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Thread: Advice on Medicare Advantage vs Medigap

  1. #1
    Senior Member catherine's Avatar
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    Advice on Medicare Advantage vs Medigap

    Arghhh.. I hate this stuff.

    DH turns 65 in a couple of weeks. I'm already on Medicare but since I rarely go to the doctor (maybe less than 10 times over the past 15 years) and have no chronic conditions, other than osteopenia, I chose the cheap option: Just the basic A&B.

    But DH has a few medical conditions and 4 regular prescriptions (all available in generic form) so I definitely want to shore up his coverage.

    My instinct is to go with Medicare Advantage over MediGap/Medicare Supplemental. He has two doctors that he definitely wants to stick with and there's one Advantage plan I found that has both in its network.

    Any reason why I should choose MediGap instead?
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  2. #2
    Senior Member Sad Eyed Lady's Avatar
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    I have no answer because I am mulling over those options myself right now. I get so confused with all this stuff. I too am leaning toward an advantage plan because they seem more conclusive, some have dental and vision as well as the drug plan. I called one of the advantage companies yesterday because I had just received the new booklet in the mail and he said they would not have any answers until next Monday as to pricing and coverage area. Good luck! I hope someone with more knowledge will share on this post.
    "Like a bird on the wire, like a drunk in the midnight choir, I have tried in my way to be free." Leonard Cohen

  3. #3
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    This might be a good question for the city data.com retirement forum. I have to start thinking about this stuff too...

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    I have friends on the advantage plan. They say many doctors aren’t taking regular Medicare but everyone takes the advantage plans.

  5. #5
    Senior Member Rogar's Avatar
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    Probably worth verifying, but I understand that under the advantage plans if you want to see a specialist you need a referral from you designated primary care doctor. With medigap you can see a specialist of choice and at your discretion as long as they accept medicare and do not need a referral.

    I have had questions about whether you are in an advantage plan and develop medical problems, whether you can switch into a comprehensive medigap policy during open enrollment?

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    Locally that’s not true for us Roger. In fact here you can see whoever you want no referrals needed. But I am sure every place is different.

  7. #7
    Senior Member Rogar's Avatar
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    Quote Originally Posted by Teacher Terry View Post
    Locally that’s not true for us Roger. In fact here you can see whoever you want no referrals needed. But I am sure every place is different.
    I don't know that all advantage plans are the same either?

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    My guess would be that they are not the same.

  9. #9
    Senior Member Sad Eyed Lady's Avatar
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    No, they are not all the same. The booklet I was looking at yesterday listed some as needing a referral for a specialist, some not. Some offer drug plans, some not. All different.
    "Like a bird on the wire, like a drunk in the midnight choir, I have tried in my way to be free." Leonard Cohen

  10. #10
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    Mom always had a gap plan. She was on SS only and she knew exactly what her healthcare would cost-just her premium. And all expenses were paid by it. That said, she died in 2007. Her premium was $168 and she liked the peace of mind it offered her. She had 2 total joints and a triple bypass with that plan over 15 years.

    Don't forget about plan D. There is an accumulating penalty if you don't have it.

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