Is Medigap or Medicare Advantage Enough?


Gang of Six - Cartoon

Gang of Six – Cartoon (Photo credit: DonkeyHotey)

A few days back I read this comment on a different blog.  I tried to leave a comment but was unable to get registered.  I agree with most of what was said.  My problem is more with what was not said.

The comment was…

“I just got off the phone with Medicare.

Upshot: 1. Obamacare has no provisions, now or in the future, to assist seniors with either Medicare Advantage plans or Medigap plans.

2. Medicare Advantage plans are not the same thing as Medigap plans. Medigap plans are supplemental insurance plans to pay the 20% of medical bills Medicare doesn’t pick up. With Medicare Advantage, by contrast, Medicare beneficiaries have “the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). There’s a big difference between the two. But Thom continually confuses Medicare Advantage with Medigap. In any case, according to my Medicare agent, Obamacare will not affect either plan…

Perhaps there’s some part of Obamacare that benefits Medicare Advantage subscribers, but my agent knew of no such thing. Whatever, Medicare Advantage was a bad deal for seniors (that’s why I didn’t go for it), so I hope my agent is wrong.”

This individual is correct on many issues.  There is a huge difference between Medigap and Medicare Advantage.  He is right that Obamacare does not even mention Medigap.

However, Obamacare does mention Medicare Advantage in a bad way.  Medicare Advantage was developed during the Clinton administration to allow seniors the option to get their health insurance from private health insurance companies rather than a government program.  Obamacare did not do away with the program, it just froze the amount of money that the federal government was paying private insurance companies at 2010 rates.

It is anticipated that as doctors, hospitals and pharmacies continue to increase their charges, private insurance companies will either need to increase premiums or decrease benefits just to remain where they are in future years.

It shocks me that this insurance agent did not apparently mention the one part of Obamacare that does affect people on Medicare.  Original Medicare does not pay for prescription medications.  Neither does Medigap or Medicare Advantage.  For insurance help with that, you will need a Medicare D (Prescription Drug Plan.)  Sometimes those types of plans are attached to Medicare Advantage plans.  When they are, the plan is often abbreviated as MAPD.

Other times a person with an Advantage plan will need to get a separate Medicare D (PDP) plan.  At no time will there be prescription coverage with Medigap, unless you have an obsolete plan J.  If you want insurance help with your prescriptions, you will have no option but to get a Medicare D (PDP) with your Medigap.

What scares me is that this fellow is willing to accept the word of an insurance agent who apparently does not know what he is talking about rather than spend the time to do his own study.  Apparently, he, like millions of other Americans, is willing to base his opinion on rumors from total strangers rather than taking the time to find out the truth for himself.  The really scary thing is that all of these people are allowed to vote.  It explains why we have so many liars and crooks in political office.  Why should the politicians take the trouble to do things right when there are enough people who would rather believe a lie than hold politicians accountable to the truth?

About these ads