Community Chat

[monicakm]

@Sooner 

I have never looked at the Medicare website. Didn't think about it

[monicakm]

@bikerbabe 

I have learned a lot on these forums. We all share our knowledge on a variety of topics. Questions are asked here dozens of times in a day. I don't see anything wrong with asking the ladies here that have knowledge and experience with this.   

[Carmie]

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@Barkanyc wrote:

The problem with Advantage programs is that they are attractive when you are well but using the plan when you are ill is problematic.  I have traditional Medical plus a Plan F (now Plan G) and during my 6 week hospital was not charged a penny. Plus I was able to choose my phyisian out of network.  Medicare has no limit but advantage plans come with large deductibles and perhaps compromised treatment. Who really cares about a free gym membership when your life is at stake. Yes, supplemental plans are expensive but I chose to sacrifice in other areas to enroll in the plan. It has paid dividends many times over. 

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What you are saying is true for some Advantage Plans, but not all of them.

I have one that costs me $43.50 a month that covers everything at 100% in and out of network.  I have no deductible or copayments, except for RX drugs that have a small copay.

I have dental, vision and hearing aid coverage as well as as silver sneakers.

I don't need permission to have services.  I just show my card and all covered services are paid...no questions asked.

Traditional Medicare with Supplement Plan G is excellent, but my advantage plan is better and less expensive. You still have to pay the Medicare Part B deductible every year which will be $257 for 2025 and I do not.

[Carmie]

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@Nightowlz wrote:

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@millieshops wrote:

@Nightowlz   Not all Advantage plans operate the same as yours - and some people are not eligible for all of the various plans.

I often see "if you are eligible for both Medicare and Medicaid..." as part of many of the annual ads for available plans.  

As for the idea of a top limit, I've never had n experience to test that,  Hope I never do!

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@millieshops 

Well I'm paying for Part B, Part D plus a supplement plan  which costs more then an Advantage Plan.

We are supposed to buy a supplement to pay the 20% Medicare doesn't pay?

My MIL has Medicare but not a supplement. She didn't have to pay her 20% when she had full hip replacement.

I don't get why some have to pay 20% while others don't? I bet if I had hip replacement they would want their 20%.

If we don't have to pay the 20% if we don't have a supplement why pay for the supplement? I could just save the money? That's the big question? 

I will have to ask my SIL if she has to pay 20% or if she just pays the copays, coinsurance & deductibles. She had $300,000 heart surgery & was only out of pocket $3000?

Sounds like if you are on regular Medicare not an Advantage Plan that we are helping pay the bills of those on Advantage Plans IMO. 

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@Nightowlz   I am guessing your MIL has Medicaid and Medicare.  If so, Medicaid would pay that 20%.  If you have MEDICARE AND MEDICAID, you do not need a supplement. These plans can work together.

[Nightowlz]

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@Carmie wrote:

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@Nightowlz wrote:

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@millieshops wrote:

@Nightowlz   Not all Advantage plans operate the same as yours - and some people are not eligible for all of the various plans.

I often see "if you are eligible for both Medicare and Medicaid..." as part of many of the annual ads for available plans.  

As for the idea of a top limit, I've never had n experience to test that,  Hope I never do!

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@millieshops 

Well I'm paying for Part B, Part D plus a supplement plan  which costs more then an Advantage Plan.

We are supposed to buy a supplement to pay the 20% Medicare doesn't pay?

My MIL has Medicare but not a supplement. She didn't have to pay her 20% when she had full hip replacement.

I don't get why some have to pay 20% while others don't? I bet if I had hip replacement they would want their 20%.

If we don't have to pay the 20% if we don't have a supplement why pay for the supplement? I could just save the money? That's the big question? 

I will have to ask my SIL if she has to pay 20% or if she just pays the copays, coinsurance & deductibles. She had $300,000 heart surgery & was only out of pocket $3000?

Sounds like if you are on regular Medicare not an Advantage Plan that we are helping pay the bills of those on Advantage Plans IMO. 

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@Nightowlz   I am guessing your MIL has Medicaid and Medicare.  If so, Medicaid would pay that 20%.  If you have MEDICARE AND MEDICAID, you do not need a supplement. These plans can work together.

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@Carmie 

She doesn't have Medicaid. She has never been on any type of assistance even though she probably qualifies on her income.