Is Medigap worth it?

[Rachel]

I am trying to wrap my head around the ins and outs of Medicare---ugh! In expectation of retiring in the next 12-18 months. I am 65, very healthy, no problems. I have no risky hobbies, don't ride a bike, no horseback riding, no climbing. Don't even drive. I'm super annoyed by the cost of the Medigap policies and am wondering if they are worth it for someone who is fit and healthy. Yes, I do know that old age is coming whether I like it or not...

[catherine]

I turned 65 a year and a half ago. I did not buy Medigap for the reasons you stated. I also have no problems, and no medications. I did, of course, opt for Medicare A & B.

Now, DH just turned 65 and I definitely bought Medigap for him, as well as PDP (Part D) plan.

I know that if something unexpected come up, maybe I'll wish I had bought Medigap. My friend bought Plan F, and that's what I bought DH. I may decide to get something, but I've been fine with the bare bones so far.

[LDAHL]

I’m a few years away, but I plan on buying medigap or Medicare Advantage coverage. Good luck only lasts a lifetime if you die young.

[Sad Eyed Lady]

When I turned 65 two years ago I looked at Medicare supplements and they all seemed so pricey for a healthy person not on medication etc. I know that can change in the blink of an eye, but finally I read an article that said "do you really need a medicare supplement?". It made so much sense to me and I opted just for the A & B parts of Medicare. This year, during open enrollment, I have changed to a Medicare Advantage plan which includes a lot more, (dentist, eyes, drug plan, and so on), with no extra cost.

It is all so confusing, but I feel like I made a good choice for this time and one that is affordable to me. Good luck Rachel as you research and find what will work for you.

[iris lilies]

I have started to receive all kinds of mailings about Medicare since I turn 65 next May.


I have identified A health insurance expert, a sales person of course, who deals only in Medicare related policies. I’m going to have her figure out our plan. I am not even reading all the stuff that crosses my doorstep, in the mail I just put it on the recycle pile.

But for my grneral knowledge, What is the purpose of Medigap policy?

[pinkytoe]

All I know is that this stuff is way too complicated. And there are insurance salesman crawling out of the walls to supplement coverage - I wonder why?

[Teacher Terry]

We will definitely buy it. When I was 50 I was in excellent shape and no medications. Within months I developed 3 chronic conditions. Things turned on a dime. Better safe than sorry.

[Rogar]

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.

[jp1]

I’m still 14 years away from having to figure this out but i will almost definitely at least get part D prescription coverage. Having seen the proces of SO’s life saving meds. ($20k month for almost two years for just one of them) te thought of not having insurance for it is terrifying to me.

[Gardnr]

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-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-penalty

[Tybee]

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-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-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.

[pinkytoe]

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.

[Rachel]

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

[iris lilies]

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.

[Gardnr]

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!

[Tybee]

I think this is because Medicare Advantage covers part D as well:

https://www.medicare.gov/what-medicare-covers/what-medicare-health-plans-cover/medicare-advantage-plans-cover-all-medicare-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.

[catherine]

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.

[jp1]

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.


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.

[San Onofre Guy]

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