Disabled and under 65 - Medigap or Advantage Plan?

[Orcrone]

I'm sure this has been covered before but I searched to no avail.

I am 53 years old and disabled. Starting February 1 I will be eligible for Medicare. One choice is traditional Medicare (parts A and B). I would then purchase plan D (a little under $50 a month) and a Medigap policy (high deductible plan F at a little under $200 per month) giving me a yearly premium of almost $3000. My other option is a Medicare advantage plan with no additional premium.

I was ready to go with the advantage plan but I am now having second thoughts. I understand I'm eligible for Medigap plans when I'm first eligible for Medicare, but in the future I would have to meet underwriting guidelines. My concern is that I may want to switch back to Medicare if not satisfied with the advantage plan. However I would probably not be able to get a supplement plan because of my disability.

The advantage plan is a PPO so I will have out-of-network benefits. One of about four doctors I see is not a member of this PPO so I would have to pay for him out-of-pocket. However I only see him once or twice year. The specialists I see more often are within the network.

So I am now considering going with regular Medicare, purchasing plan D and amedical supplement. Is it silly to spend $3000 extra in premiums "just in case"? Or is it a good idea since it will be another 11 years until I will have another open enrollment period?

Thanks in advance for your help

 

[mattspits]

Hello,

This is a really tough decision. Let me give you some things to consider...

You do get 12 months after enrolling into a Medicare Advantage plan for the first time to go back to original Medicare and Medigap plan. During this twelve months you have a guaranteed right to the Medigap plan.

It is possible to receive an SEP while on a Medicare Advantage plan giving you guaranteed rights to the medigap plan. This usually occurs when the plan is canceled or leaves the area.

MA plans are slowly being stripped of funding by Medicare meaning that they may not even be available in 10 years, or they may look completely different.

As a rule, MA plans are great for people who are healthy while Medigap plans are great for people who frequent providers and facilities. Also, Medigap plans work great for people with multiple providers

The PPO plan should work well for you since you do have the option to see providers Out-of-Network.

Also, consider the MOOP or Maximum Out of Pocket for the MA plan you are considering. A very small percentage of people ever hit the MOOP which may be close to that $3,000 in premium.

I hope this helps,

I'm sure this has been covered before but I searched to no avail.

I am 53 years old and disabled. Starting February 1 I will be eligible for Medicare. One choice is traditional Medicare (parts A and B). I would then purchase plan D (a little under $50 a month) and a Medigap policy (high deductible plan F at a little under $200 per month) giving me a yearly premium of almost $3000. My other option is a Medicare advantage plan with no additional premium.

I was ready to go with the advantage plan but I am now having second thoughts. I understand I'm eligible for Medigap plans when I'm first eligible for Medicare, but in the future I would have to meet underwriting guidelines. My concern is that I may want to switch back to Medicare if not satisfied with the advantage plan. However I would probably not be able to get a supplement plan because of my disability.

The advantage plan is a PPO so I will have out-of-network benefits. One of about four doctors I see is not a member of this PPO so I would have to pay for him out-of-pocket. However I only see him once or twice year. The specialists I see more often are within the network.

So I am now considering going with regular Medicare, purchasing plan D and amedical supplement. Is it silly to spend $3000 extra in premiums "just in case"? Or is it a good idea since it will be another 11 years until I will have another open enrollment period?

Thanks in advance for your help