Hi, I will be new to Medicare soon and have heard that Medicare Advantage plans are not all they are cracked up to be. i live in southern Indiana and I know that it makes a difference where a person lives and what is available.

On many Advantage Plans in my area, cost is $0/$30 month for medical plus basic dental/vision/hearing covered. But, you have to go to the doctors in their network. Sounds good, but is it too good to be true?

On a Plan G Supplement - cost will be between $120-$150 month for just medical. Then $20 for Part D for any prescriptions. And vision, dental, hearing is not covered. But you can go to any doctor you choose.

I am hoping someone can give me advice based on their own experiences. I realized that there are all different plans, but I am having a difficult time deciding which way to go. I don't plan to travel much at all during retirement, but being able to go to any doctor I want is very enticing.

I hope someone answers this, our phone is ringing off the hook as my husband turns 65 this year. I dont understand any of this stuff. I had no idea you could not pick your doctor on medicare. Might have to research this more. Ive got a 6 figure hospital bill from getting screwed on obama care for the same thing. That was more about timing and I wasnt about to change surgeons just before open heart surgery. After taking care of elderly parents, I would like something that involves care.

Pam, I didn't understand a lot of it until this past year and I still have a lot to learn. My brain hurts sometimes just thinking about it! Here is a link the Medicare.gov. Maybe it will help answer some of your questions: https://www.medicare.gov/

Yes, on Medicare Advantage there is an in-network list that you are limited to go to and some areas don't even have an available MA network, so a Supplement plan is the only choice. With a Medicare Supplement Plan (aka Medigap), you can choose your own doctors and hospitals anywhere in the USA.

I would love to hear first-hand experiences from folks who either have a Supplement plan or Advantage plan. Are you happy with it? What don't you like about it? Thanks!

My husband has been on Medicare for 6 years and me for 1. One thing to think about is the ability to go to your doctor or specialist ( without needing a referral) if that is important. So if you are used to going to a certain specialist you need to confirm they are in the plan's network if you opt for that.
Also not all doctors are even accepting new Medicare patients. If you are already established with someone, no problem, they will accept the insurance change probably,but we found when we moved to a different city that the Dr we wanted to go to was closed to new Medicare patients. So we went to another newer dr in the same practice. We like her but it was a disappointment at first.
So I guess it would depend on your plans for relocating and your current health ( need for specialists that you already know for continuing care).
If you have any other questions this is a great source of information from those of us " living it"

Thanks, Teacup. When you had to switch doctors, were you on Medicare Supplement or Medicare Advantage?

We have checked out the doctors in the Medicare Advantage Plan and ours are currently in it.

My husband has been on Humana Medicare Advantage since July, and a few weeks ago we received a letter from the local hospital affiliate that said they would no longer be covering certain plans, one of which was his. Then last week we got another letter saying the issue had been resolved and the hospital would be picking up his plan next year. But can they just do this in the middle of the year? I read where that is one of the pitfalls of the MA plans.

Vickie, we are both on Medicare supplement. Basically I think hospitals can do anything they want in regards to the advantage plans. If they don't sign the contract then things change. One of the larger hospitals in our old area just announced that certain Advantage plans would no longer be part of their system.
So basically it came down to deciding for us if we can afford the extra money for the flexibility, as well as having to pay for eye care, dentists. If you have a couple of different hospital systems in your area and are comfortable with both, then it may not be an issue.

That is part of the problem with Advantage plans, for sure.

Additionally when you go to an advantage plan and want to go back to a supplemental you may have to take a physical. Talk to independent insurance agent that specializes in Medicare

I wouldn't touch an Advantage or PPO plan with a 10 ft. pole. My dh is on medicare for 7 years now & I will be going on it in less than 2 years.

You never know what's going to change in your life. You may not plan to move but that's not written in stone. Let's say your daughter or son or grand got something tragic & you needed to go take care of them or their family until they recovered or whatever. Catch my drift?

We pay for a supplement for my dh. He can go anywhere he wants, no referrals needed & no worries about if a given doc is treating him in the hospital & whether that doc is allowed "in the plan". He hasn't been in the hospital yet thank goodness but in these 7 years, he's not had to pay a cent out of pocket for doctor visits & OP procedures.
You should seriously think about getting prescription drug coverage - I think that's Part D.

That's my 2 cents worth.

So those plans wont let you go where you need?? Wherever you are. I can see this is going to be hell when its my time. I need very specific people. 2 hospital systems here but only doctors at one that can treat me. Here the for profit hospital doctors mostly will not touch you if you have medicare, they know the non profit shands has too.

@gardenglory

Pam, Dh has Medicare & I got him Florida Blue supplement. He can go where he wants. Never has to get pre-approval. I know about your situation. Don't know what to tell you when it comes your time.

We have 3 doctors in this town who will ONLY take patients who have Blue Cross/Blue Shield. They will not take any other insurance of any kind & they refuse to take you if you pay cash. They are strictly in it for the money. I don't want a doc whose only thought is $$$$$$.

Looking into it. Had no idea this was so complicated with so many choices. Its sure not the be all and end all Id dreamed about. My husband clueless, he thinks he has to do nothing to sign up. Maybe he is right but it always seems there are some kinda hoops.

Pam, you DO have to sign up for Medicare, it is not automatic. Part A is for hospital coverage and no cost to you. Part B is for dr office visits etc. that is the part that costs you and the cost is usually deducted from any Social Security payment you are getting.
Part D is prescriptions and that costs too.
Medicare Part A and B do NOT pay 100% so that is why people opt to get either a supplement plan or Advantage plan. But those are optional. If you have enough money you can just pay yourself whatever Medicare Part A and B do not pay. My mother never got any other additional plan and just got bills from her dr/hospital whenever she went.

Im going to hitch on to Anns coattails as she is pretty good with research. Checking into the supplement. My Mother never had anything extra either, of course she was on the board at the hospital and really didnt need it. I wont say she didnt in the end give enough to pay for her care, but it did not come in the form of bills and she did not like my opinion on that.

Pam, my criteria for the supplemental is that I want access to the Mayo Clinic, the only one that fits that is BCBS. In my location if MN

Checking into a blue cross supplement now. My husband has basically never been to the doctor so not sure what he will need in the future so might just start out with the basic until I get mine. Thank god ive never seen the inside of Mayo in Jaxsonville, however, if need be, I would also like to be able to get in.

Having the freedom to go wherever is certainly a very important aspect of the whole Medicare thing.

The following is taken from: https://www.medicare.gov/suppl...

"When can I buy Medigap?
Buy a policy when you're first eligible
The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period. You generally will get better prices and more choices among policies. During that time you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you're 65 and enrolled in Medicare Part B (Medical Insurance), and it can't be changed or repeated. After this enrollment period, you may not be able to buy a Medigap policy. If you're able to buy one, it may cost more due to past or present health problems.

During open enrollment
Medigap insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy. However, even if you have health problems, during your Medigap open enrollment period you can buy any policy the company sells for the same price as people with good health."

The best thing to do is not to wait 6 months if you want to get a supplement plan so you don't have to pass their health assessment.

I highly recommend that if you're new to Medicare, you use a Medicare Consultant for help. They are paid by the insurance companies, no cost to you. They make the same $ no matter what coverage you choose so they have no motive to push one company over the other. He/she can collect your information for which docs and hospitals you want, plug it into computer programs, and it can spit out a comparison. The same is true for Part D Plans. The consultant can plug in your location, your drugs, where or how you want to obtain them, and the program will spit out the information. We see our consultant every year at open enrollment time.

We both have medical issues so carry the United Healthcare Plan F supplement. It's expensive but covers everything, we can go to any hospital or doctor anywhere.

My husband had an Advantage Plan the first year. It was awful. We didn't realize he had no coverage if we traveled out of the area. Also had a very small network.

Find yourself a good Medicare consultant in your area.

Karen

Second that on the medicare consultant, you also pay the same amount whether you use them or not, so might as well get the information up front.

Ive been at this all morning. They keep trying to get me back to an advantage plan. You would think my husband would do this for his own dang self wouldnt you . Hes never been sick, to the hospital, doesnt have a doctor and takes no meds. Im guessing thats why they keep coming back to that. What they dont seem to get, is Im buying for when he does get sick, he dos have a doctor, he might have to be hospitalized and he might take meds. O lord where did I hide the ativan