I bit the bullet a few years ago and moved into the Plan with the very best coverage, including deductibles: Plan F, though BC/BS of MA called theirs "Bronze."
Thanks for the reminder. Mass. Medigap plans are different from the usual Plans A-N. There are three plans: Core, Supplement 1, and Supplement 1A. These appear to be roughly equivalent to Plan A, Plan F, and Plan G respectively. (I haven't checked all the details.)
https://www.medicare.gov/health-drug-pla...sachusetts
For some reason, BC/BS in Mass. calls these three plans Medex Core (like Plan A), Medex Bronze (Suppl. 1, like Plan F) and Medex Sapphire (Suppl 1a, like Plan G).
https://medicare.bluecrossma.com/shop-pl...year%3A111
As with Plans F and G, the only difference between Supplement Plan 1 and Plan 1A is whether the Part B deductible is covered.
Looking at their costs and benefits, it seems that for anyone using Part B services, Supplement 1a (Sapphire, Plan G) is cheaper, all in. With Supplement 1a you have the added annual $283 Part B deductible to cover. But in exchange you get a premium that's about $55/month less. Spend $283, save $660.
https://www.mass.gov/doc/massachusetts-m...n/download
Plan G (or Suppl 1a, or Sapphire), including the added cost of the Part B deductible, was predicted to become cheaper than Plan F (or Suppl 1, or Bronze) at some point. This is because the pool of customers for Plan F is always shrinking (you must have been born before 1955 to qualify), while the pool for Plan G is growing.
Quote:Crash said: "By the time I'm 80 or so, I'll be paying about $400/month. This year, the monthly is already up to $288 and some change."
Lucky you. Here in NY, my monthly premium for Plan F by AARP/UHC was just raised to $417 this year. But, as I said, I have never seen a bill or had any contact with my Medigap provider in the last 20 years, and I want to keep it that way.
Yes, the extra cost of my Plan F is worth it for my peace of mind.
@ fred495 and you can switch Medigap plans at anytime without medical underwriting. That is a nice benefit to have.
@ Mona, some states do allow Medigap switched on guaranteed basis (with some restrictions), but in general, no. Medigap switches may require medical underwriting. People later regret being trapped in wrong Medigap plans.
So, if one cannot afford Plan G, get the next best plan one can afford.
Plan F was the best, but it's no longer available for new signup, but people in it can keep it.
YBB
@ yogibearbull, thank you for your post. I was remiss in not specifying New York, where fred495 resides, which may have left the impression that switching Medigap providers without underwriting is allowed in all states.
Several have mentioned the importance of a good broker. How would one go about finding a good one? I'm in Washington state if it matters.
Quote:Several have mentioned the importance of a good broker. How would one go about finding a good one? I'm in Washington state if it matters.
To sign-up or switch in Medicare? Medigap? Before anything else, perhaps contact a local Senior Citizens' Center where they typically play trivia or host dances and there might be a pool table, light calisthenics, guest music performances, meals offered for cheap. I used to go over there weekly to play trivia and just socialize. But even if not available all through the year, there were VOLUNTEERS, mostly retired from working with Medicare and medigap outfits, to assist with signup and switching. I got that done (including Part D for drugs) right there at the senior center. No charge.
Quote:Several have mentioned the importance of a good broker.
How would one go about finding a good one?
I'm in Washington state if it matters.
The Washington state Office of the Insurance Commissioner provides information
to find your nearest Statewide Health Insurance Benefit Advisors (SHIBA) office.
SHIBA volunteers provide free, unbiased help with Medicare.
https://www.insurance.wa.gov/insurance-r...help-shiba
Since moving here, I used SHIBA once. I was going to switch my Part D coverage. (Come to find out it's a rigged system, no matter which plan you choose.) And SHIBA offered me mail-order plans. Not happy? They told me in the cover letter to call back. I did. There was never any follow-up. (Sure, I'm gonna get a mail order plan, and HOPE the stuff gets to me on time? No thanks.)
The lesson: have your questions ready. Think about stuff beforehand that you never would otherwise have a reason to think about. Jayzuz.
Where I live our CVS mail-order is really good. You get things delivered free in 1-2 days, with plenty of text messages to track progress. Great 90-day prices and I always have a big surplus. If you call with a specific need, they will ship over night. Or you can have special orders filled locally.
I realize not all services and locations are going to be that responsive. Of course, once I leave employer plan, that will all change. I expect higher drug costs.
Quote:Since moving here, I used SHIBA once. I was going to switch my Part D coverage. (Come to find out it's a rigged system, no matter which plan you choose.) And SHIBA offered me mail-order plans.
Mail order only plans, or plans where mail order was less expensive?
Mail order is best used for maintenance drugs (for chronic conditions) where you refill well in advance of running out of medication and where you can have them resend if the medication is lost in the mail. Retail pharmacies are better suited for more immediate (acute) conditions (you see your doctor for a sudden illness). I didn't think that there were any Part D policies without at least one local retail pharmacy in network.
I don't recall exactly where @ Crash moved to, so I spot checked Honolulu. There are eight plans offered and I could find an in-network retail pharmacy for each. So I'm confused as to what SHIBA suggested.
I agree that the private insurer portions of Medicare (Parts C and D) are somewhat rigged. But not because they can force you in mail order only plans. Rather, because it seems that often the drug coverage offered by Part C Medicare Advantage plans provide better coverage than all Part D (standalone drug plans) available. This tends to push people into private insurer MA plans whether they prefer them or not.
Hello.
I don't recall exactly where @Crash moved to, so I spot checked Honolulu. There are eight plans offered and I could find an in-network retail pharmacy for each. So I'm confused as to what SHIBA suggested.
I agree that the private insurer portions of Medicare (Parts C and D) are somewhat rigged. But not because they can force you in mail order only plans. Rather, because it seems that often the drug coverage offered by Part C Medicare Advantage plans provide better coverage than all Part D (standalone drug plans) available. This tends to push people into private insurer MA plans whether they prefer them or not.
The mail order option I was offered was one of a few that they "researched" for me. I looked at the details myself, and saw that the rigged system is rigged this way: Plan A covers everything you need, EXCEPT drug. X. Plan B offers lower co-pays for everything you need, but does not even cover drug Y. Plan C is the mail-order.
I just am very aware that uncle Donnie deliberately screwed up the P.O. when he appointed Louis Fart-brain DeJoy as Postmaster General. Uncle Louis, so I've seen in the news, is looking to move on or retire from that post, as soon as his replacement can be found. I've seen nothing telling me that he's gone, yet.
Even if the P.O. functioned well, the way it used to do, no one can just reorder pills when it's convenient. No, we (and the pharmacies--- mail order or otherwise) must count pills and WAIT. Because the insurance companies run everything for their own purposes. And what if you go away on vacation? If you're in a mail order Plan, there's just one more detail to worry about. "Count your pills until you meet our threshhold and are getting low, then order your pills from Chad, or wherever you might be. Yux. Not for me.
Years ago, I remember you could get a "vacation exception." Dunno if that still holds, and what kind of hoops you might have to jump through in order to GET it... And still it takes time to get the stuff to you by mail order. But... WHEN? Do the pills themselves get sent to me from somewhere LOCALLY? Or from Denver or Gettysburg? Already, it takes a letter to reach me from the East Coast about a WEEK to arrive.
I WAS getting the more expensive 'scripts from a Canadian outfit in Winnipeg. Even paying retail, involving no insurance, it was cheaper for me. But the Orange Disaster decided to tariff EVERY package coming into the States. (ILLEGAL. BUT WE ALL KNEW THAT ALREADY.) So, who pays the tariff? The customer. Geniuses in charge, everywhere. But as long as the Orange grifter is comfortable, what does he care?
... I was wrong. Mr. Fart-brain is no longer there.
"When Postmaster General David Steiner began his tenure at the U.S. Postal Service last July..." Anyhow, when it comes to mail delivery, it's not getting any better.
https://thehill.com/opinion/congress-blo..._top_pages
It must be a regional thing. Ours seems to be fine here. Occasionally, when we get a sub, he delivers junk mail to the same address number on a parallel block. But, not a big issue.
On a somewhat related note...
"Navigating drug coverage demands brain power in our DIY retirement system,
and it isn’t getting any easier. For retirees, the stakes are high for one’s health
and financial well-being. Seniors can expect to spend about 15% of their overall budget
on healthcare costs. For those who take generic drugs for common conditions
like high cholesterol, medications represent a small share of spending.
For those who mainly take brand-name drugs or medications not covered by insurance,
it can be much higher."
https://www.msn.com/en-us/money/insuranc...r-AA1XyI5h
WEEKLY BUSINESS DIGEST 2
For those without or poor PRESCRIPTION coverages, there are discounted-prescription programs: GoodRx (a broad coupon-program), TrumpRx (a limited coupon-program for only 44 popular brand-name drugs even if cheaper generics are available), special prescription programs for Amazon/AMZN, Costco/COST, Walmart/WMT members; Mark Cuban’s Cost Plus for generics, special programs by pharma companies for lower-income patients. US government is also working on drug-pricing for Medicare. RETIREES should annually review their drug coverage under Part D or Medicare Advantage (MAPD) & pay attention to the drug formulary list, not just the premiums.
#PersonalFinance #Barrons
https://ybbpersonalfinance.proboards.com...march-2026
YBB
That's good info, yogi. Still, nothing needs to be so complicated.
Thanks to the Inflation Protection Act of 2022 the donut hole has been closed and out of pocket drug expenses are capped (at $2100 for 2026).
Because of the cap, for some people it may make more sense to use Part D rather than pay using a discount card, even if the latter costs less. Say you've got four prescriptions that each cost $600/year with a discount card or $1500/year through Part D. You'd be better going through insurance because your OOP cost would be $2100 (the max), vs. $2400 with the discount card.
Is the system corrupt? The participants not benefitting from this cap might say yes. They've being forced to subsidize your high expenses with premiums higher than they might be without that cap in place. Insurance traditionally is designed to spread risks. It's not there to subsidize expected expenses.
But that's the way, to some extent, insurance is being deployed. When health care is viewed as a right, it's a cost that's spread over society. Those that need more health care receive it at less than cost. The rest of us share that cost.
A pure insurance system where people pay more (in copays, coinsurance, premiums, deductibles) if they are higher risk is not corrupt. A pure "healthcare as a right" system where everyone pays into the system and everyone gets the healthcare they need is not corrupt. And a system such as ours that falls between the two extremes is not intrinsically corrupt.
Some other discount cards:
https://capitalrxadvantage.com/
https://www.rxsaver.com/
https://www.pharmacychecker.com/
https://www.communitycaresrx.com
https://rx.com/
https://www.webmdrx.com
https://www.buzzrx.com/
https://www.cheaperrx.org/
https://www.wellrx.com/
I've bolded a few that I've found on occasion do better than goodRx. Some others are virtually useless. YMMV
That is a great post @ msf very informative and helpful. I also agree with your logic.
I looked up a few details:
So, an individual could theoretically pay the cap of $2100 plus Part D premiums, and any non-covered medications could go through goodRX.
The Part D "base premium" being $38.99 per month.
The Part D cap covers "deductibles, copayments, and coinsurance for formulary drugs".
The Part D deductible is $615 annually for 2026.
That sounds about right. Also, if a drug isn't covered and there is no reasonable (whatever that means) alternative, I think the insurer is required to cover it. Though I haven't been in that situation so I'd have to check this rule to be sure.
The Part D deductible is no more, than $615. The insurer can set a lower deductible - it depends on the policy. Same as MA OOP maxes being capped, though the more expensive polices typically set a lower max OOP.
I almost forgot about the Medigap discount that someone mentioned. Depending on how the policy is priced, it may not be permitted to adjust premiums for your age. So what it does to get around this is offer an age-based discount that gradually declines as you get older. Similar to gas stations not being allowed to charge a CC surcharge. So instead they post the 'all in" CC price, and then offer a cash discount.
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