A case study with the title "Traditional Medicare . . . Disadvantaged?" discusses how seniors under Medicare can find themselves unexpectedly with unlimited liability for their medical expenses. Obamacare puts a cap on out-of-pocket expenses for those under 65 but not for seniors. Seniors who do not want this exposure can buy a Medicare Advantage or a Medigap policy. (The Medicare Advantage polices are HMO and are usually attractively-priced, while the Medigap policies generally cost more, when taking into account the other Medicare charges, but gives the policy holder a lot of flexibility about which doctors to see.)
The article tells of a cancer patient who wanted a surgeon outside his network so wanted to switch to Medigap from Medicare Advantage. He found that since he had not opted for Medigap at the time of his original enlistment in Medicare, he couldn't get coverage because of his condition. If he switched to Medicare without the Medigap policy, he would have no cap on his co-payments.
It may be worthwhile, therefore, to pay more and get a Medigap policy in the first place.
Here is a link to the article. (Click on the bulldog.)
