Medicare: Medigap Plans vs. Medicare Advantage Plans? (policies, retirement, private)
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I did not mean to be all negative on Advantage plans. There are good plans around the country. And in some areas they are widely accepted and are pretty much the plan of choice. And from what I've read, where they work they work well.
Personally, I like the concept of pay as you go. If I weren't in Tricare (which is a form of Medigap) I'd likely go with them because they are widely accepted where I live. And IMO, like it or not current Medicare is going to transform toward a cost containment model. Sooner than later.
And lets face it, for many retirees living in areas where the plans are popular they are the only affordable insurance option.
So, if I wanted care outside of the Bay Area, I know I'm covered in all of California, but, what if I chose a facility in another state on Plan F, when it isn't an emergency? My family has a long history with the Cleveland Clinic so some work I would really rather have done there instead of here, just a familiarity thing. I thought my agent said only emergencies are covered out of state, but I may not have understood her correctly. I recall reading a post about someone needing valve repair surgery so he went to Mayo Clinic in another state which got me wondering
If you want portability, you don't pick an Advantage Plan.
Plan F, for instance, goes with you all over the US.
I have the high deductible F...That does, too...use it in NY and in Fl
So, if I wanted care outside of the Bay Area, I know I'm covered in all of California, but, what if I chose a facility in another state on Plan F, when it isn't an emergency? My family has a long history with the Cleveland Clinic so some work I would really rather have done there instead of here, just a familiarity thing. I thought my agent said only emergencies are covered out of state, but I may not have understood her correctly. I recall reading a post about someone needing valve repair surgery so he went to Mayo Clinic in another state which got me wondering
Your agent was confusing limitations on a Medicare Advantage plan with Medigap Plan F.
As I recall, you have a Medigap Plan F through United Health Care, do you not? UHC Advantage plans have networks and will pay for emergency treatment at out-of-network facilities. UHC Advantage also has its Passport program which, if you notify them you will be traveling, allows treatment in other parts of the country at designated facilities.
Medigaps (Plans A-N) do not have networks. You are not limited by doctor or facility or location - except if overseas, where it pays up to $50k.
The biggest advantage of a Medigap is its flexibility - it will pay its share of any Medicare-approved charge anywhere in the US. It is not an HMO, it is not a PPO. Your rate and carrier are determined by your state of residence, but that does not limit you to service in your state of residence.
If your agent said you needed to stay in California for treatment, she was wrong.
I should not have made it look like only some of them provide access....all the plans , A through N, are good with any doctor or other provider that accepts Medicare.(and even those that don't with some restrictions)
Some plans....F for instance...covers EVERYTHING anywhere
edited to add...in the US, if anybody was going to object to the literalness of 'everywhere'
Yes indeed! Plan f is what we have. We are more than satisified with our health care, but, I just pray that it doesn't get screwed up by the powers that be.
Just to add another layer of confusion, enter Extend Health Care. My girlfriend has been using her employer based insurance since she retired several years ago. Now, the former employer wants to get rid of them so they contracted with Extend Health Care to sell insurance to the former employees, but, if they don't like the Extend choices and buy elsewhere, they lose their subsidy. I suspect the employer is paying Extend very well to administer the health care and rake in plenty from insurance commissions while paying out little in subsidies. I just heard of this system yesterday so it is new to me, and my friend, but it sure seems like a lot of palms are getting greased at the expense of the people who need health care.
Yes indeed! Plan f is what we have. We are more than satisified with our health care, but, I just pray that it doesn't get screwed up by the powers that be.
Me too! But I don't know how much longer until it does happen. We have been getting as much done as possible by the end of the year so we avoid the system as long as possible after that.
Just to add another layer of confusion, enter Extend Health Care. My girlfriend has been using her employer based insurance since she retired several years ago. Now, the former employer wants to get rid of them so they contracted with Extend Health Care to sell insurance to the former employees, but, if they don't like the Extend choices and buy elsewhere, they lose their subsidy. I suspect the employer is paying Extend very well to administer the health care and rake in plenty from insurance commissions while paying out little in subsidies. I just heard of this system yesterday so it is new to me, and my friend, but it sure seems like a lot of palms are getting greased at the expense of the people who need health care.
What a mess.
Administrative fees to insurance companies typically run about 5% of the plan costs...
Just to add another layer of confusion, enter Extend Health Care. My girlfriend has been using her employer based insurance since she retired several years ago. Now, the former employer wants to get rid of them so they contracted with Extend Health Care to sell insurance to the former employees, but, if they don't like the Extend choices and buy elsewhere, they lose their subsidy. I suspect the employer is paying Extend very well to administer the health care and rake in plenty from insurance commissions while paying out little in subsidies. I just heard of this system yesterday so it is new to me, and my friend, but it sure seems like a lot of palms are getting greased at the expense of the people who need health care.
What a mess.
Yes, I've heard. Of Extend Health. They are a racket. I'm surprised the gov't hasn't banned them. They do get a cut from each sale they make. They are IMO not so reputable.
They do push certain Advantage plans and I'd surely check those plans carefully before signing anything with them if I were your friend. Any idea how much the subsidy is? Places like eHealth has good prices on Medigaps. And maybe Extend Health has similar deals on Medigaps. Might be best to compare their prices vs what's available elsewhere. Possible there might be enough savings to counter the subsidy?
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