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Medicare question: Traditional or Advantage approach better for MPNers
Unfortunately, my ET diagnosis comes right at the time when I start Medicare, and I now have just a week to make my choice for the first year: traditional/original medicare with expensive extra supplements, part G (gap) and part D (drugs)? I live in the NW where there are some smaller (and perhaps more ethical??) advantage plans that could save me lots of money, but already I've scheduled an out of state video appointment at the Mayo Clinic to help me make the decision about treatment for ET. I know Original Medicare is more portable, more flexible, and will contain fewer surprise bills--but also sense I am going to have some trouble finding GPs who accept new medicare patients, and I'll have to forgo alternative treatments (like from my acupuncturist) if I go that route. It also looks to me as if I'll spend over $5000 this year on parts B, G and D, and although I will have no copays I will also have no maximum out of pocket amount. Wow, so much for making healthcare affordable for retired people!! I've been doing a lot of reading in the NYT about advantage plans and medicare fraud, and about advantage plans sometimes denying treatments and medical choices. I should be worrying about whether I'm ready to start taking Hydroxyurea, but instead I'm worrying about expenses to come...
You who have been riding the MPN rodeo longer than I and had ups and downs of treatment expenses and trials--which plan did you choose and why?
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I just looked up the Medicare Part B deductible for 2023. It is $226. This means with Supplement G you will pay the first $226. Your supplement will pay the rest of the 20% that Medicare did not pay,
Eileen
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1 ReactionGood news is Plan B premiums are dropping to $164.90 in 2023.
Thank you.
So $164.90 is taken out of your SS monthly for part B.
Then Part B pays 80% and your Medicare Supplement G plan pays the other 20% after you pay the $226 deductible.
I can see why people are confused. Eileen
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1 ReactionThe part G will also cover the hospital deductible of approximately $1500 per episode. So it can really make a difference.
yes, eileen, and why people are furious at those who created such a labyrinthine system full of deadends and sleight of hand financial maneuvers. Reform Medicare! Talking to you, GOP and DP!
Thank you for the helpful clarification. I have Medicare A - B - D - G since initial enrollment, and it will remain as is.
During Ooen enrollment, which is through 12/7. Please review your Part D plan. Formularies and premiums change from year to year. You can go online to Medicare.gov. It gives you the option to find plans now. Have your drug list ready. Once you enter all of your drugs, dosages, frequency and pharmacy it will provide a list of carriers, monthly and annual drug costs and premiums. You can even enroll in your new plan. You can change your drug plan every year with no underwriting, penalties etc. sound confusing? Call your local SHIP office. They will walk you through it.
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2 ReactionsThank you! Very helpful info.
REGARDING MEDICARE PART D: words to the financially wise.
EVERY YEAR we need to call Medicare with insurance and Medicare cards in hand as well as your prescription medicine list. Ask which company will give you the best deal. For example, last year for me it was Well Care. If I had opted to just continue on with them their charge would have gone way up. So I changed this year to Aetna Silver Script for the best deal. Depending on your meds, for you it may be a different company. All I’m suggesting is that it is important to reconsider your Part D provider EVERY YEAR.
Consider this a time of annual price bidding for Part D charges and spend ten minutes of your time talking with a helpful Medicare employee. Doing so will save you hundreds of dollars.
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1 ReactionI used to have traditional medicare along with a Plan F last year. I had a pretty involved surgery at the mayo in Rochester, along with about 20 hours of physical therapy, and I did not have to pay a penny out of pocket for this.
This year, I fell for the advertising, and got an advantage plan. Earlier this year I had unexpected surgery, and had to pay a hefty copay for this. I also needed physical therapy again, and each session cost me $40 copay, each visit except with my primary care doc cost me $40 copay. I was nickeling and diming me to death with this advantage plan.
My employer has one of their brokers take car of their retirees insurance requirements, and the broker got me into a traditional medicare plan with a plan G for less cost than I had as copay for this year.