topic Re: Medicare Supplement in Wellness

Medicare Supplement

kismet — Thu, 12 Oct 2023 22:07:26 GMT

I just got a letter stating that the Medicare supplemental insurance that I have through an employer is changing. I thought I'd go with the new one since the insurance has always been good. I checked my clinic's insurance to make sure they take it and find that the one I have now is not going to be taken in 2024 and the new one that was available to me is not going to be taken either. Probably will go with United Health Care but wondering if the AARP United Health Care is different than United that is on some other sites. Can someone recommend a plan? Also, do I have to buy drug coverage separately. Have been with my doctor at the clinic for over 25 years and change will be hard.

Re: Medicare Supplement

kaydee50 — Thu, 12 Oct 2023 22:18:22 GMT

I have the AARP/United Health Care Advantage plan and will stay with it for 2024. The premium will be $34/month with an out of pocket limit of $3,800. It includes vision/dental/hearing. I don't take drugs or go to the doctor unless I have to so this plan works for me.

Re: Medicare Supplement

Love my grandkids — Thu, 12 Oct 2023 22:25:33 GMT

@kismet My supplemental is UHC. I do pay a monthly premium. I have NO out of pocket expenses and can go to any medical provider who accepts it.

I'm on a few doctor-ordered meds and have a chronic condition which means I'm in the hospital 2-3 times a year for a few days.

I had cancer, surgery, chemo and radiation in 2017 and another surgery in 2018.

I haven't put out one single penny. Without Medicare and UHC I likely would have died as these costs were nothing I could manage.

Re: Medicare Supplement

millieshops — Thu, 12 Oct 2023 22:30:51 GMT

@kismet Has the office provided you with a list of companies they do accept or maybe they even have an employee assigned to provide you with assistance for finding a new company?

In 2022, my PCP announced they'd no longer accept my insurance. I told them I had no choice and would be leaving the practice at the end of the year. It's now almost 2024 and I haven't had to change. Do your research, but also try pushing back politely.

Re: Medicare Supplement

Icegoddess — Thu, 12 Oct 2023 22:32:23 GMT

Your question about prescription coverage depends on whether you want to do an Advantage plan or a Supplement plan. For an Advantage plan, you will probably not need a separate prescription plan, but if you're looking at a Supplement plan, then you will need Plan D which is Medicare's prescription plan.

If using Plan D, you can change it every year during open enrollment if you're unhappy with it, your situation changes, or the plan changes do not suit your situation. However, you will need to be more careful with your Supplement choice as it will probably require Underwriting by the Insurance Co. to make that change.

Re: Medicare Supplement

Winkk — Thu, 12 Oct 2023 22:58:28 GMT

@kismet. I would find a Medicare consultant. They are free and will evaluate all the plans that are available to you. Each state and county have different policies. You can't go by what other forum members have. It can get overwhelming. Good luck.

Re: Medicare Supplement

kismet — Thu, 12 Oct 2023 23:17:26 GMT

Right now I'm paying $360. a month for my supplemental which includes drugs. I'm on Medicare A and B. I had cancer 17 years ago but usually now see my GP for my wellness check and the last one was good. Am on BP medication. I just called the clinic and they said they won't know if the new insurance will be approved for 2024. Guess I'll check into United and see what is good for me. Thought about changing last year because I rarely see the doctor. Would getting it through AARP be the same as buying it through a Medicare Consultant. How do I find a consultant?

Re: Medicare Supplement

Carmie — Fri, 13 Oct 2023 02:04:42 GMT

ALL MEDICARE SUPPLEMENTS ARE EXACTLY THE SAME.

If you have PLAN G for instance it is the same plan G sold in all 50 states by ever insurance company that sells supplements.

Providers don't except or not except supplements. They either accept or not accept Medicare assignment.

If they accept Medicare assignment, between Medicare and your supplement, your bill will be paid in full, except for the amount applied to the deductible.

If your doctor does not accept Medicare assignment, after Medicare and your supplement pays, you can be billed for the over charge.

Example:

Dr bill

$800

Medicare allowed $600 and paid 80% or $480

Supplement pays 20% or $120

If the provider excepts Medicare, they will except the $600. $480+$120 = $600

If they don't accept assignment, they can bill for the overcharge of $200. $800-$600=$200

Most doctors will accept Medicare assignment. By law they have to in some states.

Supplements do not cover RX drugs. You would need to buy a separate plan called PLAN D.

You need to decide what supplemental is right for you, then shop for price. Even though all insurance companies sell the exact supplemental plans, the prices are different.

You can buy a supplement from one company and Plan D from another company.

I suggest you call your state assistance Medicare hotline, not a broker. Brokers get a commission and will lead to to a company they represent.

Info is available in the booklet you should have received by now called "Medicare and You."

Re: Medicare Supplement

Sooner — Fri, 13 Oct 2023 00:25:04 GMT

Does anyone have Cigna? I have a friend who is trying to figure out what to do. Her employer had UHC but is going to Cigna. She asked me and I confessed I am not up on all this. I am on my spouse's and we're happy with it.

Anyone have experience with either?

Re: Medicare Supplement

Carmie — Fri, 13 Oct 2023 00:25:37 GMT

@kismet wrote:
Right now I'm paying $360. a month for my supplemental which includes drugs. I'm on Medicare A and B. I had cancer 17 years ago but usually now see my GP for my wellness check and the last one was good. Am on BP medication. I just called the clinic and they said they won't know if the new insurance will be approved for 2024. Guess I'll check into United and see what is good for me. Thought about changing last year because I rarely see the doctor. Would getting it through AARP be the same as buying it through a Medicare Consultant. How do I find a consultant?

AARP does not sell insurance. They work with United Health Care and get a kickback if you purchase through them. They also require that you belong to AARP before you can sign up. You do not have to continuing paying dues yearly, through.

You can get the same insurance through United Health Care on your own.

Every state provides help with Medicare insurance. You can find the number online for your state or in the "Medicare and You" handbook.

Re: Medicare Supplement

Josmad — Fri, 13 Oct 2023 02:01:45 GMT

If the provider accepts Medicare they must accept your supplement. They do not have a choice. They are probably thinking it is an Advantage plan.

Re: Medicare Supplement

Josmad — Fri, 13 Oct 2023 02:04:37 GMT

@Carmie wrote:
ALL MEDICARE SUPPLEMENTS ARE EXACTLY THE SAME.

If you have PLAN for instance it is the same plan G sold in all 50 states by ever insurance company that sells supplements.

Providers don't except or not except supplements. They either accept or not accept Medicare assignment.

If they accept Medicare assignment, between Medicare and your supplement, your bill will be paid in full, except for the amount applied to the deductible.

If your doctor does not accept Medicare assignment, after Medicare and your supplement pays, you can be billed for the over charge.

Example:

Dr bill
$800

Medicare allowed $600 and paid 80% or $480
Supplement pays 20% or $120
If the provider excepts Medicare, they will except the $600. $480+$120 = $600

If they don't accept assignment, they can bill for the overcharge of $200. $800-$600=$200

Most doctors will accept Medicare assignment. By law they have to in some states.

Supplements do not cover RX drugs. You would need to buy a separate plan called PLAN D.

You need to decide what supplemental is right for you, then shop for price. Even though all insurance companies sell the exact supplemental plans, the prices are different.

You can buy a supplement from one company and Plan D from another company.

I suggest you call your state assistance Medicare hotline, not a broker. Brokers get a commission and will lead to to a company they represent.

Info is available in the booklet you should have received by now called "Medicare and You."

Accepting Medicare and accepting Medicare assignment are two different things. A provider may accept Medicare and not accept Medicare assignment.

Re: Medicare Supplement

Carmie — Fri, 13 Oct 2023 02:12:27 GMT

@Josmad That is 100% true If they do not, they can bill you for the overcharge. Up to 15% more now. It used be up to 100%.

But in some states, they cannot bill you the overage charge and must except. The states are MA, PA, OH, MN, RI and VT.

Re: Medicare Supplement

Josmad — Fri, 13 Oct 2023 02:40:52 GMT

@Carmie wrote:
@Josmad That is 100% true If they do not, they can bill you for the overcharge. Up to 15% more now. It used be up to 100%.

But in some states, they cannot bill you the overage charge and must except. The states are MA, PA, OH, MN, RI and VT.

Yes they can only charge 15% above the allowed amount so your example is incorrect.If the allowed amount is $600 they cannot bill you $200 they can only bill 15% of $600 which is only $90.

Re: Medicare Supplement

kismet — Fri, 13 Oct 2023 06:06:23 GMT

I talked to a neighbor that is retired and she said the same thing about the plans. Said all the plans are the same through different companies. She said she's on Cigna and likes it. She's on regular medicare also. She suggested Cigna but I have friends who are on UHC and they said they were happy with it. I figured my doctor would retire before I would lose insurance with the clinic. For this area I think the company changing the insurance is making a bad choice. A lot of people in this area go to the clinics. The new plan with the company is an advantage plan and I don't want that. Would rather pay more a month to stay on regular medicare. I did find a few sites online that will help get a plan. I pretty much know what I need. I will get drug coverage but I have used GoodRX when my drug plan gave me a generic I couldn't tolerate and I bought it myself. Does anyone remember when we used name brand drugs? Seems like so long ago.

Re: Medicare Supplement

10sluvr — Fri, 13 Oct 2023 07:10:42 GMT

i'm in michigan and we have priority health and it's been wonderful. My hubs takes care of everything, but i know we don't pay anything for me. i have no rx, no health issues, he has diabetes.

Re: Medicare Supplement

Carmie — Fri, 13 Oct 2023 08:11:11 GMT

@Josmad wrote:
@Carmie wrote:
@Josmad That is 100% true If they do not, they can bill you for the overcharge. Up to 15% more now. It used be up to 100%.

But in some states, they cannot bill you the overage charge and must except. The states are MA, PA, OH, MN, RI and VT.

Yes they can only charge 15% above the allowed amount so your example is incorrect.If the allowed amount is $600 they cannot bill you $200 they can only bill 15% of $600 which is only $90. They

Yes, I am aware. It used to be where they could charge 100%, but now they can only bill up to 15%.

Re: Medicare Supplement

Teddixat — Fri, 13 Oct 2023 15:31:34 GMT

one of the best videos on Medicare supplement plans and drug plans and advantage or non advantage plans

https://m.youtube.com/watch?v=AlCJwhqZE0s

https://m.youtube.com/watch?v=Gysh2WLwho0

https://m.youtube.com/watch?v=KLUZJMY5QYw&pp=ygURUGFydCBiIGRydWcgcGxhbnM%3D

Re: Medicare Supplement

chrystaltree — Fri, 13 Oct 2023 17:12:39 GMT

@Carmie wrote:
ALL MEDICARE SUPPLEMENTS ARE EXACTLY THE SAME.

If you have PLAN G for instance it is the same plan G sold in all 50 states by ever insurance company that sells supplements.

Providers don't except or not except supplements. They either accept or not accept Medicare assignment.

If they accept Medicare assignment, between Medicare and your supplement, your bill will be paid in full, except for the amount applied to the deductible.

If your doctor does not accept Medicare assignment, after Medicare and your supplement pays, you can be billed for the over charge.

Example:

Dr bill
$800

Medicare allowed $600 and paid 80% or $480
Supplement pays 20% or $120
If the provider excepts Medicare, they will except the $600. $480+$120 = $600

If they don't accept assignment, they can bill for the overcharge of $200. $800-$600=$200

Most doctors will accept Medicare assignment. By law they have to in some states.

Supplements do not cover RX drugs. You would need to buy a separate plan called PLAN D.

You need to decide what supplemental is right for you, then shop for price. Even though all insurance companies sell the exact supplemental plans, the prices are different.

You can buy a supplement from one company and Plan D from another company.

I suggest you call your state assistance Medicare hotline, not a broker. Brokers get a commission and will lead to to a company they represent.

Info is available in the booklet you should have received by now called "Medicare and You."

Thank you! This makes it easy to understand. I don't need it myself but I printed this to give to two friends.

Re: Medicare Supplement

CelticCrafter — Fri, 13 Oct 2023 18:16:52 GMT

@chrystaltree wrote:
@Carmie wrote:
ALL MEDICARE SUPPLEMENTS ARE EXACTLY THE SAME.

If you have PLAN G for instance it is the same plan G sold in all 50 states by ever insurance company that sells supplements.

Providers don't except or not except supplements. They either accept or not accept Medicare assignment.

If they accept Medicare assignment, between Medicare and your supplement, your bill will be paid in full, except for the amount applied to the deductible.

If your doctor does not accept Medicare assignment, after Medicare and your supplement pays, you can be billed for the over charge.

Example:

Dr bill
$800

Medicare allowed $600 and paid 80% or $480
Supplement pays 20% or $120
If the provider excepts Medicare, they will except the $600. $480+$120 = $600

If they don't accept assignment, they can bill for the overcharge of $200. $800-$600=$200

Most doctors will accept Medicare assignment. By law they have to in some states.

Supplements do not cover RX drugs. You would need to buy a separate plan called PLAN D.

You need to decide what supplemental is right for you, then shop for price. Even though all insurance companies sell the exact supplemental plans, the prices are different.

You can buy a supplement from one company and Plan D from another company.

I suggest you call your state assistance Medicare hotline, not a broker. Brokers get a commission and will lead to to a company they represent.

Info is available in the booklet you should have received by now called "Medicare and You."

Thank you! This makes it easy to understand. I don't need it myself but I printed this to give to two friends.

@chrystaltree you really need to learn how to separate your comment from what you are quoting.