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Thread: Is Medigap worth it?

  1. #11
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    Quote Originally Posted by Gardnr View Post
    Mom lived on a tight income with no residual or potential to earn. She bought a GAP policy because she knew exactly what healthcare would cost her no matter what happened. It covered all remaining OOP expense not covered by Medicare. This was very important to her.

    Medicare Part D: There is a growing penalty for not starting it when you enroll in Medicare. It can be sizeable. If you take zero meds, buy the cheapest plan you can find. My oldest sister found an $8/m plan.

    Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($35.02 in 2018; $33.19 in 2019) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium. https://www.medicare.gov/drug-covera...llment-penalty
    I have not enrolled yet as it will be two more years until I was eligible. But this post really reinforces what we have found with my parents. I would not forego D as there are penalties if you add it later. I would also have a gap policy.

    Not counting hospitalizations or rehab costs, my dad ran up 120,000 in doctor bills and other medical so if he were on traditional medicare with no gap policy, he would owe over 20,000 this year.

    I think this is really important to consider:
    "Mom lived on a tight income with no residual or potential to earn. She bought a GAP policy because she knew exactly what healthcare would cost her no matter what happened"

    I think that is what we will do. I read that the F policy is actually going away, but will be grandfathered in for those who have it--so I would consider that one, personally, if I were eligible now. Unfortunately, it will not be available when we can sign up.

  2. #12
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    I studied up on my situation yesterday and learned that my retirement benefit plan covers the gap and prescription drugs. They advise I not sign up for D but I wonder what happens in the future if that changes. Guess I'll have to call and discuss.

  3. #13
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    This is helpful, I really appreciate the responses. I did not know about SHIP--I'll look into that.

  4. #14
    Senior Member iris lilies's Avatar
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    Quote Originally Posted by Rogar View Post
    There is a penalty for not enrolling in part D when you first are eligible that you may have to pay for the duration of part D coverage. It all gets a little complicated for me so I'd suggest checking it out on your own. Prescription drug coverage is not a bad idea even if you are healthy right now.

    I had to refresh my memory on this too, but I think every state offers free counselling on medicare coverage. From the Consumer Reports website:

    If you have a complicated question about Medicare, or just want some help talking through your options, you should take advantage of the free one-on-one counseling available through your state's State Health Insurance Assistance Program (SHIP)

    These federally funded programs are not connected to any insurance company or health plan. SHIPs were established to help beneficiaries with plan choices, billing problems, complaints about medical care or treatment, and Medicare rights.
    Thanks for this. I investigated the state paid Medicare advisors here and now know how to contact them. I will start contacting them for an appointment in February.

    Part D—yes, that’s it! I knew there was one of those letters that had to be signed on or else a lifetime penalty ensued.

  5. #15
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    Quote Originally Posted by pinkytoe View Post
    They advise I not sign up for D but I wonder what happens in the future if that changes. Guess I'll have to call and discuss.
    Given the well published and assigned penalty, i'm very surprised at this. Can't wait to hear what you learn!

  6. #16
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    I think this is because Medicare Advantage covers part D as well:

    https://www.medicare.gov/what-medica...icare-services

    That is what my parents have, and the problem they had with it had to do with it being easier to get rehab approved of from regular Medicare than from Medicare Advantage. As in they will not approve rehab--would not approve time in rehab for my mother, even though her leg had a very serious injury that required medical attention each day.

  7. #17
    Senior Member catherine's Avatar
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    Quote Originally Posted by Gardnr View Post
    Given the well published and assigned penalty, i'm very surprised at this. Can't wait to hear what you learn!
    Well, you guys scared me, so I just signed up for Part D. I got a low premium one. They did say on the site that a penalty would be incurred if didn't sign up when I was eligible. I'll let you know what the actual premium with the penalty will be when I find out--probably in a week.
    "Do any human beings ever realize life while they live it--every, every minute?" Emily Webb, Our Town
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  8. #18
    Senior Member jp1's Avatar
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    Quote Originally Posted by pinkytoe View Post
    I studied up on my situation yesterday and learned that my retirement benefit plan covers the gap and prescription drugs. They advise I not sign up for D but I wonder what happens in the future if that changes. Guess I'll have to call and discuss.
    Quote Originally Posted by Gardnr View Post
    Given the well published and assigned penalty, i'm very surprised at this. Can't wait to hear what you learn!
    My guess, and it’s just a guess, is that the plan she’s signing up for would qualify as ‘credible coverage’ if she ever decided to change and needs to later sign up for Part D. And the penalty would be avoided.

  9. #19
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    I don’t care how healthy you are, the odds are that you will need GAP coverage. Buy it. Many Medicare Advantage plans are inexpensive and well worth it

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