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Post by anovice on Dec 14, 2022 12:22:28 GMT
I'm currently with BCBS and tried to get Medicare supplement pricing on-line yesterday but it stated I was too far out from my birthday. BCBS swings a pretty big stick in MN as far as what they allow providers to charge. In regard to an earlier question, no one has an HSA that they use to pay Medicare premiums? mnfish to your question first. It does not appear that you can for a Medigap policy. www.65incorporated.com/topics/out-pocket-medicare-costs/heath-savings-account-distributions-medicare-premiums/"After you turn 65, you can also withdraw money tax-free from your HSA to pay premiums for Medicare Part B, Part D prescription drug coverage and Medicare Advantage plans, but not Medicare supplemental plans, also called Medigap. You also can pay your Part A premiums with HSA money if you or your spouse did not work long enough to be eligible for premium-free Part A coverage." www.aarp.org/health/medicare-qa-tool/health-savings-account/Where I reside, BCBS controls over 75% of the market for both employer PPO and HMO plans as well as Medicare Advantage PPO and HMO plans. However, they have a small percentage of the Medigap market. Why is that? Because BCBC is made up of a number of separate companies that partner with each other. One of the big benefits of Medigap is that you go anywhere in the county when you want. Since one BCBS company needs to communicate with the other, it makes things more complicated. For a Medigap policy, go with one of the big national companies in my last post. Also, find a broker in your area to assist you. A good one is worth his/her weight in gold, and it cost you nothing.
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Post by anovice on Dec 14, 2022 12:45:19 GMT
FD1000: I am not understanding your post. What makes Aetna and Mutual of Omaha "top choices"? Certainly, UnitedHealthcare (AARP), Cigna, Humana, and a few others are equally good (or bad) companies. After looking at the financial strength of the insurer, I would submit that the top choices depend on where you reside. While all these companies are national, their presence is stronger/weaker in different places. For example, where I live, Mutual of Omaha does not have a strong presence. If I lived in Georgia, I would inquire with the likes of Emory University Hospital as to which companies they have the best experience with. If the provider has an easy time processing a claim, that would be a top choice for me. I'm talking about Medigap which is supplement to original Medicare. You want a strong company with lower prices, a large number of patients, and long reliable history. For example, BCBS got out for several years, and came back. Emory offers advantage not Medigap. The fact that most advantage companies don't have all my doctors is a red flag. Medigap or advantage is an old debate. FD: We are not communicating. I know that you were talking about Medigap. There are other companies besides Aetna and Mutual of Omaha that meet your stated criteria. All the companies in my post meet your criteria of a "strong company", "large number of patients", "long reliable history". Regarding price, that solely depends on the market. There is no product differentiation so if these companies were not price competitive in certain markets, they would not be in business. Regarding Emory University Hospital, they are not in the insurance business. They do not sell (offer) any plans. I wrote " If I lived in Georgia, I would inquire with the likes of Emory University Hospital as to which companies they have the best experience with". For example, Aetna, UnitedHealthcare, Cigna, etc.
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Post by FD1000 on Dec 14, 2022 14:11:52 GMT
I'm talking about Medigap which is supplement to original Medicare. You want a strong company with lower prices, a large number of patients, and long reliable history. For example, BCBS got out for several years, and came back. Emory offers advantage not Medigap. The fact that most advantage companies don't have all my doctors is a red flag. Medigap or advantage is an old debate. FD: We are not communicating. I know that you were talking about Medigap. There are other companies besides Aetna and Mutual of Omaha that meet your stated criteria. All the companies in my post meet your criteria of a "strong company", "large number of patients", "long reliable history". Regarding price, that solely depends on the market. There is no product differentiation so if these companies were not price competitive in certain markets, they would not be in business. Regarding Emory University Hospital, they are not in the insurance business. They do not sell (offer) any plans. I wrote " If I lived in Georgia, I would inquire with the likes of Emory University Hospital as to which companies they have the best experience with". For example, Aetna, UnitedHealthcare, Cigna, etc. OK, we are on the same page. It is state dependent. Chances you can't get an answer from Emory, even when I asked my family Dr he wouldn't give me an answer. Actually, it's pretty difficult to get any true answer. I called several brokers, most sell 2-3 companies, mainly BCBS and AARP and trash the rest. Amazingly, most don't sell Aetna and mutual of Omaha which are very strong, that was already a warning for me. BTW, none of my MDs belongs to Emory, most of them have their own group.
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Post by flipperxxx on Dec 14, 2022 14:22:24 GMT
so who do you think is the strongest in so. california? i'm trying to get my girlfriend on a medigap policy right now but she recently had a stroke so it's all very confusing for her. and for me. we're thinking of going through a broker like boomer benefits but i know they don't offer all plans.
she's eligible for plan F as well as plan G but my understanding is the when you net it out, F and G are about the same.
and then there's the drug plan. and that's a huge perplexity unto itself for the two of us.
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Post by marquay on Dec 14, 2022 15:12:29 GMT
Good for you Fred. to have Plan F. Now Only Plan G is offered. Plan F is discontinued.
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Post by anovice on Dec 14, 2022 15:45:30 GMT
so who do you think is the strongest in so. california? i'm trying to get my girlfriend on a medigap policy right now but she recently had a stroke so it's all very confusing for her. and for me. we're thinking of going through a broker like boomer benefits but i know they don't offer all plans.
she's eligible for plan F as well as plan G but my understanding is the when you net it out, F and G are about the same.
and then there's the drug plan. and that's a huge perplexity unto itself for the two of us.
The only difference between F and G is that F picks up Part B deductible and G does not. Part B deductible for 2023 is $226.00. However, Plans F is not available to people who were newly eligible for Medicare on or after January 1, 2020. "How to compare Medigap policies" from Medicare.gov, which is a very good website. www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policiesAll this stuff can be very confusing, especially in the beginning. I do not recommend that you tackle this on your own. I have read on the Bogleheads forum that a number of people used boomer benefits and were pleased. I wanted a local broker, so I asked friends for some names, and I found one that was outstanding. I recommend that you take this path.
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Post by FD1000 on Dec 14, 2022 17:02:40 GMT
Wow, when I started Medicare in May 2022, only one advantage, out of 50+, had all my MDs. I checked now, and...none have it. This should be a red flag for anyone who can afford to pay a higher premium, but be safer later and maybe cheaper too. Hint: you will get very sick, because you get older. Calling a broker is a good choice, but try to get one that knows the big ones, at least 7-10, and sell all of them. Example: several brokers offered me BCBS. I asked why this is better than others. A typical answer: I sold many, and all are happy. So I asked: did you sell the other big 5, and why are they not as good? The answer: BS.
I called many and eventually found 2 brokers. Ask open questions, listen, make notes, by the fifth one, you should know a lot more. I could detect the bad from the good within minutes now.
It's similar to a (FA)financial advisor: Catch 22: when you don't know much, you don't know if the FA is good. When you know more than the average, you don't need one.
That's true about finance in general. You are making decisions that affect you for decades, so why not invest in yourself and learn, learn and learn more. We are talking about just several hours for Medicare.
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Post by Chahta on Dec 14, 2022 17:11:48 GMT
so who do you think is the strongest in so. california? i'm trying to get my girlfriend on a medigap policy right now but she recently had a stroke so it's all very confusing for her. and for me. we're thinking of going through a broker like boomer benefits but i know they don't offer all plans.
she's eligible for plan F as well as plan G but my understanding is the when you net it out, F and G are about the same.
and then there's the drug plan. and that's a huge perplexity unto itself for the two of us.
The only difference between F and G is that F picks up Part B deductible and G does not. Part B deductible for 2023 is $226.00. However, Plans F is not available to people who were newly eligible for Medicare on or after January 1, 2020. "How to compare Medigap policies" from Medicare.gov, which is a very good website. www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policiesAll this stuff can be very confusing, especially in the beginning. I do not recommend that you tackle this on your own. I have read on the Bogleheads forum that a number of people used boomer benefits and were pleased. I wanted a local broker, so I asked friends for some names, and I found one that was outstanding. I recommend that you take this path. Not exactly true. Plan F is no longer offered unless you are grandfathered in and had Medicare prior to 2020. As such the pool is smaller and getting smaller. You will be over-paying for premiums. Plan G will save a significant amount of money which exceeds the Medicare yearly deductible of $226. That is the only difference between F and G. The prescription plan is easy to assess. You can call Medicare, tell them your current meds and they will give you the best (least expensive) plans to look at. You need to weigh premiums, prescription costs and yearly deductible. A broker is a good way to go. He can guide her to get a plan for her. When I left CA I had Blue Shield of CA Plan F. Before that I had United Health Care Plan F. Both companies are big in CA. Now I have Mutual of Omaha PLan G.
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Post by anovice on Dec 14, 2022 18:09:37 GMT
The only difference between F and G is that F picks up Part B deductible and G does not. Part B deductible for 2023 is $226.00. However, Plans F is not available to people who were newly eligible for Medicare on or after January 1, 2020. "How to compare Medigap policies" from Medicare.gov, which is a very good website. www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policiesAll this stuff can be very confusing, especially in the beginning. I do not recommend that you tackle this on your own. I have read on the Bogleheads forum that a number of people used boomer benefits and were pleased. I wanted a local broker, so I asked friends for some names, and I found one that was outstanding. I recommend that you take this path. Not exactly true. Plan F is no longer offered unless you are grandfathered in and had Medicare prior to 2020. As such the pool is smaller and getting smaller. You will be over-paying for premiums. Plan G will save a significant amount of money which exceeds the Medicare yearly deductible of $226. That is the only difference between F and G. The prescription plan is easy to assess. You can call Medicare, tell them your current meds and they will give you the best (least expensive) plans to look at. You need to weigh premiums, prescription costs and yearly deductible. A broker is a good way to go. He can guide her to get a plan for her. When I left CA I had Blue Shield of CA Plan F. Before that I had United Health Care Plan F. Both companies are big in CA. Now I have Mutual of Omaha PLan G. Hi Chahta, I am not certain which part of my sentence is not exactly true. It is not a requirement to have "had Medicare prior to 2020" in order to get Plan F today. If your 65th birthday was before January 1, 2020, but you chose to stay employed with your employer's plan, you can still get Plan F. The operative words are newly eligible for Medicare January 1, 2020.
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Post by habsui on Dec 14, 2022 18:14:04 GMT
These days, Plan G is more cost effective than Plan F. This is certainly true in the states that I'm familiar with.
The perceived strength of companies that offer plans in your area is state dependent. Out here on the western frontier, UH, BlueShield work fine. I have seen some not so good reviews for Aetna.
Good health..
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Post by retiredat48 on Dec 14, 2022 18:33:35 GMT
A quick note...I have found that GoodRX for several drugs is the real deal...and easy to use. In one case spouse had a (temporary med) that was $350/month on my current plan...and $250 at lowest plan, and goodrx had it for $200/month.
In doing my annual assessment of drug plans recently (VIA benefits, free with GE), I noticed goodrx had drugs through CVS, Wallgreens, Publix etc that were less with them, than by my low cost drug plan.
Factor goodrx into your plan assessments, for the drugs you take.
R48
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Post by marquay on Dec 14, 2022 18:42:07 GMT
Where or how do you hire a broker? I live in NYC (Manhattan). Thanks.
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Post by fred495 on Dec 14, 2022 19:06:35 GMT
However, Chatha makes a good point when he says that: "Plan F is no longer offered unless you are grandfathered in and had Medicare prior to 2020. As such the pool is smaller and getting smaller. You will be over-paying for premiums. Plan G will save a significant amount of money which exceeds the Medicare yearly deductible of $226. That is the only difference between F and G."
For example, based on current premiums for AARP/UHC Medigap plans in my ZIP code, the annual savings if you pick plan G over F is $251.
Fred
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Post by anovice on Dec 14, 2022 19:07:56 GMT
Where or how do you hire a broker? I live in NYC (Manhattan). Thanks. I used a financial advisor who also sold Medicare Advantage and Medigap policies. Ask a few people in your building that are over 65 who they use.
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Post by Chahta on Dec 14, 2022 21:18:39 GMT
anovice , one had to be eligible for Medicare by the end of 2019 to be able to buy Plan F. Someone signing up in 2022 for Medicare cannot buy it. But those that have Plan F can keep it, even though it is a waste of money. marquay, you should be able to find insurance salesmen that sell only supplemental plans. It's big business.
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Post by liftlock on Dec 14, 2022 21:40:06 GMT
so who do you think is the strongest in so. california? i'm trying to get my girlfriend on a medigap policy right now but she recently had a stroke so it's all very confusing for her. and for me. we're thinking of going through a broker like boomer benefits but i know they don't offer all plans.
she's eligible for plan F as well as plan G but my understanding is the when you net it out, F and G are about the same.
and then there's the drug plan. and that's a huge perplexity unto itself for the two of us.
You can go to Medicare.Gov to find and compare the cost of plans for your zip code. www.medicare.gov/plan-compare/#/?year=2023&lang=enYou might want to compare the annual premium cost of Plan G versus Plan F. Add the annual Medicare deductable to the premium cost of Plan G to compare the total cost of Plan G versus Plan F. I re-shop for a Part D drug plan every year. I typically go with the lowest annual cost plan (annual premium plus cost of drugs) for the known drugs I expect to take. Note that total cost may vary by the type of pharmacy (mail order, preferred or standard retail). Costs for specific drugs will vary by the pricing tiers the drugs are assigned to within each plans formulary. Some plans do not cover specific drugs which means the plan pays nothing for the drug and your out of pocket costs will not count toward the plans out of pocket limits. The Medicare drug plan finder provides transparency to all of this. Free help in selecting plans is available from your local SHIP program office. acl.gov/programs/connecting-people-services/state-health-insurance-assistance-program-shipLicensed brokers are also free to use.
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Post by liftlock on Dec 14, 2022 21:51:20 GMT
In doing my annual assessment of drug plans recently (VIA benefits, free with GE), I noticed goodrx had drugs through CVS, Wallgreens, Publix etc that were less with them, than by my low cost drug plan. R48 R48, My former employer requires me to use Via Benefits to obtain automatic retiree reimbursement for my Medicare supplement plan premiums. When I shopped for a Part D drug plan for 2023 I noticed that ViaBenefits was not offering the lowest cost plans found on Medicare.Gov. I ended up buying a lower cost plan through Medicare.Gov.
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Post by anovice on Dec 14, 2022 22:28:07 GMT
anovice , one had to be eligible for Medicare by the end of 2019 to be able to buy Plan F. Someone signing up in 2022 for Medicare cannot buy it. But those that have Plan F can keep it, even though it is a waste of money. marquay , you should be able to find insurance salesmen that sell only supplemental plans. It's big business. Chahta: Someone signing up in 2022 for Medicare cannot buy it. My good friend, I am going to challenge you on this ;-) We are in agreement that one had to be eligible for Medicare by the end of 2019. But I am saying that so long as one was eligible for Medicare by the end of 2019, even if they did not sign up (I used the example that they stayed employed and on their employees' health insurance plan), they can still sign up for Plan F. Are you disagreeing?
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Post by Chahta on Dec 14, 2022 23:24:54 GMT
anovice it’s ok with me and I agree. I’m going by what my broker told me. I changed from F to G in 2020 since paying the Medicare deductible of $230 (2020) saved me hundreds more. Possibly things have changed or she qualified in 2019 for Medicare. I could have stayed on F but why throw money away? Cheers.
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Post by marquay on Dec 15, 2022 0:14:24 GMT
Supplement plan G. does not include Vision and Dental and Prescription. This a problem because I need an eye doctor to examine my eye yearly for cataracts or glaucoma (family history). Where do I buy separate insurance just for eye care? Any suggestions? Thanks
The Advantage plan may be good, but not all my doctors are in network, and I like the flexibility and no preauthorization of Original Medicare.
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Post by anovice on Dec 15, 2022 0:57:01 GMT
Supplement plan G. does not include Vision and Dental and Prescription. This a problem because I need an eye doctor to examine my eye yearly for cataracts or glaucoma (family history). Where do I buy separate insurance just for eye care? The Advantage plan may be good, but not all my doctors are in the network, and I like the flexibility and no preauthorization of Original Medicare. Medigap plans do not include vision, dental or prescription. Call your optometrist/ophthalmologist's office to discuss this issue. I think what you will find out is that in the course of checking your cataracts, which is picked up under medical in Plan G, they do an eye exam for which you will get a prescription for glasses.
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Post by flipperxxx on Dec 15, 2022 2:04:36 GMT
hi, all: thanks for your advice. timely and helpful. altho my girlfriend does qualify for plan f, we are going with g.
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Post by nobhead on Dec 15, 2022 2:36:39 GMT
Supplement plan G. does not include Vision and Dental and Prescription. This a problem because I need an eye doctor to examine my eye yearly for cataracts or glaucoma (family history). Where do I buy separate insurance just for eye care? Any suggestions? Thanks marquay , I have plan F and my optometrist checks my cataracts every 9 months to see if they need to be removed and I never pay anything for the appointments. He also checks my eyes once a year and I never have to pay for those visits. My understanding is they pay for annual eye exams when you are over 65. I do have to pay full price for glasses.
My wife has had cataracts removed and we had to pay for the surgeries. She has had to visit the ophthalmologist for some problems and our plan F paid for each of the visits.
Plan G is supposed to be the same as plan F except for the deductible.
Just my experience since being on Medicare for a few years.
Nob
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Post by retiredat48 on Dec 15, 2022 5:23:21 GMT
Supplement plan G. does not include Vision and Dental and Prescription. This a problem because I need an eye doctor to examine my eye yearly for cataracts or glaucoma (family history). Where do I buy separate insurance just for eye care? Any suggestions? Thanks The Advantage plan may be good, but not all my doctors are in network, and I like the flexibility and no preauthorization of Original Medicare. marquay,...If you visit an eyedoctor annually, what about self-insurance? Seems likely the eye insurance will cost you at least one visit worth . R48
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Post by retiredat48 on Dec 15, 2022 5:26:46 GMT
In doing my annual assessment of drug plans recently (VIA benefits, free with GE), I noticed goodrx had drugs through CVS, Wallgreens, Publix etc that were less with them, than by my low cost drug plan. R48 R48, My former employer requires me to use Via Benefits to obtain automatic retiree reimbursement for my Medicare supplement plan premiums. When I shopped for a Part D drug plan for 2023 I noticed that ViaBenefits was not offering the lowest cost plans found on Medicare.Gov. I ended up buying a lower cost plan through Medicare.Gov. Thanks for heads-up. GE requires me to use Via benefits if I want $1000 towards my med insurance. Not sure I can buy another drug plan that is not with via? I'll check next year. R48
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Post by anovice on Dec 15, 2022 9:44:00 GMT
A quick note...I have found that GoodRX for several drugs is the real deal...and easy to use. In one case spouse had a (temporary med) that was $350/month on my current plan...and $250 at lowest plan, and goodrx had it for $200/month. In doing my annual assessment of drug plans recently (VIA benefits, free with GE), I noticed goodrx had drugs through CVS, Wallgreens, Publix etc that were less with them, than by my low cost drug plan. Factor goodrx into your plan assessments, for the drugs you take. R48 GoodRx is very good, and they have a nice app for your phone. Another good one is Cost Plus Drugs. Mark Cuban is doing good stuff to try to change the playing field. costplusdrugs.com/news.yahoo.com/mark-cuban-cost-plus-drugs-company-pharmacy-supply-chain-132531582.html
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Post by marquay on Dec 15, 2022 14:38:09 GMT
Anovice, Noshead.
Yes, It's covered.
I called my Opthalmologist, and even few others. I was told eye doctor is billed under regular medical insurance and not vision..Thank you.
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Post by Chahta on Dec 15, 2022 15:05:29 GMT
Good RX is OK to use opportunistically. If you have a Part D RX plan you may be hurting yourself by not using the deductible. You need to do the math. Especially if you end up needing an expensive RX not regularly used.
I am curious if an eye doctor does an exam for a glass prescription, if in the course of a cataract exam, that is covered by Part B. Supplemental plans only pay if Medicare pays.
Vision coverage is like dental coverage. It is generally cheaper to pay yourself unless you have very bad eyes and/or teeth.
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Post by anovice on Dec 15, 2022 15:53:52 GMT
Good RX is OK to use opportunistically. If you have a Part D RX plan you may be hurting yourself by not using the deductible. You need to do the math. Especially if you end up needing an expensive RX not regularly used. I am curious if an eye doctor does an exam for a glass prescription, if in the course of a cataract exam, that is covered by Part B. Supplemental plans only pay if Medicare pays. Vision coverage is like dental coverage. It is generally cheaper to pay yourself unless you have very bad eyes and/or teeth. "Medicare will not cover eye doctor visits for simple eyewear and regular eye care. Medicare Part B will cover medically-necessary exams once every 12 months with a state-certified doctor to treat diabetes-related vision issues or glaucoma-related issues. For accidental eye injuries, Medicare extends coverage so you can get a diagnostic exam to learn the injuries’ extent." www.medicarefaq.com/faqs/medicare-vision-care-coverage/#:~:text=Medicare%20will%20not%20cover%20eye,issues%20or%20glaucoma%2Drelated%20issues. Medically necessary: www.medicarefaq.com/faqs/what-does-medically-necessary-mean/I have a cataract (I think many elderly people do). I get a medically necessary eye exam every 12 months. In the course of that exam, vision is checked. With those results, I get a new prescription for my glasses.
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Post by marquay on Dec 15, 2022 16:06:55 GMT
Anovice, so in the event that I will have glaucoma or cataract surgeries, these are partially or not covered by Original Medicare?
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