Medicare vs Medicare Advantage

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Re: Medicare vs Medicare Advantage

Postby Cudedog » Tue Feb 07, 2023 2:16 pm

Bethers wrote:There really are some other decent advantage plans. Kaiser is the diamond. My sister and bil are on an advantage plan because it was what came with his pension. His union made sure it was good. I have a gf that can only afford an advantage plan. I will never write them all off. And no one should. We have to do what's best for ourselves individually. It's like I check rates on my supplement yearly and don't understand anyone who doesn't because "it's done good for them". A plan G is a plan G no matter what company it comes from. Same with n, etc. The minor differences could be optional extras that can be with a plan one year and gone the next. So as long as I can pass underwriting I'll check rates and switch companies without any hesitation. I'm not willing to give any of these insurance companies more money than necessary.


Beth, the experience that my ex-husband has had with his Advantage plan (and this is the same experience that a few other people I have known have had as well) is that so long as a person remains healthy, things are fine with the Advantage plan.

It is when a person begins to experience health "issues" (as all of us will, sooner or later), and needs more intensive "care" (and thus more claims needing to be paid by the Advantage plan) is when things begin to go south (by "south" I mean claims begin to be disputed and denied by the Advantage plan in question).

So as long as I can pass underwriting I'll check rates and switch companies without any hesitation.


Another small caveat here: a person with health "issues" (particularly major health issues) generally doesn't "pass underwriting". Happy to hear you are still healthy enough to pass.

Kaiser has been named here as a "good" Advantage plan (with the caveat that I mention above, is that Kaiser is not widely available - for example, Kaiser is not available here in my area).

You say above that "there really are some other decent advantage plans". You also say that your sister and bil, and a gf are (presumably) happy with their Advantage plans.

You also say that "We have to do what's best for ourselves individually." Of course we do! I absolutely agree with you here.

So. . . in view of the above. . . what are the names of the Advantage plans that you feel are "decent Advantage plans"? What are the names of the Advantage plans your sister and bil and gf have?

I'm all for saving a chunk of change. Regular Medicare, plus my out-of-pocket Medi-gap plan, surely is a big drain on my wallet. I might be ready to make a change!

Names, please.

Thank you.

Anne
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Re: Medicare vs Medicare Advantage

Postby Bethers » Tue Feb 07, 2023 3:22 pm

My g/f just had to change plans as she moved states. I don't know the name of either one. I'm sure my sister had mentioned theirs but I don't remember. They've had surgeries, etc. One thing to remember, their plan was written for retirees of my bil's company and the same company wouldn't necessarily be offering that exact plan to anyone else. And the companies in multiple states do not offer the same plan our rates from one to another. That's one of the scary parts of advantage plans. Even if yours is good, traveling or moving can change everything.

I know the day will come I'll not pass underwriting. Until then, I will continue checking rates every year when I get my latest increase. If I don't pass, they win and I pay their rates.
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Re: Medicare vs Medicare Advantage

Postby Bethers » Tue Feb 07, 2023 3:27 pm

Anne, on regular Medicare with a supplement you can check supplement plans any time. If you're curious, I highly recommend letting Boomer Benefits answer any questions you have and give you current quotes. No charge to you but if you sign up with a plan through them they have an excellent customer service team that beats out calling the insurance agencies for help, in my experience.
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Re: Medicare vs Medicare Advantage

Postby Cudedog » Tue Feb 07, 2023 8:40 pm

Thanks, Beth.

I appreciate the information. I don't know the name of my ex's Advantage plan, either.

There are just so darn many of them, and they can all be so different.

And, of course, the "elephant in the room" (that nobody talks about) is that if one has regular Medicare, and pays out-of-pocket for a supplement, and then has a major health issue - good luck finding a doc that is willing to treat the issue.

It seems it's always about "connections".

I have a friend in our general age group (with Medicare, and a supplement) that needed major surgery, and had it - no problems at all - Medicare and supplement paid everything.

I have another friend that also has a health issue - far less serious, and not nearly as potentially costly an issue as my first friend had (this friend also has Medicare, and a supplement) that has spent literally months trying to find a doc willing to treat the condition. So far, nada in the doctor department.

The difference? The first friend's brother is a retired doc. He "made some calls". My other friend doesn't have any "connections".

I think that one of the problems here is that many docs won't treat Medicare patients, because Medicare pays less than the open market.

I have no idea what the solution is - except maybe stay healthy. If a person is unable to do that - it seems that, these days, all bets are off.

Except for maybe Kaiser (if so, good on them). And also those with "connections", of course.

But I suppose I have gotten a bit off-topic here. Sorry.

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Re: Medicare vs Medicare Advantage

Postby Colliemom » Thu Feb 16, 2023 3:06 pm

I have stuck with my Blue Cross supplemental insurance through a few rate increases and I have another one this year. The plan that I am on is no longer available. I am grandfathered in along with everyone else who was on the plan at the time they stopped it. It is plan C. I am willing to pay the rate that they charge because I have not had to pay one cent out of my pocket for anything that I have had done including the dermatology stuff I had done, the emergency visit for the kidney stone and even my checkup with the Retina doctor. Any tests related to my annual Medicare Wellness checkup are of course covered by Medicare. I do have to pay my dentist because I don’t have dental coverage and my chiropractor. But that’s because Medicare won’t cover that, because I am going on my own and not for medical reasons. So I ain’t changin :lol:
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Re: Medicare vs Medicare Advantage

Postby OregonLuvr » Thu Feb 16, 2023 3:31 pm

I am happy with my United Healthcare supplemental coverage also. It is not cheap but like you, I have never had to pay a penny (surgery, ambulance, eye injections, rheumatology, labs, ct scans, xrays). Also I dont need a referral for anyone and I can go anywhere I happen to be. I have the Medicare Plan F They cancelled that one long time ago but I too am grandfathered in and I am not giving it up.
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Re: Medicare vs Medicare Advantage

Postby BirdbyBird » Thu Feb 16, 2023 5:02 pm

Just a note … I have UnitedHealth care Supplement and Medicare covered my chiropractor visits. For one of the practitioners a couple years ago I was told they wouldn’t cover the electronic stimulation then last fall they seemed to cover it all. But sadly … over the years that I have tried different practitioners I have yet found one that was able to give me relief for issues. So happy that they work for some of you.
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Re: Medicare vs Medicare Advantage

Postby JudyJB » Thu Feb 16, 2023 9:06 pm

I also have Plan F and other than some prescription copays, i have not paid a penny out of my pocket for almost 20 years. (Had a similar plan from work once I turned 62.)

The plan to stay healthy is a good one, and works until you aren't healthy anymore! Other than some kidney stones and one bout of pancreatitis caused by a sedative, I even told my kids that I figured I had gotten old enough that I had bypassed cancer and that several doctors had told me that statins had cleaned out my veins and arteries so I had a very low chance of a stroke or heart attack. Then I got CLL or chronic lymphocytic leukemia.

There were no oncologists at U of Michigan where my doctors were at the time, and I could not find anyone at Cleveland Clinic where I had switched my doctors to. Living in a motorhome and having Plan F allowed me to search the entire country for a doctor that focused primarily on this disease. That enabled me to join a research study with him and get top-of-the-line treatment wherever I wanted to go. And I did not have to get anyone's permission to choose that doctor.
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