Should You Switch to a Medicare Advantage Plan?

The screen on my digital calculator kept flashing and threatened to burn out as I added up the numbers again:

In 2018, by switching to an Aetna Medicare Advantage plan and staying within an approved network of doctors, I would pay $76 a month for my supplemental health coverage, instead of $141.44 for an Aetna Medigap policy, which covers 20% of the health care costs Medicare doesn’t, and an additional $18 for prescription drug coverage. Also, all of my doctors participated Aetna Medicare Advantage.

After getting giddy over the prospect of saving $996 in monthly premiums (actually more than that: these policies cover prescription drugs, $150 for both vision and dental services, and free classes at certain gyms), I realized that I would only save that much if I didn’t go to the doctor at all this year. So I did an estimate, revised according to the cost of my share of medical services for Aetna Medicare Advantage:

4 visits to the primary care doctor                             $15 x4=$60

2 visits to the eye doctor                                                 $45 x 2=$90

2 visits to the audiologist                                              $45 x 3=$135

4 visits to the ear, nose and throat doctor               $45 x 4=$180

2 visits to the foot doctor                                               $45 x 2=$90

That added up to more than I thought, $555, and only a savings of $441 every year, or $37 a month–money you can easily fritter away with a few fancy coffees or manicures. Still, “That’s not nothing,” as Aunt Josephine, who was born a few months before the Great Depression and knows how to squeeze a dime, likes to say.

Save that money every year, over 10, 20, and 30 years when you’re retired, and you’re talking about having some nice extra cash on hand to pay for health care costs in retirement.

Darn it, I thought, my brother, Tom, who lives in Illinois, was right when we talked last Thanksgiving Day: I could save a lot of money on health care costs in retirement in 2018–and beyond–by switching to a Medicare Advantage plan.

To be honest, I had never considered one of these plans when I signed up for Medicare a few years ago when I was evaluating Medigap policies; I simply thought an HMO-style Medigap plan was the better choice because I didn’t have to pay for any extra health care costs.

I’d save more, if I had access to a zero-based plan, but as it turns out, there are no zero-cost Medicare Advantage plans in the New Jersey county where I live. These plans are priced by the availability of the health insurance companies that offer these plans, and currently, only 11% of the retiree health population has access to these plans. They’re also affected by the cost of medical care in your zip code (which may be something to think about in the future in choosing an “ideal” place to retire).

But several months into 2018, I’m wondering if I made the right choice by switching to Medicare Advantage at all.

Shortly after I signed up for one of these plans, I rated my health as “excellent.” Then the arthritis in my right knee that I’ve managed on my own for the past decade flared up, which led to multiple visits to the orthopedic doctor ($45 a pop) and expensive gel injections. But that didn’t resolve the inflammation in my leg, so I had to follow up with a vascular surgeon, who said I had “venous insufficiency,” meaning the blood flow in my veins needed to be corrected. By the time I visit these two doctors for follow up appointments, and pay my share for the outpatient surgery I had last week ($300), I will spend $1,190 out of pocket, not including premiums. If I don’t go to the doctor anymore this year, I’ll spend just about the same money I spent on my Aetna Medigap policy in 2017.

So here’s question, or questions, as I look ahead to the Open Enrollment Period later this year, one to myself and one to you:

Should I switch back to a Medigap policy? Will I pay a penalty? Will Medigap coverage now cost me more?

And a second, to you: Did you switch to a Medicare Advantage plan like me in 2018 to save money? If so, what’s your experience been like so far? Do you plan to stick with your Medicare Advantage plan, or aare you thinking of switching later this year? And if you thought about one of these plans, but backed away, would you tell me why? You may have gleaned some insights that will help me, and others, make a more informed decision in 2018.

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