topic Re: Medicare Insurance in Wellness

Medicare Insurance

kivah — Tue, 07 Apr 2015 02:15:18 GMT

I live in Oxnard, CA (southern calif) and have had SCAN Medicare Advantage Insurance for 9 years. I have an option to switch to Kaiser --- but don't know the differences. I'm happy with SCAN - but wonder if Kaiser is better and cheaper. With SCAN, u can't get supplemental insurance (to pay the 20% balance - as SCAN covers approx. 80%).

Re: Medicare Insurance

Carmie — Tue, 07 Apr 2015 03:07:45 GMT

Kivah, as you are probably aware, Medicare Advantage plans do not work like Traditional Medicare. You can't buy supplemental insurance for Advantage Medicare. Advantage plans are all different and not all types are sold in every state. When you choose Advantage, you have to read the policy carefully to compare what is covered and how much is paid for that insurance. I work for a health insurance company but, I have no way to compare SCAN with Kaiser. I think SCAN is an HMO. Is Keiser a PPO or a medical insurance for use with Traditional Medicare? I would advise you to call your local office on the aging and make an appointment to speak with them. They are aware of all the Medicare policies sold in the area where you live and can explain the difference so you can decide which is better for you. If you won't or can't, and you like what you already have, stick with it. If you can provide a website address to both insurance sites, I'd be happy to look them over and compare them for you.

Re: Medicare Insurance

Q4u — Tue, 07 Apr 2015 03:27:42 GMT

Oh my goodness... I was born in Oxnard~! My Dad worked at Pt. Mugu, Pt Hueneme! Small World...

I've lived in So Calif my entire life up until four years ago and had Kaiser for about 30 years. We found them to be efficient and effective and my husband's employer paid for well over half so our portion was always relatively small. I found that you have to be willing to speak up, be somewhat aggressive in getting the treatment you need but that's pretty much everywhere anymore.

My parents both had Kaiser later in their lives and they treated my father very well when he became seriously ill and then passed away. The same with my Mom when she got lung cancer. I have had some serious problems (Sarcoidosis, a very serious fall and nearly died) and they treated me very well, sent me to Stat appointments elsewhere when they were booked and thought the Sarcoidosis was cancer.... we've been very impressed with them and wish they were up here in Wyoming.

I'm afraid I don't know Scan in order to give you some differences in which to study.....

Re: Medicare Insurance

Q4u — Tue, 07 Apr 2015 03:28:36 GMT

Kaiser is an HMO...

Re: Medicare Insurance

Annabellethecat66 — Tue, 07 Apr 2015 03:33:53 GMT

I only know that people all around me HATE Kaiser. If someone says they have Kaiser, you'd think they were saying they were dying (I'm not kidding). I've heard people say, "I'm sorry for you".

My friend recently said that to someone. I said to her later, "You can't say that. Maybe they like Kaiser". She said, "Are you kidding? Were you just next to me? Did you hear her complaining about what happened to her Mother"? I shut up.

Just check everything out. Maybe it's better in other places. I just don't know anyone who likes it.

Re: Medicare Insurance

nomless — Tue, 07 Apr 2015 03:38:53 GMT

Find a Medicare advisor who can explain the details of both to you.

Re: Medicare Insurance

Q4u — Tue, 07 Apr 2015 15:11:39 GMT

On 4/6/2015 annabellethecat said:
I only know that people all around me HATE Kaiser. If someone says they have Kaiser, you'd think they were saying they were dying (I'm not kidding). I've heard people say, "I'm sorry for you".

My friend recently said that to someone. I said to her later, "You can't say that. Maybe they like Kaiser". She said, "Are you kidding? Were you just next to me? Did you hear her complaining about what happened to her Mother"? I shut up.

Just check everything out. Maybe it's better in other places. I just don't know anyone who likes it.

Wow... maybe it's a regional thing but the Kaiser in San Diego as well as their satellite offices and affiliate skilled nursing facilities were good imho... both to my immediate family and to my parents...

But there is one thing... you DO have to speak up, ask questions and be a firm advocate if you have to, but that's pretty much anywhere you go. It's imperative to also have a basic understanding of what's going on, which is not hard to do, just takes some research. But if I heard negative comments from anyone over the 30 years we used Kaiser.... it was mainly because the patient (or patient's family) just went along with what was going on....

Re: Medicare Insurance

terrier3 — Tue, 07 Apr 2015 16:42:26 GMT

I sell health insurance.

There are many independent places you can go to compare plans - your local senior services department, an independent insurance broker, seminars and health fairs...the booklet you get every year from the feds before open enrollment in the Fall, etc.

Seniors are lucky in this regard - MANY groups are out there to help.

This is a good time to start comparing since you can't switch until October. The insurance companies always keep the best and most experienced benefit consultants on year-round - and they have plenty of time to talk to you now.

You have to SEEK OUT assistance - there are strict laws re: soliciting for Medicare clients.

Good luck!

Re: Medicare Insurance

goodstuff — Tue, 07 Apr 2015 17:00:19 GMT

Most Medicare Advantage plans are HMO-type plans with tight networks of providers and facilities and proscribed procedures and benefits. A Medicare Advantage plan supercedes "regular Medicare". It administers your Medicare for you and approves/provides all medical care, and you can't buy another supplemental plan to go with it. If you choose a Medicare supplemental ("Medigap") plan, on the other hand, it goes along with regular Medicare and pays some or all of the costs remaining after Medicare covers its portion of a medical bill.

I'd suggest you look for a good Medicare insurance agency that can give you information on various Medicare supplemental and Medicare Advantage plans available in your area and inform you about the coverage, benefits, and pricing for each. Then you'll have enough information to make a good decision.

Re: Medicare Insurance

Tinkrbl44 — Tue, 07 Apr 2015 17:07:17 GMT

On 4/6/2015 kivah said:
I live in Oxnard, CA (southern calif) and have had SCAN Medicare Advantage Insurance for 9 years. I have an option to switch to Kaiser --- but don't know the differences. I'm happy with SCAN - but wonder if Kaiser is better and cheaper. With SCAN, u can't get supplemental insurance (to pay the 20% balance - as SCAN covers approx. 80%).

Kivah, I'm in LA and have sold health insurance and supplemental benefits for more than 15 years. Did you change jobs? I'm not sure what qualifies you to switch mid-year, but if it's not a valid change, you could be penalized for doing so.

My suggestion would be to go to ehealthinsurance dot com and click on Medicare. Be sure you are familiar with the difference between Traditional Medicare and Medicare Advantage first ..... then call one of their agents and ask about the specifics of your situation. (Generally speaking, Medicare advantage can have a lower monthly premium, but might have higher charges on an ongoing basis .... I'm generalizing here.)

As for Kaiser (IMO), it's managed care ..... and can be great IF you never get seriously sick .... HOWEVER, if you get seriously ill, you may have to fight to get the right treatments, or go elsewhere and pay out of pocket.

There are many variables, so take this information gathering one step at a time.

Hope this helps.

Tink

Re: Medicare Insurance

Kathlen — Tue, 07 Apr 2015 17:15:51 GMT

When I lived in CA years ago I had Kaiser HMO through my employers ... never had a problem. Perfectly satisfied.

Now - back in NYC and retired - I have just basic Medicare and a supplemental plan that's a retirement benefit. It picks up what Medicare doesn't pay minus a small deductible and gives me excellent prescription coverage.

Re: Medicare Insurance

Gooday — Tue, 07 Apr 2015 22:58:14 GMT

About 6 weeks ago I was checking out at the doctor's office and this situation was disturbing and sad for me to witness.

A female senior citizen was told to see her PA. She showed the male receptionist 4 different insurance cards, all of which were Blue Advantage cards, ALL expired. The young man TRIED, Lord he TRIED to explain the cards were expired AND when she finally produced the correct card, he explained they did not take Blue Advantage at that particular clinic. That the PA would have to see her at another clinic a few towns over. THEN, she whips out her red, white and blue Medicare Card to which he TRIED to explain that her Blue Advantage IS her current coverage and when you sign up for Blue Advantage, your Medicare Card is not in effect.

WHY oh WHY, aren't people more educated when they sign up for these policies? Because I believe they are selling these people policies they don't understand. IMO and it's JMO, if I were a senior, the last thing I would want is to get rid of Medicare. Get a decent supplemental. It's like the old saying, "you get what you pay for".

Re: Medicare Insurance

Teddixat — Wed, 08 Apr 2015 00:15:04 GMT

Hello Kivah

I just moved to Newbury Park, California - not far from Oxnard. I recently retired and went on Medicare. I did choose Kaiser because of all of the positive feedback I got from so many people. My SO was on Kaiser for years until he became eligible for medicare and Kaiser Senior Advantage accepts Medicare as full payment. He loves Kaiser and decided to stay with them. The Woodland Hills facility is very close to him. I decided to sign up for Kaiser also. They are rated number #1 by Medicare. I am so far a very healthy individual and have not had the opportunity to use their services yet but they are very hands on and do inundate you with a lot of paperwork at first but it all evens out. I know there are some people who love the freedom to chose their own doctor and go wherever they want and there are a lot of good secondary insurance companies. Kaiser is an HMO and you have to go to their doctors. I will say that someone I know had a serious illness which required specialized care and Kaiser sent him to a specialty hospital to receive proper card. Don't always believe the negatives.

Hope this helps

Re: Medicare Insurance

RinaRina — Wed, 08 Apr 2015 00:19:10 GMT

I'll be KIND .... Kaiser is the worst insurance I've ever had.

EOM.

Re: Medicare Insurance

kivah — Wed, 08 Apr 2015 01:11:12 GMT

Lousgirl: I lived in Newbury Park from 1978 to 1988 on Los Vientos - I always regret selling my beautiful house there.

Q4U: I've rented out rooms in my house thru the years to military and contractors at Point Mugu and Port Hueneme.

Ladies: Thanks for such good advice. I'm 74 yrs old and have been retired for a long time. Nine yrs ago, I had ovarian cancer and SCAN's services and doctors were amazing. One of the doctors, a surgeon (who was a contractor), saved my life. I don't know how much it cost for all my medical care when I had surgery/chemo, but I only had to pay around $8,000 out of pocket. I've also been happy with the other doctors - and I was never inundated with paperwork. All this insurance stuff confuses me and I'm not one who can ever understand the differences. I think I'll stay with SCAN.

Re: Medicare Insurance

italia814 — Wed, 08 Apr 2015 01:44:51 GMT

On 4/7/2015 rina33 said:
I'll be KIND .... Kaiser is the worst insurance I've ever had.

EOM.

Ditto - I'd never have an HMO.

Re: Medicare Insurance

goodstuff — Wed, 08 Apr 2015 16:19:18 GMT

I have heard and read that Kaiser's Medicare advantage program is good in California......and not nearly so good elsewhere. My mom was on a Kaiser M.A. plan in Georgia prior to her death, and I'd describe the care and coverage as adequate, but not spectacular. My dad died from sepsis (needlessly, I think) while under the care of Kaiser doctors in a hospital.

Re: Medicare Insurance

LilacTree — Wed, 08 Apr 2015 21:33:23 GMT

I live on SS, Medicare (all parts), and Long Term Care Insurance Benefits. I paid into all of them for many years. Without them, I would have no income. I have no complaints about any of them, they are a godsend to me.

I never even considered any of the Advantage plans.

Re: Medicare Insurance

Gooday — Thu, 09 Apr 2015 17:47:18 GMT

I want to ask a serious question to those who are Medicare eligible: other than cost, why would you pick an Advantage plan over Medicare with a supplemental? Aren't you limited as to where you have to be seen? Can you go to ANY doctor at ANY facility? Are they all HMO's?

I am nearly 62 and have Blue Cross/Blue Shield PPO through my retired husband's job. However, the premiums are astronomical. He is Medicare with the PPO supplemental. It's my premium that is ridiculous. However, I have no plans on changing until I hit Medicare age. Then, we'll see what the situation is at that time.

Re: Medicare Insurance

terrier3 — Thu, 09 Apr 2015 19:12:10 GMT

On 4/9/2015 Gooday said:
I want to ask a serious question to those who are Medicare eligible: other than cost, why would you pick an Advantage plan over Medicare with a supplemental? Aren't you limited as to where you have to be seen? Can you go to ANY doctor at ANY facility? Are they all HMO's?

I am nearly 62 and have Blue Cross/Blue Shield PPO through my retired husband's job. However, the premiums are astronomical. He is Medicare with the PPO supplemental. It's my premium that is ridiculous. However, I have no plans on changing until I hit Medicare age. Then, we'll see what the situation is at that time.

May I suggest you check out a Blue Cross/Blue Shield Plan directly? Or based on your income, you may be able to get coverage with a tax credit through your state exchange.

I have had many clients in your situation who have found that getting an individual BC/BlueS plan saves them money. There are PPO plans on both the exchange and individual markets - at 4 levels of deductibles and co-pays - everything from ZERO deductible plans to $6,600 deductibles.

If you stick with BC/BlueShield, they are accepted by over 90% of US hospitals and doctors.