@Nicknack wrote:
@151949 wrote:
@Nicknack wrote:
@BalletBabe wrote:
@Carmie wrote:
@BalletBabe wrote:
@Carmie wrote:
@Kachina624 wrote:
@conlt wrote:
I have said it many times on these boards and people always argue with me but the Medicare Advantage Plans do not pay just like Medicare. I have worked in health care specifically with the elderly as a RN executive in home care. My business is a Medicare business. I think the advantage plans are fine for a healthy individual who wants to save money on prescriptions however, I have seen many times when they don't want to take care of someone who needs more intensive care. When Medicare rolls around for me I am taking straight Medicare, a supplement to cover the other 20% and then a part D drug plan. My 91 year old mother is on this and she never pays a dime for anything other than her insurance. Please be careful with the Medicare Advantage plans, you never know when a critical illness is going to happen and you need good coverage.
@conlt I don't know what you're talking about because my plan has no maximum lifetime limit. Mine also has a part D drug plan. It covers everything I would ever need. These plans are not all the same.
I know what she is talking about. I worked in Health a Insurance for over 25 years, and I agree with Halo117.
You might be surprised what your Advantage plan does not cover at 100%. You won't know until you need that benefit.
One of my family members is in the hospital right now. She has an Advantage plan that covers just about everything. She pays $90 a month for it.
I just checked into her benefits today. She has a $200 deductible for the first through the 7th day of an inpatient admission. She has been there four days already and will probably owe $1400 at least for seven days when she is discharged.
She used to have Traditional Medicare and Plan F which paid 100% of all her inpatient admissions. She dropped that insurance on Jan. 1. I have no idea where she will get the money to pay this bill. She is living on $1200 a month from SS.
You can set up a payment plan with the hospital. They have to take what she can give. Do not give them a charge card or a debit card. They try to get it out of you while you are there. DON'T GIVE IT TO THEM.
I know what you are saying is true. The hospital won't bill her until after the claim is processed, so no CC on file.
I just don't have a clue where the extra money for this bill will come from. Her monthly bills for her RX drugs are very high. Hundreds a month because she takes so many. 17 pills in the am and 12 in the pm. She also has a mortgage and pays her utilitiy bills. My brother pays her RE taxes and I help her with her grocery bills and other expenses. Her home is in need of repair. My sons can fix things for her, but things need replaced and updated, not fixed.
There is no money left at the end of the month. Her clothing is getting worn out. Her health is not good and mentally, she isn't always "with it". Sometimes she will spend money she can't afford to or give it to the small children in the family as a gift for a birthday or holiday and her bills suffer.
She used to work in finance, so this is unlike her.
I have been trying to get the family together for a meeting, but they keep resisting.
I would suggest she sell her house and move to a senior apartment that has an income based rent. Something small. She lived with me for 9 months after a serious hip injury and back surgery, but begged to go home. So home she went home last April.
I am her POA, but don't want to make or force her do anything. I want her to except change and move on. She keeps saying, "but I want to live here in my home." Well, she can't afford to.
Lately she has been sick, hence the hospitalization. Her kitchen was so dirty and gross when I went to check on her, that I almost fell over from the stink. She was too sick to clean or do dishes.
She has always been clean crazy and used to re do everything I did because it was never clean enough for her. I just spent a whole day cleaning her home, scrubbing and deep cleaning because it was so bad.
She was sick, but didn't tell anyone how bad she was. She called me for an unrelated issue and I knew something was wrong right away. I took her to the ER still in her nightgown, slippers and robe and she was admitted.
I don't think she should live alone anymore, but I don't know what to do for her. I am going to call the office for the aging on Monday. I hope they can help or offer suggestions.
Sorry for the long rant. I just needed to vent..
She definitly needs to get off the Advantage plan. That plan is for people that are healthy and don't need meds that are expensive. You might want to have her apply for Medicaid, especially if she cannot afford a supplemental. There are also pland to help patients with low income to get help with meds. Make some phone calls! Good Luck! It is a shame that they do this to the older generation.
She may be able to get on a Medicaid plan now, but she couldn't go to Plan F. You can't switch from an Advantage plan once you're already on it. At least that's the way I read it.
That would be incorrect information. You can't switch from an advantage plan to regular medicare while you are being treated for something -- for instance if you are on an advantage plan and you get diagnosed with cancer - you can't just switch to a plan F now so they pay all your bills. You would have to stay on the advantage plan until you are through the treatments for your cancer, but then you could switch if you want to.If you aren't being treated for any major illness you could switch during the sign up period in the fall if you want to.
Thank you @151949. I read this completely wrong then. I'm glad to know this.
She can switch back to Traditional Medicare and go back to the same Supplemental plan ( Plan F) she had before January as long as she does it soon. You can change your mind, I think within a six month period. She can do this because she has had Traditional Medicare since she was first eligible. It's a one time option.
The problem is with her RX program. If she switches back to Traditional Medicare, she will have no RX coverage at all and not be eligible to pick it up until open enrollment and it will be higher( pentality) because she had a lapse.
All of this came about because her original RX coverage was through her deceased spouses retirement plan for $20 a month. They cancelled that plan and now offer only three Advantage plans with RX coverage. She chose the best they offered.
She could not afford the Supplemental plan that went up in price and a Medicare RX plan that was way for than $20 a month. Her best option at the time was Advantage at $90 a month.
She takes a lot of drugs due to many issues, so she can't go without RX coverage. I have a lot to sort out.
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