Questions re: Which Medicare Supplements to Get?

I had a successful RP in July and am now with an undetectable PSA. I will be turning 65 next July and want to know which Medicare supplements I need to pay for in the unfortunate event I have a recurrence. I attended two Us Too support groups and was alarmed to learn of the extra expenses older men had when they experienced recurrences if they didn't get financial help from the pharma companies or get into a clinical trial. Very scary. Can put a monkey wrench in one's retirement plan!

I am on four drugs for diabetes and a heart condition, otherwise very healthy.

So, which plans/supplements should I consider for Medicare? I am attending an informational meeting at the library this week hosted by an insurance representative and want to go into it informed.

Thanks,

|Nick

I have the standard Medicare A and B. I also have a supplememntal plan through AARP United Healthcare. And a prescription plan through Humana/Walmart. Each state has a program called SHIP which is the State Health Insurance Assistance Program (?). If you look up the one in your state in line, they list the different plans available to you for Medicare Supplememtal, Medicare Advantage and Part D prescription plans. They also may have a phone number to speak with someone. Prices for the plans vary by state and county. I've been pretty lucky so far with the plans I have. Aside from the monthly Medicare charge and the charges for each plan, my out of pocket for my Pca treatment has been $0. I also have other medical issues and they have covered me 100% on those also. Supplemental plans are more expensive but you can use almost any doctor. Advantage plans are cheaper and some or most include a prescription plan, but they are like an HMO or PPO plan. You Have to use a doctor in the network or you pay extra to use out of network.
Good luck

Nick2017 said...
...want to know which Medicare supplements I need to pay for in the unfortunate event I have a recurrence.

I suggest you look at Plan F, it's the most comprehensive supplement plan, no co-pays or deductibles. I have yet to pay anything out of pocket on my PC journey, even 2nd opinions from Epstein were paid for.

PDL17 said...
Dogdays,

How much do you pay monthly for your plan? I have been in healthcare for almost 40 years and insurance is still very confusing to me.


As 142 and I said, the availability and cost of each plan varies by state and sometimes county. When I started looking for a Medicare plan, I contacted my states SHIP office for assistance. There's no cost for the service and they have all the info on whats available in your area. For what its worth, my monthly for the supplemental and prescription plans is under $180
I believe Plan F is like the top of the line plan, covers a great deal, but I believe it is the most expensive option.

There have been two recent lengthy discussions of this topic, with a variety of options, opinions and personal experiences shared. One thread began on 7/18/17 and the other on 9/117. It may be helpful to anyone entering medicare or concerned anout the upcoming open enrollment period to read through those threads. I am one of several SHiP counselors who post on this forum and encourage everyone to review your options carefully at this year's open enrollment. Even if you have a supplement and your ability to change to a different carrier or supplement type is limited by medical underwriting, you still should have a stand alone Part D plan and those plans can and do change every year and should be re-shopped at each open enrollment period.

Good afternoon, I just went through this since I turn 65 this month. I enrolled in Medicare part A and B and bought a supplement plan "F". Because of the fact that I make a little too much money my part B premium is $184.00 a month. The supplement I chose has a $2200.00 deductable for the first 3 years. My premium on that policy is $150.00 per month as long as I have the policy. The reason I chose that is other than PCa I am and have been healthy all my life I do not take any prescription meds and only go to the doctor once a year (except for my PCa stuff now) so I am taking a chance on continued good health. I second the advice about getting a local agent that you can look in the eye if there is a problem.
Perry

RobLee said...

Note that the 'C' plans are VERY heavily advertised on TV and elsewhere. These are "medicare advantage' plans,

RobLee,
I have a “C” plan and its a supplemental plan, not a Medicare Advantage plan. In my case, since I am on SSDI, i am only permitted to have a plan C supplemental policy in my state. Maybe lovif can shed some light on what plan C is.

Lovif,
Thanks for getting me straightened out. Now I got ya RobLee

I am still working and getting employer-sponsored medical benefits. I have only Medicare A at this point.

The plan one chooses should be the one that fits each individual's unique circumstances. Due diligence is important. I have subscribed to the newsletter Kiplinger's Retirement Report for many years, and find it's information helpful, timely and unbiased about Medicare supplements. Among other books, there's a good book, Medicare for Dummies.

Once again, excellent advice given here. Here are a few things to consider when making a Medicare plan choice.

1) The most flexible plan is an F supplement . It will cost much more per month, but usually has no co pays or out of pocket costs. When paired with a strong prescription plan it will pay for much of your medical needs. It is "age rated", that is, the premiums will increase as you get older. You can also be denied coverage if you do not sign up for it in the beginning and acquire a disqualifying medical conditions (kidney disease). Your medical cost on a plan F supplement will be less than for an Advantage plan, even though your premium might be double or triple. You will also have more flexibility in choosing a medical provider. The Advantage plan usually limits you to the HMO and it's doctors.

2) It is easy to be fooled into thinking that an Advantage plan with low or even no monthly premium and no age related premium increase will be cheaper. It will not be unless you have excellent health and no need for significant medical attention. The best Advantage plans (like mine) have a maximum out of pocket cost ($4900) and co-pays for prescriptions and all medical appointments. However the supplement plan usually has no out of pocket or co-pay costs beyond the monthly premium. So , on balance, the supplement is cheaper if you need long term medical attention.

3) Maybe the most important consideration is the ability to change from an Advantage plan to a supplement plan. There are currently a few pre-existing conditions that would prevent such a change, however insurance companies are trying to extend that. They are also trying to create avenues to increase premium cost more quickly.

I have always been on an Advantage plan. I tried to change to a supplement, but was denied due to low grade kidney disease. They also said that my premiums would increase beyond the usual for a person my age even if I was accepted. If I knew then what I know now, I wold have chosen a supplement plan..hindsight is 20/20.

I turn 65 in March 2018 and just signed up for my supplement. A company called United Medicare Advisors did all the looking for me free of charge--sort of like a travel agent. I'm not on Social Security so Medicare is $134 per month. My supplement (Plan G) will run me $85 and I'm only on 2 prescriptions so they told me my Plan D drug portion will be about $25. Can't get an exact number until December when I can first sign up for Part A and B.

Tom

Hi love,

You said that here were recent threads re: Medicare on 7/19 and 9/1, but how do you search by date on this forum?

And when I use the search box and enter Medicare, other forums' threads pop up. Please advise.

Thanks,

Nick

Just for fun...I'll provide a slight counter point re Medicare Advantage plans. Turns out that these are offered in my geography as PPO's on a no fee basis. Because of the demographics in South Florida, almost all local doctors accept my plan and, for a small fee, I am free to use out of network docs. I do have a small co-pay for each PCP visit ($15) and for specialists (no referral needed) visits ($50). There is of course a max out of pocket of $6700 that kicks in if we suffer a medical calamity. The plan includes a drug plan as well as (very) routine eye care.

When my wife and I signed up for this we were 65. Supplemental Plan F + a Plan D would have run us about $6500 per year. We are now 6 years down the Medicare Advantage road so have basically pocketed the $6500 each year = $39,000 over the whole time. This is because our health has been good and our medical bills have been basically nothing over this interval.

So it's all about risk. For a healthy couple in our county, Medicare Advantage plans offer a huge financial advantage with some protection.

But, I would be remiss if I didn't state my fear that if and when I would prefer a Supplemental Plan I may not be able to get one (see lifeguyd's post). I can only hope that our health holds out and I keeping accruing the big savings for many more years so if we max out our out of pocket or need added funding for our medical needs we have the "savings" from past years on our Medicare Advantage plan. So, I may come to regret my choice but so far it's worked out ok.

Jim