Navigating Through Medicare and Medicare Advantage Choices

Oh boy, I have set a daunting task for myself here. If you are like me and using Medicare, then probably starting this past summer, your mailbox, email, and phone have been deluged with offers and outright annoyances from Medicare Advantage plan providers. My call block list on my phone has grown astronomically and I am keeping the recycle paper folks happy as well.

Earlier this fall, you should have received a handbook from Medicare titled “Medicare & You 2022.” This is a paperback handbook about a half inch thick. I hope you saved it and still have it handy. I keep mine from year to year for reference. Here is a copy of the cover of mine that came this year:

I know it’s a chore to read through all of this, but it is worth the time. I can share some pages that will help with this and shrink the chore. I would start with pages 6 and 7: “At A Glance – Original Medicare vs. Medicare Advantage”:

These two pages help to explain the difference between Original Medicare and Medicare Advantage. The Part B cost of Original Medicare is deducted from your Social Security payment each month. You receive your Social Security benefit less the premium/cost for Part B. For most of us this year, the amount deducted from our Social Security benefit for Part B has been $148.50 per month. This is going up in 2022 to $170.10 per month. The increase is explained as being driven by the availability of a new Alzheimer medication and the Covid 19 pandemic.

Some of us, myself included, have supplemented our Original Medicare with a Medicare supplement referred to as a “Medigap Plan.” These are available from different health insurance providers such as BlueCross/Blue Shield and AARP to name a couple. In the Medicare 2022 handbook there is a page that compares the coverages in the various “Medigap” plans. Look for this chart on page 76:

Sorry for such a raft of information. Unfortunately, it cannot be helped. I know it is not fun and is more of a chore than we should have at this stage in our lives. I wish it wasn’t so.

This next page is from the section in the Medicare Handbook that will help you to compare the health care plans available in our area (Vermont).

This section beginning on page 121 starts with a couple of pages that explain the charts/spread sheets of the various plans available in Vermont. The explanation for the terms used is very helpful. On page 124 the charts/spread sheets begin with the plans by provider for you to look over. Here is the first page of this section:

Here is where you can spend some time perusing the options and benefits available. Yuck to all of this but it has to be done if you want to understand what your choices are.

I will share what I have done, but this is my personal choice and it is mostly due to my health care needs and what I could afford. I was sorely tempted by the savings I would realize with the Medicare Advantage plans. You will find most of them cheaper than the Medigap plan route, but like all choices in the marketplace, you get what you pay for.

I stayed with a known quantity when I chose a Medigap plan, Vermont BlueCross/Blue Shield. Their Medigap plan is called “Medigap Blue.” This is a supplement plan to the Original Medicare. My cost is $184.40 per month for this supplement. It covers just about all my out-of-pocket costs and I get no surprises. This past year I had two out-patient vasuclar surgeries on my legs to remove bad veins. Each of these surgeries was over $55,000. It was all covered as well as weekly visits to the Wound Center at Dartmouth-Hitchcock Medical Center for most of the year prior to my two surgeries. I would have been faced with some out-of-pocket costs of about $5000-6000 if I had gone the Medicare Advantage plan route but I would have saved on my $184.40 premium charges every month. I came out ahead with the Medigap policy. I am faced with a third surgery in 2022 and the choice is self-evident – stick with what I have.

For me, I am at that age when health problems come with the territory. I wanted to cobble together the best insurance coverage I could afford to pay for the inevitable health care needs. These choices are personal and not for me to tell anyone what to do, I can only share my choices and explain why.

You only have until December 7th to make changes to your Medicare package. I apologize for putting this together so late in the season. I should have done this sooner. A friend recently asked for some help with all of this and that is why I am putting all of this out there now. Next year I will get my act together sooner and have this up for sharing.

I am not an expert on all of this Medicare. Old age should come with a guide to this season of our lives but it doesn’t – damn! If we share with each other what we learn it will help and this is what I am doing. I keep thinking this is for seniors and then I look in the mirror and realize I’m a senior too. How did that happen? I must have dozed off or was not paying attention.

Take care and hope I have added some clarity and guidance to the Medicare challenge Meanwhile, my call block list keeps growing – good place to put most of these annoyers.

Published by Ed Pirie

I am a Vermonter, been one all my life. That just about tells you all you need to know. I am not much of a follower and like to do my own thinking. I value my family and a quiet existence in a very rural part of Vermont. There is a lot in the world I do not understand. My writing is my attempt to wrap my head around much that is swirling around me. Some time ago gasoline pumps changed to the way they look now. I had stopped to fill my Jeep and I could not get the gas to pump to save my life. I went inside and complained to the attendant. She knew me and said, "Ed, the whole world is changing and if you don't figure out the changes you are going to fall off the earth as it spins around." Well, I am not always successful figuring out the changes, but my writing is my way of working through some of them. I hope you enjoy.

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