I love that you think docs know how Medicare works from a consumer standpoint. They don't even know how their own health insurance plan works much less anyone else's. It's a total mystery. Just because we get paid by these companies/services doesn't mean we know how they work beyond the payment structure and sometimes not even that. There's a reason I used a word like "guess" so it conveyed some uncertainty.
You might be right, I have no idea. I haven't had to make this decision myself so I haven't done a super deep dive on it. But I do know that if just get Medicare A, or even if you get Medicare A, B, and, D, you're likely getting less coverage than you had with traditional insurance. The best way to fill that gap has never been entirely clear to me.
You might want to look into it a bit more before making statements such as "...I'd guess you'll want a Medicare Advantage plan so it acts a lot more like typical insurance...." or perhaps not make recommendations at all.
For patients, what is said/recommended by someone like you ("White Coat Provider"... an ER physician!) is likely to be taken very seriously, and especially by those who are less familiar with the topic.
Most people who select Medicare Advantage do so because the initial costs are lower than a good Medicare/Medigap Supplement combo is (also need to add in Rx coverage). Medicare Advantage typically has, to some degree, fewer providers to choose from and some (and sometimes a LOT) of pre-approval hoops, including denials that might require appeals (unless patients give up...).
And in many (most?) states, once you have been on Medicare Advantage (at least past the first year), IF you want to change to Medicare/Medigap, you may need to go through medical vetting. That means that some people will *not* be able to change to the Medicare/Medigap type of coverage (or will need to pay even more to do so).
DH and I just started Medicare, very belatedly (he's still working, long past any "regular" retirement age, but finally went part time) so we switched to Medicare with Employer add-on (works like a Medigap plan).
We had zero question about Medicare Advantage or Medicare/Medigap [<<==THIS one!] after having spent far too much time, effort, and aggravation helping SisterInLaw navigate her Medicare Advantage plan while she was acutely ill. SO many hurdles to her care...
Among other serious medical problems, she was in hosptial with blood clots in her brain, among other problems, and was unable to feed herself.
BUT... the brave beancounters decided she didn't even need rehab, that she could just "go straight home" and take care of her central line on her own. She had very limited ability to use her hands and fingers, but she's supposed to take care of her own IV lines!?
DH made a bunch of outraged calls, and "suddenly", "Oh, she's NOT going home yet; she'll be staying in the hospital for a while..."
Those hurdles typically don't exist that way with Medicare/Medigap policies. There's no intermediary who is trying to profit by minimizing expenses/payments.
RM
Given you just started Medicare, I suspect you have done a great deal more analysis on this topic lately than I have. But sounds from several comments since mine in this thread that Medigap is a better option than Medicare Advantage for lots of/most people. So thank you to you and everyone else for sharing that.
Statistics: Posted by White Coat Investor — Fri Dec 20, 2024 12:29 pm