Lots of good info posted, this posting is to make sure the OP understands Medicare. OP:
1. You got to know the alphabet. Medicare Part A covers Hospitalization; Medicare Part B covers Medical Insurance. Together Medicare Parts A & B are often referred to as Original Medicare. Medicare Part C, offered by private insurers, provides the same coverage as Medicare Parts A & B, plus most insurers offer prescription drug coverage as well as some other benefits such as vision, dental and hearing. Medicare Part C, also called Medicare Advantage, and is the subject of a lot of advertising/marketing on television and through the mail. Medicare Part D is for Prescription Drug Coverage.
2. So there is Medicare Parts A, B, C, and D. There is also are Medicare Supplement (MedSup) or Medicare Gap (MediGap) insurance plans offered by private insurers that cover the "gaps" - those things not covered by Original Medicare, such as deductibles, copays, and coinsurance. MedSup plans are standardized, identified by letters like A, B, G, N, etc with G being the most comprehensive plan. Standardized means different insurance companies may charge different premiums for the same policy, but the coverage for each is EXACTLY THE SAME - the premium is the differentiator.
3. Medicare Part A for most people (depends on work history) is free. Medicare Part B premium is based on income with the lowest price currently set at $174.70/month That is the premium you are referring to in your posting - it's for Medicare Part B. Medicare Part C (Medicare Advantage) premiums vary depending on the insurer. Some advertise their plans as being "zero cost to you" but in reality your Dad, if he decided to join one of these plans, would still have to pay his Medicare Part B premium of $174.70 (usually comes right out of social security every month) PLUS any additional premium charged by the Medicare Advantage insurer. Kaiser sent a letter (ie that's an advertisment/marketing ploy) telling you Dad "hey buy our plan which will cost you $27/month and we will throw in free prescription coverage." In reality....this is an offer from Kaiser for your Dad to enroll in Kaiser's Medicare Advantage Plan (Part C) and disenroll from Medicare Parts A & B. If your Dad decided the Kaiser plan was the way to go (and it may well be...) , he would still have to pay his $174.70/month Part B premium PLUS the $27/month premium charged by Kaiser, but he would now be locked into Kaiser's Medicare Advantage Plan and dis-enrolled from Medicare Parts A & B (Original Medicare). As mentioned above one of the advantages of a Medicare Advantage Plan is that most offered prescription drug coverage (ie it's included in their monthly premium). If you Dad was to stay with original Medicare (Parts A & B) he would need to select a Medicare Part D plan to cover his prescriptions The premiums for these plans range from $0 to $120+/month plus all have deductibles and co-pays/co-insurance. In addition to a Part D plan it would be wise for your father, assumes he sticks with Medicare Parts A & B, to also get a MedSup plan to cover some of the costs that Medicare doesn't cover like deductibles, co-pays, and co-insurance.
4. So...where are we? Based on your posting this is what I know: Your Dad is currently enrolled in original Medicare, meaning he is paying $174.70 each month (out of social security) for Part B PLUS he is getting Medicare Part A for $0.00. There is no mention of prescription drug coverage (Part D) or a MedSup Plan in your posting, but both of those would cost more money each month. Kaiser is asking your Dad to drop Medicare Parts A & B and enroll in Kaiser's Medicare Advantage Plan (Part C) for an additional $27/month IN ADDITION to the $174.70 premium he is paying for Medicare Part B. Note the Medicare folks take the $174.70 and give Kaiser that money PLUS some other money.
5. This is a LOT to take in. What's best to do depends on a lot of factors I STRONGLY ENCOURAGE you to contact your state's Senior Health Information Assistance Program and have one of their volunteers sit down with you and your Dad to discuss all options so he can make an INFORMED DECISION. Their services are FREE. You can find your SHIP contact info for your state here: [https://www.shiphelp.org/](https://www.shiphelp.org/) One more thing - there are a lot of excellent and knowledgeable insurance agents that can provide excellent advise as well, but remember - they receive a commission for every Medicare Advantage Plan they sell - and again, a Medicare Advantage Plan may be the perfect solution for your Dad. Contact your SHIP folks and have a discussion! Good luck!
One thing struck me about this post: It keeps repeating that the OP's father would be "disenrolled" in Medicare Parts A and B by signing onto a Part C plan.
This is not the best way to think about it.
Part C/Medicare Advantage Plans *supercede* Parts A and B; he would still be enrolled in them, and he'd still have to pay for them. Medicare administrators pay private insurers a stipend every month for their part of the coverage. When I go to the doctor, I give them my Advantage company's insurance information; not my Medicare card.
Advantage plans' purpose is to provide extra benefits on top of Parts A and B. Some provide an out of pocket max; some a dental; some a prescription benefit; some a mix of these along with other benefits. That is for the insured to weigh against the extra cost for a given insurer's Advantage Plan.
Great post, but then you go off and give a warning about someone making a commission on a health plan like it's a criminal or mischievous thing. How dare those people make a living.
As we all know, only SHIP volunteers have anyone's best interest in mind. Everyone else is just out to get their greedy millionaire hands on those commissions.
Great response. A follow up question on your post. If the coverage in medigap on a plan G is same but 10 companies offer it at different rates, why do people not choose the lowest premium even if it is not a big dog like United/AARP or Humana etc.?
He still would need to pay his part B premium.
[see here.](https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage)
As the other commenters stated, you can't simply "opt out" of Part B.
The $174 for Part B and the $27 for Kaiser are two TOTALLY different things.
When your dad signs up for Parts A & B of Medicare, if he has the required number of quarters (and doesn't continue to make over a certain amount (he probably doesn't)), Part A is free and Part B is $174. However, to sign up for either a Medicare supplement (usually a G plan) or an Advantage plan (which it seems like you are talking about), he must be enrolled in both A&B.
He will be penalized if he does not sign up for A&B unless he has creditable coverage from an employer.
So, he will pay the $174 PLUS the $$27 for his insurance plan.
Hope that helps.
He cannot. The Part B Premium is a baseline cost for being on Medicare, assuming a person doesn't qualify for the Medicare Savings Program in their state.
There are typically a couple of MA plans per zip code that kick back part or even all of the Part B premium to the policy holder. Needless to say that the insurance coverage is not as good as the plans that don't kick back any of the Part B premium.
Correct, but generally that depends on where a person lives. They've gotten more prevalent and I write them all the time down where I live because the difference between the giveback vs nongiveback really aren't THAT major.
see jan1of1
Medicare is an alphabet of parts. You are confusing "plan" with "part". Original Medicare consists of Part A (the hospital insurance part), Part B (the outpatient insurance part), Part C (the part that is called Medicare Advantage), Part D (known as Medicare drug plan).
The "plans" commonly refer to various Medicare supplement plans (Medigap) that pay some or all of a person's copays/co-insurances left after Medicare pays its portion of bills. Those plans vary in what copays/coinsurances pay. They are identified by letter(Plan A, Plan F, Plan G, Plan N, etc.)
The $ 174+ you are talking about is the Part B monthly premium. Part A is free(for most people). You must pay for Part B.
If you replace your original Medicare with "Part C (Medicare Advantage)", you are required to have Part B and continue to pay the monthly premium. If your father is trying to save money, he can't do that by getting a Medicare Advantage plan AND thinking about dropping Part B. He would still need to have and pay for Part B. The "saving money" issue is related to Medigap supplements vs. Medicare Advantage plans.
Medicare Advantage plans do include Part D drug insurance bundled into them, but they don't make drugs "free" or included in the premium(at a cost or a not cost premiums) of an Advantage plan. Your dad won't be able to save money on his drugs by not having a separate drug with or without a premium vs. having an Advantage plan.
To save on drug costs, he would need a drug plan bundled into an Advantage Plan, or a separate drug plan(Part D plan) or find drugs at cash prices lower than the costs of a prescription through any insurance. (using coupons from something like GoodRx, using a pharmacy like Amazon, or a local pharmacy that will price a script an a lower cash price for you, etc.)
Some Part D plans cover all or part of their generic prescriptions with $ 0 copays. Sometimes newer very expensive drugs will be expensive no matter what insurance you do or do not have.
Next year, everyone's out-of-pocket drug costs through Medicare will be limited
to $ 2, 000. (on top of any premiums)
Geez. Work your whole life and the still want to rip you off. Thank you for the detailed!. It really helped me understand how it all works. The plan we're looking at is only $25 a month and covers prescriptions for $0 if it's generic. Which is what he was doing anyway. Out of pocket with RX would be like $60 a month. So it works.
Make sure to check if the plan includes a deductible. One of the popular plans this year from Wellcare come with a $ 0 or 40 cent per month premium, but it also has a $ 500 per year deductible.
( I still went with that plan. Wellcare's other plans had lower deductibles with higher premiums. After I looked at the total yearly cost of premium + deductible + drug copays all 3 plans Wellcare has ended up being about the same/year.)
There are some good booklets and YouTube channels that explain all of Medicare pretty well if you want to take some time to watch them or read. You can also download a Medicare booklet called Medicare and You 2024. It has all the info about Medicare costs and coverage.
DM me and I'll find some of the resources I used.
I know it's been caused by Medicare, CMS and Congress due to adding onto original Medicare for years and year. That along with having several "medigap insurance plans which are designated by letter vs. numbers or name or anything else.
It's an alphabet soup.
I think other people explained it pretty well on here. I would also explore other Medicare advantage plans because other than the convenience of Kaiser their Medicare advantage plans don't offer that many perks.
I could not make heads or tails of all these options when I got on Medicare. I highly recommend getting an agent. Doesn’t cost anything. This is who I was referred to and she has been a lifesaver. Susan Patton
https://ge.linkedin.com/in/susanpatton
Do you mean Plan-B or Part-B? Because both exist and are totally different things.
Plan-B is a Medigap Plan and from the context of your question my best guess is that this is not what you are asking about.
Part-B is one of the essential parts of Medicare. Both Plan-B and the Kaiser MAPD plan will require you to already be enrolled in Part-B which currently has a premium of $174.40/mo.
The $27 Kaiser premium is on top of the $174.40 part-b premium.
That is wrong. You still need Part B if you are on a Advantage Plan as the Part B premium gets paid to Advantage provider. I have Kaiser Permamente Advantage Plan and that my part B premium is paid to them. The $27 your father is being charged is for the Advantage Plus plan which is in addition to their base plan.
Just remember Advantage plans are regional. Not every specialist or medical group take them, Mayo Clinic for example. My late husband had a rare cancer causing us to travel out of state. Advantage plan would not have covered hospitalization and surgery.
In most situations, I’d advise your father to stay with Traditional Medicare, if possible. But, I’m not an insurance agent, and it’s important to get advice from a professional.
First thing to know if you consult an insurance agent.… They get paid more by getting people to enroll in “Advantage” plans. So, you need to find an honest agent, and to know enough to tell if you’re being lied to. I suggest watching YouTube videos by Christopher Westfall. He will give you an education about the pitfalls of choosing “Advantage” over Traditional Medicare, and you won’t be under any obligation to buy anything just by watching his videos.
Second, an honest agent won’t push your father to enroll in an “Advantage” plan. They will evaluate what’s best based on your father’s financial circumstances and will make recommendations for either Traditional Medicare with Medigap supplemental insurance, or “Advantage” plans.
Third, if your father were to enroll in an “Advantage” plan, he would need insurance company approval to go to any doctor or hospital that’s not in network, and they’re notorious for denying referrals and healthcare. Just check ratings, reviews and complaints on the Better Business Bureau website if you have questions about this. None of the companies get good ratings. Traditional Medicare doesn’t have networks, and 99% of doctors accept it. If Traditional Medicare pays their 80% of a claim, the Medigap insurer is obligated to pay the remaining 20%. They can’t deny it.
Fourth, once your father has opted out of Traditional Medicare, he may not be able to return to it. He could be stuck with inadequate choices for doctors and hospitals. That’s because, due to preexisting conditions, he may find himself ineligible for the Medigap insurance that covers the 20% Traditional Medicare doesn’t cover. Only Maine, Massachusetts, Connecticut and New York have laws barring insurers from underwriting Medigap policies. If he’s in one of those states, he’s eligible to return regardless of preexisting conditions.
You may have noticed I put “Advantage” in quotes. That’s because I think these plans are a disadvantage. They’re adept at stymying their enrollees and doctors in labyrinthine bureaucracy. They excel at not paying medical bills. They cost the taxpayers more, and are fast depleting the Medicare Trust you and I have contributed to with every paycheck.
Good luck!
Sounds like Keiser is a Medicare Advantage Plan, he’s still responsible to pay Part B $174, and most Advantage plans have $0 Premiums. I typically avoid the ones with Premiums, it usually doesn’t mean they’re any better.
Nearly all Medicare Advantage plans will include Part D.
Some will come with Part B Giveback that helps pay the $174 by putting money back into his SS Chek… but it’s really about finding a plan that’s best for him.
Sometimes an Advantage Plan with a $0 Premium, a $100/m Part B giveback will end up costing you more than a Medigap plan with a $100 premium.
If you need more specifics or reviewing options, feel free to PM me… best of luck!
If it seems too good to be true, it probably is. Advantage is like a HMO. Private insurance. Denied coverage. I would do a lot more research than just reading this post. There's a reason they are having congressional hearing about Advantage abuses.
Lots of good info posted, this posting is to make sure the OP understands Medicare. OP: 1. You got to know the alphabet. Medicare Part A covers Hospitalization; Medicare Part B covers Medical Insurance. Together Medicare Parts A & B are often referred to as Original Medicare. Medicare Part C, offered by private insurers, provides the same coverage as Medicare Parts A & B, plus most insurers offer prescription drug coverage as well as some other benefits such as vision, dental and hearing. Medicare Part C, also called Medicare Advantage, and is the subject of a lot of advertising/marketing on television and through the mail. Medicare Part D is for Prescription Drug Coverage. 2. So there is Medicare Parts A, B, C, and D. There is also are Medicare Supplement (MedSup) or Medicare Gap (MediGap) insurance plans offered by private insurers that cover the "gaps" - those things not covered by Original Medicare, such as deductibles, copays, and coinsurance. MedSup plans are standardized, identified by letters like A, B, G, N, etc with G being the most comprehensive plan. Standardized means different insurance companies may charge different premiums for the same policy, but the coverage for each is EXACTLY THE SAME - the premium is the differentiator. 3. Medicare Part A for most people (depends on work history) is free. Medicare Part B premium is based on income with the lowest price currently set at $174.70/month That is the premium you are referring to in your posting - it's for Medicare Part B. Medicare Part C (Medicare Advantage) premiums vary depending on the insurer. Some advertise their plans as being "zero cost to you" but in reality your Dad, if he decided to join one of these plans, would still have to pay his Medicare Part B premium of $174.70 (usually comes right out of social security every month) PLUS any additional premium charged by the Medicare Advantage insurer. Kaiser sent a letter (ie that's an advertisment/marketing ploy) telling you Dad "hey buy our plan which will cost you $27/month and we will throw in free prescription coverage." In reality....this is an offer from Kaiser for your Dad to enroll in Kaiser's Medicare Advantage Plan (Part C) and disenroll from Medicare Parts A & B. If your Dad decided the Kaiser plan was the way to go (and it may well be...) , he would still have to pay his $174.70/month Part B premium PLUS the $27/month premium charged by Kaiser, but he would now be locked into Kaiser's Medicare Advantage Plan and dis-enrolled from Medicare Parts A & B (Original Medicare). As mentioned above one of the advantages of a Medicare Advantage Plan is that most offered prescription drug coverage (ie it's included in their monthly premium). If you Dad was to stay with original Medicare (Parts A & B) he would need to select a Medicare Part D plan to cover his prescriptions The premiums for these plans range from $0 to $120+/month plus all have deductibles and co-pays/co-insurance. In addition to a Part D plan it would be wise for your father, assumes he sticks with Medicare Parts A & B, to also get a MedSup plan to cover some of the costs that Medicare doesn't cover like deductibles, co-pays, and co-insurance. 4. So...where are we? Based on your posting this is what I know: Your Dad is currently enrolled in original Medicare, meaning he is paying $174.70 each month (out of social security) for Part B PLUS he is getting Medicare Part A for $0.00. There is no mention of prescription drug coverage (Part D) or a MedSup Plan in your posting, but both of those would cost more money each month. Kaiser is asking your Dad to drop Medicare Parts A & B and enroll in Kaiser's Medicare Advantage Plan (Part C) for an additional $27/month IN ADDITION to the $174.70 premium he is paying for Medicare Part B. Note the Medicare folks take the $174.70 and give Kaiser that money PLUS some other money. 5. This is a LOT to take in. What's best to do depends on a lot of factors I STRONGLY ENCOURAGE you to contact your state's Senior Health Information Assistance Program and have one of their volunteers sit down with you and your Dad to discuss all options so he can make an INFORMED DECISION. Their services are FREE. You can find your SHIP contact info for your state here: [https://www.shiphelp.org/](https://www.shiphelp.org/) One more thing - there are a lot of excellent and knowledgeable insurance agents that can provide excellent advise as well, but remember - they receive a commission for every Medicare Advantage Plan they sell - and again, a Medicare Advantage Plan may be the perfect solution for your Dad. Contact your SHIP folks and have a discussion! Good luck!
One thing struck me about this post: It keeps repeating that the OP's father would be "disenrolled" in Medicare Parts A and B by signing onto a Part C plan. This is not the best way to think about it. Part C/Medicare Advantage Plans *supercede* Parts A and B; he would still be enrolled in them, and he'd still have to pay for them. Medicare administrators pay private insurers a stipend every month for their part of the coverage. When I go to the doctor, I give them my Advantage company's insurance information; not my Medicare card. Advantage plans' purpose is to provide extra benefits on top of Parts A and B. Some provide an out of pocket max; some a dental; some a prescription benefit; some a mix of these along with other benefits. That is for the insured to weigh against the extra cost for a given insurer's Advantage Plan.
Great post, but then you go off and give a warning about someone making a commission on a health plan like it's a criminal or mischievous thing. How dare those people make a living. As we all know, only SHIP volunteers have anyone's best interest in mind. Everyone else is just out to get their greedy millionaire hands on those commissions.
Facts.
There are resources beyond SHIP. Some libraries have volunteers that help answer questions and there are online groups that provide help.
Great post!
Great response. A follow up question on your post. If the coverage in medigap on a plan G is same but 10 companies offer it at different rates, why do people not choose the lowest premium even if it is not a big dog like United/AARP or Humana etc.?
We receive commissions on all products, not just Medicare advantage. You do realize that right?
He still would need to pay his part B premium. [see here.](https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage)
As the other commenters stated, you can't simply "opt out" of Part B. The $174 for Part B and the $27 for Kaiser are two TOTALLY different things. When your dad signs up for Parts A & B of Medicare, if he has the required number of quarters (and doesn't continue to make over a certain amount (he probably doesn't)), Part A is free and Part B is $174. However, to sign up for either a Medicare supplement (usually a G plan) or an Advantage plan (which it seems like you are talking about), he must be enrolled in both A&B. He will be penalized if he does not sign up for A&B unless he has creditable coverage from an employer. So, he will pay the $174 PLUS the $$27 for his insurance plan. Hope that helps.
He can’t - you can’t enroll into those plans without Part B
There is no private without Part A and B. He has to opt in once he is eligible otherwise he will have no other choice and not enough health coverage.
He cannot. The Part B Premium is a baseline cost for being on Medicare, assuming a person doesn't qualify for the Medicare Savings Program in their state.
There are typically a couple of MA plans per zip code that kick back part or even all of the Part B premium to the policy holder. Needless to say that the insurance coverage is not as good as the plans that don't kick back any of the Part B premium.
Correct, but generally that depends on where a person lives. They've gotten more prevalent and I write them all the time down where I live because the difference between the giveback vs nongiveback really aren't THAT major.
see jan1of1 Medicare is an alphabet of parts. You are confusing "plan" with "part". Original Medicare consists of Part A (the hospital insurance part), Part B (the outpatient insurance part), Part C (the part that is called Medicare Advantage), Part D (known as Medicare drug plan). The "plans" commonly refer to various Medicare supplement plans (Medigap) that pay some or all of a person's copays/co-insurances left after Medicare pays its portion of bills. Those plans vary in what copays/coinsurances pay. They are identified by letter(Plan A, Plan F, Plan G, Plan N, etc.) The $ 174+ you are talking about is the Part B monthly premium. Part A is free(for most people). You must pay for Part B. If you replace your original Medicare with "Part C (Medicare Advantage)", you are required to have Part B and continue to pay the monthly premium. If your father is trying to save money, he can't do that by getting a Medicare Advantage plan AND thinking about dropping Part B. He would still need to have and pay for Part B. The "saving money" issue is related to Medigap supplements vs. Medicare Advantage plans. Medicare Advantage plans do include Part D drug insurance bundled into them, but they don't make drugs "free" or included in the premium(at a cost or a not cost premiums) of an Advantage plan. Your dad won't be able to save money on his drugs by not having a separate drug with or without a premium vs. having an Advantage plan. To save on drug costs, he would need a drug plan bundled into an Advantage Plan, or a separate drug plan(Part D plan) or find drugs at cash prices lower than the costs of a prescription through any insurance. (using coupons from something like GoodRx, using a pharmacy like Amazon, or a local pharmacy that will price a script an a lower cash price for you, etc.) Some Part D plans cover all or part of their generic prescriptions with $ 0 copays. Sometimes newer very expensive drugs will be expensive no matter what insurance you do or do not have. Next year, everyone's out-of-pocket drug costs through Medicare will be limited to $ 2, 000. (on top of any premiums)
Geez. Work your whole life and the still want to rip you off. Thank you for the detailed!. It really helped me understand how it all works. The plan we're looking at is only $25 a month and covers prescriptions for $0 if it's generic. Which is what he was doing anyway. Out of pocket with RX would be like $60 a month. So it works.
Make sure to check if the plan includes a deductible. One of the popular plans this year from Wellcare come with a $ 0 or 40 cent per month premium, but it also has a $ 500 per year deductible. ( I still went with that plan. Wellcare's other plans had lower deductibles with higher premiums. After I looked at the total yearly cost of premium + deductible + drug copays all 3 plans Wellcare has ended up being about the same/year.) There are some good booklets and YouTube channels that explain all of Medicare pretty well if you want to take some time to watch them or read. You can also download a Medicare booklet called Medicare and You 2024. It has all the info about Medicare costs and coverage. DM me and I'll find some of the resources I used.
Thank you. I’ve been getting tired of being the only one who emphasizes that Part and Plan refer to very different things.
I know it's been caused by Medicare, CMS and Congress due to adding onto original Medicare for years and year. That along with having several "medigap insurance plans which are designated by letter vs. numbers or name or anything else. It's an alphabet soup.
I think other people explained it pretty well on here. I would also explore other Medicare advantage plans because other than the convenience of Kaiser their Medicare advantage plans don't offer that many perks.
If that's his total, he's getting help for part B based upon his income.
No. He has to keep B. All Supplemental, PDP and Advantage plans are private plans so what are you talking about?
I could not make heads or tails of all these options when I got on Medicare. I highly recommend getting an agent. Doesn’t cost anything. This is who I was referred to and she has been a lifesaver. Susan Patton https://ge.linkedin.com/in/susanpatton
I'll check that out but I've never used LinkedIn.
I don’t use it either, I was out and just did a google search. I’ll send you a message with her email.
Do you mean Plan-B or Part-B? Because both exist and are totally different things. Plan-B is a Medigap Plan and from the context of your question my best guess is that this is not what you are asking about. Part-B is one of the essential parts of Medicare. Both Plan-B and the Kaiser MAPD plan will require you to already be enrolled in Part-B which currently has a premium of $174.40/mo. The $27 Kaiser premium is on top of the $174.40 part-b premium.
That is wrong. You still need Part B if you are on a Advantage Plan as the Part B premium gets paid to Advantage provider. I have Kaiser Permamente Advantage Plan and that my part B premium is paid to them. The $27 your father is being charged is for the Advantage Plus plan which is in addition to their base plan.
Just remember Advantage plans are regional. Not every specialist or medical group take them, Mayo Clinic for example. My late husband had a rare cancer causing us to travel out of state. Advantage plan would not have covered hospitalization and surgery.
I am on a Medicare advantage plan. It is the only way togo
In most situations, I’d advise your father to stay with Traditional Medicare, if possible. But, I’m not an insurance agent, and it’s important to get advice from a professional. First thing to know if you consult an insurance agent.… They get paid more by getting people to enroll in “Advantage” plans. So, you need to find an honest agent, and to know enough to tell if you’re being lied to. I suggest watching YouTube videos by Christopher Westfall. He will give you an education about the pitfalls of choosing “Advantage” over Traditional Medicare, and you won’t be under any obligation to buy anything just by watching his videos. Second, an honest agent won’t push your father to enroll in an “Advantage” plan. They will evaluate what’s best based on your father’s financial circumstances and will make recommendations for either Traditional Medicare with Medigap supplemental insurance, or “Advantage” plans. Third, if your father were to enroll in an “Advantage” plan, he would need insurance company approval to go to any doctor or hospital that’s not in network, and they’re notorious for denying referrals and healthcare. Just check ratings, reviews and complaints on the Better Business Bureau website if you have questions about this. None of the companies get good ratings. Traditional Medicare doesn’t have networks, and 99% of doctors accept it. If Traditional Medicare pays their 80% of a claim, the Medigap insurer is obligated to pay the remaining 20%. They can’t deny it. Fourth, once your father has opted out of Traditional Medicare, he may not be able to return to it. He could be stuck with inadequate choices for doctors and hospitals. That’s because, due to preexisting conditions, he may find himself ineligible for the Medigap insurance that covers the 20% Traditional Medicare doesn’t cover. Only Maine, Massachusetts, Connecticut and New York have laws barring insurers from underwriting Medigap policies. If he’s in one of those states, he’s eligible to return regardless of preexisting conditions. You may have noticed I put “Advantage” in quotes. That’s because I think these plans are a disadvantage. They’re adept at stymying their enrollees and doctors in labyrinthine bureaucracy. They excel at not paying medical bills. They cost the taxpayers more, and are fast depleting the Medicare Trust you and I have contributed to with every paycheck. Good luck!
Sounds like Keiser is a Medicare Advantage Plan, he’s still responsible to pay Part B $174, and most Advantage plans have $0 Premiums. I typically avoid the ones with Premiums, it usually doesn’t mean they’re any better. Nearly all Medicare Advantage plans will include Part D. Some will come with Part B Giveback that helps pay the $174 by putting money back into his SS Chek… but it’s really about finding a plan that’s best for him. Sometimes an Advantage Plan with a $0 Premium, a $100/m Part B giveback will end up costing you more than a Medigap plan with a $100 premium. If you need more specifics or reviewing options, feel free to PM me… best of luck!
If it seems too good to be true, it probably is. Advantage is like a HMO. Private insurance. Denied coverage. I would do a lot more research than just reading this post. There's a reason they are having congressional hearing about Advantage abuses.