Page 2 of 4 FirstFirst 1234 LastLast
Results 11 to 20 of 38

Thread: Medicare open enrollment

  1. #11
    Senior Member
    Join Date
    Jan 2011
    Posts
    3,417
    We got Mom one of the "free" advantage plans. However, it comes with copays, very limited area, limited doctors, etc. More like an HMO. They are all going to get it from you one way or the other.

    However, she has gotten good care at the modern hospital assoc. with her plan. She likes her cardiologist and got all the tests needed to find out there was not much they could do for her issues.

    I pay a huge amount for my supplemental Medicare plan but it is comprehensive, I have total choice in specialists (if I can get an appointment), total choice in where to get care, etc.

  2. #12
    Senior Member
    Join Date
    Jan 2011
    Posts
    4,732
    My "advantage" plan is covered by my previous employer (thankfully). But...I have a stack of mail four inches high from various providers to look at with DH. Obviously, there is dough to be made by the insurance companies.

  3. #13
    Senior Member
    Join Date
    Aug 2016
    Posts
    5,874
    IL, when I was deciding whether to go with Advantage or a Medigap, I read a lot on City Data. Here is one thread; read it and you will see the outline of the issues involved:

    https://www.city-data.com/forum/heal...t-plans-3.html

    There are also links to lengthy discussions of why people prefer the Medigap, or vice versa.

    When I had to decide, I just went and looked at what Catherine did and just followed suit! That and fact that my parents' assisted living director told me to stay away from Advantage; my mom had it and they would not pay for her rehab, even with a gangrenous leg wound. She had horror stories about Advantage plans, but I know my mom's new guardian has one and she put my mom on one. So go figure.

  4. #14
    Senior Member catherine's Avatar
    Join Date
    Jan 2011
    Location
    Vermont
    Posts
    12,644
    Quote Originally Posted by Tybee View Post

    When I had to decide, I just went and looked at what Catherine did and just followed suit!
    Yikes! I hope it's working out for you, Tybee! I had simply done what my very financially-astute market research partner had done. So far I'm very pleased.

    One of my main drivers for MediGap vs Advantage was that my understanding is Advantage doesn't travel as well as MediGap (I could be wrong). In other words, when I was 65 I didn't know if I was going to be living in NJ or VT, and I didn't want to have to switch to a different regional policy/premiums.

    But mainly I just did what Vickie did because she's smart, and she had done her homework.
    "Do any human beings ever realize life while they live it--every, every minute?" Emily Webb, Our Town
    www.silententry.wordpress.com

  5. #15
    Senior Member
    Join Date
    Aug 2016
    Posts
    5,874
    And ditto to you!

  6. #16
    Senior Member
    Join Date
    Jan 2011
    Posts
    1,338
    I know there must be many regional differences Medicare coverage. DH has had a free advantage PPO plan for four years now and it has been great. They pay for almost everything, with small co-pays - more than my work healthcare plan (county government) covered. We picked one that covers the doctors we already use, and plenty of others are in network, as is the closest hospital, which is part of a large regional chain. Most importantly, the pain clinic my husband uses is covered, with only the co-pay and a small percentage of the amount charged for treatments is left for us, which is fine. As this is a HUGE expense, we wanted to be sure we got a plan that covered it, and it does. Ala Catherine, I followed the lead of my sister-in-law, who researches things to death, then checks with a consultant of hers to verify her findings. She and my brother have been on an advantage plan for quite a few years - my brother is 80- and have been quite pleased. I just signed up with the same plan DH has, as I turned 65 this summer. Of course, ymmv!! But I would not write off an advantage plan without checking what it's like in your situation, in your geographic area.

  7. #17
    Senior Member
    Join Date
    Dec 2010
    Location
    SoCal
    Posts
    9,041
    I don't like that my mom is on an Advantage plan, but I have to say it's been working great so far (lots and lots of follow up from surgery etc.). I don't know if there will be surprise billing. But the care is excellent. And my mom is poor (well truthfully she's not poor as in can't afford food or anything, but not rich) and so likely couldn't AFFORD regular Medicare with a supplemental plan regardless. So many people are probably in that situation. But it's worked amazingly well so far.
    If you want something to get done, ask a busy person. If you want them to have a nervous breakdown that is.

  8. #18
    Senior Member iris lilies's Avatar
    Join Date
    Mar 2013
    Location
    Always logged in
    Posts
    20,397
    Thanks for the city-data link Tybee. Since insurance is so heavily regulated at the state level, I learned that not all Advantage plans are the same, and some are HMOs and some are PPOs.
    Also, apparently, some states dont have the limiting factor of leaving.adagtage requires hoops to get on a Medigap plan.

    This is really the year where we should sit down and evaluate our health plans but we won’t because we’re not interested and are too busy doing other things.

    I chose a plan G because it was represented by the insurance broker as being the most comprehensive. At the time I didn’t have a physician, I later chose a direct care physician who is not part of the insurance network. I like it that way.

    We’ve been in this situation where every year since 2015 when I retired has been a different health insurance environment: we move from my work covers insurance with us paying for DH, to cobra for 18 months covering for both of us and we pay for that, to us on an ACA plan, to Me on Medicare and DH on an ACA plan for some months and there was drama there, to both of us finally on Medicare.

    Last year we “rested “from change, but this is the year where we should be delving into details. But we won’t. Maybe next year.

  9. #19
    Senior Member Teacher Terry's Avatar
    Join Date
    Dec 2013
    Location
    Nevada
    Posts
    11,859
    I am not fond of slowly dying while they are allowed to try step therapy and by the time I get to the step I need it being too late. Also in some states you can’t go back to regular Medicare without passing underwriting. Plus all the other negatives people have mentioned. If I was too poor to afford regular Medicare then I wouldn’t have a choice. Luckily I do.

  10. #20
    Senior Member
    Join Date
    Dec 2010
    Posts
    4,413
    Sigh... this all leaves my head spinning. We will need to figure out dh by next year. Have an appointment in December. Meanwhile, the Medicare phone calls keep rolling in - one day had 5 calls in a 3 hours span!
    To give pleasure to a single heart by a single act is better than a thousand heads bowing in prayer." Mahatma Gandhi
    Be nice whenever possible. It's always possible. HH Dalai Lama
    In a world where you can be anything - be kind. Unknown

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •