topic Re: Medicare advantage in Community Chat

Medicare advantage

Elom — Tue, 20 Oct 2020 18:02:35 GMT

Does anyone use this plan? I have had Mutual of Omaha for 5 years and it just raised 40 dollars again. Any other plans that any of you have and are pleased with? This all is very frustrating at 71. Thank you

Re: Medicare advantage

henderson — Tue, 20 Oct 2020 18:06:38 GMT

We have Medicare Focus through United Health Care (Medicare Advantage Plan). There are so many out there. We're meeting with an Insurance Specialty Firm who will review our current insurance against not just one, but several plans.

Re: Medicare advantage

CelticCrafter — Tue, 20 Oct 2020 18:07:10 GMT

What do you have now - an Advantage plan or a supplement plan?

If you have a supplement plan, it does not fall under the annual open enrollment.

Re: Medicare advantage

QVCkitty1 — Tue, 20 Oct 2020 18:15:02 GMT

I have Excellus Blue Cross Blue Shield. So far it has been fine, but I've had no major claims.

Re: Medicare advantage

I am still oxox — Tue, 20 Oct 2020 18:15:38 GMT

We have original Medicare and a supplement, the supplement was hubbies insurnace which is now converted to our supplement

Re: Medicare advantage

Elom — Tue, 20 Oct 2020 18:18:03 GMT

@CelticCrafter @I have a supplemental.

Re: Medicare advantage

Marybella — Tue, 20 Oct 2020 18:20:14 GMT

@CelticCrafter wrote:
What do you have now - an Advantage plan or a supplement plan?

If you have a supplement plan, it does not fall under the annual open enrollment.

I changed my supplemental plan last year under open enrollment to be effective on Jan. 1. Not understanding your statement. Maybe I'm missing something.

Re: Medicare advantage

quilter61 — Tue, 20 Oct 2020 18:26:43 GMT

I have been on Medicare for two years and have an Advantage plan. My suggestion for you is to find a insurance broker that deals with Medicare. There are so many plans out there and they can help you choose the best plan for you. They will check to make sure the doctors and any medications you are on are covered.

The first year I was on Medicare I selected a plan without a broker. It was a good plan, however last year when I met with a broker they suggested another carrier. The plan I have now has a 0 monthly premium. They made sure that my meds were covered and the doctor I see were in network. The only thing I had to do was change pharmacies to a preferred pharmacy. By changing pharmacies my two scripts which are generic are also at 0 copay.

Re: Medicare advantage

froggy — Tue, 20 Oct 2020 18:29:01 GMT

You need to speak with a Medicare specialist to explain the difference between Advantage and Supplement plans. They are different in every state.

Re: Medicare advantage

shopped out — Tue, 20 Oct 2020 18:34:15 GMT

My husband (76) and I (74) have Medicare Complete with United Health Care.

It is a HMO plan and we have been happy with it for 11 years. Health Insurace

Premiums costs vary from State to State and then within in the State varies from

zip code to zip code.

Confusing? yes it can be.

I suggest you call other insurnace companies to ask questions about plans and

coverage and costs. In the past companies would come to your home and go

over everything.... everything they have to offer. Not so sure if they do this with

COVID 19 now. Not all States have the same plans offered ..."HMO", PPO"

or PPO with supplements as needed or without as needed. Yes confusing.

My husband was really confused when they were explaining all of it to him.

Becuase I worked in the field (on the provider's side) I understood it. I told

him.... cost wise and simplicity ..... choose the HMO. You and your doctor

decide if going to a specialist is necessary and your doctor will request the

referral to that specialist. We have medical, prescriptions, vision and dental

in our plan.

We moved from California to Oregon last year. In California they deducted our

premiums for Medicare from our Social Security every month but we had to pay

an extra directly to United Health Care. please note this was NOT a supplement

payment. In 2008 we moved from Napa (the wine country) to an area between

Sacramento South Lake Tahoe . That extra cost changed. In Oregon we only pay what is deducted from our Social Security. Nothing extra is paid to United Health

Care and we still have the same coverage. Everything went up. Senors received a cost of living raise of say 7% but the premium for Medicare was raised by 15%. Without getting into politics.... the seniors got it stuck to them.

PLEASE NOTE I AM NOT TRYING TO SELL ANYONE ON UNITED HEALTH CARE.

Re: Medicare advantage

HerRoyaLioness — Tue, 20 Oct 2020 18:40:02 GMT

I have a Medicare Advantage Plan, Humana Gold. I pay $0 for it, only what they take out of my Social Security before I get it. It includes a Drug Plan (I don't pay anything extra for it), of which several of my medicines are $0 co-pay, and I get a few hundred dollars worth of over the counter type things free each year. $0 co pay for my primary care visits, and $40 for specialists.

I have had no major things wrong, but the hospital costs seem similar to other plans.

I almost switched to Blue Cross this year, they have a similar plan in my area. In the back of your "Medicare & You 2021" it shows plans available in your area. If you get just straight Medicare, you will need to purchase a Drug Plan also. HTH!

Re: Medicare advantage

chessylady — Tue, 20 Oct 2020 18:44:16 GMT

I have a Medicare Advantage plan through Kaiser. I had Kaiser before Medicare so I did not change doctors. I am also a retired state employee who has lifetime medical benefits. I pay no monthly premium. I have a $10 copay for a 90 day generic medication. I pay a $10 copay for chiropractor for 20 visits a year. I have a free gym membership (not currently using) and a free Calm app. When the ACA is struck down by the Supreme court there may be changes for me as well as others.

Re: Medicare advantage

BLH — Tue, 20 Oct 2020 18:44:09 GMT

Make sure you understand. When you have medicare and a supplement you can go to any doctor or hospital in this country every day if you want to. When you have a medicare advantage plan you have to be careful about where you can go. If you get a HMO you have no out of network benefits. If you get a PPO you have out of network benefits. With medicare and a supplement you don't have co-pays, but with an advantage plan you probably will have co-pays. Nothing is written in stone, you can change every year if you want.

Re: Medicare advantage

SeaMaiden — Tue, 20 Oct 2020 18:44:36 GMT

We have Medicare and Premera Blue Cross as our supplemental insurance. The supplemental insurance costs about $850 a month for both of us. We have been on this plan for several years now...seems to be ok.

Re: Medicare advantage

Mindy D — Tue, 20 Oct 2020 19:10:23 GMT

Between my husband, my parents and I we have had many Medicare Advantage Plans. Right now, my husband has United Healthcare's Advantage plan called Preferred Care Partners HMO and I have had Florida Blue Medicare Premier HMO. In Florida, Blue Cross Blue Sheild is called Florida Blue. Up until now all the plans have been fantastic. You can include dental and vision, your medications are covered and the annual out of pocket amounts depend on the plan you choose. Advantage plans cover so much and we both have $0.00 monthly premiums. Most have no premium other than the regular Medicare Part B of $144.60 that everyone pays (for couples making $174,000 or less). That is up until now. Right now I'm not happy. I need to see a specialist, a dermatologist. When I signed up for my plan there were great dermatologists and other specialists with it and with my husbands plan. This has changed. I have called many dermatologists with the special skills I need but none of them take the HMO. They all take the PPO. I checked through many other carriers and it's the same thing. Most of the Advantage plans also come in a PPO version so I'm thinking of switching but the PPOs do not pay for services the way the HMOs do. With the PPOs you have to pay for a part of hospital stays and there are many other costs that are much higher than with the HMOs.

I'mnot sure what I'm going to do about my plan selection. I know that I prefer specialists for my medical situation.

Re: Medicare advantage

kaydee50 — Tue, 20 Oct 2020 18:59:57 GMT

I think a choice of plan, i.e, an advantage vs. a supplemental Medicare plan depends on what's important to you. Do you want to keep your same doctors? Do you take drugs? In the past advantage plans were basically HMOs which did not appeal to my DH and me. But they have changed greatly over the years and although we currently have supplemental plans, we are seriously thinking about switching to an advantage.

There is a lot of research to be done and it does vary by state.

Re: Medicare advantage

Kachina624 — Tue, 20 Oct 2020 19:08:30 GMT

Read the fine print carefully on these so-called "Advantage" plans. Many have a maximum lifetime amount that will be paid, then you're out of luck. They've been pushing them so hard, you've got to figure somebody is getting rich.

Re: Medicare advantage

BalletBabe — Tue, 20 Oct 2020 19:10:22 GMT

@Elom wrote:
Does anyone use this plan? I have had Mutual of Omaha, Texas and ore for 5 years and it just raised 40 dollars again. Any other plans that any of you have and are pleased with? This all is very frustrating at 71. Thank you

I have a advantage plan and I love it but the only problems I had is because my Dr. signed a contract with Well Med, they were bugging me to have every test there is. I had to remove my Dr. from my card and say I have no family Dr. to get rid of them. I eventhreatened them with legal action for harrassing me. Nothing would stop the calls. I still have the same Dr. but they have to bill Unite Health Care instead of going through Well Med. Well med made me get certain meds through them which was very time consuming and frustrating for my eye Dr. I agree all states are different and if you are in a big state such as Florida or California unless you like your phone ringing 3 times a day and on weekends stay away from any Well Med program.

Re: Medicare advantage

DiAnne — Tue, 20 Oct 2020 19:10:54 GMT

Many specialists are no longer taking Medicare patients because of low reimbursements. That adds another problem.

Re: Medicare advantage

Mindy D — Tue, 20 Oct 2020 19:19:05 GMT

@Kachina624 wrote:
Read the fine print carefully on these so-called "Advantage" plans. Many have a maximum lifetime amount that will be paid, then you're out of luck. They've been pushing them so hard, you've got to figure somebody is getting rich.

@Kachina624 @Things have changed. The maximum lifetime amounts are no longer legal. What the Advantage plans due have is annual out of pocket maximums that vary by plan. The largest in network out of pocket maximum is $10,000. The first thing to look at when choosing any advantage plan is what the annual out of pocket maximum is for that plan,