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We're both retired
At age 65 DW has an available Medigap plan from her employer or a Advantage plan from my employer.
We have to pick one. Monthly cost of either is low.
I'm already on the Advantage plan, have used it and paid some reasonable copays.
DW has no medical issues.
The Medigap plan shows zero copays for most things.
The Medigap will reimburse the cost of Part D for prescriptions
The Advantage plan covers prescriptions.
I've called and asked questions for each plan. Probably will ask more. There's too many details to compare everything.
This could come down to a coin flip.
Any thoughts?
The Medigap will reimburse the cost of Part D for prescriptions
Retiree Advantage plans are usually better performers than those offered to the public - more benefits, cheaper or no copays, low OOPs, better behavior on oversight. That said, if your wife's Medigap will reimburse the cost of Part D, I favor the Medigap. No matter how good, Advantage plans remain more restrictive as to providers and oversight on medical procedures. With a Medigap, your doctor decides on your treatment, not the Advantage plan which, for many procedures, will require a preapproval. Medigap gets my vote.
Thanks for that link.
I have more detailed info for my Advantage plan
0 deductables, $1250 annual OOP for medical in or out of network
They claim a 4 1/2 star rating from Medicare
They don't give it a letter but I think it's like plan F or better
Aetna Medicare plan PPO with Extended Service area, seems to cover many providers, will pay out of network
Covers glasses & eye exams. up to a limit.
No dental but I think there's a dental plan available ad additional cost
The Medigap plan covers eye exams but not frames or lenses.
Medigap is $12/mth less
No Dental
Unless you feel that vision benefit and drug benefits are really worth the bucks and you are on a tight retirement budget, I still vote Medigap. No worries about providers at all anywhere, no worries about preapprovals for medical procedures. Just make appt with any doc who accepts Medicare anywhere in the country. Medigaps are the Cadillac of Medicare coverage. Advantage has disadvantages, although as I've said before, retiree Advantage plans can be very good.
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Be careful with employer medicare plans. My employer offered the same for retirees until two years ago. Due to a lack of participation the cost was not justified so they cancelled it. No longer available to future retirees, and cancelled for those already using it effective with the next open enrollment period.
Be careful with employer medicare plans. My employer offered the same for retirees until two years ago. Due to a lack of participation the cost was not justified so they cancelled it. No longer available to future retirees, and cancelled for those already using it effective with the next open enrollment period.
In the event that happens, those who lose their insurance are given a guaranteed issue right (no health underwriting) to purchase a Medigap.
You have the right to buy
Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in your state
You only have this right if you switch to Original Medicare rather than joining another Medicare Advantage Plan. You can/must apply for a Medigap policy:
As early as 60 days before the date your coverage will end
No later than 63 calendar days after your coverage ends
Medigap coverage can't start until your Medicare Advantage Plan coverage ends.
Be careful with employer medicare plans. My employer offered the same for retirees until two years ago. Due to a lack of participation the cost was not justified so they cancelled it. No longer available to future retirees, and cancelled for those already using it effective with the next open enrollment period.
There is that. Both of us were with union companies. Every time contract negotiations come around there's a fight between the union and the company. The union wants to preserve or increase benefits. The company wants to cut costs. Retirees are probably a lower priority than workers. Plans can change. DW thinks her company may have more stability because it's a electric/gas utility.
There's no lack of participation with either company health plan. You'd have to be crazy. Our pre medicare plans helped us retire in our 50's.
We went to the SS office to sign up for A & B. We got some information but all they could do was schedule a phone interview that would be weeks away. We found out DW age 70 SS will be a few thousand more than we thought, so that was nice. We went home and signed up online. Still waiting for approval or processing or whatever.
So, we thought we'd go with her employers medigap plan but,
We just received a letter from my benefits office explaining my pension deduction for DW medical is gonna change as she transitions to medicare. The letter warns that she must sign up for medicare to avoid a gap in coverage. It seems this is happening by default. Both companies had said we must get A & B and then apply for the benefit.
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