This post contains Affilliate links which will pay a small commission to me (at no cost to you) if you order through the links.
A question has been plaguing me lately…
“How To Choose The Best Medicare Plan For You”
I’m turning 62 this month and inching closer to a decision I view with mixed feelings.
On the one hand, I’ve heard from many retirees that Medicare is a confusing web of options. I have a friend who has spent hundreds of hours analyzing the options, and I dread doing that myself. I’ve only recently begun to read about the topic, and I’m realizing the complexity of the decision ahead.
I’m dreading the thought of figuring it all out. (Fortunately, I’ve discovered a solution…read on)
On the other hand, there’s the relief of saving some serious money. We’ve been paying for private insurance since I retired 7 years ago. It’s expensive, and I’m excited to experience the lower costs associated with Medicare.
I just wish there were an easier way to sign up for Medicare…
Fortunately, I’ve found a great (and easy, and free) solution, and today I’m excited to share it with you.
I now know how we’re going to choose the best Medicare for my wife and me. The great news is, you’re going to be able to use the same solution I’ve discovered, for free! But I’m getting ahead of myself…
I've been dreading the chore of figuring out Medicare. Fortunately, I found an easier solution, and today I'm sharing it with you. Share on X
How To Choose The Best Medicare Plan For You
If you were paying attention, you received an email a few weeks ago announcing my first webinar. Today, I’m sharing the story behind that webinar, which includes the solution I’ve found for a question that’s been plaguing me: How To Choose The Best Medicare Plan.
I couldn’t be happier with the solution I’ve found, and I’m excited to share it with you. But first, here’s a reminder in case you missed the announcement:
I’m Hosting My First Webinar!
Post Publishing Edit: Here’s The Recording of the Webinar:
The Solution I’m Using To Choose The Best Medicare Plan
Here’s the fun part – the story behind the webinar.
There’s a reason I’m doing this webinar with Ari. As I started looking into Medicare, I made a conscious decision. Rather than invest my time researching Medicare, wouldn’t it be smarter to use that time to research Medicare experts instead? Some areas are best outsourced, and I’ve concluded that deciding on how to choose the best Medicare plan is something I’m comfortable leaving to the experts.
Ari’s company (Chapter) is the solution I’ve found to solve the puzzle of How To Choose The Best Medicare Plan.
Solving the Medicare puzzle is what they do. And they’re good at it. Very good at it. Here’s a quick summary:
- Dave Ramsey uses them for all of his listeners.
- They’re independent and unbiased experts on Medicare.
- Their advisors do not know the commissions of the products they recommend.
- They have an A+ Rating from the Better Business Bureau.
- They have a 5.0 rating, with over 2,500 reviews.
- Their proprietary software finds your best solution.
- It’s entirely free, and there’s no obligation.
A special point on Bullet 3: This was one of the biggest reasons I chose Chapter. The reality is that many Medicare “experts” are guilty of being overly influenced by the commissions they receive on various products. One of my biggest concerns was having my advisor recommending something that made them the most money, rather than the product that best matched my needs. The fact that their advisors are “blind” to the commissions on the products they’re recommending was a big factor in my final decision.
Let me be clear: I’m not going to try to “sell” you on using them. I’m simply sharing what I’ve found in my research, and letting you know that I’m going to be using them to help me choose the best Medicare for my wife and me. I believe they are a great solution to a difficult challenge all of us face, and I wanted to make you aware.
Second, rest assured that the webinar will NOT be a sales pitch. I have asked Ari to focus his presentation on common mistakes people make when choosing a Medicare plan and answering the reader’s questions. I will mention my new partnership with Ari’s company, but that will be it. The purpose of the webinar is to provide education to you from a true Medicare expert, NOT to sell you on a solution.
Based on the response to the webinar, I know Medicare is a major concern for many of you. I’m simply sharing what I’ve discovered as the solution I’ll be using to make it a lot easier when it’s my time to decide on a plan.
The Good News – A Solution For My Readers
I’ve had numerous phone calls with Ari and his team, and we’ve reached an agreement. I’ve decided that Ari’s company will be the company I recommend for any of my readers looking for help with Medicare. For readers of The Retirement Manifesto, they’ll:
- Help you choose the best Medicare plan for you, at no cost.
- Provide expertise in all 50 States, based on the plans available in your area.
- Get you signed up with whatever plan you choose.
- Conduct an annual review during the “enrollment window” and advise if changes should be made.
- If you’re already enrolled, they’ll review your plan and let you know if it’s the best for you.
- Once you’ve talked with them, you’re under no obligation to follow their recommendation.
If you’re interested in talking to them:
CLICK THIS LINK TO GET STARTED (Affiliate Link)
If you prefer to call, simply dial (775) 565-0284.
In full transparency, I’ve entered an “Affiliate Agreement” with Ari’s company, Chapter. It’s a common arrangement in the blogging world, and it means I’ll get a small commission (at no cost to you) if you decide to use Chapter as your Medicare advisor. I wouldn’t have entered this agreement if I didn’t believe it was the best solution available, and I’d be recommending them regardless of whether or not I received a commission. In fact, as a show of good faith, I’ve decided to donate 50% of any commissions earned to charity. I’m not in this for the money, and I hope I’ve earned enough of your trust at this point for you to recognize my motives are pure.
The good news: you can take advantage of that link, talk with them to get their input on the best Medicare plan (or have them review your current plan and give their recommendation on whether it’s the best plan for you), and then decide you don’t want to go that route and do something else.
There’s no obligation, and it’s always free.
Decide For Yourself
I wanted to share the full story before you joined the webinar. Hopefully, you’ll now be watching with a slightly different perspective. Consider it your opportunity to get a glimpse into Ari’s way of thinking as you review your options for how you’re going to choose the best Medicare plan for you and your family. If you like what you see, come back to this post and simply click the link to start the process.
A Brief Homework Assignment: Medicare 101 (3 P’s)
As we prepare for the webinar, I wanted to give a brief overview of Medicare to “get you up to speed” on the basics before the session. The “3 P’s” outline below are taken from Ari’s book, “It’s Not That Complicated: The Three Medicare Decisions to Protect Your Health and Money” (Amazon Affiliate link). I ordered the book last week and look forward to reading it as I continue my Medicare education.
Medicare 101:
Traditional Medicare consists of two parts:
- Part A covers hospital stays and is premium-free for most people but there’s a substantial deductible.
- Part B covers doctor visits and outpatient care. The monthly premium is $185/mo for most Americans.
Part D is prescription drug coverage. It’s technically optional, but there’s a late enrollment penalty if you don’t sign up in time. It’s crucial to understand that Original Medicare (Part A and Part B) is not comprehensive health insurance. So, the key question is:
How will you cover the 20% Medicare doesn’t cover?
The good news is that there are only two options to cover the 20%.
– Option 1 is to choose a Medicare Supplement (Medigap) plan, which sits on top of your Original Medicare and allows you to see any Medicare provider nationwide.
– Option 2 is a Medicare Advantage plan, which is an “all-in-one” alternative to Original Medicare offered by private insurers. These bundled plans typically include Part D drug coverage and extras like dental and vision. They often have lower premiums than Medigap but come with network restrictions and other rules.
The Three P’s
When deciding between Original Medicare (Parts A & B) plus a separate drug plan versus an all-in-one Medicare Advantage plan, consider these “3 P’s”:
Providers: Is it important to keep your current doctors? With Original Medicare, you can see any provider nationwide who accepts Medicare. Most Advantage plans have restricted networks.
Prescriptions: How much do you spend on medications? Compare Part D and Advantage plan formularies and costs for the drugs you take. An inexpensive plan may cost more in the long run if it has high prescription copays.
Priorities: What do you value most in a health plan – low premiums, extra benefits, simplicity, flexibility, or minimal out-of-pocket costs? Advantage plans often have low premiums but more restrictions. Pairing Medigap with Original Medicare costs more monthly but covers more with less complexity.
In closing, it’s important to note that every Chapter Advisor is trained to use their proven 3 Ps Method to review each Medicare beneficiary’s providers, prescriptions, and priorities — “ensuring that every client receives the high-quality healthcare they need and deserve at the best value.”
Conclusion
I’m so impressed with the company that I’ve decided to partner with them. I realize Medicare is a concern for many of the readers of this blog, and I wanted to share the solution that I’ve decided to use personally. Yes, I have an Affiliate Partnership with them, but my motives are pure. I think they’re the best solution available, so I’m sharing it with you. If you know of a better solution, drop a comment below. Let’s work together to solve a frustratingly complex issue for all of us – How To Choose The Best Medicare Plan.
As a next step, I’d encourage you to join the free webinar and see what you think. At a minimum, you’ll learn a lot about Medicare from a true expert. At best, you’ll be on a path to figuring out how you’re going to choose the best Medicare plan for your family. If you haven’t yet, click the button below to register for the webinar:
Then, make your own decision. If you’ve already heard enough and want to get started with Chapter:
Click This Link To Talk With Chapter (Affiliate Link)
If you’d rather call, dial (775) 565-0284.
I’m excited about being able to provide this solution to my readers.
I know there’s a real need, and I hope others can benefit from the solution I’ve chosen for myself.
Your Turn: If you’re already on Medicare, what process did you use and how confident are you that you chose the best Medicare plan for you? If you’re not yet on Medicare, are you intimidated by the decision? How are you planning to go about making the decision? Let’s chat…
Chapter Advisory, LLC (“Chapter”) is a private health insurance agency. In California, Chapter does business as Chapter Insurance Services (Lic. No. 6003691). Chapter is not affiliated with or endorsed by any government entity. While Chapter has a database of every Medicare plan option nationwide and can help you to search among all options, it has contracts with many but not all plans. As a result, Chapter does not offer every plan available in your area. Currently, Chapter represents 50 organizations which offer 18,601 products nationwide. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or you are in your Medicare Initial Enrollment Period.
Fritz,
Thank you.
A few years ago, I went with Boomer Benefits when you shared that Medicare recommendation via a post.
I predict you’ll go with a Medigap Plan at 65. You can afford it and much better than any Medicare Advantage.
Boomer Benefits set me up with United Healthcare which is currently $211 per month.
Look forward to the webinar and thanks again!
Mike
Mike, good point about Medigap plans. Each Medigap plan letter type offers identical standardized hospital and medical benefits under federal law, regardless of insurer.
Premium rates like your $211/month can vary significantly by state, age, sex, the applicability of certain discounts, and of course the specific Medigap plan letter type you’re interested in. The same coverage can cost quite differently depending on location – especially in states like Connecticut, Florida, Maine, Massachusetts, New York, and Washington, which typically have higher premiums than other states.
Ari’s in the house!
Thanks for stopping by, Ari. Looking forward to doing the webinar with you next week!
It’s great for you to help bring options to the public’s awareness.
A fortunate few of us face another alternative as we reach age 65, namely that our previous employer’s healthcare plan will shift from being primary to being secondary coverage after Medicare. I worked for the State of Alaska for 30 years and one of the huge benefits they offered to new employees back many years ago, was free health insurance for life.
I used another group of experts called Boomer Benefits…they have lots of good content/videos that helped me make an informed decision…in addition, as a Pharmaceutical rep for over 35 years in Florida, I witnessed the difference for myself in terms of how the Dr.s that had primarily a Medicare Advantage plan patient base, vs one that had a mix of Medicare and commercial plan patients operated…let’s just say that the differences were alarming, and not in a “good” way. Add that to the fact that if you pick a Medicare Advantage plan and then after a year or two change your mind and want traditional Medicare you must undergo Medical underwriting for pre-existing conditions, for me, it was a clear route to choose traditional medicare with a supplement.
As a physician who sees most Medicare Advantage patients get denied for rehabilitation services following stroke/fractures/etc – I agree 100%.
Thanks for mentioning this. I don’t think most people realize this limitation that hits when you need your insurance the most.
Aloha Fritz!
I have been on Medicare Part A and B for 1.5 years. After speaking to countless military retirees, they all advised me to not buy any supplemental insurance. We have Tricare for Life, it picks up all bills after Medicare pays its’ part. That insurance was hard earned and well deserved for all vets who made a career in our military. I hardly ever use this benefit, as our Lord has blessed me with excellent health.
Thanks for making this webinar available to everyone Fritz. You are such a giving person. Time, talents and treasures….where have I read about those? 😉
God bless you and all of your readers, Steve
It’s an excellent topic that is incredibly confusing to most people. I first started researching Medicare for my clients but soon realized that this is a niche best left to professionals who live and breathe this topic. As I recently turned 65, this topic has now become personal. Fortunately, I am still covered by my wife’s insurance, so I still have time to make my own decisions (beyond just signing up for Part A). I am hoping to learn lots more in your webinar.
Fritz,
Thanks for the post, and for scheduling the webinar with Chapter. This webinar will be extremely helpful for all of your followers.
My wife and I have had Kaiser Permanente coverage since we got married. She is 7 years older than me, and when she retired 7 years ago the best fit for us was to switch to Kaiser Medicare Advantage Plan for multiple reasons.
I’m now on Kaiser Medicare Advantage as well. We couldn’t be happier.
Since I’m still working we pay a lot of IRMAA premiums each year.
Phil
Is IRMAA applicable for all Advantage Plans?
Yep, IRMAA is still applicable. We’ll discuss IRMAA on Wednesday night.
Ari, thanks for covering IRMAA during the webinar.
For those who aren’t familiar with IRMAAA, it’s an additional premium on top of your Medicare/Medicare Advantage premiums and is per person for both of us.
Even worse the IRMAA and Federal Tax Brackets aren’t synched. It’s an extra step in planning for both Federal Tax Planning and IRMAA premium planning. Not hard, just one more thing to consider.
Good info Fritz. I begin Medicare with Kaiser in June. They make it super simple to sign up, and their Value package starts at zero, then two more packages at $58 and $112 per month for those who have more complex health needs. I picked the zero cost package and their Senior Advantage at $46 a month for dental, vision, etc. Since retiring at 63, I’ve been paying either COBRA or ACA at $1200 a month so naturally I am looking forward to major savings in a few months. Good luck with your webinar.
Good topic. I wish there was a better way to analyze private insurance for pre-65 folks. I spend a few weeks each year analyzing the plans in depth.
As a side note, the post was “OK”. It seems to have a lot of padding and repetition to fill some word quota. I feel like I was listening to a story with so many tangents. Cut to the chase.
Walter, you’re in luck. I recently used Lig Solutions to help me reduce our pre-65 private insurance, would definitely recommend them for folks not yet eligible for Medicare. Their website is: https://ligsolutions.com/
As for the suggestion to be more pithy, noted.
Fritz – you should inform your readers about the SHIP program available in all states at the county level. SHIP stands for State Health Insurance assistance Program. Each of the county SHIP offices is staffed by trained Medicare counselors who are unbiased and work to provide information and guidance to current and future Medicare beneficiaries.
I am a current volunteer SHIP counselor and only 61 years old. I had to help my elderly mother navigate some Medicare issues a couple of years ago and found SHIP super helpful. All counselors undergo intense training and are required to pass certification exams in order to begin counseling.
For more information check here: https://www.shiphelp.org/.
“You should inform your readers about the SHIP program…”
Um…you just did. Wink. You also informed me, that wasn’t a program I was familiar with prior to your comment. As I noted, I’m just starting to study the entire Medicare issue, thanks for educating me. And, thanks for volunteering your time to help others figure it all out.
I attempted to use SHIP in North Carolina to help me with my Medicare Enrollment. I was told they can’t and I would need to contact Social Security directly. Very frustrating and disappointing since my question was related to the health insurance my wife has a retiree of the State.
SHIP counselors cannot sign you up for Medicare so they were correct in your case to refer you to Social Security. SSA is responsible for Medicare enrollment. You can do that in-person at a Social Security office, on the phone or on the SSA.gov website. SHIP counselors are meant to help you with understanding your Medicare choices and providing guidance.
Excellent info for those about to begin Medicare. Boomer Benefits seemed like a solid choice to go with but in the end I did the research myself, and plenty of it, before my wife and I opted for Original Medicare along with a Plan N Medigap policy from Aetna that costs $185 each per month. It’s been seven years now and we’ve been pleased with our choice.
I am 64 7/8 yo (yes, I sound like a 4 yo). I have been inundated with Medicare “help” and offers (how does everyone know how old I am?). I also choose to take a supplement part N (reasonable price, $146/month) from Humana (outside of the Requisite Parts A, B & D… part D if you don’t want a permanent penalty later). Reason for Part N vs a free advantage plan is the pre-existing condition clauses to join a supplement plan later should a condition present itself. Free sounds good now but it could come back to haunt my wife and I. Note that my broker said that all Part N plans are identical by law and you can shop for the cheapest. Note to Aetna Ted, might be worth some research.
Bob, thanks for the suggestion. We’ve been with Anthem (sorry, I mistakenly said Aetna) for 7 years and while Humana was slightly less, I wasn’t sure if the hassle of switching was going to be worth it. Does anyone have experience moving from one insurer to another and how difficult/easy it might be?
Ted, I’ve added your question about the ease of switching to the list of questions for our webinar, hoping Ari will have time to touch on it during the webinar.
Thank you!!!
Fritz, can you please ask Ari to address the issue of military retirees and whether those who have Tricare for Life as a secondary payer should or should not have a separate additional part B medigap supplement or a part D supplement?… I’m unsure what options or restrictions might be for any very expensive drug that might not be covered by a Tricare formulary? Brian
Hi Brian, thank you for your service to our country.
Please keep your TriCARE For Life (TFL) and do *not* sign up for a Medigap plan or separate Part D coverage. Your TFL coverage serves as your secondary coverage and also provides prescription coverage.
The TriCARE formulary is very comprehensive, but if you happen to need a prescription that isn’t covered, then you would simply go through the appeals process, which is outlined here: https://tricare.mil/CoveredServices/Pharmacy/Appeals
Fritz, as always I appreciate your transparency and desire to help better the lives of others on this retirement journey. While I’m not yet eligible for Medicare, I did attend a Medicare Seminar at our local library put on by SHIBA, state health insurance benefits advisors. I live in Washington state and this was a well put together comprehensive, presentation that gave me a framework to think about Medicare. I’ll be interested to hear how Chapter approaches this topic. My initial take away is that while Medicare Advantage policies are popular and initially affordable, there are some real “gotchas” that people need to be aware of, in particular the difficulty in switching back to original Medicare and then having to be rated for your Medi-Gap insurance policy.
Hi Allison, this is an excellent point and we will certainly discuss it Wednesday night.
Hi Fritz,
Thanks for making this webinar available. It will be helpful even for those of us who are already on plans.
I am 75 & had to make this decision 14 years ago after retiring early at 61 & having to purchase my own insurance for 5 years (found thru an independent agent in another state before moving). My independent personality (need to make my own decisions), health (healthy cancer survivor), financial situation, insurance changes across the years, & caring for a 90 year old parent had a lot to do with my decision to get Medicare & Medigap (a plan with deductible money in an account earning interest- plan is no longer available). I found that someone needs to consider all the variables to be satisfied with their decision.
Regarding prescription drug plans– fortunately I did my research & got a prescription drug plan right away after an agent told me: “you can wait to get one.” Remember the saying: “there are no free lunches.” If you go the Medicare route DON’T wait to get a prescription drug plan. There’s a penalty fee that really adds up if you wait.
Hope this helps someone.
I eagerly await the webinar!
Hi Pat:
Great callout that there’s a Late Enrollment Penalty for Medicare Part D (drugs) unless you have the option of creditable coverage, i.e. at least as good as what you would have received from Part D.
I enrolled in Medicare almost 7 years ago. I hadn’t done any homework at all. I told the broker to just go with the best (most comprehensive) for the time being. I told him not to worry about the cost for now. I was extremely healthy.
Two months after enrolling in a plan F, medigap, I was diagnosed with stage 4 cancer. Dumb luck for sure
I’ve never received and bills, co-pays and could seek out the most advanced care, including 2nd opinions.
The best part was the lack.of any paperwork or denial of services.
Downside is it’s a little pricy. My mistake, quite possibly, is why I am still alive today.
Jim, thank you for sharing your story for the benefit of Fritz’s readers. It is a relief to hear you were able to receive the care you needed thanks to having comprehensive insurance.
Fritz,
Another great dive into important decisions in retirement. My wife and I met with a counselor from SHINE (Serving Health Insurance Needs of Elders),
a service of the Department of Elder Affairs, State of Florida. They cover the option available, companies offering the options, and explain the differences
between them. There is no cost or limit to one on one meetings. They do not sell anything but will help you contact the insurer you have chosen. They will also
offer guidance on SSI but will not offer any financial advice on timing it per your personal situation. We were both very impressed by their knowledge and patience.
I purchased health insurance for my business for many years and am somewhat knowledgeable of the coverages and pitfalls of different options. I do not like the restrictions or approval processes of network plans. I did not want any limitations on medical coverage or decisions made about my care other than by my
Doctors. I did not want any concerns as to the costs of procedures or the access. I did not want to have any copays, uncovered expenses or out of pocket charges.
We were in a fortunate position as are many of your followers, and chose the Plan G supplement policy. It is more expensive than other plans, currently $220 per month at age 69, but for us, was/is well worth it. When my wife’s health failed and spent 3 months in hospitals and rehab hospitals at the end of her life, there were $0 in bills and all doctors, facilities, and services, were much easier to work with utilizing this plan. Many expressed dissatisfaction with Advantage plans and were seemingly able to service and schedule us more easily with original Medicare and a supplement. I am very pleased with our choice and I fully plan on
maintaining my plan into the future.
Thanks for all you bring to the table for all of us out here!
Kerry
Kerry, thanks for sharing your story, sounds like you benefited from doing your research. Sorry to hear about your wife, but thankful you made the “right” decision on Medicare and didn’t have to deal with the potential hassles of an Advantage plan during her final days. Your comment, “I did not want any limitations on medical coverage or decisions made about my care other than by my Doctors,” resonates with me. I’m still learning, but leaning heavily toward a Medigap solution based on your input and that of others in these comments.
I am still working at age 64 and I will be traveling when the webinar is aired, so thank you in advance for posting the “rerun” of the webinar on your blog.
In addition to your introduction on the topic, I appreciate the readers’ responses on Medigap v. Medicare Advantage. Very helpful – thank you.
My plan is to fully retire at age 67 because this will leave only a one-year gap for my wife who will be age 64 (we will look at Medi-Share or something like this for that one year). My question: Even though there is no penalty for delaying signing up for Medicare at 65 if I am still working for a company with a viable health plan, the stark warnings against signing up beyond this date are legion. I’d be interested in Ari’s thoughts on this.
Thank you!
Ken, I’ve added your question about “stark warnings” to the list for our webinar, hope we have time for Ari to address it.
Ken, if you are planning to use employer coverage at age 65 and beyond, make sure you understand how it works. There are rules for when to sign up for Medicare that depend on the number of employees at your company. A helpful book I read when I was researching Medicare was Medicare for Dummies by Patricia Barry.
Thanks, Sharon. I checked out this book from the local library (frugal like Fritz) and I found it very helpful – especially about the various filing timelines. Much appreciated!
Looking forward to the webinar! I would like to understand the implications of having pre-existing conditions on the choice we make.
Adrian, I’ve added your question to the list for the webinar. We have too many questions to answer them all, but I’m sure the topic of pre-existing conditions will be covered during Ari’s presentation.
I started Medicare in December and chose regular Medicare plus a Plan G supplement with the help of a local broker. We live in a retirement community and have quite a few health care brokers that are very good at educating people on the differences between Medigap and Medicare Advantage. Almost everyone choses a Medigap plan, with Plan G being the most popular. Other Medigap or Medicare Advantage plans are less expensive, but realize this:
1. During the initial enrollment period, insurance companies have to take you, no matter what medical conditions you may have. After that, they
can refuse you.
2. Medicare Advantage has cheaper premiums but it limits provider options. This might not be a good option if you travel a lot or have health issues.
I have friends that are very happy that they can choose the best doctors or hospitals like Mayo.
3. You might be in good health now, but things can rapidly change. Despite a healthy diet and lifestyle, I got a surprise diagnosis of AFIB this past
November. Medicare and my Plan G supplement saved me tens of thousands of dollars, and my after my recent ablation the AFIB is gone. My total cost
was the $240 Medicare deductible. Choosing another Medicare plan is no longer a viable option, not that I would want to do that.
Great summary of the key differences, Dave. Thanks for sharing your knowledge.
At 75, I have a High-Deductible Paln G (HDG) supplement, which is often overlooked or dismissed because of the higher out-of-pocket cap — and the much lower commission to agents. But the math is compelling.
In Texas, I pay $46/month, or $552/year in premiums. If I had a standard Plan G, my premium would be $1920/year, or $1368 more. My out-pocket-cap is $2800, so with G I’d be paying an additional $800 a year to cover the risk of about $900 in extra costs, which makes no sense from an insurance standpoint.
The reality is that it’s very difficult to hit that $2800 cap, with the aggressive pricing that Medicare negotiates. I had back surgery recently: $20,000 in charges reduced to $2,000, of which I pay 20%, or $400. I’ve never gotten near the cap. Even if I encountered a couple of high-expense years in a row and did hit the cap, the long-term savings would still be there.
Furthermore, the healthier client (= less claims payout) pool in HDG means that annual increase percentages will be less than the less-healthy G cohort, so the premium gap will only grow over time.
Yes, there’s the minor inconvenience of paying individual bills, but that’s all done online now in minutes anyway. The only people I steer away from HDG are those with chronic illnesses, those who worry about every charge, or those who ignore commonsense advice about diet and exercise.
Fritz, you are always very helpful and thoughtful. I had to navigate this problem 1 year ago. People need to be aware of the various options and the insurance industry wants to capture you in the Medicare advantage program. The person or company you sign up through receives a commission for the rest of the time you are on the plan they sign you up for. That is why so many folks contact you about using them. I chose a medigap policy part N and my wife medigap part G. Just different thoughts on the deductible. We used Boomer Benefits after doing research as you did. The produce a book 10 mistakes not to make with Medicare. It is thorough. Thanks again Fritz for your work. You are an awesome resource.
Hi, my wife is a retired teacher and will have the option at age 65 to purchase Medigap coverage through the Ohio State Teachers Retirement System. Will the webinar cover how to analyze this coverage versus options in the general marketplace?
Scott, given the general nature of the webinar (as required by the 1,400+ folks who are now registered), we’ll likely need to steer away from detailed situational questions like yours. I’d encourage you to call Chapter directly at (775) 565-0284, I’m sure they can answer your question with no obligations.
I agree it is very beneficial to contact your state’s version of SHIP. I was fortunate enough to have worked for the state agency which handled Medicaid and unfortunately also dealt with my now deceased parents Medicare choices. Prior to my husband’s 65th birthday, I read a very informative book by Jae Oh entitled Maximize Your Medicare. We chose a Medigap Part G plan which is $137 in our location which covers all doctors and facilities which accept Medicare. We travel outside our state regularly and have been fortunate to have this coverage. Many people in the medical field locally have shared the same sentiment I have about Advantage plans. They have very stringent prior authorization regulations. My mother would do one week of physical therapy for a leg which wasn’t moving, then had to wait two weeks for another authorization for one more week of treatment. Unfortunately she lost whatever ground she had gained and eventually gave up. On the other hand, it covered all expenses when my father fell and had emergency transportation for treatment of a hematoma on his head.
As we always said in my office, they make things harder than they need to be for the people who often understand it the least.
“…they make things harder than they need to be for the people who often understand it the least.”
Great quote, Roberta. Thanks for the book suggestion, added it to my list. Like you, we travel outside our home state regularly (we have a second home near our daughter in an adjacent state) and I’m leaning heavily toward Original Medicare with a Medigap plan. Thanks for sharing your knowledge.
Thanks Fritz. Our selection was really more about risk management in all its forms than anything else. We went at 65 because it was better coverage and a better deal even with high IRMAAs than my work options (I worked until 68) and at 65 you can’t make further HSA contributions. Traditional Medicare with a plan G supplement worked best for our health matters and because the all in cost fits easily within our defined benefit income. However, Dan has given me something to consider as to the supplement, thank you for that post. Sounds very similar to managing a HDHP whether or not you tap the HSA along the way. Paying an occasional bill doesn’t seem like too big a lift, and trust the supplement insurer tracks it for you just like the Part B deductible. I am very sympathetic to those at the lower end of the income scale for whom the Part B premium, supplement premium and part D costs are problematic and an advantage plan is a necessity. If you’re simply trying to save money over traditional Medicare, be careful. Is there adequate disclosure out there, or should you have a separate broker or hire counsel competent in the area to inform the agreement you’re making? One additional question, assume Social Security retirement benefits are Federally tax exempt in the new tax bill. Does that mean Part B and Part D premiums and IRMAAs that are deducted by Social Security are paid with pre-tax Dollars and effectively tax exempt as well? Thanks, Steve
“However, Dan has given me something to consider…”
I love how the readers of this blog are able to help each other (and me!) through these comments. As for your question about “adequate disclosure” and whether you should hire a “separate broker or counsel,” that’s exactly the reason I’ve decided to go with Chapter and their unbiased expertise when it’s time for my wife and I to make our decisions about Medicare. Also, good question about the potential SS tax law changes and what it means for Medicare premiums. Time will tell, I suppose?
I think Dr. Bronson has settled my Medicare advantage question, which is no. Prior authorization means you subordinate the judgment and advice of your doctor(s) to your insurer. Your only option is to comply with the insurer’s requirements and schedule nothing until you have it. As to plan G, I will add to Dan’s back surgery my Haglund’s removal and related Achilles repair in January, my exposure was paying up my $257 Part B deductible a little earlier than usual.
Does Ari have a tool (application) that he plugs your plan options into, I assume with questions that you answer about anticipated use and the it provides a recommendation, expected out of pocket cost, etc. for each option?
I found out via another service such as this that in NY, CT and Mass. that you can move from Advantage to medical any time durian enrollment without risk of denial due to pre existing conditions. I’m in NY and plan to take advantage of that.
Thanks and I plan to attend.
Dave
“Does Ari have a tool that….”
Dave, that’s my understanding of exactly what Chapter does, but I’ve added your question to our list for the webinar, hoping Ari is able to comment on it then.
Thanks for researching this. I am only 59 and have always figured I will go with a Medigap plan but even selecting a Medigap and especially a Part D plan is work. Is there an expert for ACA plans? I am used to have 2 or 3 plan options at work. I think some of my co-worker work until 65 to avoid the ACA issue.
Chuck, I should have mentioned the ACA Plans. I found an ACA expert that I used to find a new (and cheaper) plan for 2025, would definitely recommend them. The company is Lig Solutions, and I was very impressed with their customer service and expertise. Their website is: https://ligsolutions.com/
Another great topic, Fritz! I found my person here in FLorida…Cindy at Mature Markets. She makes finding my plans easy every year.
I’m a retired physician. I retired one year ago and Retirement Manifesto has been a great source of information and encouragement. The worst, most limiting, most unreasonable and inflexible insurance coverage I observed in my career for my patients, involved Medicare advantage plans!
Great caution is needed when considering Medicare advantage plans.
As a retired physician, the worst and most limiting coverage my patients experienced, when they needed care, was with Medicare advantage plans. Worst and most inflexible coverage I observed in my career ! Caution with advantage plans is needed.
I love all the information you have given us over the year. Retirement is coming for me this year. I have a few years before Medicare. I’m not sold on this one, I just don’t trust commission based jobs, being a mechanic for over 35 years. I’ve seen how corrupt it can be! From sales to owners, everyone looks out for them self. So I can tell you ,the need to find an honest advisor is going to be hard. Right now, I’m wondering where am I going to take my vehicle for repairs. They do know what plans make them the most commission.
Thank you for sharing your journey and insights on navigating Medicare! Like you, I’ve been feeling overwhelmed by the complexity of choosing the right plan. It’s reassuring to hear that there’s a solution like Chapter that simplifies the process and provides unbiased guidance. The fact that their advisors are blind to commissions is a huge plus—it’s so important to trust that recommendations are truly in your best interest.
I’m looking forward to attending the webinar and learning more about common mistakes to avoid when selecting a Medicare plan. It’s great to know that the session will focus on education rather than a sales pitch. This kind of transparency is exactly what people need when making such an important decision.
Well I thought the webinar was tonight the 13th. Looking for the email today and looks like I missed it last night!😩 Serves me right for not checking my email daily. But is there a replay link anywhere? Our mailbox is inundated with Medicare offers as we both turn 65 this year.
You’re in luck – I just emailed a link of the recording to all of my email subscribers!
I signed up for but missed the webinar. Can you send a replay? Thank you!
I watched the seminar as well and it was very informative. My Medicare needs will be in full swing and demand in about two years. I do question about using an agency that is out of state to handle one’s local area for the best Medicare plans. Plus, in the future if you need a review, how easy is it to use a nationwide firm? Isn’t it better to be able to use a local merchant to meet in person? I am only inquiring about logistics, etc.
I watched the seminar as well and it was very informative. My Medicare needs will be in full swing and demand in about two years. I do question about using an agency that is out of state to handle one’s local area for the best Medicare plans. Plus, in the future if you need a review, how easy is it to use a nationwide firm? Isn’t it better to be able to use a local merchant to meet in person? I am only inquiring about logistics, etc.