Community Chat

[gertrudecloset]

---

@qvcaddition wrote:

@Carmie 

---

@Carmie wrote:

@Cakers3   

Some people who have Advantage  Medicare Plans pay zero premiums, have no deductible or copays.

They get covered services paid at 100%.

The only thing they pay out of pocket is the Medicare  Part B Premium which  is taken from their SS payments each month.

This is what I have, Senior Advantage.

---

---

@qvcadditionyour State is Supplementing your insurance with Medicaid.  I know someone that qualified for it too.  That's the only way you're not paying absolutely nothing.  You have both.

[77yangya]

Bottom line.....if you have an income that is pretty decent well, I don't think medicare or anthing medicare has to "offer" will be free.

I think your income has to be extremely small and no assets for anyone to get anything free.

I believe this is why those commercials talk about your "zip code".  Which probably just means depressed areas.  Sad, but I think true.

They can keep medicare and I saw people even opting out of Part A which I know is free.

[gertrudecloset]

---

@77yangya wrote:

Bottom line.....if you have an income that is pretty decent well, I don't think medicare or anthing medicare has to "offer" will be free.

I think your income has to be extremely small and no assets for anyone to get anything free.

I believe this is why those commercials talk about your "zip code".  Which probably just means depressed areas.  Sad, but I think true.

They can keep medicare and I saw people even opting out of Part A which I know is free.

---

@77yangya  bottom line is everything you stated above is inaccurate.  The insurance companies decide which market place they will enter.  Center for Medicare and Medicaid Services rate the plans in every area of the country when open enrollment starts.  All one has to do to find the plans being offered in their area is go to Medicare.gov and put in zip.

This has nothing to do with "depressed areas" and more to do with The insurance industry and which markets they want to work in.  Some insurance companies leave one market and go to others or just stop offering plans in an area period.  That's not up to the median income of an area.  It's the insurance company's discretion.  Some plans have dual coverage which means they will coordinate your state Medicaid assistance with your Medicare (extremely low income).  Those plans are minimal where I live some years and some years there are more.  They most always are HMO's. I see the referred to as Dual SNP (Special Needs Plans).

"Depressed areas" don't have anything to do with it.  They all have a contract with Medicare in order to provide the same or more than what original Medicare provides.  They can not provide less than Standard Medicare provides (they just do it different in terms of co-pays and hospital stays).  When you see services that have dental coverage that's more than Medicare covers. 

[Carmie]

---

@gertrudecloset wrote:

---

@qvcaddition wrote:

@Carmie 

---

@Carmie wrote:

@Cakers3   

Some people who have Advantage  Medicare Plans pay zero premiums, have no deductible or copays.

They get covered services paid at 100%.

The only thing they pay out of pocket is the Medicare  Part B Premium which  is taken from their SS payments each month.

This is what I have, Senior Advantage.

---

---

@qvcadditionyour State is Supplementing your insurance with Medicaid.  I know someone that qualified for it too.  That's the only way you're not paying absolutely nothing.  You have both.

---

Oh no, no.

There are absolutely Advantage Plans out there with zero premiums., and no deductibles and no copayments...except for RX drugs.

These plans are not in addition to Medicaid.  You still have to pay the Medicare Part B premium to get an Advantage plan, but that is it.

Advantage Plans like this are not available in every state or in every county in states that offer them, but they do exist.

[Carmie]

---

@77yangya wrote:

Bottom line.....if you have an income that is pretty decent well, I don't think medicare or anthing medicare has to "offer" will be free.

I think your income has to be extremely small and no assets for anyone to get anything free.

I believe this is why those commercials talk about your "zip code".  Which probably just means depressed areas.  Sad, but I think true.

They can keep medicare and I saw people even opting out of Part A which I know is free.

---

Again, not a true assumption.  Medicare Advantage Plans that are available in any area are not based on income. They are available to everyone who wants to join.

[gertrudecloset]

---

@Carmie wrote:

---

@gertrudecloset wrote:

---

@qvcaddition wrote:

@Carmie 

---

@Carmie wrote:

@Cakers3   

Some people who have Advantage  Medicare Plans pay zero premiums, have no deductible or copays.

They get covered services paid at 100%.

The only thing they pay out of pocket is the Medicare  Part B Premium which  is taken from their SS payments each month.

This is what I have, Senior Advantage.

---

---

@qvcadditionyour State is Supplementing your insurance with Medicaid.  I know someone that qualified for it too.  That's the only way you're not paying absolutely nothing.  You have both.

---

Oh no, no.

There are absolutely Advantage Plans out there with zero premiums., and no deductibles and no copayments...except for RX drugs.

These plans are not in addition to Medicaid.  You still have to pay the Medicare Part B premium to get an Advantage plan, but that is it.

Advantage Plans like this are not available in every state or in every county in states that offer them, but they do exist.

---

Then this would mean some get Medicare for free and don't have to pay their 20% share.  That just doesn't sound right to me.  Everybody has that 20% out of pocket (unless a state subsidy is picking it up).  No one, no one, no one gets free 100% Medicare @Carmie .  It is being subsidized in some shape or form.

I also am aware that very low income people get their part B premiums put back in their check depending on income.  The person I know who qualifed for dual coverage had a cash draw down, despite his low income.

No one gets away without paying their 20% that Medicare doesn't cover.  Someone is paying for it and trust it's not the insurance company.

[Carmie]

@gertrudecloset   You are very confused...lots of people are.

There are two types of Medicare

Traditional Medicare.  This Medicare consists of Medicare Part A and Part B.  Part B preminums are normally taken out of your SS check monthly.  Part B pays 80% of eligible medical charges and the patient is responsible for 20% and sometimes more if the provider does not accept Medicare.

People normally buy a Medicare supplement to cover that 20% and the inpatient hospital deductible that Medicare Part A doesn't cover.

The second type of Medicare is Medicare Advantage.  With this type of coverage, the same amount if money is withheld from your SS check the same as those who have Traditional Medicare and are paying for Part B, but they do not really have Medicare Part A and B.  Everyone pays 148.50 if they have Either type of Medicare ( except some low income people )

They have a plan that has everything rolled into one coverage.  It normally covers hospital, doctors, RX drugs and often services that Traditional Medicare does not cover...like routine dental and vision.

these plans are not universal Like Trasitional Medicare and supplement plans.  They vary from state to state and from counties in each state.  Some have no preminums, no deductible and no copayments...some do.

Some are expensive, some very affordable.  You have to shop around and see what is in your area.  people who live in Florida seem to have really great Advantage Plans.

I personally have one.  I pay $61 a month for mine. It pays everything 100%, except I have a copayment for RX drugs. I have dental and vision and it pays for me to join a gym and other classes if I am interested.  

So, for Medicare I pay $148.50 a month out of my SS check and $61 for Medicare Advantage.  I no longer have Traditional Medicare and therefore, I never get billed for 20% for outpatient services and will not owe the inpatient Medicare deductible if I am ever in the hospital.

Some advantage Plans charge a flat fee to see a doctor..like maybe $10 or $20 a visit, some have zero fees to see a doctor. There are many different plans and many different types of benefits.

Medicare open enrollment begins in October.  You can check and see what types of plans are available to you at that time.

[gertrudecloset]

@Carmie  YOU should have read the entire thread.  I posted within the differences between the various ways one can receive Medicare.

Fact is Medicare is Medicare.  There's only one type in this country.  There are two ways one can receive it.  Big difference.  One can receive their Medicare benefits through Insurance Plans and they are typically, HMO's or PPO's or POS plans.  THEY ARE CALLED MEDICARE ADVANTAGE PLANS.  These Insurance companies have a contract with Medicare and Medicaid (state).  They are CALLED PART C MEDICARE.  PART D MEDICARE IS FOR PRESCRIPTION COVERAGE ONLY AND ARE USUALLY USED INSTEAD OF AN ADVANTAGE PLAN FOR THOSE WILL USE THEIR STRAIGHT MEDICARE CARD AND NOT THE INSURANCE CARD..  PART F IS IS MEDIGAP. (SUPPLEMENTAL INSURANCE) that people can pay a premium for.  This helps offset that 20% out of pocket costs.

Go read before calling me uninformed, because I already broke down what you think you know in this thread. 

No one gets Medicare for free.  Someone is paying for the subsidies for low income individuals.  This is especially true for people who receive SSI.

[Annabellethecat66]

Who is surprised?  Am I surprised?

That would be no....more to come..just wait and see...

[Carmie]

@gertrudecloset   I never said you were misinformed, I said you were confused.  You still are.

I spent 25 years working with Medicare and Health insurance doing customer service for members, doctors and hospitals. I absolutely know about this subject. 

I don't need to go read.  I am an expert in this field.  

You are right that no one gets Medicare for free.  No one including me said they did. 

No matter what you think you know, there are people who do not pay an extra penny for their Medicare Advantage Plan except for the $148.50 that Is taken taken from their SS check each month and they are not low income people.

These are called $0 preminum Medicare Plans.  They are not associated with Medicad at all.  You may sign up for an Advantage Plan if you have Medicaid, but they really are not related.

There are MAP advantage Plans for those who have Medicaid, but that is not what we are discussing here.  

Oh, before you go off on me again...yea, some higher income people do pay more than $148.50 a month for Medicare Part B. Some pay up to $471 a month.

And there are more supplements than just Plan F which covers way more than just the 20% Coinsurance.
A,B, C, D, F, G, H, K, l and M.  Not all all sold in every state or by all insurance companies and Plan H and C is no longer available to new members,  but some people still have them grandfathered in from years ago.