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[Botany]

This message was self-deleted by its author (Botany) on Sun Oct 23, 2022, 12:06 PM. When the original post in a discussion thread is self-deleted, the entire discussion thread is automatically locked so new replies cannot be posted.

[OAITW r.2.0]

1. Why do we need a Medicare Advantage?

Why can't I pay the USG for this service? And not contribute a 20% profit to private insurers? Why not an option?

[Botany]

2. These medicare plus and medicare advantage programs are just unneeded scams

Or at least that is how I see it.

[MOMFUDSKI]

5. Regular Medicare takes over $100/month from the top of your SS check. (It varies)

An Advantage Plan gives most all of it back. There are added bennies of dental, eye, and an over-the-counter medical items free of charge. There are many that just can't afford $225 or more premium for regular Medicare PLUS what is taken off the top of their SS check. Looking at roughly $400/month compared to roughly $15. Until the government can compete with those numbers, many will stay with their Advantage Plan. Just comes down to money. I agree Advantage is a way of 'killing' Medicare but the government will have to come up with a more attractive offer to lure the not-so-well-off away from Advantage.

[Joinfortmill]

28. Advantage plans work. Just saying.

Brain aneurysm. Hundreds of thousands of dollars for procedure. My cost was $365.

[stopdiggin]

16. because Republicans? -(nt)-

[Celerity]

3. Scam city. Shake down gran for what little dosh she has.

[unc70]

4. Regular Medicare does not cover dental

Nor hearing, nor vision.

The better Advantage plans do provide some coverage in these areas. For example, the plan I have has $1400 of dental. Last year I got a couple of cleanings and a crown from my $0 premium plan. Advantage plans are a mixed bag. Many of the allegations made here at DU are not true WRT to the plan I have -- a $0 premium Aetna plan in NC.

[Delphinus]

6. I'm pretty

sure I can't afford one of these - I think it's the Advantage. I'll probably go with the Medigap.

I went to a workshop not too long ago - guess I'd better pull it out and relearn as my time is coming soon.

[unc70]

8. Notice I said the premium is zero dollars

How is the meditation cheaper?

[Delphinus]

9. I wonder

if it depends upon which state you live.

There is so much to this and I may be very confused.

[MOMFUDSKI]

11. The state you live in does matter.

An agent in Wisconsin looked at my Advantage from Florida and fell off his chair. He said there was nothing that good in Wisconsin.

[unc70]

12. Yes, the plans do depend on your state. More than that ...

The plans offered to you depend not just on your state, but also on your particular county. Then you have whether it is an HMO or a Preferred Provider plan. The same company might have somewhat different plans offered in different groups of counties in NC because of which hospital groups serve which areas.

Plans also must meet the various laws of each state. It can be very confusing. I recommend you read you personalized copy of the book "Medicare & You". The plans available to you are summarized in the tables at the back. T

The consult with the free advisors provided through your council on aging or similar group.

Good luck.

[MOMFUDSKI]

13. When I had my cataracts done, I wanted to go to a doc that was not "in network" so my agent

had me get a PPO Plan for the 2 months I needed it to get my cataracts done. Then I was able to switch back into my Advantage Plan. I am diabetic and I believe that is why I had the once-a-year option to switch out and back.

[MOMFUDSKI]

17. Go to "Medicare.Gov" and put in your Zip Code.

Then plug in your meds. The meds you take determine which Plan would be best for you. That is the crux of the matter. Then up pops the best plans for you. Go from there.

[Joinfortmill]

30. Depends on classification. My 2 meds are free.

[Joinfortmill]

29. Aetna Advantage plans are good.

[redstateblues]

7. I'm switching to an Advantage Medicare Plan

The premium with the supplemental plan was going up every six months. I like the 0 premium better. Apparently the Advantage plan has been around for quite a while. I should have switched a long time ago

[MOMFUDSKI]

10. I got a regular Medicare Plan when I became eligible. Then

I attended a meeting being given by an Advantage Plan Insurance Company. That is when I learned a lot. Stayed after the meeting and had a sit-down with the agent giving the presentation. Had a zillion questions for him and then I switched. I would recommend you attend one of these presentations and get all of your questions answered. Find an agent that brokers in Medicare AND Advantage and have it explained to you. Just do your homework. I developed a great relationship with my agent and call him whenever I have any questions. You can do this!

[redstateblues]

20. Talk to friends

I read everything I could find and I talked to some good friends who have the the PPO Advantage Plan and they said it was great.

[KentuckyWoman]

14. Medicare does not cover vision, dental, hearing

Some medigap insurers do. Many Advantage plans do.
Technically Advantage plans are NOT Medicare. It is totally private insurance that Uncle Sam pays to get you off their books.

Most of the time when an Advantage plan says "no additional cost to you", they mean no additional premiums. They still have any variety of copays, coinsurance, deductibles, max out of pocket etc just like any other private insurer.

I have Medicare and a Medigap plan. The AARP United Healthcare plan. I got the Gap coverage in case things get ridiculously expensive. I have no costs outside of premiums but Vision, Dental and hearing is not covered.

I am in my 80's. My husband was on an advantage plan. He was already fighting cancer when Medicare kicked in so he took the Advantage plan through his union. Doing the math later, we would have had lower annual costs with Medicare and Supplemental.

It's hard to decide, and the best option will be different for everyone.

[MOMFUDSKI]

18. I recently asked my agent when it was smarter to have a regular Medicare Plan.

His answer was when one is quite sick on an ongoing basis. It is my understanding one can always switch to regular Medicare beginning the start of the next calendar year. Do not know if there would be a penalty or not.

[KentuckyWoman]

19. No penalty. Enrollment is Oct 15 to Dec 7

A lot of it depends on what state you are in. The feds set basic rules but Medicare is run state by state.

[DuaneT]

22. The Feds regulate Medicare and Medicare Advantage programs not the states. You probably are thinking

Medicaid.

[KentuckyWoman]

33. Poor wording on my part

Part A and B are controlled Federally. ALL Medigaps and Advantage plans, plus the private insurers offering Part D have to meet the state requirements in addition to the federal minimum coverage requirements. In addition even straight Medicare only is mostly serviced by private contractors in each region, not federal employees. Those private contractors also are beholden to both state and federal rules.

It is rare for someone to have Part A and B only. I was not thinking of that crowd. I apologize for being mushy in my post.

[karynnj]

24. The problem may be the medigap plan

When you first become eligible for Medicare there is a 6 month window where all companies offering medigap policies in your area must take you. At a later point, they might insist on medical underwriting where they look at your medical history and your current health. They have the right to deny you coverage or demand a higher premium.

In the example given, where you want to change to standard Medicare AND medigap at a point where you have significant medical costs, you almost certainly will not be offered a medigap plan at a rate offered to those who are 65 just entering Medicare.

[DuaneT]

25. This is the way it works: First timer's to a MAPD plan has a 12 month, so to speak a free trial.

Somewhere in that 12 months if you decide you would be better off on a Medigap plan and separate Part D drug plan you can switch with no questions asked.

If you are on a MAPD after 12 months and you want to switch back to regular Medicare and a medigap plan you have to answer health questions and could be turned down for the medigap plan not original Medicare.

Depending on your state and county you make pay a monthly premium for a medigap and Part D drug plan anywhere from $200 to $300 per month.

[brush]

15. I have Anthem/Caremore plus. I get 10 calls a day...

saying there are plans that can give me added benefits but I tell them no as their plans will take more out of my SS check every month.

They keep calling though. I've gotten to the point where I just say "no thank you" and hang up.

[DuaneT]

23. They probably do have a few added benefits but they definitely don't take any more money out of your

social security each month unless they have a small premium and you elect to have them take it out of SS each month.

[brush]

26. I've sat through the discussion with a rep before...

and what they proposed did takes more out of my monthly SS benefit. It wasn't worth it to as I'm still pretty healthy.

[SilverDawg]

21. I have The Anthem plan

And I do get hearing, dental and vision. However I pay a premium for the dental.

So far I have not had the experience of feeling “scammed.”

[Emile]

31. I know after the first of the year I can get a Shingles vaccine paid for

through Medicare. Thanks Joe!

[LiberalFighter]

32. Regular Medicare only covers 80% of covered costs.

It does not cover dental, hearing, or vision.

Part A (medical doctors) is covered from our payments when we were employed.
Part B (hospital) is from the monthly premium deducted from our Social Security.
Part C is the additional plan provided under Medicare Advantage.

Our retirement plan from our employer offers 3 different plans for our Medicare eligible members. 1 for those that want to remain on regular Medicare and two different Medicare Advantage plans. In both cases, our retirement plan included paying for the 20% and additional benefits not provided by regular Medicare. We don't pay a monthly premium for it and our co-pays, deductibles, etc are lower than the plans offered by mail or on tv.

In addition, we have multiple resources available to have issues resolved dedicated to our group.