Turning 65 in 6 months and am bombarded by insurance brokers daily

[cane]

I already have Healthcare insurance for my wife (63) and I via marketplace. We are retired. In 6 months I will switch to Medicare, and based on what I read, I should stick with A, B and D. The proactive marketing makes me resist tapping one of these insurance brokers as I suspect each may have some bias. Who did you trust to broker or do you need anyone at all, and just enroll vis medicare.gov? (Not sure if it matters, we live in Delaware)

 

[rain2yu]

@cane This process is a royal pain you know where.

Most cities and counties usually have a senior center. While the focus of these places may seem recreational, the staffers often have info on resources in the community for various senior citizen issues. In my state (CA), I got a referral to the Health Insurance Counseling and Advocacy Program (HICAP). I spoke with a counselor who explained the differences between traditional Medicare and Medicare Advantage versus Medigap plans in my area. The counselors are NOT salespeople! They discussed the plans available.

They are trained volunteers and they should give you objective advice about which of the myriad Medicare options would likely would work for you.

As an example, I take a certain prescription drug. I found out that with one Part D plan, my copay for that drug was $2.00, but with a different Part D plan the copay would have been $32.00! Who knew?

Terminology for this program in your state may be different, but you should be able to locate a comparable service for your needs.

A definite improvement over listening to sales people telling you their plan is the greatest thing since the invention of white bread.

Good luck with this.

 

[sharonsvs]

@rain2yu I’m Turning 65 in 8 months. Thanks for the great info!

 

[livingbyfaith1]

@sharonsvs Join the Reddit Medicare forum.

 

[kellic]

@livingbyfaith1 Yes, and also look for your local Medicare Counseling group, called SHIP in most states: https://www.shiphelp.org/

 

[enoob57]

@cane With A (which you don't pay for), B ($174/month), and D (which you have to pick) you are advised to buy a medigap policy/Medicare supplement. It's the D and the Medicare supplement that you're being bombarded about. (Or in the alternative, Medicare advantage)

 

[aisling1]

@enoob57 I live in a house that 2 rounds of previous owners were 65+.

I get constant barages of Medicare Advantage spams for them. The percentage of MA spam vs supplement spam is overwhelming.

Medicare Disadvantage plans are simply terrible.

 

[enoob57]

@aisling1 It does matter what area of country you live in whether it's very urban area or not but I was mostly posting in order to remind the person that if they don't do Medicare advantage they will need to do a medigap Medicare supplement plan

 

[aisling1]

@enoob57 Yeah; I live in a state capitol area.

 

[enoob57]

@aisling1 I'm not on Medicare but my husband is and he has access to the major university hospitals in our area on advantage.

In addition to not having had issues (he has one serious health condition and has had several minor incidents as well), we can't easily afford the more expensive original Medicare plus D plus Medigap. My current (ACA) health insurance that I've had for a number for years is also an HMO type and I need to get pre-approved and I have a high deductible so I'm used to that.

My parent is also "stuck" with a retirement based Medicare advantage plan, which has never denied anything for their numerous serious illnesses, except the time we tried to get them to extend a skilled nursing rehab by an extra week which they turned down.

 

[humza]

@aisling1 My advantage plan is absolutely awesome. No premium 5000 ded/coins. Prescriptions, pays on everything. Easy to manage. Can see who I want in a broad network and never a worry about coverage when traveling.

 

[aisling1]

@humza Medicare advantage plans work because they provide bells and whistles which are cheap.

But when you start talking expensive hospitalizations and rehab and then rinse and repeat, that's then their true nature shines.

They limit coverage, they are only on network with a few companies, they don't cover you unless you are really sick, they don't cover you where you want to receive are.

Say you develop a UTI and become dehydrated and weak, and fall and break your wrist. You need 3 days in the hospital. Your Medicare advantage plan doesn't feel you need to be hospitalized because your vitals were never unstable, even though you couldn't walk and needed O2 and were so dizzy when you stood up you felt weak.

You needed therapy, and had to go to rehab, but you don't qualify for acute inpatient rehab with those medical diagnoses. So you have to go to a subacute nursing home rehab. But your Medicare advantage plan is only in network with 3 of the 12 local facilities, and you dont like any of them.

So you choose to go home. But your Medicare advantage plan is only in network with 1 of the 8 local home health agencies and they can't provide care, so you don't get any home nursing or therapy. You do see your PCP within a week for follow -up, but by then you are not doing well, so he sends you back to the ED for further evaluation.

Yes, this is not uncommon.

In my service market, we run into issues all the time with availability and service coverage. Is this a one off? No

Many people love their insurance. That's awesome! Insurance is great, until you can't get what you want covered, for no real reason other than "just because."

Because when you have 2 people in side by side rooms, with the same diagnoses, and I can get care easily for one because they have straight Medicare, and the other one I cant because they have a terrible Advantage plan? It's just not right.

 

[_marc97]

@aisling1 Advantage isn't as bad as you portray it but we chose Medigap.