Switching from Medicare Advantage to original Medicare plus Medigap and PDP.

[LostDollar]

I've been in a closed block with my Aetna Plan G for two or three years now and I'm still happier than a dead hog in the sunshine.

Gross!

 

[rmhaire]

Gross!

Got to admit though, that's pretty happy.

 

[Garya505]

Tell me if I'm wrong, but it seems to me that even HDF or HDG is much better than any Medicare Advantage plan. I mean, how many MA plans have a $2870 MOOP?

 

[frank04]

Many here in Florida would have you around that range moop for an HMO with drugs, dental, vision, gym membership and an otc allowance. That's why we rarely sell em. It's like why?

 

[Ron Van D]

Real life experience with HDG:
I had about $35,000 of bills submitted to medicare. After they did their voodoo magic repricing, my share was under $600. (Which is the average for HDG's with Physician's Mutual.)

I think it would take a lot to max out the HD of $2800.

 

[Garya505]

Real life experience with HDG:
I had about $35,000 of bills submitted to medicare. After they did their voodoo magic repricing, my share was under $600. (Which is the average for HDG's with Physician's Mutual.)

I think it would take a lot to max out the HD of $2800.

It would take $14000 of charges at Medicare's allowed costs to get to $2800.
And to lose money over time on HDF or HDG, just one year wouldn't be enough. You'd have to have that on average over your lifetime.

 

[Garya505]

Many here in Florida would have you around that range moop for an HMO with drugs, dental, vision, gym membership and an otc allowance. That's why we rarely sell em. It's like why?

The lowest deductible I can find on a MA HMO in my area is $4900.

But then I'm limited to HMO doctors, subject to MA approvals, and I'd have to pray I don't ever need to go to somewhere like Mayo Clinic or MD Anderson for treatment.

 

[goillini52]

I didn't say I was going to pay annually, I was talking about planning.

Let's set aside the issues of how much of my Soc Sec check is consumed by various taxes and insurances and just look at HD medigap and deductibles.

(I am using round numbers below, and remember you and I went through the exercise of matching KDOI online numbers to your sources a few years back.)

(For purposes of this we will also assume I can pass underwriting at any carrier so the plan I mention below will be available to me.)

So a forum member agent recommends to me a Medigap plan that costs $2,600 per year per KDOI.

HDF premium $700 per year. 2025 HDF deductible $2,900 per year.

HDF + 100% HD = 700 + 2900 = $3,600.
So I assume the risk of having medigap with a premium of $3,600+ for somewhere between one year and the rest of my life.

HDF + 75% hd = 700 + 2175 = $2,875.
Higher than the issue age Plan G an experienced Medicare agent would encourage me to buy.

HDF + 50% HD = 700 + 1450 =$2,150.
Lower than the issue age Plan G an experienced Medicare agent would encourage me to buy.

So when I think my Part B expenses are going to start running at $1,400 to $1,500 per year, I need to be more carefully considering my Medigap coverage choice.

That's one reason I would need to convert a monthly premium to an annual premium for planning purposes.

And note: Those comments totally exclude Mom's comments about cognition and which family member will actually be processing incoming medical invoices for payment.

I used to get the book from the state every year that listed the companies, the plans they offered, the premiums, etc. Half of the premiums were wrong because the different carriers didn't raise their prices at the same time. Many had premium increase after the state published the premiums.

You'd be better off using CSG for accurate pricing.

 

[LostDollar]

Real life experience with HDG:
I had about $35,000 of bills submitted to medicare. After they did their voodoo magic repricing, my share was under $600. (Which is the average for HDG's with Physician's Mutual.)

I think it would take a lot to max out the HD of $2800.

2-3 years ago I did that with whatever the deductible was then with ER visit for chest pain plus hip replacement (using hospital rather than dr clinic for surgery site). I had a horrible mess of paperwork to manage.

Not sure anymore, but I think those charges would probably have hit the $2,800 max too.

 

[Garya505]

2-3 years ago I did that with whatever the deductible was then with ER visit for chest pain plus hip replacement (using hospital rather than dr clinic for surgery site). I had a horrible mess of paperwork to manage.

Not sure anymore, but I think those charges would probably have hit the $2,800 max too.

That's one consideration that's difficult to put a value on. I wouldn't want to burden my wife with something like that if I were to get really sick, or when I die.