Are My Choices?
There are four parts
basic free Medicare that covers hospitals stays.
part is not free. This year (2007) it cost $93.50 per month.
It is more expensive if your income is over $80,000 (individual)
or $160,000 (couple). You can expect Part B to continue to
go up each year. Part B covers physicians, lab tests, x-rays,
medical equipment and a whole lot more. Unless you are destitute
or have a Part C program, be sure you sign up for Part B.
Advantage programs are private health insurance companies
taking over your Medicare coverage. For each person who signs
up, Medicare pays the company a monthly fee. Be aware that
these are private programs and you are not covered by the
government's Medicare program when you are a member.
is the part that covers prescription drugs. These plans are
administered by private health insurance companies. Each company
has their own program. Figuring this one out is a pain in
There are all of these
different parts plus 12 different MediGap plans. There is Medicare
Select and I have lost count of the different Medicare Advantage
plans. I bet you are as about as confused as you can get.
Since this is my website
and there are no right and wrong choices, I am going to give you
my opinion - for what it is worth. Here is my personal take.
begin with, you want to always be aware that some choices cannot
be reversed. Yes, you can always go back to the standard Medicare
Part A and B plans. But, you cannot necessarily always get a Medigap
plan. There are only certain times and circumstances
that allow you to get Medigap coverage regardless of your health.
The best time to
purchase a Medicare Supplement or Medigap policy is during your
open enrollment. This is a period of six months from the date
you turn 65 and enroll in Medicare Part B. During this window
of time, regardless of your health, no company can deny, put conditions
on, or discriminate in the pricing of the policy you want because
of your medical history, health status or claims experience.
However, if you try
to get a Medicare Supplement or Medigap policy after the designated
periods for Medicare Part B enrollment, companies who sell Medigap
policies have the right to review your medical records and deny
There are exceptions. For instance, if your Medicare HMO is going
out of business or leaving the area served by your plan, you may
be eligible for guaranteed coverage.
But, if you do decide
on a Medicare Advantage plan and decide two years down the road
that you really don't like it (for any reason), you may not always
be able to buy a Medigap plan.
A Medicare Advantage
plan comes in a few different flavors. They can be PPO or HMO
plans. You want to be damn sure you like the network. Check for
the hospitals and make sure there are plenty of physicians who
you like. Remember, a physician can wake up one day and say "screw
it, I am not going to participate in the plan anymore".
The Medicare Advantage
plans usually require no out of pocket expense and include, to
varying degrees, drug coverage. If the cost of Part B and a Medigap
plan are going to present a financial problem to you, then one
of these plans might work for you. Again, watch the network.
you can afford it, my personal preference is to take the standard
Medicare (A and B) and buy a Medicare Supplement. You don't have
to get the plan that covers the most. You just need the standard
coverage that extends your eligible hospital days and takes care
of the larger deductibles.
I do not like the fact
that a private health insurance company is going to take money
from Medicare and then try to make money on it. Someone, somewhere
gets screwed, and it is usually the consumer. Stick with Medicare
and get a supplement. You will not have to hunt around for doctors,
worry if you are in or out of network, etc.
Since all Medicare
Supplement or Medigap plans have to cover exactly the same thing
(in other words a B level plan from one company is identical to
a B level plan from another company), you need to find a company
that has been around a long time, had a good rating, pays claims
well and does not have massive increases. It may not be the cheapest
to start, but in the long run it will cost less.
Call me for my recommendations.
I carry a few top plans from carriers that have been in the business
a long time.
you wait until you are sick to get a Medicare Supplement
or Medigap policy, your goose is cooked!
you are going to get a plan do it now. It will never be
any cheaper and there is no such thing as an insurance sale.
Think of it as an early bird special. Click here now for
Making a Decision
I know that there is
a lot to learn before making a decision. The Medicare
website has a good guide and if you call me after
reading it, I will discuss the plans with you. But, please, do
not call me up and expect me to spend hours on the phone explaining
the entire Medicare system. You can read the simple pamphlet and
be an expert in less than an hour. To
get the Medicare pamplet just click here.
You can contact us
between 9 AM and 8 PM Mon - Thurs EST and on Friday until 5 PM.
Call us at
We are insurance agents that sell Medigap and Medicare Advantage
Plans, as well as Long Term Care.