Mrs. Outnumbered:

"Could anyone offer their advice on the best supplemental Medicare insurance? I'm guardian for my 97 year old Grandma and I'm trying to decide if I should set up anything to go with her Medicare Part A & B. She is remarkably healthy for her age, isn't on any medication, and basically refuses going to her doctor, dentist, etc. She lives comfortably in an adult family home. The insurance quotes I've been receiving for her are around $240/month for AARP and no one is willing to take the time to explain what the deductible and co-pays would be with that. I'm considering that it might be best to just pay out of pocket for whatever medical bills may come instead of paying a monthly premium. Thanks for your time."

When my wife and I were within a few months of retiring, we made an appointment with a Medicare specialist with Council on Aging. She was full of good advice. We then met with a local independent insurance agent who supported the decision we had made. We ended up with a Medicare supplement part F through Humana and we’re very satisfied. We also have Part D with them.

This plan isn’t available everywhere.

Mike

Whatever you decide, get some sort of supplemental to cover the 20% that Medicare doesn't pay that she'll be responsible for without it. That can get pretty salty if she requires hospitalization or some other expensive procedure. If she's financially destitute, then Medicaid will cover it, but if not, she'll have to pay without a supplemental policy.

I have MediCare Supplement Plan J. This is no longer available for new subscribers (I am grandfathered on this plan), but Plan F is substantially the same. Depending on your state, this plan might be offered by any of the major insurers. Coverage is the same no matter who you buy it through, so it pays to shop for price (premium amount).

I had this plan when I was hospitalized for a week with severe intestinal hemorrhaging, used it again for prostate cancer treatment including couple months of daily radiation, again for ambulance, ER, surgery, month and a half of live-in rehab, outpatient physical therapy, for hip / thigh fracture. Also used it for another hospital week, transfusions, etc., when I was hit with Guillain Barré Syndrome. Many doctor visits for the preceding, lab blood work on a regular basis.

My co-pay for all of the preceding: ZERO! A monthly premium near the $240 level is well worth it if you can get Plan F.

I guess I am fortunate to live in an area where the Coventry Gold Medicare Advantage Plan is available. It has $0 premiums and low copays. I currently have 7 prescriptions that cost me $0 copay.

quote:

Originally posted by Steve Collins:
I guess I am fortunate to live in an area where the Coventry Gold Medicare Advantage Plan is available. It has $0 premiums and low copays. I currently have 7 prescriptions that cost me $0 copay.

Is your Medicare Advantage Plan a PPO, or is it HMO?

Mrs. Outnumbered says thank you! We're still all ears for more input, also.

We don't know where you are Outnumbered and by whom, so hard to give specific advice.

I am in Wisconsin, so is Mrs. Outnumbered's grandma

We are outnumbered by many small children at home, and when I go to work (in Madison, WI aka "Berkeley of the Midwest", or "Sodom By The Lake"), I am outnumbered by pseudo-over-educated liberal imbeciles. Nonetheless, we remain optimistic!

What state do you live in? What part of that state do you live in? This is what will determine what coverage options will be available to you.

Does your grandmother already have a plan for the medical side? Does she already have a Part D plan or other creditable drug coverage? At her age getting a Medicare Supplement plan might be an issue due to underwriting. Medicare Advantage (also known as Part C plans) generally are prohibited from asking underwriting questions and have set premiums, co-pays and coverage limits.

Is she on the hook for any penalties, and if for what?

This question comes up every so often. I give the same advice every time: Seek out an insurance agent who specializes in Medicare products.

DO NOT GO WITH A P&C AGENT WHO HAS A FEW MEDICARE PRODUCTS ON THE SIDE. Medicare can (and usually is) a far more complicated beast than property and casualty insurance.

Find an agent who represents most, if not all, Part C products in the state your Grandmother lives in. That Agent should have a number of MedSupp products in their bag as well. Most (like 80-90%) of their "book" should be Medicare.

Medicare is easy to screw up, sometimes hard to fix, and you're dealing with the FedGov/Social Security and they generally have zero sense of humor. Use a professional.

Hope this helps.

I'm much younger and live in a different state so the price may be different in her circumstances.
The Part G supplement with Anthem/Blue Cross and a cheap drug plan (I don't take any med's at this point) is what I have to cover the part B stuff that isn't covered by Medicare. This is with Traditional Medicare A&B, not Advantage which is a whole different thing.
My deductible is $189 a year.

Medicare (CMS) rates health plans nationally.

Here is a link to one article with recent ratings:

Link

Do you have a multi specialty medical group nearby with a Medicare Advantage program? That can be cheaper, but you mostly have to see physicians in that group. Marshfield Clinic is well known nationally, don't know if they have services near you.

I'm trying to make the same decision for myself its actually on my agenda today.
I tried searching online to gain advice and all I ended up with was un-ending phone calls.
I went on YouTube and searched Medicare supplement plans. I watched many very informative videos that REALLY opened my eyes.I now feel like I understand the difference in plans and how the prices of different Medigap plans and Medicare Advantage plans differed and cost.
ALL the researched advised against Medicare plan F, NOT because its not good, but because it costs more and the difference between plan F and G is only a one time yearly deductible less than $200. Plan N is cheaper, but offers the same coverage as F but with the same deductible as G but with office co-pays. ANY Medigap plan is the same. It does not matter what insurance company is offering it.Its all controlled by Medicare.
The Medicare Advantage plans are MUCH more restrictive but easier to get on.