Medicare Advantage Question - Page 5

conlt · ‎03-16-2010

@MrsCat21 I am totally against Advantage Plans, but as many noted, there are good and bad things about it.

The reason that I do not like advantage plans is because if a person really has something wrong with them, they are at the mercy of the insurance company on the choice of doctors, hospitals, rehab facilities, etc.

I think they are fine for people who do not have many health problems, but as we age, the health problems mount and some are stuck paying high co-pays and deductibles.

I can put the money away for my dental and vision.

I have experience with Medicare, lots of experience, providing medical care to seniors, usually with complex medical problems. I have seen the shortcomings of the advantage plans.

One thing that I am especially against with the Advantage plans is that once you sign-up with one, in order to return to regular Medicare and a supplement plan, you have to go through underwriting to obtain a supplement. Most people trying to get back onto Medicare have been sick, and decided to go of the Advantage plan. The underwriting makes obtaining a supplement plan either impossible or very expensive to obtain. Think long and hard before you give up your ability to stay on Medicare. I take Medicare and a G supplement plan and I am very happy. I have around a $224 yearly deductible, then I am covered at 100% except my drugs. I have a Part D drug plan.

I will never take an advantage plan because I have taken care of and seen to many not so great things happen with my patients.

conlt · ‎03-16-2010

Actually in rehab, after a qualifying 3 day stay in the hospital. Medicare will pay up to 20 days of inpatient rehab at 100%. In order to be covered, the patient has to show the ability to improve. After that, Medicare pays 80% up to day 100, and if you are lucky enough to have a supplement that pays the other 20%, you are covered. If not 20% of inpatient costs can be expensive.

Right now, the G supplement plan is the most comprehensive.

Winkk · ‎03-15-2010

@I am still oxox wrote:
It is my understanding that is covers less than tradational Medicare and you still will have a co pay. If you do not have any chronic considering it might be a consideration. You also might have diffiuclty finding doctors that accept the plan.

@I am still oxox -- An advantage plan has to cover what Medicare covers. Plus most "reputable" insurance companies give you a large selection of doctors and hospitals. I have yet to find a doctor who did not take my advantage plan.

Winkk · ‎03-15-2010

@MrsCat21 wrote:
@geezerette But, my real questoin is why arent more people on Advantage, not so much the company i.e. Cigna, BCBS, Humana? All of our friends are on "traditional" Medigap plans and when I ask them about it they just say "I want to choose my doctors" or "I dont want anyone telling me where to go", one person actuallly said "I dont want the government telling me what to do". 🤦‍♀️Our insurance broker just says most people dont know that Advantage has changed alot in the past years and its not what it used to be.

@MrsCat21 -- I believe people are afraid to switch. That these advantage plans sound too good to be true. But, they are good as long as you use a reputable insurance company. My sister uses traditional Medicare. She has a Medicare card, supplemental card and rx card. I have one card that covers everything. She pays a lot each month for her insurance. I pay nothing and I have all the same (or better) benefits. It does sound too good to be true but it exists. Good luck.

Desert Lily · ‎06-24-2011

@MrsCat21 I would google "medicare advantage plans news" and read current news articles about Advantage plans - not articles by insurance companies.

According to the news, Advantage plans were found to routinely deny reimbursements, overcharge the govt., etc. Insurance agents receive an average $300 for Supplement policies and $600 for Advantage plans.

I'd find out what the options are & how much $ I'd be responsible for if something major came up.

As others have posted, plans differ in different states. There are differences in Advantage plans & differences in Supplement plans by company, too. Some Supplement plan premiums are based on the group of people in it, others may base the premium on age - age when you join OR premiums that increase as your age increases.

Some Advantage plans might be great for you, while others may not.

Medicaredotgov has info on what Advantage plans & Supplement plans are available in your area according to your zip code. It will also show your costs, premiums, etc.

It takes individual research to decide which plan is best for you.

blinksmom · ‎11-24-2011

I agree

Barkanyc · ‎06-04-2015

There is no such thing as a free lunch nor free health insurance. Advantage plans are subject to pre authorizations, denials, co pays and slow reimbursement rates. I have always been relatively healthy but, virtually overnight, I became seriously I'll and spent 9 weeks in the hospital. Throught this time I probably incurred over $300,000 worth of charges and, since I have supplemental Plan F (now offered as Plan G), it did not cost me one penny. In many states, you cannot arbitrarily change from Advantage to a Supplement. Just remember you can never predict your future heath concerns. One chronic illness, one accident can change your life in a nano second, regardless of age.

meem120 · ‎03-09-2010

There is alot of misinformation on this thread. Please check with a professional so you arent misled. Nothing is free and most Advantage plans have high out of pocket expenses. Be careful.

Still Raining · ‎03-30-2014

For those who might want a deeper understanding about Part C and possible conflict of interest between patients needs and denials, read up on how the capitated payments to the business offering Part C are calculated.

Eyeopening.

And based on potential over billing of services to FFS patients.

CelticCrafter · ‎03-09-2010

@Barkanyc wrote:
There is no such thing as a free lunch nor free health insurance. Advantage plans are subject to pre authorizations, denials, co pays and slow reimbursement rates. I have always been relatively healthy but, virtually overnight, I became seriously I'll and spent 9 weeks in the hospital. Throught this time I probably incurred over $300,000 worth of charges and, since I have supplemental Plan F (now offered as Plan G), it did not cost me one penny. In many states, you cannot arbitrarily change from Advantage to a Supplement. Just remember you can never predict your future heath concerns. One chronic illness, one accident can change your life in a nano second, regardless of age.

@Barkanyc unless it comes down to us not being able to afford our Supplement we wouldn't even consider switching to an Advantage. That's just us and what fits our needs. We have Plan N.