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because i have a high deductible plan which cost less than a third of a regular g plan and a new g plan in a high deductible is exactly the same price as the high deductible f plan since neither pays the deductible in a high deductible plan
in either case f or g they pay nothing until i hit the 2800 deductible, which in 8 years never happened even with my wife and i hospitalized with covid for two weeks back in 2020 and our bills were 125k each .
we save a lot each year with the high deductible plan vs the regular plan .
about 3800 for the g plan each vs 1200 each .for the high deductible plan .
so we pay 2600 less for high deductible and only spend about 500 a year on out of pocket expenses . we bank the difference and the most exposure we have is an additional 200 bucks because once we hit 2800 everything is covered
Ok, I think I understand.
From some googling, it appears that Plan G's difference from Plan F is that F covers the $240 Medicare Part B deductible while G does not. That saves a couple $480 a year. I'm guessing that's why people don't switch from Plan F to Plan G. Of course, that assumes that Plan G's cost isn't $240 a year lesser than Plan F. Or maybe Plan G's annual per person cost is roughly $240 lesser than Plan Fs (give or take), but not enough to warrant screwing around with one's Medicare insurance.
Also, if one maxes out the $2,800 deductible every year, it's $200 cheaper to use regular Plan G than high deductible Plan G. As Mathjak and spouse each pay out a $500 deductible on average, they save the difference between the "pre-paid" deductible of the regular plan and the actual out of pocket deductible paid on the high deductible plan, $2,300 a year each, $4,600 combined.
The COVID illnesses one year maxxed out the deductible, so the extra out of pocket expense was $200 per each spouse that year. Miniscule that year compared to the total savings from not paying the full deductibles the other seven years.
It would seem that the only good reason for someone to go regular vs high deductible is if they're certain that they'll pay out at least $2,600 every year in deductibles for Plan G coverage.
As for the observation about Medicare Part D - good to know, but not part of my initial line of inquiry. I already knew about it because MathJak brought up his Trulicity prescription and the Medicare Part D donut hole in the Health forum. Being on Ozempic myself (A1C dropped from 6.3 to 5.2), the looming donut hole is something I'll need to budget for when I retire and go on Medicare. For now, my health insurance picks up my drug costs with only a $10 co-pay; currently my Ozempic prescription costs me only $120 a year.
From some googling, it appears that Plan G's difference from Plan F is that F covers the $240 Medicare Part B deductible while G does not. That saves a couple $480 a year. I'm guessing that's why people don't switch from Plan F to Plan G. Of course, that assumes that Plan G's cost isn't $240 a year lesser than Plan F. Or maybe Plan G's annual per person cost is roughly $240 lesser than Plan Fs (give or take), but not enough to warrant screwing around with one's Medicare insurance.
Also, if one maxes out the $2,800 deductible every year, it's $200 cheaper to use regular Plan G than high deductible Plan G. As Mathjak and spouse each pay out a $500 deductible on average, they save the difference between the "pre-paid" deductible of the regular plan and the actual out of pocket deductible paid on the high deductible plan, $2,300 a year each, $4,600 combined.
The COVID illnesses one year maxxed out the deductible, so the extra out of pocket expense was $200 per each spouse that year. Miniscule that year compared to the total savings from not paying the full deductibles the other seven years.
It would seem that the only good reason for someone to go regular vs high deductible is if they're certain that they'll pay out at least $2,600 every year in deductibles for Plan G coverage.
As for the observation about Medicare Part D - good to know, but not part of my initial line of inquiry. I already knew about it because MathJak brought up his Trulicity prescription and the Medicare Part D donut hole in the Health forum. Being on Ozempic myself (A1C dropped from 6.3 to 5.2), the looming donut hole is something I'll need to budget for when I retire and go on Medicare. For now, my health insurance picks up my drug costs with only a $10 co-pay; currently my Ozempic prescription costs me only $120 a year.
even hospitalized for covid we didn’t come close to maxing the 2800 . we hit about 1500 each… most of that was ambulance charges
i had one ride in , my wife had a ride in the day after me but because they were so over crowded they put her on home care because her o2 levels were still over admittance levels .
next day she plunged and had another ambulance ride in , this time being admitted.
then we needed an ambulance ride home for both of us because we had portable oxygen generators required by them whether we needed it or not .
so we would have had even less except for the rides
the big cost is my trulicity and all part d plans have the gap .
if i spent more then 500 a year more for a better drug plan the difference was no 500 deductible on these high tier drugs .
that would be silly to change so our 13 dollar a month plan is the same otherwise .
so i pay 511 for the first month in january for trulicity …then 11 a month until the insurer pays out 5k , trulicity is 1k a month to the insurer .
then once 5k is paid out i pay 25% of the cost for the rest of the year which is 250 a month.
every new drug you see on tv is very costly and will fall in the gap all to easily
Last edited by mathjak107; 03-18-2024 at 02:46 AM..
the reality is the amounts not covered by medicare can be very small .
as an example if they bill an mri at 1500 …medicare pays them 400 .. so 20% would be 80 dollars on a 1500 dollar service .
so it takes a lot to recover what one pays for a supplement a year . so we find the high deductible one a huge savings vs an extra 200 or so should we max it out at 2800.
our supplement has never paid out a thing yet since hitting 2800 has been impossible for us to date
plus our supplement pays for our gym thru silver sneakers so in effect out of the 101 a month , it covers our 50 dollar a month membership
plus we can join as many gyms as accept silver sneakers .
we used to belong to two gyms thru it but one gym dropped silver sneakers
I have always had A, B, D, and F, I pay the premium and my ex-employer reimburses me monthly.
I understand that you can't get it back once you get off the F plan. Also, the F plan is
coverage when traveling in a foreign country.
The only difference between a F and G plan is the F plan covers the annual $240 deductible and the G plan does not. Both will cover you in another country.
I've been very happy with my medigap plan from USAA. It pays for pretty much everything Medicare doesn't, except for drugs (I wish they offered drug coverage).
You mentioned the military, so you may be eligible.
I've heard many people are having issues with their Advantage plans. Since they are NOT Medicare, they don't pay the same amounts. For instance, when I had an Advantage plan, they paid for only 70% of my medical supplies. Medicare pays 80%, and my Medigap plan pays the other 20%. That saves about $100/month for me.
Thanks for the info.
Since I'm not claiming SS until 66 then I should only need plan A for now but been told that my insurance which is Tricare (military) will stop once I turn 65 so I will need plan B. I already have eye vision and Dental under the Government insurance. Hopefully, I won't lose those also.
Your Tricare, provided you are a retired service member, becomes Tricare for Life at age 65. It acts as a Medicare supplemental. It will cover the expenses that Medicare does not. You do not need an additional Medicare Supplemental. Your drug benefit should also not change. I have FedVIP for Dental and Vision and as long as I pay the premiums, it won't change either.
You are required to have A and B for Tricare for life, so you will be paying the part B cost out of your SS.
I thought B was automatically deducted from your SS payments. Mine is & I pay separately for Part D. I do also pay for a medicare supplement. A & B
Part B is the supplemental or so called "medical" insurance.
You can have it directly deducted from your SS check.
Part A IS deducted from SS check..to be sure govt gets that premium! It covers only 80% of medicare authorized medical coverage.
Part B is the supplemental that covers the other 20% that Medicare doesn't cover on part A.
I have UHC United Health Care AARP supplement plan F (the old plan F...I'm grandfathered in that..I never see a bill for anything ever and have zero copays.)
Of the Part B supplemental plans..there's choices of plans by different letters for different plans..some are high deductible with low copays, others are low deductible but higher copays.
Those are voices you choose and the monthly premium varies for each lettered plan depending on deductible and copays.
If you have a well funded HSA (Health Savings Account ...only can be funded while working..not available if collecting any SS ) then a low monthly premium with high deductible (can be paid out of the HSA) MIGHT be best.
Low deductible/low copays but higher monthly premium if you don't have major resources to cover serious medical issues.
Part D is the Prescription plans..again different plans, different monthly premium different copay based on your current meds, or if you know future meds.
Now for PART C..the "Advantage Plans"..5/these are the ones advertising ad nauseous on TV "Check your zip code! You may get zero premium zero copays, well give you money for gas, food, rent and even prostitutes!!!"
These, well think about it..if they are giving you all that AND advertising ad nauseum on TV (costing money)...think..just how much will they actually COVER medical issues if/when you have them?
These are a company/is that are paid a flat fee by Medicare to cover you...no more.
Pres. George W Bush set these up in about 2002 to try to save Medicare expenses.
These plans often require pre-authorization for most things over $1. People have died awaiting pre&auth because they denied and appeal while waiting.
And THINK CAREFULLY before choosing these...I DON'T recommend. Just like mathjak said..I don't recommend.
You can call Medicare (good luck!) to discuss options with them, or look up plans online and call and talk to a couple before deciding.
Hope that answers all or most of your questions (and more) though I'm late to the party.
BTW, even my supplement plan is based on zip code...I've moved south to another state. This year my spouse and my costs (different supplemental) premium would have been $800+ a month. Up drastically! Because it was known as an "expensive/"rich" zip code even though our house was modest 800 sf 2/1 on the "cheap side of town".
The new zip code down here meant instead our combined samd plans premium is only $342/m!!! BIG DIFFERENCE.
Supplemental plans also cover anywhere in US.
Part C advantage plans require "in network" Drs and providers when traveling in US.
Another reason I don't recommend.
Explore lots of options, and all options, examine your health and financial matters BEFORE decisions!!
Wife and I both have Plan G. It is not the cheapest but in my mind the best.
Any doctor or hospital will take Plan G and the most out of pocket you will suffer for the year is $240.
Wife had cancer, been several years now and everything looks great, but our total out of pocket for chemo, surgery and all the looking after was $240 for the year. Once we spent that we were done.
The best advice I have ever heard on Medicare was from Clark Howard.
"Only choose an Advantage plan if you can't afford the $175 monthly premium for Medicare Part B. If you can afford the monthly premium, then don't get an Advantage plan."
What really sold me was the hard push I got from Advantage Plan providers trying to get me to opt for one. If it was that good for me and provided so much benefit over government Medicare, they wouldn't be pushing it so hard.
It is obviously very good for them. Not so much for me.
Also, the government doesn't like competition. That the government is fine with hundreds of Advantage plans stealing their business means that it is saving the government a lot of money. Health care costs what it costs so the about the only way Advantage can provide lower cost health care than the government is to ration it.
No thanks.
Last edited by Igor Blevin; 03-20-2024 at 05:05 PM..
The best advice I have ever heard on Medicare was from Clark Howard.
"Only choose an Advantage plan if you can't afford the $175 monthly premium for Medicare Part B. If you can afford the monthly premium, then don't get an Advantage plan."
What really sold me was the hard push I got from Advantage Plan providers trying to get me to opt for one. If it was that good for me and provided so much benefit over government Medicare, they wouldn't be pushing it so hard.
It is obviously very good for them. Not so much for me.
Also, the government doesn't like competition. That the government is fine with hundreds of Advantage plans stealing their business means that it is saving the government a lot of money. Health care costs what it costs so the about the only way Advantage can provide lower cost health care than the government is to ration it.
No thanks.
This is how much the government has to kick in.
The government pays Medicare Advantage plans a set rate per person, per year (around $12,000 in 2019, not including Part D–related expenses) under what's known as a risk-based contract.
That means that each plan agrees to assume the full risk of providing all care for that inclusive amount.
The only difference between a F and G plan is the F plan covers the annual $240 deductible and the G plan does not. Both will cover you in another country.
It's important to note that while G doesn't cover the $240 Medicare deductible, the $240 you pay out-of-pocket for it gets applied towards the $2800 G deductible, so you're actually not paying anything more than you would on the F plan.
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