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Thread: Medigap plans?

  1. #1

    Medigap plans?

    From cursory reading the better plans seem to be A through G, M, N. Anyone have any advice, warnings or or thumbs up they could say re the plans?

    thanks
    Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer

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    I think the plans vary a bit by state, so I can't address the issue of the letters you list, but my one word of advice is to go with a straight Medigap plan as opposed to a plan tied into a specific insurance company that will only let you see doctors in their network service. I have a Medigap plan that simply pays the 20% that Medicare does not pay for, so I never have a co-pay and can see any doctor I choose as long as she/he is a Medicare provider (almost all are around here).

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    Senior Member marycsm77's Avatar
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    I thought all Medigap plan were tied to/offered by private insurance companies (i believe this is what it it says in the Medicare book I have. This is my understanding of it so far. I am getting Medicare starting April 1st and have been wading thru all this information trying to make decisions. I have spoken to a SHIP advocate, spoken to Medicare, read the book, still unsure.

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    Quote Originally Posted by marycsm77 View Post
    I thought all Medigap plan were tied to/offered by private insurance companies (i believe this is what it it says in the Medicare book I have. This is my understanding of it so far. I am getting Medicare starting April 1st and have been wading thru all this information trying to make decisions. I have spoken to a SHIP advocate, spoken to Medicare, read the book, still unsure.
    They are, but some work differently than others. I have my medigap policy through Blue Cross/Blue Shield, but I can go to any doctor who accepts Medicare, and almost all do in my area. Another policy (using someone in my area as an example) is through Tuft's Healthcare, and you can only see doctors in their network. To me it is a critical difference and allows me to see whoever I am most comfortable with, or whoever might be the most knowledgeable without having to get referrals.

  5. #5
    Dave is starting Medicare in April and has been very confusing. Because he was on Medicaid after our COBRA expired it appears his drug plan is free, but the list is limited.
    He has been on SS 24 months so being automatically switched over causing much confusion.

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    Some of the "keep you in our network" plans offer drug coverage slightly better than being able to roam free to whoever you choose to see, but my co-pay for generic drugs is only $7 (can also be only $10 at Target, Wal Mart for a 3 month supply!) so it isn't too bad and personally I would rather not have to deal with referrals, paperwork, or limited choice on the medical service areas.

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    Senior Member marycsm77's Avatar
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    Quote Originally Posted by leschinsky View Post
    From cursory reading the better plans seem to be A through G, M, N. Anyone have any advice, warnings or or thumbs up they could say re the plans

    thanks
    Have you spoken to SHIP regarding this? When i spoke to them on the phone, they were unwilling to make recommendations, however, when I went in person to see an advocate, their were 3 people there to answer questions and they didn't have a problem recommending plans they were familiar with. I don't have recommendations for this as my injury is tied to worker's compensation, so for me a medigap plan would probably more than I need for other health issues.

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    Quote Originally Posted by Eileen View Post
    They are, but some work differently than others. I have my medigap policy through Blue Cross/Blue Shield, but I can go to any doctor who accepts Medicare, and almost all do in my area. Another policy (using someone in my area as an example) is through Tuft's Healthcare, and you can only see doctors in their network. To me it is a critical difference and allows me to see whoever I am most comfortable with, or whoever might be the most knowledgeable without having to get referrals.

    I will say that this is the MOST important thing that you have to consider when choosing a plan. I took an advantage plan for several years only to discover that slowly doctors in North Carolina then in Colorado (when I later moved) would not accept it. I went back to basic Medicare and now am choosing a Medigap policy now. Most Medigap policies don't have network requirements.

    As far as primary insurance goes, I will not choose a "network" provider even though premiums are sometimes cheaper or an Advantage plan because you may end up driving miles to see some doctor who will accept your insurance and/or you end up paying out even though you have a medigap policy. A Medigap secondary insurance will not pay unless your primary pays first.

    Doctors can also refuse to accept Medicare. Rural doctors are increasingly doing this. Most hospitals however cannot.

    LES , I would read what the Medigap policy is going to provide carefully. The A plan is probably useless IMHO as it doesn't provide much. The F is going to cover your part B deductible and excess charges which is where your major expenses is going to come in if you have to have lots of outpatient testing or braces etc like I do occasionally. The F plans are going to be a bit more expensive though....
    Last edited by darkeyed_daisy; 03-16-2011 at 09:30 PM.
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    Senior Member marycsm77's Avatar
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    I was also told by Medicare that only certain Medigap plans will take people under 65, which is something that I had read on this website.

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    Quote Originally Posted by marycsm77 View Post
    I was also told by Medicare that only certain Medigap plans will take people under 65, which is something that I had read on this website.
    There are 29 states with laws that require insurance companies to offer the same coverage for the disabled that they do for people over 65. So it depends on what state you live in as to whether you can get a Medigap policy. I believe Tennessee's just went into effect in January of this year.

    It was attempted at the federal level but did not make it.
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

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