Questions re: Which Medicare Supplements to Get?

How about an apples-to-apples comparison? You say you have pocketed the would-be cost of a supplemental plan, but I do not see how that is possible if you also have to pay $15-50 just to see a doctor! ... If you feel that the advantage plan has worked well for you, then more power to you. But as you yourself have stated, you might be unable to switch to a supplemental plan at this point, not without a hefty penalty, if you would even be accepted at all.

My wife and I both have cancer. I'm not sure how many readers here have read our story. But I consider myself fortunate that with my supplemental plan G, my TOTAL cost (premiums plus deductible) for last year was $1630, which is considerably less than the $6500 you estimated. And with mine there are no co-pays. Zero, for three surgeries, eight weeks of radiation and 10 months so far on Lupron.

My wife turns sixty five later this month and has also selected a plan G supplement. I suppose to match your analysis I would need to add her costs to mine for a true total. But my costs were minimal compared to what we incurred last year when she was diagnosed. Our out of pocket was over $7000 because we also had to pay cash for a couple MRI's just so we could get her treated before her disease progressed any further (stage 4 primary bone lymphoma with tumors in her spine, pelvis and cranium).

Not everyone would be in a similar situation (fortunately!) but basing decisions upon an assumption that you will always be healthy is probably not the wisest move. Just sayin'.

Rob, no problem. As it turns out, other than physicals (free) we have had very few doctors visits over the past 6 years so have have saved almost $40K in premiums (assuming we would have picked Part F which was what we were thinking at the time).

Having said that, I'm not suggesting that these plans are for everyone or even anyone. We have been very lucky and, who knows, I may be back here in a few years with serious regret about my choice. I'm simply pointing out that under the right set of circumstances these plans can work out ok.

Jim

I don't recall the details, but I did work with a professional group that helps you identify the "best" plan. They make nothing from the sale of the policy. If I recall, it was the definition in the Texas CMMS area of how the deductible was applied, the validity and reliability of the companies involved, and that an F plan offered better defenses than a G for someone in my circumstances. I'll be seeing them again in March of '18.

But the bottom line is that everyone is trying to sell you something (witness the piles of junk mail I trash), and you will rarely win. Be very careful.

I will endorse what Tudpuck said about Advantage plans. Not for everyone, but I did the math when I retired 6 years ago and weighed the certainty of paying $450 or so per month more for me and my wife if we went with a supplement plan and pharmacy plan along with traditional Medicare vs. the potential maximum out of pocket on the Advantage plan. I agree, this could all go pear-shaped if we both had hospitalizations several years in a row and had to each pay the maximum out of pocket (currently $4,900 each). On the other hand we'd not have had an additional $25-30,000 in retirement savings over the past 6 years. And going forward, even if we were on a Plan F or equivalent, we'd be paying an additional $3,000 or so per year above our Advantage premiums (the combined total for for both of us) whether we were hospitalized or had major treatment or not.

That said, we chose upper-tier PPO Advantage plans that include dental cleanings, eye glasses, and prescription drugs, (not the so-called "free" plans that restrict access to doctors and charge high co-pays). FWIW, my ex signed up for one of those "free" plans and the next year decided that moving to a higher-tier Advantage plan like ours was money well spent.

So far I've had no regrets -- even as I am headed into the next level of PCa care at Dana Farber. Our most expensive out of pocket medical expenses were when I was still covered by an employer insurance plan -- my SRT, which cost me the then maximum out-of-pocket of $3,500 or so, and hand surgery for my wife which cost us a few hundred beyond what the insurance covered.

All of that said, I do have a fall-back, though not sure if I will ever exercise it. I'm an Agent Orange Vietnam veteran and can, if I ever choose to, transfer my care to the V.A. for free. And should the V.A. ever decide to rate my PCa permanent (as opposed to still subject to potential cure) my wife would also qualify for V.A. co-insurance, which would mean she could revert to conventional Medicare with the V.A. as her supplemental plan (with no late-enrollment penalty.) So I grant that I'm taking a calculated risk but one that I would likely take even without the V.A. as a back-up plan. But to be fair, I also recognize I have some risk mitigation that isn't available to everyone.
Jim

Hey...I have a great idea...Why don't we ask our government to set up a universal medical plan. Then everyone would have access to equal medical coverage and pay for it equally based on their financial ability. What a wonderful humanitarian idea.

Fairwind said...
MANY doctors will not accept new standard Medicare patients...

In Florida that's not a problem. Any practitioner or facility that would reject that group would likely go out of business soon, given the demographics here. In fact, some doctors accept ONLY medicare patients.

Fairwind said...
..I am fortunate enough to get these drugs through the VA Medical System..Otherwise, that would have been a problem.

Good info Fairwind, thanks. I signed up for VA drug coverage as a backup plan. I have yet to actually use it, as my scripts so far have been cheap using GoodRx and cost less than I would pay in premiums for a part D plan, and going to the VA is a bit of a hassle. But having that coverage means that I will NOT have to pay a penalty if in the future I want to enroll in a part D plan.

I am so sorry that your latest treatments have failed, but it is good to know that even those drugs are covered by the VA.