Staying the Course -- December 3, 2020

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Superbob

Steely Resolve!
Joined
Apr 21, 2005
Messages
8,479
Location
Coastal Carolina
Hello there fellow Coursers! It was great to read your comments about how Thanksgiving went for you and your families. Hope you all are doing well as we continue in holiday mode and perhaps the most joyous New Year's Eve ever, ringing out 2020. Unfortunately it looks like we will still be dealing with the horrible pandemic, but perhaps we can see better days ahead in 2021.

I'm so late with a week starter that I almost skipped it. But thought I'd give you my excuse: I have been wrestling with the annual dilemma that Medicare Open Enrollment (which ends in just a few days) brings to my household. Most of you likely are younger than I so maybe you haven't faced this yet. Medicare doesn't cover everything, so it is important to buy a supplemental plan. During Open Enrollment, you can change plans --and wow is there ever hype this season for Medicare Advantage plans! Many come with $0 premiums or close to it -- plus prescriptions, dental, vision, hearings aid...even a gym membership. TV pitches sound almost like MA is something for nothing. So why then do my wife and I continue to have Medigap plans and pay premiums for the two almost equaling a home mortgage?

A basic reason is freedom of choice -- and in our situations, needing that choice. With Medigap, you can select from all doctors in the USA who accept Medicare. You pay a big premium but your plan covers virtually all your expenses. With MA, you are restricted to a network of providers; you can go outside for service, but then you shell out of pocket, often quite a bit. Within the past two years, I had aortic aneurysm surgery and for that was able to select an out-of-state surgeon who is nationally renowned as an aorta specialist. My wife had a terrible fall and was hospitalized for two weeks and then in a rehab center for another two. Our Medigap paid for everything she and I needed, even an interstate ambulance ride for me from the hospital two weeks after surgery to a rehab center near home. It has extensive coverage for skilled nursing, much more than the MA plans seem to have.

For many folks, Medicare Advantage plans are great. I have been on the verge several times during this Open Enrollment of switching to one. I mean a free gym plus free Silver Sneaker classes -- would love that! But if you are likely to need outstanding medical specialists and services from wherever they may be found, I find that Medigap gives you that freedom.

It all would be so much easier to navigate if you had a crystal ball. But while I gnash my teeth over our monthly premiums, I am somewhat reassured that we are pre-paying all our medical expenses for the year, thus sparing us from a batch of medical bills in the mail.

So most of this week is gone, and so is most of Open Enrollment. If you are soon to wrestle with this, please know that my thoughts above do not amount to all the pros and cons. Decide for yourself what best meets your needs as best you can predict them.

Cheers,
Superbob
🦸‍♂️✍
 

MartinF

Well-known member
Joined
Jul 10, 2016
Messages
219
Location
Southern California USA
Thanks SB. I'm a year away from going thru this. I've typically had an HMO since I am fairly active and healthy.
Just had my yearly physical today. Will have to wait for the blood test results. BP was high but it was early in the morning before my meds kicked in. Pulse rate of 41 got the nurse to question me. They did an EKG but didn't comment on it so I guess it was OK. Seems like it was rushed.
 

rich01

Well-known member
Joined
Aug 23, 2018
Messages
419
Location
Virginia US
I was going to change from F to G last year, but my insurance agent said that I couldn't because I just had 2 stents and TAVR. I think I remember her saying that after some time period with no new problems I could apply to change.

If anyone knows differently, please let me know as I could save a few hundred dollars a year.
 

Superman

Well-known member
Joined
Oct 2, 2009
Messages
1,554
Location
Grand Rapids, MI, USA
Medicare concerns that are being discussed are still pretty far off here. Instead we’re getting ready for the holidays. Online shopping with returns as needed leading to shorter trips. Safer and easier. We’ve actually done it this way for. Couple years now.

Decorating the house. A little Clark Griswold outside and in. Of course, playing with my birthday gift while decorating.

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It is open enrollment season at work so figuring out what’s changed and how much it will cost us is always fun this time of year. But I’m trying not to stress it too much.

Enjoying the treadmill along with the spin bike. The tread has a “free” mode where the motor disengages and it’s like pushing a sled. Woke up some little used muscles with that one doing a “boot camp” instructor led workout on the treads big 32” monitor.

Repost of the dogs in case anyone missed them in last weeks thread. Yes. The annoying guy who breaks out the photo albums when nobody cares. 😂

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Superbob

Steely Resolve!
Joined
Apr 21, 2005
Messages
8,479
Location
Coastal Carolina
I was going to change from F to G last year, but my insurance agent said that I couldn't because I just had 2 stents and TAVR. I think I remember her saying that after some time period with no new problems I could apply to change.

If anyone knows differently, please let me know as I could save a few hundred dollars a year.
I checked around about changing F to F or F to G for a somewhat lower premium and often found a requirement for medical underwriting and/or stipulations against coverage for treatment of pre-existing conditions -- or requiring a six-month waiting period for major procedures. Since I may well have surgery in first quarter of 2021, it was enough to deter me from the hassle. Nightmare would be to get stuck with a new plan that had fine print allowing them to deny coverage to you in certain circumstances.
 

CindyBain

VR.org Supporter
Joined
Oct 13, 2020
Messages
21
Location
Ponte Vedra, FL
My understanding, is that you can change, but you will have to fill out a forms for G and then your conditions are reviewed by an insurance underwriter and they have the right to turn you down. It may be worth sticking with plan F. I have plan G and every year must meet the deductible, which so far, is not a lot, but my monthly premiums are less than plan F. I think if I were you, if you're able, I would stay with plan F. Other than the deductible and slightly lower premium they are the exact same plan. My husband has plan F, and our premiums are getting closer together in price now more than when I first began with plan G four years ago.
 

Superbob

Steely Resolve!
Joined
Apr 21, 2005
Messages
8,479
Location
Coastal Carolina
My understanding, is that you can change, but you will have to fill out a forms for G and then your conditions are reviewed by an insurance underwriter and they have the right to turn you down. It may be worth sticking with plan F. I have plan G and every year must meet the deductible, which so far, is not a lot, but my monthly premiums are less than plan F. I think if I were you, if you're able, I would stay with plan F. Other than the deductible and slightly lower premium they are the exact same plan. My husband has plan F, and our premiums are getting closer together in price now more than when I first began with plan G four years ago.
Thanks, Cindy. That's the course we've taken. I like the security that comprehensive Plan F brings us. And I discovered from considering other plans that many offer a discount, typically 5 percent, when more than one policyholder are in a family. Our current plan has put in for that for us, and hopefully it will ease the premium pain a little.
 

rich01

Well-known member
Joined
Aug 23, 2018
Messages
419
Location
Virginia US
Thanks, Cindy. That's the course we've taken. I like the security that comprehensive Plan F brings us. And I discovered from considering other plans that many offer a discount, typically 5 percent, when more than one policyholder are in a family. Our current plan has put in for that for us, and hopefully it will ease the premium pain a little.
It is nice to be able to go to any doctor anywhere in the country without having to get approval, as long as they accept Medicare.
 
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