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Do any of the medigap rx plans have a maximum out-of-pocket? Of those I reviewed, once the true out-of-pocket reaches $7050, the co-payment is the greater of 5% or some max. dollar amount, but there is no annual maximum out-of-pocket.
There is no such thing as a Medigap RX plan. Part D plans are usually bought to augment a Medigap, but can also be purchased when one is enrolled in certain Advantage plans which do not provide drugs. Donut hole issues are the same for all plans.
There are no max out of pockets.
In-depth answer to your question on the Donut Hole thread, here:
So if I want to explore going back on std Medicare, and get a supplemental, do I just do that online? Any concerns about my current M-Adv provider seeing that?
So if I want to explore going back on std Medicare, and get a supplemental, do I just do that online? Any concerns about my current M-Adv provider seeing that?
MAs don't care, they can't cancel you unless you ask them to.
Process for switching from Advantage when I did it in 2013 is to apply for a Medigap, once approved, IN WRITING, disenroll from Advantage.
You might call UHC and ask about their procedure in your situation. I used a Physicians Mutual agent, met with him personally. He/Physician's Mutual needed a hard copy of the Advantage provider's cancellation of coverage based on my letter requesting cancellation before it would finalize coverage. Not sure if that's necessary now.
MAs don't care, they can't cancel you unless you ask them to.
Process for switching from Advantage when I did it in 2013 is to apply for a Medigap, once approved, IN WRITING, disenroll from Advantage.
You might call UHC and ask about their procedure in your situation. I used a Physicians Mutual agent, met with him personally. He/Physician's Mutual needed a hard copy of the Advantage provider's cancellation of coverage based on my letter requesting cancellation before it would finalize coverage. Not sure if that's necessary now.
You're very welcome. I've been researching medigap plans here and online for about 2 years. AARP/UH plan G with $200 deductible seems like the best from feedback here. If you want more info, DM me, I'll give you the links to the threads I read that helped me decide. I wrote everything in an email draft. I also recently posted it in about 3 threads in the last few weeks.
Quote:
Originally Posted by GWoodle
Correct.
When you retire in your 60's should have no health problems. In the initial stage, at some time you go thru a set of screenings from cancer to heart to overweight. So if they find something maybe you start on meds. To control blood pressure, to control cholesterol, generic meds are cheap if not free. But if/when they do find something BAM here comes expensive meds.
With your Plan G you also need a separate Part D drug plan. In the plan get meds cheaper than full retail cost. BAM when you do get something & approach coverage gap to catastrophic phase be thankful those costs are met.
Don't know if you have had experience in taking family members to the hospital/doctor. Ask & find what their experience is compared with someone on an Advantage plan. In an Advantage plan maybe they can't see the doctor they want. Maybe they have to wait for the insurance company to do something.
Great advice to ask friends and family what insurance they have and feedback.
I went with a BCBS medigap because my dad had a medigap. He had terminal leukemia, to my knowledge, he never got a bill for anything.
The cancer center had to get the clinical trial approved back then (2005), that was the only time there was an "issue" the ok came pretty quick.
I had to go with BCBS medigap because I'm in my 50's, not many companies offer medigaps to people my age. My hub had just lost our BCBS coverage, new employer didn't offer health insurance. I called BCBS to see if they had a medigap plan for me, they did, so I signed up. They already had years of my medical history.
Quote:
Originally Posted by JRR
A couple of years ago, my wife needed some surgery on her back. The neurosurgeon said that they would clear it with her insurance company and then schedule her for the surgery. Said that it might take a few days.
My wife said that she had regular Medicare with a supplement. Response was "In that case, let's go ahead and get that surgery scheduled".
Medigaps sure make it a lot easier to get treatment. I don't ever want a health system like Canada has, take a number, hope where you go is good
Quote:
Originally Posted by Ariadne22
MAs don't care, they can't cancel you unless you ask them to.
Process for switching from Advantage when I did it in 2013 is to apply for a Medigap, once approved, IN WRITING, disenroll from Advantage.
You might call UHC and ask about their procedure in your situation. I used a Physicians Mutual agent, met with him personally. He/Physician's Mutual needed a hard copy of the Advantage provider's cancellation of coverage based on my letter requesting cancellation before it would finalize coverage. Not sure if that's necessary now.
I agree with calling United healthcare to have one of their reps help. I'm not an agent sort of person, I don't like having a middle man when I can speak to the company directly. It has always paid off for me. I don't recall what issue I had a few years ago but dealing directly with the company verses having the middle man be responsible to fix the issue would have cost me time and a headache. I'm not one to play phone tag which is what usually happens.
The beautiful thing is we're almost in 2022, technology makes things so much easier when you need a medical bill copy that you have to send to insurance. Most places have patient portals where you can access a lot of information quickly.
I am enrolled in UHC Supplement G for 2022. But I am trying to convince my wife to also change to the supplement plan too. And we will be finalizing my Plan D policy later in December. During this year I maxed out my deductibles early on in the year due to a injury I had. Whereas my wife only needs to go to the doctor for her annual checkup. And we are both not on any lifesaving medications. Or have any underline health issues.
The back story is we both picked up Medicare B when my wife retired on 2020/07/01. And we enrolled in Priority health advantage plan at that time. The cost is very low at $42 each. It covers part D, eye care and vision too. And it is also good nationwide.
My DOB = 1952/12/27
Wife's DOB = 1954/03/21
My question that I cannot get a real solid answer for with actual numbers are:
1. I keep getting told that there is a trial period that you can use a Advantage plan and still be able to switch to a Supplement plan without a cost penalty or underwriting. How long exactly is that trial period? With the assumption that we are not having any medical issues and our health is good.
2. When I talked to the insurance person he quoted me a price for my wife of $103/ m with UHC. if she switch when I switched to the supplement plan G for 2022.
If she switches to supplement plan G for year 2023 what would the cost be?
If she switches to supplement plan G for year 2024 what would the cost be?
3. Why is there a $ penalty for switching 2 or 3 years down the road if there are no health issues?
The back story is we both picked up Medicare B when my wife retired on 2020/07/01. And we enrolled in Priority health advantage plan at that time. The cost is very low at $42 each. It covers part D, eye care and vision too. And it is also good nationwide.
My DOB = 1952/12/27
Wife's DOB = 1954/03/21
My question that I cannot get a real solid answer for with actual numbers are:
1. I keep getting told that there is a trial period that you can use a Advantage plan and still be able to switch to a Supplement plan without a cost penalty or underwriting. How long exactly is that trial period? With the assumption that we are not having any medical issues and our health is good.
2. When I talked to the insurance person he quoted me a price for my wife of $103/ m with UHC. if she switch when I switched to the supplement plan G for 2022.
If she switches to supplement plan G for year 2023 what would the cost be?
If she switches to supplement plan G for year 2024 what would the cost be?
3. Why is there a $ penalty for switching 2 or 3 years down the road if there are no health issues?
1. Trial right to a supplement is a right given for one year when you first enroll in Medicare at age 65 and join an Advantage plan. Neither of you qualify. See:
2. No one knows because of the cost of medical inflation. UHC discounts one portion of the premium because of age, incrementally removing that discount each year until you reach 77/81, depending on age. The age component of the increase is about 3%. After you reach age 77/81, the increase is inflation-based only. UHC's age-discount schedule, here:
I am enrolled in UHC Supplement G for 2022. But I am trying to convince my wife to also change to the supplement plan too. And we will be finalizing my Plan D policy later in December. During this year I maxed out my deductibles early on in the year due to a injury I had. Whereas my wife only needs to go to the doctor for her annual checkup. And we are both not on any lifesaving medications. Or have any underline health issues.
The back story is we both picked up Medicare B when my wife retired on 2020/07/01. And we enrolled in Priority health advantage plan at that time. The cost is very low at $42 each. It covers part D, eye care and vision too. And it is also good nationwide.
My DOB = 1952/12/27
Wife's DOB = 1954/03/21
My question that I cannot get a real solid answer for with actual numbers are:
1. I keep getting told that there is a trial period that you can use a Advantage plan and still be able to switch to a Supplement plan without a cost penalty or underwriting. How long exactly is that trial period? With the assumption that we are not having any medical issues and our health is good.
2. When I talked to the insurance person he quoted me a price for my wife of $103/ m with UHC. if she switch when I switched to the supplement plan G for 2022.
If she switches to supplement plan G for year 2023 what would the cost be?
If she switches to supplement plan G for year 2024 what would the cost be?
3. Why is there a $ penalty for switching 2 or 3 years down the road if there are no health issues?
Can I ask why you decided to switch? I am in a similar situation and the medicare advantage is appealing -- all our providers and hospitals are in the network, we do not need referrals (PPO) model and we can go out of network if it is ever necessary. I did an economic analysis of the premiums and out-of-pocket expenses and the medicare advantage plan is reasonable vs. the medicare supplement. We have a larger out-of-pocket max. but the monthly savings will cover the out-of-pocket max in about 18 months. and we may never reach the out-of-pocket max. Since the medicare advantage is community rated, we don't have to worry about age based rates.
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