The Great Medicare Advantage Marketing Scam

[Ms. Toad]

89. AARP Plan N in Seattle,

very similar to plan G, except for copays, is $165/month. At that difference, as long as you don't expect more than 2 office visits a month, you come out ahead on plan N.

We went back and forth between G and N, but in Ohio the price difference between the two isn't as significant - IIRC we break even at 8 visits (rather than around 24). It's about a toss-up with our current level of visits - and since Ohio is one of the few states which doesn't permit excess charges (up to 15% for doctors who accept medicare but not assignment), Plan N is an attractive less costly option. It's the plan my father is on. But I may need to go to Texas for care - and Texas allows excess charges. And Plan G also covers some out-of-country care, and I do travel to places which Plan G, but not Plan N, would cover. So that combination tipped the scale to plan G.

But excess charges may be one of the reasons Plan G is so much more expensive there. In Ohio, there is no risk that the insurance company will be hit with paying excess charges, since the state doesn't permit them. In Washington (and most states), doctors are free to charge 15% more, and plan G has to cover them.

I checked Nebraska - where my parents first purchased Medicare - the cost there is a bit more than Ohio, but still closer to 100 than 200, and the difference between plan G and plan N there is only $5/month.