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Medicare Health Plans
#1
I'm 14 years retired from a major corporation and was just notified that the company group health insurance plan will be cancelled for all salaried retirees at the end of 2014. After several hours of reading about various plans from private insurance companies, I am rightfully confused about the best choice.

I would really appreciate any advice from anyone who has been down this road. My questions are:

Which do you prefer (or hate):
Original Medicare
Original Medicare with Medigap
Medicare Advantage?

Which is better, HMO or PPO?

Which insurance company (or type of company) do you prefer (or hate)? I'm not sure the forum rules allow this question. If not, advise me and I will edit it out.

I also wonder if this question could be posted in the main forum. Maybe a poll?


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#2
Medicare with a "F" plan medigap pretty much covers anything that can go wrong. That plus a prescription plan. That's what Mrs. R_G has. I'm covered by VA which works well in my area. Some areas maybe not so much, but I'm a big fan of them out here.

I would stay away from any of the Advantage programs. Again it's somewhat related to where you live, but out here the Advantage programs should all have a bit "Dis" affixed to their name.
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#3
Medicare and a high-deductible plan 'F" works for me. The HD plan F works the same as the regular plan except I have to pay 2k before it kicks in. That's like being my own insurance company for the small stuff and still having the best catastrophic coverage available. The HD plan has a much lower premium...about half the cost of the full version.

I also have the prescription coverage but it has never impressed me as to its value. YMMV
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#4
Thanks guys. A friend who works at a hospital gave me the same opinion you offered. That was after talking with an expert in the hospital insurance office. So it appears that you are absolutely right! Of course... The insurance companies do a hard sell on the Medicare Advantage plans but when you think about it, there must be a lot of administrative costs in those plans.
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#5
OK... I give up........... What is "YMMV?" I see this a lot and I can't decipher the acronym. "Your results may vary?" That would be "YRMV." Maybe it's "Your miracles may vary." Or "Yo Mama, my volkswagon?" I don't know. It's a puzzle.
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#6
YMMV = Your Mileage May Vary. It comes from the misleading miles per gallon stickers that the auto manufacturers place on new car windows to lie about the great gas mileage the car will get...NOT.

It has become a common way to say that your own experience may not work for others.
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#7
(09-16-2014, 12:59 PM)surferdude2 Wrote: YMMV = Your Mileage May Vary. It comes from the misleading miles per gallon stickers that the auto manufacturers place on new car windows to lie about the great gas mileage the car will get...NOT.

Thanks! That has been making me crazy. Well, crazier anyhow.
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#8
R_G, Does your wife have a high deductible? I mean with the health plan "F"...not anything else that comes to mind..

It sure has saved me a bunch. I switched to it from the standard type when I found that I could change as often as I liked and didn't have to wait for the usual annual plan change program. I figure I'll give them a call when things go down hill further than they are now...at least I'll have saved enough to pay for the call. YMMV (there it is AGAIN)
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#9
I do NOT like regular medicare. If you go in the hospital, the deductible and daily pay out is high and that is every time you go in the hospital for a different reason and even if you go in the hospital for the same reason but it is past the time period set by medicare (I can't remember what that time period is) then the deductible is due again. Since I am not old enough for medigap, I don't know much about it. I prefer medicare advantage plans myself as they have to follow medicare guidelines but the deductibles are lower, copays are sometimes lower, some are eligible for premium reduction and lower prescription copays. A lot of providers are moving away from accepting medicare and I think part of that is because the deductibles, etc. are so high that the providers are having more people that don't pay their portion and are losing money. Medicare allowable amount is not that much and then when a patient can't pay, that only causes more problems for the provider. My medicare advantage plan is a PPO and I like that because I can go to any doctor without a referral and going to a doc for a referral and then to the specialist just costs more money and time. This is just my opinion and what works for me. I would suggest finding a person that signs people up for medicare advantage PPO plans and let them explain it to you. That is what I did. I am very happy the way I went. Even paying the additional premiums for the medicare advantage plan, it is less costly than if I were to go straight medicare. Again, this is my opinion and what works for me. I don't know how medigap works so that may be feasible for those eligible for it (although I was told that there are additional premiums for that and they can be expensive) if medigap picks up all the deductibles and out of pocket expenses not covered by medicare.
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#10
(09-16-2014, 01:08 PM)surferdude2 Wrote: R_G, Does your wife have a high deductible? I mean with the health plan "F"...not anything else that comes to mind..

It sure has saved me a bunch. I switched to it from the standard type when I found that I could change as often as I liked and didn't have to wait for the usual annual plan change program. I figure I'll give them a call when things go down hill further than they are now...at least I'll have saved enough to pay for the call. YMMV (there it is AGAIN)

No. She has the regular plan F which covers from dollar 1. It is more expensive and in her case (thank God) a waste of money. She has yet to even hit her prescription deductible. So it's insurance for the sake of insurance. But if something does happen, she's set financially. She had a DVT in her leg a few years back and is on warfarin to make sure that doesn't happen again. But warfarin is scumbag cheap, so no way she'll see much prescription coverage for that. And as long as it does it's job she shouldn't see a need to use her medicare bucks either. She does go to the Doc every 6 months or so and that is completely covered.

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