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Respected Contributor
Posts: 2,334
Registered: ‎03-13-2010

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!

Respected Contributor
Posts: 2,892
Registered: ‎05-01-2010

Re: Medicare advantage

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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.

Valued Contributor
Posts: 618
Registered: ‎03-10-2010

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.

Honored Contributor
Posts: 19,362
Registered: ‎03-10-2010

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. 

 

Esteemed Contributor
Posts: 6,388
Registered: ‎05-23-2010

Re: Medicare advantage

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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.  

Respected Contributor
Posts: 4,386
Registered: ‎02-07-2011

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.

 

Honored Contributor
Posts: 45,203
Registered: ‎03-10-2010

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.

New Mexico☀️Land Of Enchantment
Respected Contributor
Posts: 4,756
Registered: ‎03-05-2011

@EvOm 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. 

Honored Contributor
Posts: 9,694
Registered: ‎09-22-2010

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

Esteemed Contributor
Posts: 6,388
Registered: ‎05-23-2010

@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,