Ugh. Open enrollment.

[intrepidity]

I just keep vascillating, plagued by indecision and uncertainty.

I have the chance to opt into "traditional" medicare (w/o a qualifying exam), having turned 65 recently. Currently in a MA plan, but having moved (CA to WA), need to switch that even if I elect to stick with MA.

Have not yet engaged with any local health providers but will need to asap for Rx renewals.

I have an "agent" who I really like and trust, but it could just be that she and I get along and laugh; how can I be certain she is giving me all the info I need? I know these agents get paid based on what we enroll in, right?

I know that no matter what I end up in, I will live with it and make it work, so all this anxiety is probably unnecessary.

I've had HMOs (like Kaiser) most of my life, so I'm used to just going to the doc and not having to think about all this other stuff (am I covered? can I afford it? ugh)

I guess I'll read through all the threads here and elsewhere, but the more I read, the more anxious I become.

Have not been to a doc office since the beginning of covid, but have a feeling that an avalance of health issues has been piling up and is about to let loose.

[IbogaProject]

1. Advantage is a trade off

Cheaper now, but coverage can be denied so it is a trade off. You have to evaluate your financial and medical health status. Catch with Medicare Advantage is it can be costly to switch back. One or Two years might not be too tough but switching back requires you back pay all the financial contributions you skip by being in a MA plan.

[intrepidity]

2. Wait wait what?

Paying back huh?

[IbogaProject]

9. To switch back to non advantage medicare

You have to pay all your missed years of medigap premiums, if you can get that coverage. If your medicare advantage is part of a retiree package it might be easier. Medicare only covers 80% and the doctors can't wave the 20%. And medicare doesn't include precriptions.

https://www.latimes.com/business/story/2024-03-16/when-you-want-to-leave-your-medicare-advantage-plan-but-feel-stuck#:~:text=Returning%20to%20Original%20Medicare%20from,to%20get%20a%20Medigap%20plan.&text=About%20half%20of%20Medicare%20Advantage,University%20School%20of%20Public%20Health.

[intrepidity]

12. I just read the article at the link

but did not see where it discusses paying anything back?

[IbogaProject]

13. not pay back

the issue is getting supplemental, AKA medigap coverage. If you are very poor or have retirement health coverage than MA might be OK.

[SheltieLover]

3. Call your senior center & Council on Aging

They helped me immeasurably when I needed a gap plan.

Gap plans ranged from $125/mo to nearly $400/mo for identical coverage!

Farm Bureau was the $125/mo option for the best plan available, so that's what I went with.

Same with Part D for drugs. Make sure you sign up immediately because there is a 1%/month penalty for life for every month you wait. And it's not 1% of the plan you choose, it's the median price plan. This year that's $40/month (that they base the penalty on).

I can't say enough about how wonderful standard Medicare & my gap plan have been.

[intrepidity]

4. Did you ever have a MA plan?

How did you decide on the gap plan? Did the medicare website have enough detailed info to decide, or did you have to also visit the site of each insurance company? Maybe I haven't dug deeply enough yet.

I'm inclined to go with trad med, even tho it seems more expensive up front, but i just can't decide.

Thanks for the tips about who to contact

[Skittles]

11. bottom line

if you want an insurance company between you and your doctor, and have go over all the changes every year with MA plans, go with MA.....if that does not sound appealing to you, STICK WITH TRADITIONAL MEDICARE

[CoopersDad]

5. Best advice, find your local nonprofit neutral

For Washington state, go here: https://www.insurance.wa.gov/get-free-unbiased-medicare-help-washington-shiba-program

My wife and I had two visits months apart with our local provider and chose a Medigap plan and NOT a Medicare Advantage plan.

Your advisors will explain the pros and cons of each, and different directions work for different people.

We were provided comparison charts and went with an AARP Medigap Plan and Wellcare Part D coverage.

Good luck!

[Joinfortmill]

6. I just lost my reply to you, so the short version.

If you choose original medicare when you're first eligible, and you decide to purchase a supplement plan to pay the 20% medicare doesn't cover, no pre existing requirements are allowed. If you initially choose a MA and at a later time find your MA plan is no longer offered and you then decide to choose original medicare, a supplemental plan can apply pre existing conditions that can last from 6 mo to a year.

[intrepidity]

7. Right, yes, this I knew

Upon first eligability (SSDI), I went with a MA plan purely due to cost. After turning 65, you get a second chance to enroll in the traditional medicare and medigap plans without a qualifying exam, which is my current situation. You get 6 months after turning 65 to do this.

[Auggie]

8. When I enrolled I factored what I could afford with what I was willing to risk losing

I went with the Plan G supplement, not MA, knowing that my yearly deductible would be low even if my monthly payments would be higher. Eight months later I was diagnosed with cancer.

With the Plan G supplement I was able to assemble an awesome medical in my home town. I wasn't denied any test or any doctor. I haven't paid more than $500 in deductibles over two years despite racking up over $800,000 for minor surgery, infusion, radiation, blood work, imaging, doctor's visits, etc.

I went through a broker too, who I vetted very well. What you do want to ask them is what Plan B provider in Washington has the history of the least or lowest amount of rate hikes.

Don't do Medicare Advantage. My 95-year old mother has it, and it is a nightmare.

[Skittles]

10. if you can afford it, STICK WITH ORIGINAL MEDICARE

especially if you dread "this time of year"

Advantage is a con that was designed to eventually get rid of Medicare.