What I have learned about Advantage vs Original
Posted 11-11-2021 at 05:21 PM by jdhpa
Quote:
Originally Posted by Ariadne22
These are the reasons people purchase a Medigap.
1. Medigap MUST PAY its share of any expense covered under Medicare. They cannot deny any Medicare approved service.
2. Plan F isn't the "best one" in terms of price or bang for the buck. Much better off with G or N, N especially if one doesn't need the rare nonparticipating provider. Significantly lower premium for Plan N in most states as one ages.
3. Only deductible w/Original, if also covered under a Medigap, is Part B - currently $203. Medigap pays the hospital deductible 100%.
4. Part B premium is necessary to join Advantage. Some Advantage plans will reimburse part or all of this premium.
5. There is NO OUT OF POCKET with a Medigap, other than the Part B deductible and tiny cost-sharing w/Plan N (up to $20 dr. appt./$50 ER if not admitted to hospital). Advantage plans have an out of pockekt exposure generally of somewhere between $5k-$8k. Some plans as high as $13k. Advantage plan out-of-pockets can be twice the cost of a Medigap, if not more, if one encounters a health crisis or has a chronic ailment.
6. Medigaps provide COMPLETE PROVIDER FLEXIBILITY - see any Medicare provider, anywhere. Advantage plan enrollees are restricted to providers in that plan's network.
Please read this thread carefully:
https://www.city-data.com/forum/heal...nary-info.html
Then read:
https://www.city-data.com/forum/heal...-medicare.html
https://www.city-data.com/forum/heal...nrollment.html
- Provider flexibility
- No insurer oversight/approvals
- Medical costs limited to premium for Part B/Medigap - with exception of $203 Part B deductible and services not covered by Medicare - and Part D premium/copays.
1. Medigap MUST PAY its share of any expense covered under Medicare. They cannot deny any Medicare approved service.
2. Plan F isn't the "best one" in terms of price or bang for the buck. Much better off with G or N, N especially if one doesn't need the rare nonparticipating provider. Significantly lower premium for Plan N in most states as one ages.
3. Only deductible w/Original, if also covered under a Medigap, is Part B - currently $203. Medigap pays the hospital deductible 100%.
4. Part B premium is necessary to join Advantage. Some Advantage plans will reimburse part or all of this premium.
5. There is NO OUT OF POCKET with a Medigap, other than the Part B deductible and tiny cost-sharing w/Plan N (up to $20 dr. appt./$50 ER if not admitted to hospital). Advantage plans have an out of pockekt exposure generally of somewhere between $5k-$8k. Some plans as high as $13k. Advantage plan out-of-pockets can be twice the cost of a Medigap, if not more, if one encounters a health crisis or has a chronic ailment.
6. Medigaps provide COMPLETE PROVIDER FLEXIBILITY - see any Medicare provider, anywhere. Advantage plan enrollees are restricted to providers in that plan's network.
Please read this thread carefully:
https://www.city-data.com/forum/heal...nary-info.html
Then read:
https://www.city-data.com/forum/heal...-medicare.html
https://www.city-data.com/forum/heal...nrollment.html
.
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