Which Medicare confusion

[SonyaK]

Hello! I was finally approved (absolute nightmare) for SSDI and now I have to choose a Medicare plan. So confusing. I know I have to get part B and D to avoid a penalty later, but it's all so confusing as to what is best to get with a disease like MS. My insurance broker is really pushing me to get a Medicare Advantage plan, but I've read several places say that Medigap is better when you have a chronic disease with a lot of doctor appointments, etc...

I'm 48, so those Medigap plans seem pricey when I looked, but isn't it hard to get on Medigap after initial enrollment into Medicare? I do at times have lots of appointments (PT, etc), so I'm just wondering if anyone has any good or bad experiences with either type of plan? Thank you so much!

[KoKo]

Hi SonyaK!

I'm 48, so those Medigap plans seem pricey when I looked, but isn't it hard to get on Medigap after initial enrollment into Medicare? I do at times have lots of appointments (PT, etc), so I'm just wondering if anyone has any good or bad experiences with either type of plan? Thank you so much!

I don't have either one, so I can't help you with my experience on those plans.

(My former place of employment allows retirees to continue on with the health insurance we had while employed, so I use Medicare and that insurance plan.)

I found this info on Medigap, which seems to be pretty straight forward to decipher.

When can I buy Medigap? | Medicare

[SonyaK]

Thank you so much for your reply and the very helpful link! I think this whole Medicare choices thing just has my anxiety up because for the first 10 years of having MS I didn't have health insurance so all the constant appointments and monthly IVSM, etc basically forced me into filing medical bankruptcy. Luckily, after that SSI gave me Medicaid.

My biggest fear with this Medicare situation is making a wrong choice and somehow ending up terribly under insured or something. The link you shared looks like it answers a lot of my questions, though, so very much appreciated!

[pennstater]

The policies offered and rules around them can vary by state. If you can, I would find your state agency that helps with Medicare and review questions with them.

Some things to consider:

• After the first year when you opt into a medigap plan, if you want to change to a different medigap plan, will you then be subject to medical underwriting?
• If you select Medicare advantage and then want to change to medigap, is there any penalty assessed and again, are to subject to medical underwriting?
• Are there any disadvantage of choosing one versus the other and then switching?
• If you travel,will your advantage plan cover out of network?
• Under what conditions can they price discriminate, knowing the only reason you have Medicare under the age of 65 is due to disability?

I have to start researching this myself for next year coverage mid year and am dreading it as well.

As for your insurance broker, are they independent or affiliated with a company and/or specific plan? You want to make sure there is no financial benefit to the broker in recommending one plan over another.

It can be overwhelming, but if you make some calls, it will get you where you need to be.

[KoKo]

Hey SonyaK!

My biggest fear with this Medicare situation is making a wrong choice and somehow ending up terribly under insured or something.

There is an open enrollment period every year (from mid-October thru early-December) when you can switch / change a Medicare Advantage plan if it's not working for you.

[SonyaK]

Thank you all for your help! This is some great information. And after I read these replies, I searched the internet and found a local Medicare help number I can call that says they can answer all Medicare questions and I'm going to ask the ones that pennstater listed, too. All this help is very much appreciated. Many thanks!

[KoKo]

SonyaK

Well thank you for starting this topic!

I'm sure that it will be helpful to many other members as well.