topic Re: Medicare Advantage Question in Wellness

Medicare Advantage Question

MrsCat21 — Tue, 26 Dec 2023 16:52:37 GMT

I am about to sign up for Medicare and I think I am going to go with an Advantage Plan. If anyone is on the Advantage side, are there any downsides in choosing Advantage over a Medigap plan? It now has a PPO option so all my doctors and my dentist are in the plan, so its not the plan of the past (HMO).

Re: Medicare Advantage Question

kaydee50 — Tue, 26 Dec 2023 16:43:49 GMT

I switched a few years ago from the regular Medicare plan to an Advantage Plan with AARP. It is a PPO and has dental and vision for $36/month. Haven't had to use any of the medical so I'm not sure how that would work out but I'm happy I switched.

Re: Medicare Advantage Question

MrsCat21 — Tue, 26 Dec 2023 16:53:20 GMT

@kaydee50 My understanding is that it is FREE, and includes Dental (not positive about the vision), What are your paying for? Im in IL, maybe different ddepending on the state you are in?

Re: Medicare Advantage Question

I am still oxox — Tue, 26 Dec 2023 16:53:09 GMT

It is my understanding that is covers less than tradational Medicare and you still will have a co pay. If you do not have any chronic considering it might be a consideration. You also might have diffiuclty finding doctors that accept the plan.

Re: Medicare Advantage Question

geezerette — Tue, 26 Dec 2023 16:58:46 GMT

@MrsCat21

The problem with asking about Advantage plans is that they vary from plan to plan. Some plans are great and people love them, others not so much.

You really need to ask people that are on you same plan in your same county.

Re: Medicare Advantage Question

MrsCat21 — Tue, 26 Dec 2023 16:58:47 GMT

@I am still oxox Yes, there is a co pay. I think if you are a relatively health person the co pay will be cheaper than the monthly premium with the traditonal plan. Guess I will have to really dig deep on the "what it covers side".

Re: Medicare Advantage Question

kaydee50 — Tue, 26 Dec 2023 16:58:57 GMT

@MrsCat21 I'm also in IL. I think it may depend on the zip code you live in.

@I am still oxox It's my understanding that if the doctor accepts Medicare they will accept an Advantage plan.

Re: Medicare Advantage Question

Icegoddess — Tue, 26 Dec 2023 17:02:41 GMT

Advantage plans are required to cover anything that Medicare covers.

Re: Medicare Advantage Question

MrsCat21 — Tue, 26 Dec 2023 17:10:12 GMT

@geezerette But, my real questoin is why arent more people on Advantage, not so much the company i.e. Cigna, BCBS, Humana? All of our friends are on "traditional" Medigap plans and when I ask them about it they just say "I want to choose my doctors" or "I dont want anyone telling me where to go", one person actuallly said "I dont want the government telling me what to do". 🤦‍♀️Our insurance broker just says most people dont know that Advantage has changed alot in the past years and its not what it used to be.

Re: Medicare Advantage Question

Kachina624 — Tue, 26 Dec 2023 17:08:13 GMT

Medicare Advantage Plans differ so greatly, it's impossible to compare them. Mine was especially designed for my group, is self-insured and just administered by UHC. I pay no premium, no co-pay, no deductible and there's no maximum limit. Have never paid a penny out of pocket. I've never run across anything I needed that wasn't covered.

Re: Medicare Advantage Question

geezerette — Tue, 26 Dec 2023 17:16:05 GMT

@MrsCat21 wrote:
@geezerette But, my real questoin is why arent more people on Advantage, not so much the company i.e. Cigna, BCBS, Humana? All of our friends are on "traditional" Medigap plans and when I ask them about it they just say "I want to choose my doctors" or "I dont want anyone telling me where to go". Our insurance broker just says most people dont know that Advantage has changed alot in the past years and its not what it used to be.

@MrsCat21

Again, it's how they may differ.

I can't presume to answer why "all your friends" chose traditional Medigap plans. There is no one answer for all. Everyone makes the best decision they can at the time of signing for their situation at the time. That decision may or may not continue to work for them.

Re: Medicare Advantage Question

Ainhisg — Tue, 26 Dec 2023 17:18:20 GMT

My mom was in assisted living for 6 years, and I became friends with the administrator who has to deal with Medicare, Medicaid, and Medicare Advantage plans. She is extremely knowledgeable about all of it. She recently posted this on her personal FB page, and I took a screenshot of it. For me, there is no way I will choose a Medicare Advantage plan when the time comes in a few years.

ETA: She also stated that agents get commissions on Advantage plans, so they have reason to promote them.

Re: Medicare Advantage Question

MrsCat21 — Tue, 26 Dec 2023 17:16:27 GMT

@Kachina624. Yes, each plan is different, but my undersatanding is that all Advantage plans are FREE. So that is the reason for my question. Why would you pay a monthly premium whan you can get the insurance for free?? BTW, sounds like you have a great plan. All the plans Im looking at under the Advantage umbrella have a co pay...

Re: Medicare Advantage Question

MrsCat21 — Tue, 26 Dec 2023 17:28:15 GMT

@Ainhisg the Brokers receive a commssion only on Advantage plans?

@Ainhisg wrote:
My mom was in assisted living for 6 years, and I became friends with the administrator who has to deal with Medicare, Medicaid, and Medicare Advantage plans. She is extremely knowledgeable about all of it. She recently posted this on her personal FB page, and I took a screenshot of it. For me, there is no way I will choose a Medicare Advantage plan when the time comes in a few years.

ETA: She also stated that agents get commissions on Advantage plans, so they have reason to promote them.

Re: Medicare Advantage Question

geezerette — Tue, 26 Dec 2023 17:28:47 GMT

@MrsCat21 wrote:
@Kachina624. Yes, each plan is different, but my undersatanding is that all Advantage plans are FREE. So that is the reason for my question. Why would you pay a monthly premium whan you can get the insurance for free?? BTW, sounds like you have a great plan. All the plans Im looking at under the Advantage umbrella have a co pay...

Turn that question around: Why would a company give me health insurance for FREE if others are charging for the same thing?

Don't be blinded by the no premium payments. Just make sure the rest of the policy works for you now and in the future.

Re: Medicare Advantage Question

teganslaw — Tue, 26 Dec 2023 17:33:12 GMT

Not all Medicare Advantage plans are free, some have a small premium. It depends on your state, county or zipcode. Plans vary for each area.

Your best bet is to ask a representative in your area who deals with Medicare. You would get better information from that person than from a message board where no one knows your situation.

Re: Medicare Advantage Question

quilter61 — Tue, 26 Dec 2023 17:34:19 GMT

You really need to talk to an insurance broker. Advantage plans differ from State to State and even different areas of a State. In my area along there were about 80 Advantage plans to select from. An insurance broker will ask who your doctors are, if you are taking any medications to help select the best plan for you.

All Advantage plans are not free. I happen to have one that is and I love it. Have had no issues with coverage. Can go to any doctor. They are also required to cover everything that original Medicare covers.

Re: Medicare Advantage Question

MrsCat21 — Tue, 26 Dec 2023 17:36:30 GMT

@geezerette Yes, that was the reason for the post. Why is it free? I wanted to see if anyone had knowledge of both plans and what is the upside/downside of Advantage.

@teganslaw I have had an insurance broker to my house and we went over both Medigap plans and Advantage plans.

Re: Medicare Advantage Question

Trix — Tue, 26 Dec 2023 17:40:19 GMT

@MrsCat21 Not all Medicare Advantage (it is also called Medicare Part C) plans are free. They have pricing tiers that vary among the insurance companies and even the states. There will be co-pays on the vast majority of Advantage plans for every single thing from doctor office visits, to preventative tests such as mammograms. There are free plans, but in my research, the co-pays for those plans can be outrageously high. You may also find that the restrictions on your flexibility as to who you can see, when you can see them, what hospital or medical facility you can go to for services, and worse yet, getting approval for services can be a frustrating experience.

I think the summation is only the person who will be using the coverage can determine what is the best Medicare option. In my case where medical visits can be several in one week and often double-digits for a month, the co-pays would go into the hundreds of dollars even if I had a low one of $20 per service. For me this makes Advantage plans not the best financial or care option. I'm better served with standard Medicare and a Medicare supplemental insurance plan. This eliminates co-pays and all restrictions (the who, what, where, and when and waiting for approvals) out of my medical care.

Re: Medicare Advantage Question

Teddixat — Tue, 26 Dec 2023 17:50:19 GMT

All states and even counties within those states are different. I have AARP UHC medical Supplement and it is quite expensive in my estimation but I like the freedom of choosing my doctors. Ican go to any doctor I want. My monthly premium is high but everything is covered except the $266 deductible. I have Plan G. I do not have dental or vision. I prefer my dentist and I get the works from him for $300 a year which includes x-rays. I did find a cheaper prescription drug plan with Cigna for $15 a month - my Gerd prescription is free.

''I have had Advantage plans in the past but none of them cover my preferred doctors and too many restrictions.

that's my experience. Everyone has different needs. It can be mind boggling to get through it all.