QUESTION: I am retired from American Airlines and they are cancelling our retirement health drug plan and I know the health coverage will soon follow. I have been wondering what to do about choosing between a MEDICARE ADVANTAGE PLAN or a MEDICARE SUPPLEMENT. Could you please help me?
ANSWER: I would be happy to explain the differences between these two choices you have for your health coverage with Medicare. I will begin my answer with the Medicare Advantage Plans:
MEDICARE ADVANTAGE PLANS
IMPORTANT WARNING: IF YOU JOIN A MEDICARE ADVANTAGE PLAN FIRST, INSTEAD OF A MEDICARE SUPPLEMENT, DURING YOUR 63 DAYS OF OPEN ENROLLMENT, YOU MAY NEVER BE ABLE TO GET A MEDICARE SUPPLEMENT, YOU WILL FORFIT YOUR RIGHT TO HAVE A CHOICE, EVEN IF YOU ARE NOT HAPPY WITH THE MEDICARE ADVANTAGE PLAN. AFTER YOUR 63 DAYS OF GUARENTEED ISSUE OPPORTUNITY ON THE PLAN OF YOUR CHOICE, YOU WILL GO THROUGH THE UNDERWRITING PROCESS IF YOU WANT TO CHANGE YOUR PLAN, AND YOU MAY BE TURNED DOWN FOR HEALTH REASONS. OUR ADVICE IS TO ENROLL IN A MEDICARE SUPPLEMENT FIRST, THEN IF YOU WANT TO TRY A MEDICARE ADVANTAGE PLAN YOU CAN DO SO, WITHOUT RISKING YOUR OPTIONS TO CHANGE.
YOU CAN ONLY USE THE FOLLOWING 12 MONTH PERIOD IF YOU HAVE BEEN ON A MEDICARE SUPPLEMENT FIRST!! If you have joined a Medicare Advantage Plan and are not happy with it for “any reason”, you have 12 months to get back on Original Medicare and a Medicare Supplement policy with NO UNDERWRITING, no health questions. You cannot be turned down for coverage within that 12 month period PROVIDED YOU LEFT A MEDICARE SUPPLEMENT TO JOIN A MEDICARE ADVANTAGE PLAN.
This is the ruling from the Centers for Medicare.
The Medicare Advantage Plans do not tell you this!!
Medicare Advantage Plans do not travel well. You have many hoops to jump through to see a specialist and your doctor can choose not to take this coverage at any time he chooses. You may have trouble finding a doctor that will take a Medicare Advantage Plans form of payment, because Medicare does not make the payment for your services. You are not really using your Medicare benefits, because the insurance company is paying your bills.
Also, they usually have a built in drug plan with formularies that are inferior.
Please read my other blogs about Medicare Advantage Plans by clicking on that catagory on the left side of this page!!!
Medicare Supplements or Medigap Coverage
By choosing a Medicare Supplement policy combined with a Stand Alone Part D Drug Plan, you get the most comprehensive coverage and maintain your choice in drug plans. As you know, Medicare pays 80% of your doctor and hospital coverage. You need the Supplement to pay the other 20%. The only out of pocket costs you will have is your monthly premium. You can go to any doctor or hospital all over the USA, see any specialist at any time you wish, and there are no “extra hoops” to jump through. All you need to do is get a comparison of prices for supplements. A Plan F is a Plan F, no matter what company you choose as all these benefits are regulated by the Centers for Medicare and are exactly the same! The only difference is one company will charge you a higher premium than another one will. There is no need to pay a higher price for your coverage!!
Then you will need a comparison of all the drug plans available to you based on your individual medications! That way you will always have the best drug plan, saving you the most on co-pays and premiums.
If after you read all the other blogs I have written about MAPD plans and Medicare Sups, and you still have a questions about your specific situation, please call my toll free number and I would be most happy to talk with you!