# I'm so confused about supplemental plan and advantage plan



## JAW7373 (Jan 11, 2020)

I will be 65 in March and currently still employed. I will keep my ins at work for one more year. (I think ugh) It costs me 60/mth with a $2,000 deductible. I only take one pill a day that cost around $4.00 month. (without ins.) Everyone keeps telling me I am a prime candidate for the free Advantage Plan. I'm just lost with all of this. Can someone tell me what would happen if I had decided to switch to another supplemental plan if I hated it? What would happen if I became ill or disabled while on the Advantage Plan? I have never understood any kind of insurance. hehe

Thanks to all for your response!


----------



## Ladybj (Jan 11, 2020)

Prior to retirement I was in the medical billing arena for years.  You HAVE to review the plan very carefully.  I wish I was there to view different plans with you.  Sounds like you are pretty healthy, that is a plus with a $2000 deductible.  If you switch to another plan and is locked in, you may not be able to switch plans until open enrollment....this is why you have to review the plan very carefully.  Feel free to send me a private message.


----------



## Aunt Bea (Jan 12, 2020)

What happens if you hate the insurance offered by your employer?

At least with Medicare supplements, you have the option to choose the insurance for yourself and if you make a mistake you can change plans or companies once a year during the open enrollment period.

Take the time to read the Medicare & You handbook to familiarize yourself with what Medicare covers then go to Medicare.gov to see what options exist for you in your area.

It's really up to you to take control of this important decision and not allow others to make it for you.  By all means, listen to what people have to say and read all of the promotional material but make the choice that fits you and your situation.

Good luck!


----------



## Liberty (Jan 12, 2020)

We've always had Medicare & a standard supplement.  That, to us, is real peace of mind.  Don't want to have to be in the hospital with any nasty financial surprises on top of what ails ya'.  Some of those cheap plans are free now, when you are healthy  with potential  high deductibles kicking in for hospitalization when you aren't.  They are "Managed Care" , not standard Medicare plans.

On the other hand, if you think you will be healthy for years...not fall or  have a traffic accident or something that might cost you big time out of pocket, you could take a chance for a few years with the cheap plan and then maybe you can opt out and still qualify for a good standard medicare supplement plan later on.

There are a couple brokers on this forum that could certainly help you make a  knowledgable decision.  Good luck!


----------



## TravelinMan (Jan 12, 2020)

My advise is to find a good independent insurance broker and have him/her explain the options that you have.  It is extremely confusing trying to figure it out on your own.  Be sure to go to a broker who can find plans from many different companies, not an agent that is employed by a specific insurance company.

When I turned 65 I was still working and just enrolled in Medicare as my secondary insurance.  When I retired at age 66 I bought a Medicare supplement policy as my secondary coverage and switched Medicare as my primary.

Please understand that you may enroll in Medicare on the first day of the month _3 months prior to your 65th birthday.  _example:  birthday on August 31st, you may apply on or after May 1st.  You may wish to apply for Medicare Part D (if you don't apply for an Advantage Plan), which covers drugs, at the same time you apply since you will be charged an on-going penalty if you wait past your birthday.

You may want to go ahead and set up an online account for Medicare at _Mecicare.gov   _That is where I applied for my coverage.

I just noticed that you said you turn 65 in March, so you now qualify to enroll since the first day of the month of your birthday is within 3 months.  Concerning the Advantage Plans, all I really know is that I have had 2 different independent insurance brokers advise against it.  I think you would really benefit from speaking in person to a qualified insurance broker face to face so that your options may be explained and can have all of your questions answered.


----------



## Myquest55 (Jan 12, 2020)

We too, were very confused about all of this - what a nightmare!  I also turn 65 in March but have been getting things in the mail from all kinds of insurance companies for months!!  Last fall, we got a post card from Anthem ( the local Blue Cross/Blue Shield carrier) for a FREE seminar in the next town.  We called in the RSVP and attended.  The Rep. laid out the basics so we finally had a much better idea of what we faced and since there were 4 of us, he took time to answer questions and explain how the different programs relate to what basic Medicare offers.  It was totally worth the hour to have it finally make sense!

That said - there are dozens of insurance plans that supplement basic Medicare.  We made a personal appointment with the Anthem Rep and sat down to discuss what would cover everything for my husband's situation.  (NOTE - He could not do that until my husband had his Medicare card and I am waiting for mine so I can sit down with him and discuss my plan.)  Most people I have talked to have the "Advantage plan" and are happy with it, but there are other plans you can opt for besides just that one.  Depends on the carriers.  We decided to stick with what we knew - to begin with.  You can change plans DURING THE ENROLLMENT period - once a year.  GOOD LUCK!


----------



## Ladybj (Jan 13, 2020)

Aunt Bea said:


> What happens if you hate the insurance offered by your employer?
> 
> At least with Medicare supplements, you have the option to choose the insurance for yourself and if you make a mistake you can change plans or companies once a year during the open enrollment period.
> 
> ...


Great advice but unfortunately some people will not take the time to read their health insurance material and those that do may find it a bit confusing.  When I was in the medical billing field, people called in so confused as to why they were billed for this or that and some of them had Medicare Part A only and I explained to them that Part A takes care of in patient hospital stay and not office visits nor out patient procedures.  A lot of patients used their Medicare Part A as their secondary insurance which of course their claim was denied.  Several people feel they made a good decision in choosing their healthcare insurance until they start getting bills for services rendered. When hubby had a procedure done..(we have good insurance) he was surprised to get a bill which was a bit high.. but I explained to him why.  No matter how good your health insurance plan is, with some, their will be out of pocket cost.  Some cost higher than others.


----------



## Butterfly (Jan 14, 2020)

JAW7373 said:


> I will be 65 in March and currently still employed. I will keep my ins at work for one more year. (I think ugh) It costs me 60/mth with a $2,000 deductible. I only take one pill a day that cost around $4.00 month. (without ins.) Everyone keeps telling me I am a prime candidate for the free Advantage Plan. I'm just lost with all of this. Can someone tell me what would happen if I had decided to switch to another supplemental plan if I hated it? What would happen if I became ill or disabled while on the Advantage Plan? I have never understood any kind of insurance. hehe
> 
> Thanks to all for your response!



As others here have stated, the only reliable way to get correct information for you and in your state is to get with an independent insurance agent who has experience in medicare supplements/plans.

All you will get from an online forum (except of course, from experts -- there are a couple on this forum) is anecdotal stories about what has or has not worked for us, where we live, and which may or may not work for you, where you live.

It is just way too important a decision to try to muddle through on your own, or based on others' stories of what does or doesn't work.

Seeking guidance from an independent insurance agent who is an expert in this area will not cost you anything, and may save you a fortune.


----------



## Ken N Tx (Jan 14, 2020)

Myquest55 said:


> We too, were very confused about all of this - what a nightmare!  I also turn 65 in March but have been getting things in the mail from all kinds of insurance companies for months!!  Last fall, we got a post card from Anthem ( the local Blue Cross/Blue Shield carrier) for a FREE seminar in the next town.  We called in the RSVP and attended.  The Rep. laid out the basics so we finally had a much better idea of what we faced and since there were 4 of us, he took time to answer questions and explain how the different programs relate to what basic Medicare offers.  It was totally worth the hour to have it finally make sense!
> 
> That said - there are dozens of insurance plans that supplement basic Medicare.  We made a personal appointment with the Anthem Rep and sat down to discuss what would cover everything for my husband's situation.  (NOTE - He could not do that until my husband had his Medicare card and I am waiting for mine so I can sit down with him and discuss my plan.)  Most people I have talked to have the "Advantage plan" and are happy with it, but there are other plans you can opt for besides just that one.  Depends on the carriers.  We decided to stick with what we knew - to begin with.  You can change plans DURING THE ENROLLMENT period - once a year.  GOOD LUCK!


You can change Medical Supplement Plans any time during the year.>>>CLICK HERE<<<
We switched my wife's plan and saved over $200 a Month!! I could not switch because of pre-existing conditions..


----------



## mathjak107 (Feb 3, 2020)

Ken N Tx said:


> You can change Medical Supplement Plans any time during the year.>>>CLICK HERE<<<
> We switched my wife's plan and saved over $200 a Month!! I could not switch because of pre-existing conditions..


We pay more in New York for our plans but we get no age based increases and we can switch plans with no medical underwriting


----------



## Ladybj (Feb 3, 2020)

Butterfly said:


> As others here have stated, the only reliable way to get correct information for you and in your state is to get with an independent insurance agent who has experience in medicare supplements/plans.
> 
> All you will get from an online forum (except of course, from experts -- there are a couple on this forum) is anecdotal stories about what has or has not worked for us, where we live, and which may or may not work for you, where you live.
> 
> ...


The downside in obtaining an insurance agent is that most of them are basically working with an insurance company which you will still need to read the bottom line very carefully.


----------



## Ken N Tx (Feb 4, 2020)

Ladybj said:


> The downside in obtaining an insurance agent is that most of them are basically working with an insurance company which you will still need to read the bottom line very carefully.


You need to switch to with an insurance *BROKER.. He will search for the right company...*


----------



## Butterfly (Feb 4, 2020)

Ladybj said:


> The downside in obtaining an insurance agent is that most of them are basically working with an insurance company which you will still need to read the bottom line very carefully.



I said an *"independent"* insurance broker.  They are not working for a particular company and can help you find the best plan for your needs and financial situation.  I worked with a great one and she did just that.  I had been searching around for coverage because my employer didn't provide it and she was able to find me coverage that worked and I could afford; her help cost me nothing.  Trying to do it yourself will just leave you tearing your hair out.


----------



## Ken N Tx (Feb 4, 2020)

Butterfly said:


> Trying to do it yourself will just leave you tearing your hair out.


----------



## treeguy64 (Feb 4, 2020)

Don't immediately assume you'll need a broker, agent, whatever. If you're meticulous in your research, you can select the best plan for your personal needs without anyone pitching anything at you. Take your time. Read everything. If there are sticking points that you find confusing, call the company directly and get a rep to go over those points. If the rep confuses you, try another one.

Good luck!


----------



## fmdog44 (Feb 4, 2020)

Start now reading everything you can about what to do. When I finally applied I had done a lot of homework and wrote my own notes and interpretations of all I read. Then I got on the phone with a very helpful broker she took a lot of time to clear me up on my questions. Don't believe all the scary stories you hear. Even if you do screw up on something you are not in ball & chains on it. Everything can be changed the next year.


----------



## OneEyedDiva (Feb 29, 2020)

I have Aetna Open Access Medicare (HMO).  I love the plan...but it is group through my former employer. I don't know if it would cost you differently than what I pay, which is the basic Medicare charge that comes out of my social security....$146/mo.  My doctor and specialist in network co-pays are $10.  ER visits $75 unless I'm admitted, then there's no co-pay.  My hospital stay wound up costing me nothing. The first  post op visit cost nothing. My eye surgeries were the cost of the co-pay (if that). It's been awhile so don't remember for sure but I know the most they cost were $10. All lab work and imaging is free. And like regular Medicare, annual visits are free. The state is now offering us Aetna Medicare PPO which is supposed to be better. One reason is that out of network doctors co-pays are the same as for in network doctors.


----------

