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Thread: Medicare open enrollment

  1. #21
    Senior Member Teacher Terry's Avatar
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    Advantage plans are pushed by insurance brokers. I imagine that they get a bigger profit to get people on one.

  2. #22
    Senior Member iris lilies's Avatar
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    Before I really knew much about Medicare, I heard about the plan that pay for a gym membership. I thought that was great and I thought to myself hey I’m going get that plan! But later I learned that was an Advantage plan.

    I don’t know if that is a current perk of an Advantage plan here.

  3. #23
    Senior Member Teacher Terry's Avatar
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    It’s a common ploy to offer that. In Wisconsin it’s called Silver Sneakers.

  4. #24
    Senior Member flowerseverywhere's Avatar
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    Our advantage plan fits us. We have access to two major cancer centers in my state. We can go to U of Florida. DH needed surgery there and we stayed in a hotel onsite for $100 as it was an hour away and I didnít want to stress about driving up at 4:30 am to make sure we were there by 6. Our primary care group is large with multiple locations and we can be seen by a nurse practitioner or PA within a few hours. I see my MD, whom I love, twice a year minimum. An ER connected to the university is 1.5 miles from my house. Imaging, bloodwork and specialists are within a few miles. Our mail order is through Walgreens and we can get refills on the road locally at a bricks and mortar Walgreens too.
    yMMV but it certainly is perfect for us. Last year was a horrible medical year for us as we both were hospitalized after we were sent to the hospital by ambulance. I was out of state. Our out of pocket was less than $1000 each and we had a zero premium plan. So it has worked out very well for us. But I live in a pretty populated area now. A rural area would be much more of a challenge I imagine. Plus every county has different plans available so look very carefully into how far away providers are and what hospitals you can go to, especially if you need specialists. Make sure your primary care and specialists are covered unless you want to change them. Check every medication for price, especially eye drops, creams and non generics as you donít want a nasty surprise. We choose between multiple plans here including Blue Cross and United healthcare who have very large networks of physicians and hospitals. We get a free gym membership. But that would not be a dealbreaker. Do your homework. Taking the time to check every provider, ER, Hospital and every medication, for participation and copay is well worth the time you spend.

  5. #25
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    There is another aspect to the question of Advantage plans that no one has mentioned here. That is, when you go on Medicare for the first time, you get a period where you can enroll in original Medicare and a supplement with no health exam an no raising in rates for an underlying condition. That is not true if you enroll in an Advantage plan. So I wanted to get in with a supplement plan without some big problem about do I qualify for reasonable rates on the gap supplement. Since I have had big health issues in the past.

  6. #26
    Senior Member iris lilies's Avatar
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    Quote Originally Posted by Tybee View Post
    There is another aspect to the question of Advantage plans that no one has mentioned here. That is, when you go on Medicare for the first time, you get a period where you can enroll in original Medicare and a supplement with no health exam an no raising in rates for an underlying condition. That is not true if you enroll in an Advantage plan. So I wanted to get in with a supplement plan without some big problem about do I qualify for reasonable rates on the gap supplement. Since I have had big health issues in the past.
    I think this is the aspect Teacher Terry mentioned in her comment about underwriting.
    This MAY vary by state (I saw a reference to this on that city-data site you mentioned.)

    But I am with you guys, I don’t want to test it. I want widespread, comprehensive insurance coverage and the monthly costs don’t matter much to me.

    My friend who is all about “monthly bills” keeps talking to me about how cheap her Advantage plan is and why don’t I consider it? This catch is why, but also I do not really know how an Advantage plan works in rural .Missouri. I don’t want anything that is a network. I travel between two regions.

  7. #27
    Senior Member Rogar's Avatar
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    My PCP for years would not accept regular medicare insurance, but would take advantage plan payments. At the time I did a quick search and at least in my area there was a slightly large selection of doctors taking only the advantage plan insuance, but not regular medicare. The state has a rating system that gave my plan and Kaiser five stars, for however they rate things. I may revisit things this year during open enrollment.

  8. #28
    Senior Member Teacher Terry's Avatar
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    A friend of mine has a advantage plan and she was scheduled to have surgery that she needs. Well the provider decided not to provide coverage any longer and Providence had to contract with someone else. Now all her doctors will be different and she has to start all over again.

  9. #29
    Senior Member iris lilies's Avatar
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    Quote Originally Posted by Teacher Terry View Post
    A friend of mine has a advantage plan and she was scheduled to have surgery that she needs. Well the provider decided not to provide coverage any longer and Providence had to contract with someone else. Now all her doctors will be different and she has to start all over again.
    But that can happen with a Medigap policy, too, can’t it?

  10. #30
    Senior Member flowerseverywhere's Avatar
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    Yes, IL, at any time with any plan a provider can drop out. Including traditional health insurance.

    we needed no exam but we have had continuous coverage. Could be the state too.

    don’t forget to add in the cost of part B Medicare which you have to have too. I think it’s around $147/ month. So off the bat you are paying around $2,000. Copays, deductibles and premiums can be costly even on Medicare.

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