Wellness

[151949]

Everyone should read their MEDICARE AND YOU book when it comes each year. It is dull reading but has information you need to know.

[BigOrangeKitty]

Thanks for the reply, Wink! I'm understanding this more, I guess my only question is - if you're on one of these Advantage Plans, are you still considered to be on Medicare or not? "Opting out of Medicare" sounds like no, but "an insurance co. administering the Medicare program for the govt" sounds like yes ...???? Thanks again!

[151949]

When I went to get signed in at the hospital for my knee surgery the clerk told me that about 75% of the people she admits have the same insurance we do. I have the Medicare advantage plan from United Health Care that is recommended by AARP. It is a $0 / month plan, which I'm sure has a lot to do with it's [popularity.

[151949]

On 10/7/2014 BigOrangeKitty said:

Thanks for the reply, Wink! I'm understanding this more, I guess my only question is - if you're on one of these Advantage Plans, are you still considered to be on Medicare or not? "Opting out of Medicare" sounds like no, but "an insurance co. administering the Medicare program for the govt" sounds like yes ...???? Thanks again!

No you are not "on medicare" any longer - but medicare does oversee the plan and they are required to offer as a minimum at least every coverage that medicare offers. As I just said - our agent told us to put our medicare cards in the drawer and only use our advantage plan card.Even with an advantage plan the $104 /month (or whatever you pay) is still taken from your SS check each month - plus if you choose a plan that has a premium , that will be deducted as well. Not all areas have the $0 premium options.Medicare pays that directly to the ins co. for you.

Last year my DH had a dispute with the ins co and he eventually went to our SS office to see if he could file a grievance with medicare about them. Medicare looked into it - it was resolved in our favor. So medicare does , in fact, oversee these plans.

[BigOrangeKitty]

Iam4truth, I hear ya. We all have to choose what we can reasonably afford. Health costs are out of sight. However, should something catastrophic happen concerning your health, and you end up with a hospital bill just as out of sight, most hospitals will take a monthly payment of whatever you can afford to pay. I know some people who do this. It's just a thought.

[KYToby]

I did not opt for the Advantage plans and went with part B. When I compared the copays of the Advantage plans versus the 20% responsibility with Part B, I came out better with Part B.

[jjeanne]

I have written two items on this page. I enjoy reading the answers. I am not comfused. I have a 5 star medicare advantage plan. It pays 80 percent, Secondary policy pays 80 percent of the 20 percent that the advantage plan does not pay. This is very important when having surg. or in hospital. I love my medicare advantage plan. They even paid when I had surg. by outsider doctor. I am sure regular medicare is good, but not all doctors will take medicare. Good luck on your decision, everyone is different.

[151949]

On 10/7/2014 KYToby said:

I did not opt for the Advantage plans and went with part B. When I compared the copays of the Advantage plans versus the 20% responsibility with Part B, I came out better with Part B.

Are you aware that you either have to get a part D Rx plan or will be fined?

[151949]

On 10/7/2014 woodstockillinois said:

I have written two items on this page. I enjoy reading the answers. I am not comfused. I have a 5 star medicare advantage plan. It pays 80 percent, Secondary policy pays 80 percent of the 20 percent that the advantage plan does not pay. This is very important when having surg. or in hospital. I love my medicare advantage plan. They even paid when I had surg. by outsider doctor. I am sure regular medicare is good, but not all doctors will take medicare. Good luck on your decision, everyone is different.

whatever. I seriously doubt an advantage plan that only pays 80% - why buy that when there are many many many plans that pay 100% with only small copays.? You have to be the only person in America that would buy that.

[terrier3]

On 10/7/2014 happy housewife said:

On 10/7/2014 BigOrangeKitty said:

Thank you for the reply, Happy. So if I'm understanding this correctly, you're not on Medicare - even tho you've been sent a medicare card? Should things change concerning your health once you're on an Advantage Plan, can you go back to Medicare instead of the private insurance - at any time - or only during a certain time? (They should hire you!) Thanks again.

When we went on our advantage plan the agent told us to put our medicare card in a drawer and only use the card from the advantage plan.

ALL seniors are "on Medicare." Seniors who choose a Medicare Advantage plan are in a Medicare plan administered by a private health company.

The basic benefits are set by Medicare - Medicare sends your monthly premium to the private insurance company (plus extra money). Medicare sets cost/benefit ratios that the Advantage providers must comply with - they cannot make above a certain profit on your policy.

The Advantage program was set up as an experiment to see if private insurers could administer health care to seniors for less money than regular Medicare. To this date, they cannot - Advantage plans cost an average of 12% MORE than standard Medicare. That only makes sense - they advertise the plans, they have salespeople, they have highly paid CEOs.

The Advantage plans change every year - they are competing with other private Advantage programs and have to become more cost effective every year.

So it pays to check the small print every year in ALL the available plans.