does anyone have a Medicare Advantage Plan?

[freshstart]

I'm picking mine out tomorrow and can't decide whether to go with the top of the line plan that is $120 a month plus part B premium or the next one down, which is only $60 a month. The only differences seem to be in cost of co-pays (a $5 difference) and the premium plan has a 4500 max OOP vs 5500 with the middle plan. Has anyone ever not chosen the top of the line of plans available to them? I do spend a lot on meds and co-pays but I don't think enough to justify spending double on the premium plan. But I do tend to hit the max OOP every year so maybe the premium plan is worth it. I just don't know. I hope the place I'm going tomorrow has some good advice but I expect them to push the premium plan. Any advice would be welcome

[Tammy]

With the more expensive plan, $720 of the thousand dollar lower deductible/OOP will be paid in higher premiums. If you will use a lot of copays that's another $5 every time as well. It may only save you a few hundred to get the average plan .... so if there's more advantages than what you listed - better coverage of meds and outpatient treatments etc - I think the expensive plan might be best for you.

[Tammy]

I think I talked myself in circles. As I reread what I wrote it keeps getting cloudier. I just finished my third 12 hour day in a row and my mind is tired.

To summarize, I think with these two plans being so close, it's basically a toss up. 😊

[sweetana3]

This info will be hard to find but what is the drug formulary and how many doctors and specialists belong to each plan? Are there any reviews out there, does it cover the geographic area you are in or might be in?

And the worst that can happen is to have some limits and then change at the end of the year for next year.

[Tybee]

Correct me if I am wrong, but I thought if you had a complicated medical profile, as you do, then you wanted the highest plan you could get, because you would be using it fully, and it has a lower deductible?

[freshstart]

The plans were available online and you could figure out how much you would roughly spend on meds and co pays for the year. The drug prices were pretty high for both the medium and the best plan and I'd end up in the donut hole so I priced all my meds out on Good Rx and they were miles cheaper using that benefit. So I tried it out on 2 scripts today and paid $33 for 2 scripts that my insurance would've charged me $230 for. Good RX was easy to use, readily accepted and I highly recommend trying it if you have high med co pays. So I went with the medium priced Advantage plan because I think I can avoid the donut hole by using benefit offers like Good Rx and others that are available. $60 a month for the medium plan is so much better on my budget. And I can't believe this, I get a free Y membership even though I am not 65 yrs old. I could never afford the Y now so this is great.

I'm hoping to have a much better year health wise. I had two surgeries last year, a ton of testing and specialist visits. Now that I have a diagnosis, I'm hoping not to spend over 10k on healthcare this year. I'm cleared to use the treadmill for short time periods and I've been slowly losing some wt.