain of salt. Some of what it presents as options may only apply when you’re starting at age 65.
Best of luck to you and your father.
A quick check shows that if you go for more than 63 days without “creditable” drug coverage, you can still sign up but have to pay a penalty. Creditable means as good as Medicare, so if you are on an employer plan with drug benefits and then retire and switch to Medicare, there is no penalty. Besides the signup period mentioned, you have 8 months to sign up with no penalty if you lose an employer plan, say if the employer cancels it or lays you off.
From Google AI, so don’t trust it, but it matches my understanding.
Thanks for the tags, but I’ve been out of the insurance business since 2021 or so. But if you can get your father on a Medicare Supplement plan, that would be best. I would also call your state’s SHIP office, a list of which can be found here:
Yes, do this.
You can also go to Medicare.gov. Click on Basics, and it will walk you through everything. It’s actually pretty well-written.
Also on Medicare.gov, click on Health & Drug Plans, then click on Find Health & Drug Plans. Enter your father’s zip code, and you’ll see all the plans offered in his area.
I apologize if this has already been suggested; I didn’t read through all the comments. What I have read looks like solid advice, though.