Medicare f or g to choose? Or keep current HMO?

I have Medcare Advantage and had robotic surgery. The cost was $53,000 and I was in the hosp 4 days (minor complications) and it only cost me $350.00.

Larry, if you have good coverage through your job, you don't have to sign up for part B, until you retire. But make sure you sign up for part A, within three months plus or minus of turning 65. Otherwise you'll be penalized.

As far as supplemental coverage plan F is the gold standard and if I were in your position I would get it. I'm not sure if you need it if you have part A only and get Insurance from your employer. But I think you don't need plan a fun till you lose employer coverage, plan F is a supplement to part B.

Part D's prescription drug coverage and yes you should get that for sure

Thanks All
I have community care HMO my copay on MRI last year was 876, for bone scan and cat scan with contrast my copay was 1250 I think my max out of pocket is 4000. Last year Provenge cost me a copay of 45 because I had already meant my max out of pocket.
My original question is much more complicated than I thought; there are many things I need to check on with HMO and compare with plan F and D.
I do like the idea of having a slightly higher monthly payment with plan F (Jerry) to better out of pocket coverage.
Larry

You all have helped!
I will sign up in 3 mo before birthday (Pratoman)
and for sure part D prescriptions - Dogdays

I have Part A, B and D and supplemental. All of my cancer management was done at MD Anderson and my out of pocket cost so far is $0.00. I wouldn't get locked into a Network situation where you can only seek treatment in-network or have a huge out of pocket cost.

I have A and B plus supplemental plan G. The coverage between F and G are identical and the only difference is the price of the monthly premium versus an annual deductible. My deductible is $180 per year and is usually knocked out with one doctor visit. If the F premium is more than $15/mo more than G, then go with G. Easy math (12x15=180). I have been told that plan F's will be eliminated in the year 2020, but if you have one you will be grandfathered in. Of course, prices change every year. I should add that with my plan G I have never paid anything over the annual deductible.

I would recommend that you avoid ANYTHING named 'medicare complete' or medicare gold or any other name they may slap on a plan to disguise the fact that it is an advantage plan, type C. They are limited to a specific group of doctors and hospitals. People buy advantage plans because the insurance company takes your medicare premium from the government so they believe that they are not paying any premium. The piper gets paid down the road when you need specialized care, only to learn that you are no longer eligible to switch over to a supplemental policy.

Part D depends on what drugs you may already be on, or may need in the foreseeable future. All part D plans have a premium and most have a deductible. Add them up and if it is more than your meds cost now then skip it. There is a drug price calculator on the medicare website, though it is difficult to navigate.

Using GoodRx or other similar programs you can usually get scripts for less than any monthly premium amount. The insurance salesmen will tell you that there is a 'penalty' for delaying enrollment in a part D plan, but again, you can do the math. This is a "medical-pharmaceutical complex' that forces statins on otherwise healthy people because the gov't pays for it. Just my two cents.

i am a Medicare counselor through the federally funded SHIP program that provides free of charge Medicare counseling services throughout the country. Much of the information you have received in response to your inquiry is good but some is not completely accurate.

1. The initial enrollment period for Medicare is 3 months before your 65th birthday, the month of your birthday and then 3 months after your birthday.

2. There is NOT a penalty if you do not sign up for Part A during this period. The penalty is if you do not sign up for Part B on a timely basis.

3. If you have health unsurance coverage through work either through your own insurance or through that of your spouse, you do not have to sign up for Medicare as long as you have that health insurance. You can sign up without penalty once you lose employer provided health insurance if you do so on a timely basis and submit the supporting paperwork that documents your prior coverage.

4. Most everybody signs up for part A no matter what because there is no cost (for almost everyone) for Part A. Part B currently costs new entrants $134 per month. That monthly premium from Medicare is subject to change each year. People with employer provided health insurance generally choose to delay Part B because they do not want to pay a monthly cost for insurance they will not use right away as Medicare is generally secondary to most employer plans.

5. medicare Advantage Plans and Medicare Supplement plans are totally different approaches to Medicare insurance. Mis-understanding these differences is one of the biggest areas of confusion we see with clients. The explanations provided in this thread have done a pretty good job explaining this difference.

6. We strongly encourage enrollees who are financially able to select a Medicare Supplement Plan. Although more expensive monthly, these provide more comprehensive coverage long term on a more cost effective basis than an Advantage Plan. Plan F and Plan G are the most comprehensive supplement plans currently on the market. It is particularly important for those knowing going into their initial enrollment period that they have serious health problems to buy as comprehensive a plan as possible as your ability to change from an advantage plan to a supplement after your initial enrollment is severely limited by medical underwriting.

7. If you buy a Supplement, you also need to buy a Part D free standing prescription plan. There are multiple plans in each geographic region, with different costs per month, deductibles and formularies. Purchase the plan that best works for your current drug profile. You can change prescription plans every year during Medicare open enrollment and should always check during that period to make sure your current prescription plans still meets your needs as your own drug profile may change as does the plan formulary.

8. As a general rule, a G Supplement should save you more than just the cost of the Part B deductible, which is currently $183 for 2017. Every company is different in pricing however and I have seen G supplement quotes that are not price competitive with an F plan. Shop your supplement company carefully upon signing up, not only for current price, but rate increase history, age banding practices and general customer service reputation. Unlike Advantage plans, as a general rule you are not easily able to either change supplemenypt companies or supplement plans every year during open enrollment. open enrollment is only for Part D plans and Advantage Plans.

Good luck with your ongoing treatment and insurance selections. This site has been wonderful to my husband and I the last 3+ years since his diagnosis. He just celebrated his 3 year surgery anniversary with a <0.01 psa. We were very relieved as the 3-5 year post op period makes us very nervous because of some aspects of his post op pathology. In statistics we have seen, it can get dicey around this time so we are increasingly nervous every 6 months when psa time rolls around.

Thanks Lovif
Is there a trusted place to check supplement companies for current price, rate increase history, age banding practices and general customer service reputation.
Larry

RobLee, I didn't say it was mandatory to buy a Part D plan, I said you need to buy one - it is not really the same thing. As to the thought that there is no reason to spend $200 per year to buy $100 per year of medication, that works as long as you only need $100 worth of medication per year. An individual's health can change on a dime and $100 worth of medication can become thousands of dollars worth of medication overnight. Although it is not mandatory to buy Part D, if you do not buy one during your initial eligibility for Medicare and you suddenly find that your drug profile has changed for the worst cost wise, you both have to wait for the next open enrollment period to be able to join a plan and then pay a penalty every month for the rest of the time you have have a Part D plan. At that point, you may not only wish you could buy a plan right away (or that you had bought a plan back in the day) but you probably need one as well. Choosing not to buy a drug plan works well as a long term strategy for those who are lucky enough to be able to stay on a small number of low cost generic drugs for the rest of their life. My mother actually was one of those people - she didn't pay attention to buying a prescription plan when she got her medicare supplement and then got frozen out of getting one and for her it was no big deal. She died at 91 taking like 3 cheap medications! For a high percentage of people however, choosing to pay over the counter rather than having a drug insurance plan is not a cost effective long term financial strategy for medication management. I appreciate that different people have different strategies for the management of health care costs, that Part D plans are hardly perfect and the underlying issues related to the cost of insurance, health care and medication are complex and very political. Unfortunately, I see the ramifications of a lot of these shorter term cost savings strategies every week when they go bad, which is why I talk about the need to have a drug plan up front - my mother not withstanding.

Larry E, as to your question about a trusted place to get information about various insurance companies and supplement plans - there is no public data base that I am aware of. The data bases that provide rates and rate history information are private data bases. I encourage you to find an insurance broker in your area that sells or even better yet, specializes in medicare supplement plans that you have heard good things about. They not only have access to the data base and do not represent a specific company, but they have background on what is actually going on with different companies, who really owns the insurance company that doesn't operate under the parent name, whether that company is just temporarily lowering premiums to try to open a new book of business, etc. Although I have access to a data base in PA, I actually spent some time talking to such a broker locally before I made my decision about Medicare supplement plans. I was looking for more background on company practices than I could get from just numbers in the data base. I spent my career in Human Resources and designed and bought benefit plans for years, which gave me a pretty healthy skepticism of insurance company practices and I generally found the brokers I worked with had background info and knowledge that was helpful, so that is why I sought out a broker as part of my decision making process this past summer. Just a suggestion.

One of the most comprehensive sites for comparison shopping is www.ehealthinsurance.com. They don't have all the companies but they do have enough to give you a fair comparison.

In my opinion the worst places would be associations that only sell for one company like AARP. These plans are often more costly than you can find with some simple research.

Thanks JNF,
That is just what I was looking for.
Larry

I think it would be a good idea to find a plan that provides good prescription coverage. You are a G9 and your meds will be expensive. Get ahold of the plans formulary to find out how much some of the tier 6 meds will cost.

Good advice in this thread. I went on Medicare in 2016 at age 66. I had signed up for Part A in 2015, during the seven month window of opportunity.
I want to add that it's so very important to get Part D drug coverage. I am on Xtandi, a $10k per month drug. In January, I went completely through the deductible and the donut hole. My out of pocket was over $3k in January but since then I only pay a " modest" 5% while in catastrophic coverage. That's $500 cost to me per month. Copay assistance has been no help to me, denied coverage due to prior years income.
I signed up for Original Medicare instead of Advantage plan because of the underwriting requirement mentioned earlier if I ever wanted to switch over to Original Medicare from Advantage.