Medicare advice and recommendations?

I can give you information, advice and recommendations about Medicare. I worked in medical offices for ~35 years, including doing billing and receiving payment some of that time. Greg was on SS Disability so had Medicare coverage for many years and I've had it for the last 9 years. It takes time and consideration to choose the right kind of policy (original MCR (short for Medicare) and a Part B (Supplement or Medigap), or an "Advantage plan" aka MCR part C,) and Part D, a Drug plan.

First, Medicare "allows" an amount for the coded charges from medical offices, for exams, procedures, supplies, etc. They PAY 80% of the allowed charges. There are different coverages, aka Plans, offered as supplements to MCR by commercial insurance carriers. I have a Plan G because it covers everything MCR doesn't cover of the allowed charges except the yearly deductible that we have to pay with Original MCR. An Advantage plan may have no deductible and less monthly premium, but with copays and other charges that other plans may not have.  Someone might say to choose a plan with a very low or no monthly premium. Others, me included, might say look at what the coverage is for the kind of care you want. I have an "Original" MCR plan, Plan G, not an Advantage plan because I can see any doctor who is signed up with MCR, not limited to a specific network, without additional copays, and I know what I'll pay yearly which will consist of my monthly premiums and the yearly deductible. If you have a serious illness that requires a lot of imaging or specialized testing the amounts you'll pay in copays or added charges is unknown til it happens and can be quite large.

All Plans with the same letter name (like plan G, N, etc.) are exactly the same coverage. The costs differ geographically and by company. The Advantage plans offer perks - they can be attractive, but make sure it's something you will use.

I think I threw a lot in those first 2 paragraphs and hope it wasn't written too confusingly. It's late. This is only some of what you should consider. Send me questions ([email protected]) or ask them here and I'll do my best to answer clearly. 

Good luck.

Get the best supplemental plan you can.  I kept my policy from my working days, modified.

Never pay a co-pay for doc visits, tests, procedures.  Only an occasional drug charge.

I agree, aiq.
I'm much more comfortable knowing what I will pay (and that I can pay it) for the year without add ons as care is needed.

Given the costs of cancer or some other chronic illness's diagnosis, treatment and care, a higher monthly premium can save money over the long run.

Medicare pays for some things that might be a surprise. It covers diabetic testing supplies, Hospice, and some Durable Medical Equipment.

Medicare (phone) customer service has been excellent and easy to use.
When there've been problems or delays in payments, my congressional representative's office has been very helpful.

There are insurance agents (brokers) who specialize in MCR policies. Agents sell different company's policies and sell and know about only the ones they represent. The person I use was an excellent advocate when Greg needed help getting cancer drugs from a Specialty pharmacy. Those are more common now than they were in 2007>2014 when he needed them and the insurance agent really helped make things happen. If you use an agent (no charge to you, commission paid by the insurance companies), ask them about their willingness to advocate for you.

Okay, that's it for now.

Oh yeah, check for daily hospital costs. May be written as copays.

Thom Heartman says stay away from all Advantage plans they take U completely out of Medicare. Its a scam.

I had never heard of Thom Hartmann - I just read some of his opinions and thoughts - nice that he lives in Oregon. He sounds like a good guy.

Advantage plans may be a scam, I don't know, but I do know that people like the idea that they're getting something for nothing (no or low monthly premiums). Medicare pays the insurance companies that offer the plans to take the risk.
From another website: Medicare Advantage plans are managed care, which means you might need prior authorization for a medication, you may need a referral to see a specialist, and you may have to try a cheaper treatment plan before your plan will approve a more expensive one. That’s how Medicare Advantage plans manage their costs."
I want to manage my own care and make choices for myself or with my trusted consultants and care providers, not insurance companies.

Thom is a progressive Been around for years I find him on F B and YouTube. Advantage takes U of gov.  Medicare.  Not what most folks don't know. its a a scam.

Went to Medicare on 4/1/23.  Have A, B and Plan G supplemental.  Prescription drug coverage is $5.20 per month.  Total monthly premium = $333.95 per month.  Any doctor, any hospital.  NO network bs.  That is why I avoided the Plan C advantage plans.