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  • Stay away from Medicare advantage plans.

    https://www.dailykos.com/stories/202...Advantage-Scam

  • #2
    Just because those plans have Medicare Advantage in the title does not mean all of them are painted with the same brush. Judy and I have a Medicare Advantage HMO plan through Blue Cross/Blue Shield here in Michigan. It is far from free but it has probably saved us from major financial difficulties with all of the issues that Judy has had over the last four years.

    In fact, they are a major reason she is now reasonably healthy and setting beside me as I type this because she got excellent care from the local physicians, surgeons and the hospitals in this little corner of state. They never balked at any of the care her doctors recommended.

    Just shop carefully and understand the coverage and carriers involved.

    Bob

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    • #3
      We have had a regional medicare advantage plan for more years than I can remember. We have both had good service from the plan. Each year we can change, but do not.
      Gary L.
      Wappinger, NY

      SDC member since 1968
      Studebaker enthusiast much longer

      Comment


      • #4
        Ugh, I am almost to the point of having to learn how to navigate the labyrinth of senior health care. My plan to be dead before I needed to figure it out did not work. So far.

        Luckily I have a beautiful spouse who has had a long career in the administrative side of the medical world, so she will figure it out. I find the whole process intimidating.
        Proud NON-CASO

        I do not prize the word "cheap." It is not a badge of honor...it is a symbol of despair. ~ William McKinley

        If it is decreed that I should go down, then let me go down linked with the truth - let me die in the advocacy of what is just and right.- Lincoln

        GOD BLESS AMERICA

        Ephesians 6:10-17
        Romans 15:13
        Deuteronomy 31:6
        Proverbs 28:1

        Illegitimi non carborundum

        Comment


        • #5
          I think one has to be very careful when choosing a health care plan other than original Medicare. My late wife was a medical technologist, so was around medical practices and hospitals her whole career (and her first husband was a surgeon). She was so adamant that we go with original Medicare that I thought she would divorce me if I didn't. Think about it: Medicare loses money (or breaks even); the for-profit health insurance companies make money. Where does that profit come from? Maybe out of our hides? Nancy's numerous health issues cost us nothing (zero), except for meds, which were/are greatly reduced in cost. Of course, one has to have a second payer; Mine is Blue Cross/Blue Shield, which has been perfect.

          This is just our/my experience. Your situation may be different. But, I would think carefully before falling for the siren song of a huckster trying to tell us that we will get more benefits for LESS money. There ain't no such thing as something for nothing, especially in the for-profit insurance industry.
          -Dwight

          Comment


          • #6
            Another vote for BC/BS. I had them when I was working, and kept them when I retired. Like Bob above, I found/find the whole medical insurance issue to be very intimidating, and so just took the easy way out and kept BC/BS when I retired. Am glad I did.
            Skip Lackie

            Comment


            • #7
              I have Medicare, and Tricare for Life, and don't pay a penny for ANYthing.....and I get my Meds from the VA for free. Sometimes I think that getting my ass shot of was worth it....especially if we had to pay for Wifey,s Meds.....

              Comment


              • #8
                My wife has a plan from Humana since she retired several years ago. Her co-pays are reasonable and most drugs do not cost us anything. She even gets some dental and vision. She had a bad fall when visiting our son last fall. Humana paid the hospital except for $100. So no complaints so far.

                This year I changed to Humana PPO just to get some dental. My primary care is VA and drugs are no cost to me.

                A few years ago, I was traveling and needed medical care because I cut my hand. No VA facility was nearby so I went to emergency clinic. My costs were over $2,000 for a few stitches!

                No personal experience with Humana as I have not needed it yet.
                78 Avanti RQB 2792
                64 Avanti R1 R5408
                63 Avanti R1 R4551
                63 Avanti R1 R2281
                62 GT Hawk V15949
                56 GH 6032504
                56 GH 6032588
                55 Speedster 7160047
                55 Speedster 7165279

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                • #9
                  I've also got Humana. Hooked up with them on the way out of work.
                  While I haven't needed any super delicate brain or heart operations, they have provided great service. My wallet hasn't opened once in almost three years.
                  Zero complaints or concerns.

                  Mike

                  Comment


                  • #10
                    Originally posted by Bob Andrews View Post
                    I find the whole process intimidating.
                    It is pretty complicated, unfortunately, but throwing out Advantage plans to simplify the choices is not a good idea.

                    There are actually 3 basic choices.

                    Plain old Medicare. This is about $145/month and comes straight out of your SS check. It is bare bones coverage.

                    Medicare Supplemental plans. These are the A, B, C, D, E, F... plans. They are offered by many insurance companies. Each letter offering is identical across all insurance companies. The price of any letter offering varies substantially, however, depending on which insurance company you choose. Each letter offering covers a different combination of items over and above plain old Medicare. Plan F is the Cadillac. It is pretty much like the plan high paid executives get in private industry. It costs more in comparison to any other choice.

                    Medicare Advantage Plans. These are private plans offered by various Preferred Provider Organizations. You still pay the $145/month and often another premium on top of that to the insurer. Although there are some plans at no additional cost to you. The way they work is that when you enroll in one of these, the government gives the insurer the amount of money they would theoretically spend on you each month for health care based on the data the government has on age and other factors. You are provided services by health care providers in the PPO's network which enables the insurer to keep costs down and (hopefully) make money.

                    The plans are all good options depending on your individual health history, age, income and savings situation, quality of PPOs in your area, etc.

                    We love our advantage plan. We are in the same network we were in before we were eligible for Medicare. We have the same doctors. Coverage is far better than plain old Medicare. We pay only the $145/month to the government and small co-pays for certain office visits and specialists. For us it is clearly the best choice. Your situation can be, and probably is, different.
                    Dick Steinkamp
                    Bellingham, WA

                    Comment


                    • #11
                      Thank you for that primer, Dick. Soon I’ll be forced to wade into the process.
                      Proud NON-CASO

                      I do not prize the word "cheap." It is not a badge of honor...it is a symbol of despair. ~ William McKinley

                      If it is decreed that I should go down, then let me go down linked with the truth - let me die in the advocacy of what is just and right.- Lincoln

                      GOD BLESS AMERICA

                      Ephesians 6:10-17
                      Romans 15:13
                      Deuteronomy 31:6
                      Proverbs 28:1

                      Illegitimi non carborundum

                      Comment


                      • #12
                        Originally posted by Dwight FitzSimons View Post
                        I think one has to be very careful when choosing a health care plan other than original Medicare. My late wife was a medical technologist, so was around medical practices and hospitals her whole career (and her first husband was a surgeon). She was so adamant that we go with original Medicare that I thought she would divorce me if I didn't. Think about it: Medicare loses money (or breaks even); the for-profit health insurance companies make money. Where does that profit come from? Maybe out of our hides? Nancy's numerous health issues cost us nothing (zero), except for meds, which were/are greatly reduced in cost. Of course, one has to have a second payer; Mine is Blue Cross/Blue Shield, which has been perfect.

                        This is just our/my experience. Your situation may be different. But, I would think carefully before falling for the siren song of a huckster trying to tell us that we will get more benefits for LESS money. There ain't no such thing as something for nothing, especially in the for-profit insurance industry.
                        -Dwight
                        My thoughts exactly, Let's be careful out there, Mr. Namath is getting paid by someone and running these hard-sell commercials cannot be cheap. It's my guess and only a guess that , there are a number of good providers but when you call that TV phone number you're shunted to the less than perfect providers that are paying for the commercial and are gaming the system. SOMEONE IS PAYING FOR THE COMMERCIAL TIME AND MR. Namath !!!!
                        Life isn't about how to survive the storm, but how to dance in the rain !

                        http://sites.google.com/site/intrigu...tivehistories/

                        (/url) https://goo.gl/photos/ABBDQLgZk9DyJGgr5

                        Comment


                        • #13
                          Thankfully...I married up! It was my wife who encouraged me when I decided to go against family tradition and go to college. I often joke that if you lack smarts, it helps to marry someone with brains. My wife is a registered nurse and in addition to nursing her patients, she herself suffers from many health challenges. When her health issues prevented her from continuing to serve as a floor nurse, she accepted an administrative position with one of the largest hospital systems in our state. Her title became something like Senior Medical Service Auditor. She reviewed records over a certain amount and reviewed the records to assure that the hospital staff properly documented the services and charges. So, on that end of the bill, she would hold the staff, nursing, accounting, and physicians' feet to the fire about properly documenting (coding) their part for accuracy. Then, she would do battle with the insurance companies when they would attempt to weasel out of paying what they were obligated to pay for the insured patient.

                          So, she wasn't all that popular with the hospital staff when she found them screwing up on their charges and the same with the insurance company's auditors when they would attempt to leave a patient holding the bill by denying coverage. There is one very large "for-profit" company that some of you use that she developed a visceral hatred toward. She won most of her cases against them but remains appalled at how difficult they make it to settle claims without major delays. Not only did she hold her own employer accountable for their billing accuracy, but she served as an expert witness in several court cases against doctors, medical equipment suppliers, and insurance companies.

                          Unfortunately, she has health concerns that require some rather expensive treatment and medications. If it wasn't for insurance, we would be millions of dollars in debt. So, for that, I am grateful. If it was not for her and her knowledge, I would be lost in negotiating my way through the insurance and healthcare maze. What really irritates us is the constant condescending phone calls we get from the insurance providers. They want to come to our home for personal "wellness checks." We get constant repetitive calls reminding us to get flu shots, eye exams, or physicals when we have already done so and our medical facilities make the proper reporting so they should have the records. Thing is, very few (if any) of the people making these phone calls and visit requests have as much education as we do and I resent the hell out of this kind of intrusion.

                          My wife chooses the plans, we comply with the requirements, and I drive her to doctor's appointments and make trips to the drug store for her. My main provider is the VA and due to my disability from military service, most of my healthcare is covered by them. For now, as long as my mental acuity allows me to live comfortably and safely, I want the low-level insurance clerks with a clipboard and checklist to stay away from my home!

                          With that exception...I'm a pretty friendly old cus!

                          John Clary
                          Greer, SC

                          SDC member since 1975

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                          • #14
                            Joe Namath and the constant unceasing bombardment of loooong 2 minute commercials pumping these plans inundate commercial breaks on Antenna OTA television. Free TV? Yup. Predatory Commercials. Oh Yes!

                            Comment


                            • #15
                              This scheme is to get people off of Medicare.Most people on't realize that they are no longer covered by Medicare.
                              After most people signed up for these schemes you will find that these insurance company will deny more and more claims.
                              That is the only way they can make money. I had a Humana plan and luckily I was able to get back on medicare after I found out that I could only go to discount doctors that were restricted to ten minute visits.I had dental insurance thru them and looked if my dentist was in their listing and he was.My claim was denied because it did not cover that procedure.
                              I was tricked into signing up with Humana by the primary doctors clinic ,they said that I could not be treated there unless I signed up with Humana Medicare advantage plan.When I got home I looked at their webpage (Oak street health) and they state that they accept Blue Cross, which I had for years. I got repeated phone calls to make sure that I cancelled my Blue Cross and that made me suspicious so I never cancelled my Blue Cross and called Medicare and found out that they were familiar with this scam and put me back on Medicare without having to wait a whole year for a new enrollment period. Medicare is a law and the Insurance Companies can deny claims all they want. So please don't fall for it.

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