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- This topic has 7 replies, 7 voices, and was last updated 6 years, 10 months ago by JanS.
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May 15, 2017 at 9:20 pm #883007
Ilovedogs123ParticipantI am having trouble deciding between a Medicare Supplement plan or a Medicare Advantage plan. HELP! Any advice would be very much appreciated.
May 16, 2017 at 9:48 am #883031
VanessaParticipanthttp://southseattlecollege.genoo.com/website_redirect.jsp?exlid=2455300&ebid=13755476&ebslid=876367&upid=11252687&lid=152
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Hello. I hope this link opens for you…. if not, you can call South Seattle College and find out more information.May 16, 2017 at 1:14 pm #883054
anonymeParticipantYou can also schedule a private consultation with a SHIBA rep through the Senior Center. They will not give personal recommendations, just a general overview.
Part of your choice depends on how much medical care you currently need/receive. If not much, then you might want to go with an Advantage Plan that includes Part D prescription drug coverage. This will potentially save you money on premiums, depending on the plan. The drawbacks to an Advantage Plan are that many are HMO’s or PPO’s, so your choice of providers may be limited. In addition, coverage will usually be limited to what Medicare pays, leaving you with co-payments and deductibles.
A supplemental plan will likely be more expensive, but most will fill the gap so that your out-of-pocket expenses are either greatly reduced or eliminated. And the supplemental plan may provide coverage for items or services not covered by Medicare. Bottom line: more money = more choice, more coverage.
Also, not all Advantage or supplemental plans include Part D. If you opt out of Part D, there will be a lifetime penalty imposed.
I originally chose a Premera Advantage Plan with Part D with no additional cost added to the Medicare premium amount. However, I had a terrible time finding a provider. As soon as I would choose one they dropped out, or there was a 6 month or more waiting list for Medicare patients. Finally canceled and went back to classic Medicare with no Part D. I figure that with all the upheaval in health care politics, who knows what will happen?
May 29, 2017 at 11:12 am #884228
TylerLParticipantAn excellent resource is the recent book “Get What’s Yours for Medicare,” link here: https://seattle.bibliocommons.com/item/show/3209482030_get_whats_yours_for_medicare
It’s plainly written and does a good job at breaking down an insanely complex topic. The author was a co-author of the very popular, similarly titled book on Social Security from a few years ago.
May 30, 2017 at 1:09 pm #884321
JanSParticipantanonyme…that’s interesting. I am on Premera Medicare Advantage. I go through the Polyclinic and Swedish, and have wonderful doctors. Both accept Premera MA , no problem. Yes, I’m low income, and I get extra help with reduced copays($3.30 or $8.25 for a higher tier) in Part D. I have multiple health issues, quite a few prescriptions, and their Part D covers what I need. I have never had a problem with it. I suppose it makes a difference where you are looking for a doc. My care, through a kidney transplant, and other things, has been wonderful. I’ve never had a doc drop out. If they take Medicare, they take MA. Going without a Part D is great if you don’t need any prescriptions. I think each person has to look at what they need or don’t need…you and I are compete opposites, for instance. What works for you doesn’t work for me, and vice versa.
SHIBA is a good resource, just to get the information needed to make a decision. To Ilovedogs12…good luck finding what you need. :)
May 31, 2017 at 9:42 am #884391
birdrescuerParticipantI totally agree with JanS. I have been on the premera advatange program for years and love that it includes Swedish, Polyclinic AND University Hospital. I took the 0 monthly fee and it works fine for me. If you have many medical issues you might want to get one with a higher monthly payment as it has other benefits. They have been great.
June 1, 2017 at 9:27 am #884506
JTBParticipantTake a look at your baseline health and try to anticipate any likely tests and procedures. One uncomplicated appendectomy with an overnight stay in the hospital cost me through co-pays and deductibles on Medicare Advantage what a year’s worth of premiums would have been for the most comprehensive Medicare Supplement program.
Because Medicare Advantage programs work like a PPO (you need a primary physician for referrals) it’s prudent to determine who is and isn’t in a given network.
June 1, 2017 at 7:02 pm #884586
JanSParticipantand remember…health insurance is NOT healthcare…
while Premera MA has worked for me, including the “extra help” I get through a partnership with Medicaid for low income people (reduced RX copays, etc), I can only attest to what works for me. Because I do have multiple health issues, and am low income, I have learned a lot, and am willing to share the info…mmfeelgood at geemail dot com. If you think you might like the care at the Polyclinic (I think it’s wonderful, even if not in West Seattle), I highly recommend my primary care doc, Betsy Brown, MD. For me, she was literally a life saver…just a wonderful doc and a lovely human being.
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