Medicare time!

Old Sep 4th 2020, 12:49 am
  #61  
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Default Re: Medicare time!

Originally Posted by civilservant View Post
Yes it is. A Medicare Supplement Plan only applies when one is on traditional Medicare, not an MA plan.

The supplement plan covers most of the out of pocket expenses that Medicare has. As an example, it usually covers the inpatient hospital co-insurance charges (usually at 100%)

It's more commonly know as a Medigap policy in certain parts of the US, but it's actual name is a Part F plan. Medicare Advantage Plans are Part C plans.
It's confusing enough without getting the names wrong! Supplement plans are also known as Medigap (not part F). (Plan F is one of several Medigap plans, which I think is being phased out)
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Old Sep 4th 2020, 12:56 am
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Default Re: Medicare time!

Originally Posted by vespucci View Post
It's confusing enough without getting the names wrong! Supplement plans are also known as Medigap (not part F). (Plan F is one of several Medigap plans, which I think is being phased out)
Medigap plans C and F are no longer available for new Medicare enrollees in 2020 and beyond. Those who first enrolled before 2020 can continue to enroll in a plan C or F policy. Those policies are the only Medigap plans that pay the part B deductible of $185. Yes, Medicare is a confusing mess as are the differing ways you can transition from other insurance. And, judging by the amount of marketing crap that has come through my mailbox the last few months, Advantage plans are a huge profit maker for insurance companies.

Last edited by Giantaxe; Sep 4th 2020 at 2:20 am.
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Old Sep 4th 2020, 11:55 am
  #63  
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Default Re: Medicare time!

Medigap plans C and F are no longer available for new Medicare enrollees in 2020 and beyond.
Correct. Although that it's a little simplistic.

You will still be able to get Medigap plans, but they will not be allowed to cover as much as before. The Part B deductible will now still be paid by the enrollee ($198 a year at present) but will still cover the Part A deductible and co-insurance which are by far the big ticket items for Medicare patient.

These new plans will be Part G's, just to confuse matters even further.
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Old Sep 4th 2020, 4:02 pm
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Default Re: Medicare time!

Originally Posted by civilservant View Post
Correct. Although that it's a little simplistic.

You will still be able to get Medigap plans, but they will not be allowed to cover as much as before. The Part B deductible will now still be paid by the enrollee ($198 a year at present) but will still cover the Part A deductible and co-insurance which are by far the big ticket items for Medicare patient.

These new plans will be Part G's, just to confuse matters even further.
Other Medigap plans than G are still available, at least in my area.
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Old Sep 4th 2020, 4:03 pm
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Default Re: Medicare time!

Are we getting our Plans and Parts mixed up?

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Old Sep 4th 2020, 4:11 pm
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Default Re: Medicare time!

Originally Posted by sid nv View Post
Are we getting our Plans and Parts mixed up?

No, Medigap has differing plans. Medicare has differing parts. Crazy but true...
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Old Sep 5th 2020, 3:29 am
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Default Re: Medicare time!

So with only 4 months remaining to research Medicare options for next year, I am intrigued by the Part F and the new Part G parts. I think the new Part G should be better than the older Parts A, B and so on, but one has to pay close attention to the fine print. My doctor sent me for an X-ray to the "old hospital" here, but I later discovered that this facility is not "in network" and received a big bill.
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Old Sep 5th 2020, 12:08 pm
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Default Re: Medicare time!

Originally Posted by sid nv View Post
So with only 4 months remaining to research Medicare options for next year, I am intrigued by the Part F and the new Part G parts. I think the new Part G should be better than the older Parts A, B and so on, but one has to pay close attention to the fine print. My doctor sent me for an X-ray to the "old hospital" here, but I later discovered that this facility is not "in network" and received a big bill.
Was it the hospital not in network or the radiologist who read the X-ray? It can get complicated.
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Old Sep 5th 2020, 6:02 pm
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Default Re: Medicare time!

Originally Posted by ddsrph View Post
Was it the hospital not in network or the radiologist who read the X-ray? It can get complicated.
Correct, the bill is from the radiologist. No doubt I signed some document agreeing unwittingly to any and all charges they can think up. It would not surprise me if I receive a bill for the radiologist's dog's claw-trimming procedure.

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Old Sep 5th 2020, 6:21 pm
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Default Re: Medicare time!

Originally Posted by sid nv View Post
Correct, the bill is from the radiologist. No doubt I signed some document agreeing unwittingly to any and all charges they can think up. It would not surprise me if I receive a bill for the radiologist's dog's claw-trimming procedure.
Thats why I hate Advantage plans. You never know when a big supprise is coming. The whole concept of paying them a lump sum then expect the company to pay your bills out of THEIR money.
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Old Sep 5th 2020, 6:47 pm
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Default Re: Medicare time!

Originally Posted by ddsrph View Post
Thats why I hate Advantage plans. You never know when a big supprise is coming. The whole concept of paying them a lump sum then expect the company to pay your bills out of THEIR money.
I don't support the 'advantage' plans or the insurance companies that administer them, but in fairness, the idea of paying a lump sum is to stop them from doing procedures that are medically unnecessary and then billing for it. If all costs were simply 'passed through', I can see much more fraud. I'm going to hazard a guess here that this was the system before the lump-sum reimbursement was put in place.
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Old Sep 5th 2020, 7:40 pm
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Default Re: Medicare time!

Originally Posted by Steerpike View Post
I don't support the 'advantage' plans or the insurance companies that administer them, but in fairness, the idea of paying a lump sum is to stop them from doing procedures that are medically unnecessary and then billing for it. If all costs were simply 'passed through', I can see much more fraud. I'm going to hazard a guess here that this was the system before the lump-sum reimbursement was put in place.
Before Advantage plans it was pure Medicare and I am sure some over treating for profit. However the articles I have seen puts the costs to Medicare about 15% more for each person on advantage plans than those on traditional Medicare. Do you have any information to dispute or confirm? I really only know from what little I have read.
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Old Sep 5th 2020, 10:05 pm
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Default Re: Medicare time!

Originally Posted by ddsrph View Post
Before Advantage plans it was pure Medicare and I am sure some over treating for profit. However the articles I have seen puts the costs to Medicare about 15% more for each person on advantage plans than those on traditional Medicare. Do you have any information to dispute or confirm? I really only know from what little I have read.
I really don't know much about the levels of fraud, or the 'rate' differences. If it costs Medicare 15% more to have a person on an 'Advantage' plan, I would have thought they would try to discourage the Advantage plans, or, modify the fee arrangement ... but who knows what is involved in doing that!

I'm still a few years away from decision time. I got quite into it when my g/f was making her choices, but I quickly forgot after that - this is not the type of information I can retain to any depth.
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Old Sep 6th 2020, 8:03 pm
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Default Re: Medicare time!

Originally Posted by ddsrph View Post
Thats why I hate Advantage plans. You never know when a big supprise is coming. The whole concept of paying them a lump sum then expect the company to pay your bills out of THEIR money.
This is no different from any health insurance that has "in network" and "out of network" providers. Not that I am defending that, but nevertheless there is nothing conceptually unique about Advantage plans.
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Old Sep 6th 2020, 8:26 pm
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Default Re: Medicare time!

Originally Posted by Giantaxe View Post
This is no different from any health insurance that has "in network" and "out of network" providers. Not that I am defending that, but nevertheless there is nothing conceptually unique about Advantage plans.
I think the problem is many seniors are heavily sold on these plans without fully understanding what they are signing up for. They can work fine for many but you have to be alert on your provider choices.

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