# $0/month Advantage Medicare Plans



## Cabin Fever

I am planning on retiring sometime during 2020. I will be 67 when I retire. I have been researching Medicare supplement plans since the 2020 information is out there.

During 2019, I visited my doctor once and I take no medications. Consequently, I am thinking about a $0 premium Advantage plan from Blue Cross/Blue Shield. Yes, it has a higher deductible and maximum out of pocket rate than the other BC/BS Advantage Plans have, and the drugs cost slightly more, but I am willing to take the risk to save some money. 

I look at it this way, I could sign up for the best BC/BS Advantage plan, but in premiums alone, it would cost me $2,300/year. I really doubt that I would spend anything near that if I was under the basic ($0/mo) plan. Yes, if something catastrophic occurred, I would end up having to pay a maximum out of pocket of $5,900 under the basic plan. But even the best plan has a $3400 maximum out of pocket.

I like an Advantage Plan because it not only covers medical costs, but also covers vision, hearing, dental and drug costs.

Is there a flaw in my thinking here? Am I missing something?


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## frogmammy

I keep seeing these $0 per month plans. Having discovered that nothing in life is FREE, I'm wondering what the trade off is, because for SURE, someone ALWAYS pays.

Mon


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## HDRider

Should you consider maximum payout over a year, or lifetime?


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## Cabin Fever

HDRider said:


> Should you consider maximum payout over a year, or lifetime?


I could if I had a crystal ball.


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## HDRider

Cabin Fever said:


> I could if I had a crystal ball.


No, I am saying some write in maximums in the policy.


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## Cabin Fever

frogmammy said:


> I keep seeing these $0 per month plans. Having discovered that nothing in life is FREE, I'm wondering what the trade off is, because for SURE, someone ALWAYS pays.
> 
> Mon


It's not free. All insurance carriers that offer Advantage plans are being paid by the government (ie, medicare) to offer the plans. Why? Because the private insurance companies can take the government stipend, and offer policies that go over and above Original Medicare, for the price the government is paying them to run the program.


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## Cabin Fever

HDRider said:


> No, I am saying some write in maximums in the policy.


There is an annual maximum out of pocket amount that I mentioned in the OP. There are no lifetime maximums.


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## TnAndy

frogmammy said:


> I keep seeing these $0 per month plans. Having discovered that nothing in life is FREE, I'm wondering what the trade off is, because for SURE, *someone ALWAYS pays.*
> 
> Mon



True.....but in the case of Advantage plans versus traditional supplement plans, the Feds are giving the insurance companies money to subsidize the Advantage plan because it encourages lower costs....or that is what my agent told me anyway.

We've used an Advantage plan since going on Medicare (4yrs for me, 2 for her), and like it. We currently use AARP (other than the name, it has nothing to do with AARP) United Health C Plan 1 HMO. That is the best zero premium in our area (and apparently it varies depending on location). Like Cabin Fever, we are fairly healthy, don't use a lot of care, so it works good for us.

Max out of pocket/yr $3700
$0 copay for primary care doc, $30 for specialists (per visit)
$250/day for 5 days for in hospital, 0 day 6 to unlimited
Skilled nursing: 0 day 1-20 $160/day 21-44 0 days 45-100
Outpatient hospital including surgery $175 
CT/MRI 0-$110 (was 20% last year)
X-rays $14 copay
Emergency care $90 copay
Urgent Care $30 cp
Vision $0 cp once/yr $200 towards glasses
Dental $0 cp for exams, cleanings (2/yr) x-rays
$0 cp on comprehensive (fillings/crowns/etc) with $2,000/yr limit
Hearing 0 cp once year $375-$2075 toward hearing aids every 2 yrs
Free Silver Sneakers (we can go to local gym for free)

Health/Wellness products $100/quarter (400/yr). Catalog of OTC pain meds (aspirin/alieve/etc) vitamins, tooth care stuff, cold meds, first aid stuff, heating pads, braces (back, support, wrist, etc) etc, etc. This coming year, it's thru Walmart...order online or by mail. We're absolutely covered up in stuff we used to buy at a Drugstore.....we actually have trouble finding stuff to spend $800/yr on (between the 2 of us)

Drugs: (and we don't take much, so don't know what is in what tier)
Tier 1 $0 cp
Tier 2 $8 $0 if ordered online 90 day supply
Tier3 $45
Tier4 $95

And a whole bunch more. Our experience is the plan has gotten better and better each year. IF you don't use medical care a lot, I highly recommend it.


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## HDRider

Cabin Fever said:


> There is an annual maximum out of pocket amount that I mentioned in the OP. There are no lifetime maximums.


We still are not communicating.

I am saying watch out for a policy that will only pay out to some maximum amount.


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## Wolf mom

I've had an Advantage PPO plan for years in different states. Different states - different Advantage PPO plans. As far as being a 0 plan - remember, you will get X dollars taken out of your SS check no matter what kind of a plan you get. So, it's really not a 0 plan. Specialist co-pay is usually higher with an Advantage plan. 

I'm in the process of getting my first cardiologist appointment. I'll see then if I need a different type of plan that has less out of pocket.


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## Cabin Fever

HDRider said:


> We still are not communicating.
> 
> I am saying watch out for a policy that will only pay out to some maximum amount.


Gottcha. There is no maximum pay out. All of the different types of policies I have reviewed, I never found one that had a maximum. Are you aware of any?


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## Cabin Fever

Wolf mom said:


> I've had an Advantage PPO plan for years in different states. Different states - different Advantage PPO plans. As far as being a 0 plan - remember, you will get X dollars taken out of your SS check no matter what kind of a plan you get. So, it's really not a 0 plan. Specialist co-pay is usually higher with an Advantage plan.
> 
> I'm in the process of getting my first cardiologist appointment. I'll see then if I need a different type of plan that has less out of pocket.


Yes, every plan that I reviewed, whether an Advantage Plan or other category, made sure that you knew they did not pay the Part B deductible.


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## MoonRiver

Check this out, because I think it is how it works, but I'm not 100% sure.

Let's say you get cancer and decide the Advantage plan is no longer the right plan for you. I don't think the supplemental plans are required to enroll you in their plan. I believe there may also be a waiting period for some benefits. I would also look at cost as well to see if there is penalty for switching from advantage to supplemental.


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## MoonRiver

Cabin Fever said:


> Yes, every plan that I reviewed, whether an Advantage Plan or other category, made sure that you knew they did not pay the Part B deductible.


Plan F pays part b deductible.


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## Cabin Fever

MoonRiver said:


> Check this out, because I think it is how it works, but I'm not 100% sure.
> 
> Let's say you get cancer and decide the Advantage plan is no longer the right plan for you. I don't think the supplemental plans are required to enroll you in their plan. I believe there may also be a waiting period for some benefits. I would also look at cost as well to see if there is penalty for switching from advantage to supplemental.


At least with BC/BS, you can only enroll in a supplement plan when you first get Medicare. If you first take an Advantage plan, you have lost your ability to enroll in a supplement plan in the future. 

To me, the supplement plans appear to be more expensive ($200 to 350/mo), they do not cover drugs, nor do they pay for things like dental or vision visits....just medical.


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## Cabin Fever

MoonRiver said:


> Plan F pays part b deductible.


I miss wrote. I should have said: "Yes, every plan that I reviewed, whether an Advantage Plan or other category, made sure that you knew they did not pay the Part B premium."


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## MoonRiver

Cabin Fever said:


> I miss wrote. I should have said: "Yes, every plan that I reviewed, whether an Advantage Plan or other category, made sure that you knew they did not pay the Part B premium."


Plan F does.


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## MoonRiver

Cabin Fever said:


> At least with BC/BS, you can only enroll in a supplement plan when you first get Medicare. If you first take an Advantage plan, you have lost your ability to enroll in a supplement plan in the future.
> 
> To me, the supplement plans appear to be more expensive ($200 to 350/mo), they do not cover drugs, nor do they pay for things like dental or vision visits....just medical.


That's true. I have supplemental because it allows me to go to any doctor in US that accepts Medicare. I have access to specialists that you won't have access to. It's a choice and really a gamble, as we don't know what the future holds for us.


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## Cabin Fever

MoonRiver said:


> Plan F does.


What is the name and monthly premium of your Plan F?


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## HDRider

Cabin Fever said:


> Gottcha. There is no maximum pay out. All of the different types of policies I have reviewed, I never found one that had a maximum. Are you aware of any?


I ran across it last year. It was the snare in one of the no cost, low deductible things. It may vary by state. It is buried deep, and some states may try to protect people from being mislead.


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## MoonRiver

Cabin Fever said:


> What is the name and monthly premium of your Plan F?


It's Anthem (BC/BS) and about $2000 a year. I posted in another thread that I just learned that Plan G is the exact same plan as F, but the individual pays Part B premium. It works out the Plan F companies are adding over $500/year plus the Part B premium on to the cost. I just switched from Plan F to Plan G.


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## MoonRiver

If anyone has any questions, your best bet may be to call a broker that is not locked in to one company. They can answer your questions, recommend a plan, and help you with enrollment for which they get a fee from medicare.


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## Cabin Fever

MoonRiver said:


> It's Anthem (BC/BS) and about $2000 a year. I posted in another thread that I just learned that Plan G is the exact same plan as F, but the individual pays Part B premium. It works out the Plan F companies are adding over $500/year plus the Part B premium on to the cost. I just switched from Plan F to Plan G.


Anthem is not available from BC/BS in my county. The best supplement plan is BC/BS Senior Gold. Not sure what type of Medigap plan it is (eg, Plan F, Plan G, etc). It costs close to $300/mo and you still have to buy a drug plan on top of that.


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## MoonRiver

Cabin Fever said:


> Anthem is not available from BC/BS in my county. The best supplement plan is BC/BS Senior Gold. Not sure what type of Medigap plan it is (eg, Plan F, Plan G, etc). It costs close to $300/mo and you still have to buy a drug plan on top of that.


There is something strange going on with Anthem. A few days ago I checked the medicare site and anthem didn't show up as an option for either Plan F or G. I went to the Virginia Anthem web site and both plans show as available. I will probably call Medicare tomorrow and see what the problem is.


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## vickinell

My plan G, is $122.13 monthly. My broker told me to stick with this plan until I got some health issues tended to, a kidney issue and cataract surgery. If my health looked good after they were taken care of since I don't go to the doctor much and am on no medication it might be better to switch to to an advantage plan.


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## MoonRiver

MoonRiver said:


> There is something strange going on with Anthem. A few days ago I checked the medicare site and anthem didn't show up as an option for either Plan F or G. I went to the Virginia Anthem web site and both plans show as available. I will probably call Medicare tomorrow and see what the problem is.


I called medicare this morning. On hold for about 15 minutes and after explaining (3 times) that medicare doesn't show anthem as offering plan f and g, but anthem does show Plan F and G on their site as being available, she finally agreed with me. Of course she didn't know why and her only help was for me to call anthem.

Called anthem, explained problem and eventually was told I needed to talk to a licensed agent. Got transferred to an agent who eventually understood the problem. She put me on hold while she went to talk to somebody. After about 5 minutes on hold, I was disconnected. She had asked permission to call me back if we got disconnected, so I waited for her to call back but she never did.

I wasted close to an hour and still don't know if anthem is available or not.


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## Forcast

Low income can apply for medcaid that pays the 20% left to pay from madicare and a part of drugs.


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## Forcast

Forcast said:


> Low income can apply for medcaid that pays the 20% left to pay from madicare and a part of drugs.


Just becareful make sure you check and dubble check the doctors and tests to make sure they except Medicaid.


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## MoonRiver

I've got to vent. Don't call Anthem if you don't absolutely have to.

You think you are calling a sales agent, but you actually get a data collection person who just asks a bunch of questions and records the information. Then they transfer you to an agent who reads the exact same script and asks for the exact same data. If you have a question about the plan, then they transfer you to someone that handles plans in your area.

At that point, I totally lost it. I had already gone through all this yesterday and got disconnected when the woman went to get the answer to my question. Even though I had already agreed twice that they could call me back if we got disconnected, they never called me back.

All I want to know is if these are really approved supplemental plans in Virginia, why aren't they on the Medicare web site. When I finally get to the 3rd person in the chain, she says I don't know. I ask who does? Transfer me to them. She says marketing, but she doesn't know who I should talk to. I hung up. I don't get it. Open season and no one seems concerned their plans aren't listed on Medicare site.

I can go on Anthem and sign up, but what assurance do I have that these are really medicare approved as they aren't listed on the Medicare site?


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## TnAndy

And think how much fun they will be to deal with if you have a claim !


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## Wolf mom

Forcast said:


> Low income can apply for medcaid that pays the 20% left to pay from madicare and a part of drugs.


Are you saying that those on Medicare Advantage plans can apply for Medicaid to cover the 20% that would normally come out of pocket?


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## TnAndy

I know there are Advantage plans that are REALLY great....zero premium, WAY better benefits than mine if you qualify for Medicaid. BCBS has one, I got excited when I saw how good it was until I found out I didn't qualify.


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## MoonRiver

Just learned something you all might need to know. I currently have Plan F which is a supplemental plan. I wanted to switch to Plan G, which is the exact same coverage except I pay the part b deductible. I contacted the agent that helped me 6 years ago when I first signed up for medicare.

Since I had 2 stents this year, I would have to go through underwriting to change my policy. So those of you thinking you can go with a cheaper plan and then switch to a better plan if you need it, you better check with an agent to find out if you can do that or not. if you go through underwriting, I believe they can refuse you or accept you at a higher premium.

It's tough because most of us will have a major health problem and maybe several. You may need to pay more yearly to protect yourself later on. Again, check with a broker.


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## weaselfire

HDRider said:


> We still are not communicating.
> 
> I am saying watch out for a policy that will only pay out to some maximum amount.


There are none. Lifetime maxes went away with the ACA. What the poster is talking about is a Max out of pocket, after which there is no payment for medical coverage, copay or deductible.

Jeff


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## Nimrod

There is a small penalty for each year you don't have prescription drug coverage. I didn't know about the zero premium plans at first so now I have $7.50 a month deducted from my SS benefit and will have forever.

I have the BC/BS zero premium plan you are talking about. The benefits are different depending on where you live in MN. For instance, in 2019, I did not have dental coverage but people in the Cities did. I don't know if you have the same coverage as I do since you live 60 miles west of me.

They sent me a brochure outlining the plan and changes in 2020. For 2020 it covers dental. I have to check and see what it covers but it appears to cover one cleaning a year and other services up to a $2250 max. They used to pay 45% for hearing exams and hearing aids. There is no "out of network benefit" for 2020. In 2020 they will pay up to $25 per quarter for over the counter meds that are on their list where there was no benefit in 2019.


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## HDRider

weaselfire said:


> There are none. Lifetime maxes went away with the ACA. What the poster is talking about is a Max out of pocket, after which there is no payment for medical coverage, copay or deductible.
> 
> Jeff


Sorry, but last year I found a policy that did.


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## kinnb

I've been very happy with AARP/UHC PPO Medicare Advantage over the last year and will stay with them for 2020. I started with straight gubmint Medicare when I was adjudicated disabled in 2010, because no one told me I could have anything else. 

After moving from CT to FL in 2015, I somehow found out I DID have choices. Picked up Humana Medicare Advantage, and it absolutely sucked in every way possible. I do have the low income rider, so that picks up the Part B premium, Medicaid picks up the back end of whatever Medicare does not, AND I have no copays because of the dual eligibility. 

I can see anyone I "want" anywhere, I just have to pay a little bit to go out of network. Like if I had needed to be seen in South Carolina at our service dog convention, I would have had like 70% coverage vs 80-100% coverage. 

I'm pretty sure after being totally spoiled by AARP/UHC MA, I will never go back to straight Medicare, and I LOVE that they have increased their dental and lots of other things for 2020. 

Have no idea if this helps or not, @Cabin Fever or if they offer that up your way. BC/BS down here is as bad as Humana, from what I hear. Sending you success!


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## MissyinKentucky

My husband has a $0 MA plan and so far we like it. I go on Medicare next Feb. IN the meantime, we have found that for about $72 a year the Kroger (grocery store) Savings Club for prescriptions (in conjunction with Good RX) has saved us more money than our healthcare plans for prescriptions. And since Trump signed the bill that pharmacists can offer the lowest cost options, this has really paid off. Three of my prescriptions are now free, and in the 9 months since we signed up we have saved over $12,000 in prescriptions costs. That and getting one of my husband's meds by mail order. Plan cost for his prescription is $400 a month. Prescription cost by mail, $90 for three months. affordablerxmeds.com


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## Oxankle

I have insurance thru my pension plan, and I get a choice each year, so this discussion does not fit my circumstances EXCEPT that you young fellows should be very careful mot to be locked into something you cannot get out of. 

At 67 I was a pretty good horse and needed little attention, but a couple of year later my wife contracted a terminal disease. She lived five years longer and the treatments cost (I was told) around $50,000 dollars each year, just for the medication. I had selected the best insurance available to me, so I did not go under. 

Look down the road before you get into something you can't change.


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## fordy

.....................The "0" premium Advantage Plans are plans that have VERY high participation rates in specific counties of the country ! For Instance , I'm in the AARP Medicare Complete Advantage Plan with over 100,000 members in 3 counties ! My Plan is available in Tarrant , Johnson and Hood counties ! Ft. Worth,tx has over 100,000 members not even counting the two smaller counties ! I've never paid any premiums !
....................You will encounter having to pay a premium if your HMO has low levels of enrolled members in your area ! Also , I had a heart attack (mild) in dec-17 , my total bill for a stent and 3 days in hospital was $63,120.......it was an EMERGENCY , My portion was $700 , because of the Emergency ! HMO took care of the rest........plus the Hospital was an "IN Network" facility ! Makes a big difference ! , fordy


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## Nevada

Cabin Fever said:


> At least with BC/BS, you can only enroll in a supplement plan when you first get Medicare. If you first take an Advantage plan, you have lost your ability to enroll in a supplement plan in the future.
> 
> To me, the supplement plans appear to be more expensive ($200 to 350/mo), they do not cover drugs, nor do they pay for things like dental or vision visits....just medical.


What you can get from a Medicare Advantage plan varies widely based on where you live. The more competition for medical care in your area, the better of a deal they can offer you. In general, better benefits are available in Urban areas and retirement Meccas (central Florida, for example). Remote rural areas are the most expensive.

All I pay is the Medicare Part B premium and small copays. There is no copay for doctor visits, specialist visits, outpatient surgery, or even hospital stays. There is no copay for labs but a $5 copay for x-rays. Urgent care clinic is $10 and hospital ER is $70. I have no deductible and annual maximum out of pocket is $1000. Prescription drug coverage is included and I get a $1000/year dental allowance.

Supplemental is not available to Medicare Advantage subscribers, but copays are usually low enough that it's not necessary.


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## fordy

Cabin Fever said:


> I am planning on retiring sometime during 2020. I will be 67 when I retire. I have been researching Medicare supplement plans since the 2020 information is out there.
> 
> During 2019, I visited my doctor once and I take no medications. Consequently, I am thinking about a $0 premium Advantage plan from Blue Cross/Blue Shield. Yes, it has a higher deductible and maximum out of pocket rate than the other BC/BS Advantage Plans have, and the drugs cost slightly more, but I am willing to take the risk to save some money.
> 
> I look at it this way, I could sign up for the best BC/BS Advantage plan, but in premiums alone, it would cost me $2,300/year. I really doubt that I would spend anything near that if I was under the basic ($0/mo) plan. Yes, if something catastrophic occurred, I would end up having to pay a maximum out of pocket of $5,900 under the basic plan. But even the best plan has a $3400 maximum out of pocket.
> 
> I like an Advantage Plan because it not only covers medical costs, but also covers vision, hearing, dental and drug costs.
> 
> Is there a flaw in my thinking here? Am I missing something?


.................................................................You should enroll in Plan F , if it's till available ! It covers the 20% Medicare doesn't . You'll have to pay ~$150.00 for your supplemental policy , $XX.xx for a drug plan and a 3rd. fee which I can't remember ! Long haul you'll save money , because the $20% really adds UP over time when you need extensive care ! You maybe healthy now , but the upcoming years will not be kind ! , fordy


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