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How does Medicare work? Which is better? Medicare supplement or Medicare Advantage? Can I switch from Advantage to a supplement plan during open enrollment? Independent Medicare insurance agent Bob Vineyard weighs in with this video.
Turning 65? Can't decide if original Medicare and a Medigap plan are best for you, or should you enroll in an Advantage plan? Medicare says the best time to enroll in a supplement plan is when you are first eligible. If you buy a plan during your initial enrollment period you cannot be turned down, even if you have pre-existing medical conditions. After your IEP has passed a Medigap carrier will review your medical history and either accept or reject your application.
Medigap and Advantage plans have similarities and differences. Both are senior health insurance plans. Anything that would be covered by original Medicare is also a covered expense with an MA plan. However, your out of pocket costs may be significantly higher with Advantage compared with original Medicare and a supplement plan.
Medicare Advantage plans, also known as Medicare Part C, are managed care plans offered by insurance carriers. CMS oversees this program and approves the plans before they can be sold in Georgia. The plans are also rated by Medicare based on a number of factors, including policyholder input.
These managed care plans offered in Georgia are either a PPO or HMO. Both have provider networks and rules that must be followed if you want to minimize your out of pocket costs. With a PPO plan if you use a non-par provider you may not only have higher copay's and deductibles, but your OOP costs may be higher.
Use a non-par provider when you have an HMO plan and your claim may not be paid at all unless you received emergency care.
Original Medicare does not have networks. You can use any doctor, lab or hospital in the U.S. as long as they participate in Medicare. A recent study found that 96% of primary care providers participate in Medicare.
You are free to go almost anywhere in the country without worry. Some well know cancer treatment centers do not accept Medicare Advantage plans but all participate in Medicare.
Not all cancer can be treated with chemotherapy, but 80% of cancer patients will have chemo. Your chemotherapy drugs will be treated in the doctors office or a clinic.
Chemotherapy falls under Part B if you have original Medicare and a Medigap plan.
Cancer treatment is covered by Advantage plans but your out of pocket cost could run in the thousands of dollars.
If you are trying to decide which Medicare supplement plan to buy, plan G delivers more value than plan G. Probably 90% of my clients have the G plan.
Chemotherapy drugs administered in a doctor's office or clinic normally fall under Part B. Medication from a retail pharmacy or by mail fall under your PDP.
This is why most of us chose a Medicare supplement plan in 2018. Bob Vineyard, independent Medicare insurance broker in Georgia, can explain your Georgia Medicare insurance options and will allow you to decide.
We represent several carriers including Aetna, Anthem Blue Cross, Humana and more.
According to the Mayo clinic, "new cancer treatments are routinely priced at over $100,000 per year of treatment."
I enrolled in Medicare in September, 2015. Cancer is a word I know too well. My mothers twin sister and older sister died of cancer. My wife’s father and mother died because of cancer. All 5 of my father-in-laws siblings died of cancer. Two of my mother-in-laws siblings died of cancer.
I have seen what cancer can do to the human body and the misery that accompanies this dread illness. If you are diagnosed with cancer, the last thing on your mind should not be “How will I pay for my treatment?”
I know how quickly things can change. When my health changes I want to control the direction of my care. Insurance carriers are not going to give me a list of doctors and tell me this year I can only use these, and next year the list may change.
I am enrolled in original Medicare plus Medigap plan N.
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Medicare supplement vs Advantage. Make the right choice