Best Medicare plan B insurance (coverage, deductible, monthly, mental)

[OhioJB]

There's a Youtube channel named Medicare School that puts out good information quite often. In order to help my elderly mother I wanted to educate myself on Medicare.

For some reason Youtube is telling me I'm offline after I select a video, but came across one of his videos that I was going to attach here. It's titled: 'Turning 65 Soon? What You NEED to know about Medicare!' It's from a year ago. He has plenty that are more recent.

Some things I've learned is not to get an Advantage plan. You'll have to get pre-authorizations, you're limited to which doctors you can see, and insurance companies often deny authorizing care. A lady I worked with has brittle bone disease. She fractured her spine and a couple of ribs and had surgery (I believe for the spine issue). The insurance company refused to authorize calcium shots her doctor said she needed. They said she hadn't broken enough bones yet. After she moved from Ohio to Texas to be close to her son her doctor there was finally able to get authorization for her after she fractured a few more ribs.

Also, once you chose an Advantage plan you can only switch to another plan if an insurance company will accept you.

If you can afford a Supplemental plan that's the much better option. My mother has that and has never had an issue. If her doctor orders a test or refers her to another doctor she doesn't need pre-authorization.

For her medicines she does pay for Silverscript (part D I believe), but most of the time our Kroger Health Savings plan is cheaper, and GoodRX is cheapest for one or two medicines. Her Silverscript is a waste of money, at this time anyway. I pay $72/year for the Kroger Health Savings plan (up to 6 people) and most of our medicines are $6 for a 90 day supply, and some are free. 30 day supplies are $3 or free. There are 17 chain stores that take part in the Kroger plan, they are at the bottom of the linked to page: https://www.krogerhealthsavings.com/

I'm six years away but glad I'm learning about all this now so I'm prepared in case I live to 65.

[nicet4]

Originally Posted by mathjak107

part a and b is not for profit govt medicare , its only administered by the gov.

it goes with a medical supplement

part c is an advantage plan administered by a for proft private insurance company

part d is a drug plan that goes with part a and b but usually comes packaged in part c plans as part of an advantage plan .

i don’t recommend advantage plans

Say away from advantage plans!

Wife and I both have Plan G. It is not the cheapest but in my mind the best.

What is the Plan G deductible in 2024? $240 – the annual Part B deductible in 2024 is what you will pay for your Plan G deductible. However, Plan G does not have its own deductible separate from the Part B deductible. There is also a High Deductible Plan G which has a deductible of $2,800 in 2024

Any doctor or hospital will take Plan G and the most out of pocket you will suffer for the year is $240.

Wife had cancer, been several years now and everything looks great, but our total out of pocket for chemo, surgery and all the looking after was $240 for the year. Once we spent that we were done.

[ddeemo]

Originally Posted by nash04

Thanks for the info.
Since I'm not claiming SS until 66 then I should only need plan A for now but been told that my insurance which is Tricare (military) will stop once I turn 65 so I will need plan B. I already have eye vision and Dental under the Government insurance. Hopefully, I won't lose those also.

You need Medicare part B to qualify for Tricare (TFL) at 65 - even if do not start SS until later. Also if delay Medicare past 65, it can result in paying a higher Medicare premium forever. Just pay Medicare directly. You can continue Dental and Vision like now but that is not standard Medicare or Tricare.

One big advantage of Tricare is that no need for any advantage, supplement plans or anything outside of part B - copays and part D are covered under TFL at no added cost. Also can go on an advantage plan if want to because no underwriting to go off it back onto standard Medicare with TFL - unlike most other supplement plans. Some advantage plans cover Dental and Vision or even rebate part of Medicare payments.

Ignore all the talk about Plans like F, G etc because no need for any of those if under Tricare - TFL acts as a no cost supplement plan that covers part D and most of the copays at no cost.

[mathjak107]

Originally Posted by nicet4

Say away from advantage plans!

Wife and I both have Plan G. It is not the cheapest but in my mind the best.



Any doctor or hospital will take Plan G and the most out of pocket you will suffer for the year is $240.

Wife had cancer, been several years now and everything looks great, but our total out of pocket for chemo, surgery and all the looking after was $240 for the year. Once we spent that we were done.

while that 240 may be true on the part A and B side , it isn’t true on part D or most advantage plans .

with any of the new drugs out there you will fall in to the gap on part d and that can cost up to 8k a year

all plans have the gap …

most new drugs cost 700 to 1k a month or so like my trulicity . many are more .

they have a 500 dollar deductible.. then part d pays up to 5k or so ..so for a few months its 11 dollars , then once the gap is hit you pay 25% of the cost .

so 250 a month. until you hit around 8k out of pocket .

then it starts again the new year

all plans have the gap , the only difference is one can pay more for a different part d plan and pay more then a 500 dollar difference and not have the 500 deductible.

the gap is really the old donut hole you hear so much about .

any new drug advertised on tv you can bet falls in the gap today

[djplourd]

Originally Posted by nash04

Thanks for the info.
Since I'm not claiming SS until 66 then I should only need plan A for now but been told that my insurance which is Tricare (military) will stop once I turn 65 so I will need plan B. I already have eye vision and Dental under the Government insurance. Hopefully, I won't lose those also.

Tricare doesn't stop. You have to sign up for Medicare at age 65. Your current Tricare coverage will change to Tricare for Life, which essentially becomes a medigap plan. Tricare for Life will cover the 20% that Medicare doesn't.

If you get prescriptions through Tricare now, that should continue so you don't need to sign up for a Part D (prescription coverage).

You should be able to keep your vision and dental insurance. I'm not sure if the premiums will increase.

[phoebesmom]

Originally Posted by nicet4

Say away from advantage plans!

Wife and I both have Plan G. It is not the cheapest but in my mind the best.



Any doctor or hospital will take Plan G and the most out of pocket you will suffer for the year is $240.

Wife had cancer, been several years now and everything looks great, but our total out of pocket for chemo, surgery and all the looking after was $240 for the year. Once we spent that we were done.

I agree with choosing Plan G. That is what I have. I have had a major surgery and several MRI's and CT's since having Medicare and Plan G and have only paid the yearly deductible of less than 250.

If you do not have a supplement plan, you are on the hook for 20% of the costs, although that is after Medicare pays which does bring it down. So an MRI may cost $3000, but if they contract with Medicare it pays them less, then you owe 20% of the lesser amount.

That is why I have a supplement, because there is no cap on these 20% charges, and I very quickly come out ahead by paying for the supplement with these expensive procedures.

So this year, by March, I am already way ahead by paying for the supplement, and I only pay it by the month, so I'm ahead that way, too.

My husband went on Medicare this year and he was already ahead by the end of January, due to testing for possible heart conditions.

And these were just the tests. Which we had no problem getting because he was on original Medicare. Original Medicare is the part A and B. You pay out of social security for Part B.

[mathjak107]

in our area a G plan is over 300 a month .

for 101 a month i have a high deductible F plan … it has a deductible of about 2800 before the supplement kicks in .

but we layout maybe 400-500 a year in deductibles so over the years we saved thousands of dollars over a full G PLAN .

plus out of the 101 dollars they cover my gym membership which was 50 bucks before medicare so its a score for us

[lpc123]

Originally Posted by ddeemo

You need Medicare part B to qualify for Tricare (TFL) at 65 - even if do not start SS until later. Also if delay Medicare past 65, it can result in paying a higher Medicare premium forever. Just pay Medicare directly. You can continue Dental and Vision like now but that is not standard Medicare or Tricare.

One big advantage of Tricare is that no need for any advantage, supplement plans or anything outside of part B - copays and part D are covered under TFL at no added cost. Also can go on an advantage plan if want to because no underwriting to go off it back onto standard Medicare with TFL - unlike most other supplement plans. Some advantage plans cover Dental and Vision or even rebate part of Medicare payments.

Ignore all the talk about Plans like F, G etc because no need for any of those if under Tricare - TFL acts as a no cost supplement plan that covers part D and most of the copays at no cost.

Good advice.


We have TFL, and will probably just buy separate dental insurance. We have been paying cash for dental so far. A good dental plan will "pay for itself" mostly with just the "free" cleanings twice per year.

[DaveinMtAiry]

I did not find it as complicated as so many believed. I just signed up last month. I knew to pass on Advantage, those lower premiums come at a cost. I found an independent agent who had access to many or maybe all of the Plan G insurance providers and found the best deal. Same thing with the drug plan. I decided on Plan G over Plan N because the co-pays could add up if you have health issues and I always planned on having health issues as I aged. I don't mind paying $141 a month on top of the Medicare deduction from my SS check to have coverage that will not result in big health care costs down the road.

[luvmyhoss]

Originally Posted by mathjak107

part a and b is not for profit govt medicare , its only administered by the gov.

it goes with a medical supplement

part c is an advantage plan administered by a for proft private insurance company

part d is a drug plan that goes with part a and b but usually comes packaged in part c plans as part of an advantage plan .

i don’t recommend advantage plans

We call that the Disadvantage plan.
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