Page 2 of 2 FirstFirst 12
Results 11 to 15 of 15

Thread: mediGAP plans

  1. #11
    I had to recently do quite a bit of homework on this subject. I just qualified for medicare, beginning this month.

    I gave up on Medigap until I'm sixty-five. If you can find a company that offers it, the cost is ugly. I decided on BCBS diamond plan for Tennessee. In my area, doctors and hospitals don't want to take the PFFS plans, I had to go with a PPO and make a lot of phone calls to make sure I was choosing one my current doctor uses. No problem with the hospital in Knoxville, they take them all, the smaller one in Sevierville only used a few different ones, and my neurosurgeon in Knoxville only used a few. I don't have a primary yet, so I can choose one taking new patients. I was more concerned with my surgeon, I don't want to change, after more phone calls to his office and insurance people, they'll take me out of network since I'm an established patient. My co pay to him will be 25 dollars instead of the normal 10, I can live with that.

    One thing I found out, it not only differs by state, but can also be different by county. I live in about a five county area preferring PPO's to PFFS. The billing office people were telling me it is harder to get paid by PFFS plans.

    Make sure you go into the sites of insurance you are considering. Not all policies are created equal. Some have larger deductables, co pays, and some don't have part d included if you need it. Some cover more than others etc.

    Good luck!

  2. #12
    Junior Member WeelWraith's Avatar
    Join Date
    Nov 2008
    Location
    I live in my wheelchair
    Posts
    2
    [quote=smokymtn memories;961173]One thing I found out, it not only differs by state, but can also be different by county.[/qoute]

    You're right about state by state and county by county...
    In my state of Virginia and my county Anthem BCBS offers a PFFS Advantage plan called SmartValue which seems to have a good rating as well as two Humana Gold PFFS plans. There is no BCBS Diamond plan mentioned. PPO type plans are only a couple and are very low rated. Every doctor office I call seem to say that Humana Gold is what everyonne in the are are switching to.

    Quote Originally Posted by smokymtn memories View Post
    Make sure you go into the sites of insurance you are considering. Not all policies are created equal. Some have larger deductables, co pays, and some don't have part d included if you need it. Some cover more than others etc.
    That is the hard part: the fine print. It's really hard to find someone that will navigate you through the plans without an objective to sell you a certain plan (the companies) or the best company that offers good service and good value (agents) without their bias and who will get them the most fee for selling you one company over another.

    Fine print sorting also is like calling the IRS or reading the tax code. It's all Greek or Latin to me.
    A servant of The Weel who lives and rolls in the world of shadow...not alive, yet not quite dead.

    "I'm just a dreamer, I dream my life away;
    I'm just a dreamer, Who dreams of better days." -- Ozzy

  3. #13
    I can understand why the elderly or someone totally new to insurance shopping could/would have a hard time choosing and searching.

    One of the responsibilites of my old job was choosing the best insurance policies for the company. It was much easier and straight forward to choose the commercial insurance than the health insurance.

    I worked on choosing mine for more than a week, reading policies and talking to people. You have to make the phone calls to find out the policies used in your area. One may sound good on the internet (or salesman), but you have to make sure it's used in your area, by your providers.

    In Weelwraith's area Humana Gold PFFS has a good rating, in my area, no one will take it. Anyone choosing a policy needs to do their homework or at the very least, make sure you ask your salesman the right questions. By the time I finally talked to my salesman, I already knew which policy I would go with.
    Last edited by smokymtn memories; 12-05-2008 at 05:49 PM.

  4. #14
    Senior Member
    Join Date
    Sep 2001
    Location
    middle georgia
    Posts
    2,185
    Quote Originally Posted by Wheelieboy View Post
    I have a Medicare Advantage Plan through BCBS of GA, and for $35 a month I am covered on pretty much everything plus I have an individual BCBS dental plan for as well.

    The advantage plan works great as it covers quite a few things Medicare normally wouldn't. Supplies and prescriptions are covered as well. It operates basically as an HMO which I've used all my life anyway. I just had to select my physician (the same one I've always had) and that was it. The $35 is deducted automatically from my checking account.

    For the under 65 crowd, this is probably the best route to take.
    i just talked to david he is with lol i forgot state agency you call for help on this ins.
    anyway he talked and told me as in ga they don/t have to sell me a policy till i am 65
    the plan your on was what i was looking atbut he suggest since my drug plan 18 month
    and it was adqueate for me don/t switch

  5. #15
    Quote Originally Posted by vjls View Post
    i just talked to david he is with lol i forgot state agency you call for help on this ins.
    anyway he talked and told me as in ga they don/t have to sell me a policy till i am 65
    the plan your on was what i was looking atbut he suggest since my drug plan 18 month
    and it was adqueate for me don/t switch
    Customer service reps are pretty much the last people one can rely on for accurate information sometimes. I am in the metro area so the advantage plan applies for my county. If you are in middle Ga, then you can get on the BCBS advantage PFFS plan, I do believe:

    http://www.bcbsga.com/wps/portal/chp...ervice%20(PFFS)

    Someone else mentioned a PFFS plan in this thread, and I think it's worth checking out if you want to save money and have flexibility. Enter your zip and check the coverage in your area. If prescription coverage is an issue, then you probably don't need to switch, but that coverage is based on your zip code.

Similar Threads

  1. Medicare Advantage Plans
    By darkeyed_daisy in forum Life
    Replies: 4
    Last Post: 02-26-2008, 07:00 PM
  2. Worst HMOs Don't Let Public Know Their Flaws
    By antiquity in forum Health & Science News
    Replies: 0
    Last Post: 09-24-2002, 02:05 PM
  3. Democrats Blast Bush Plans for Revamping Medicare
    By antiquity in forum Funding, Legislation, & Advocacy
    Replies: 0
    Last Post: 03-20-2002, 06:59 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •