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04-11-2015 11:30 AM
On 4/11/2015 happygal said:This is a fantastic thread. It's a great reminder to us all to be thinking ahead, taking the time to research or reach out for knowledgeable assistance. It is very confusing, but making the wrong choice can be costly. Thanks to all, especially those in the field, for participating and sharing your knowledge. People--do your homework!
I totally agree. Now I will not feel so uninformed when we meet with the OPERS connector to pick a new plan, since the state of Ohio is no longer handling the insurance for us. (retired state employees)..... thanks!
04-11-2015 06:21 PM
"United Healthcare is a good company, though. They also administer AARP supplemental plans."
United Healthcare " IS" AARP. I used to not know this and attended AARP meetings for the social once a month where we had speakers, coffee and snacks. During the socializing everybody that had United Health Care hated it. I have seen wives and husbands crying quietly in a corner talking to friends. But it was always whispered, nobody dared to speak about it. The president wouldn't have allowed it. She was covered by UHC, healthy as a horse and freely admitted that she was a registered lobbyist for AARP. After 5 years she got a taste of her insurance., a broken foot at age 74 that needed to be operated on. And a 6 month wait to see the "approved" surgeon. It was during this time that my mom got sick and I had to move to take care of her. Kissed AARP goodby and havn't looked back.
Off topic, but the history of Medicare Advantage will enlighten some. I really can't remember which party, Republican or Democrat, so I am not giving a political speech here, just the facts as I have read them. There didn't used to be a Medicare Advantage Plan C.
Then somebody in Congress figured all this mess out and that millions could be made off a Plan C. And thus we are having this discussion.
In Obamacare, Congress stated very clearly that Plan C is on its way out and some rather drastic cuts were made as of Jan 1,2015. Who knows what the future holds? I have Medicare Part A and B + Blue Cross/Blue Shield. I usually pay zero for anything except cheap co-pays for meds. I had colon cancer last year and my bill was $0. I live in between 2 good size cities where an HCA hospital was built about 10 years ago and have no complaints . All my drs. , 6 of them, are about 2 miles from me. After I retired, I moved to this dinky little town to take advantage of this hospital. I use my health insurance a lot. I am living on borrowed time, but the 6 of them take very good care of me.
Re Kaiser's quality of care, someone asked why San Diego had better care than Wyoming... If you were a dr. would you rather be in sunny San Diego or Wyoming? I'm guessing most would prefer San Diego.
04-11-2015 07:15 PM
On 4/10/2015 GoodStuff said:On 4/9/2015 Mmsfoxxie said: This so confusing. I will retire in June so I'm getting ready to talk to an insurance navigator. It sounds like most of you are saying that if your health is pretty good and you don't have a lot of prescriptions then Medicare with a supplement for drugs is fine. Or Medicare advantage which would cover everything. Hmo is fine with me because that's what I've always had.If you like flexibility and can afford monthly premiums that are perhaps a bit higher, then regular Medicare with a supplement and a Part D drug plan will work regardless of your health history or the number of meds you take. The insurance agency DH and I worked with was able to sit down with us, review the meds each of us takes, and recommend which Part D drug plan would be most cost effective for each of us. They could also explain the costs and coverages, pros and cons of various Medicare Advantage and Medicare supplement ("Medigap") plans. DH and I slogged through all this process last year and feel for others just beginning the confusing journey.
I'd break it down this way:
Medicare Advantage: Simple, everything included under one plan, tight network with limited choices and usually no coverage outside the network, runs like an HMO. If you sign up for one of these, you get a Medicare Advantage card from the insurance plan you join, and that's what you present to providers or facilities when you need care. Your Advantage plan carrier coordinates care and processes/pays your claims. Your Advantage plan is regulated by Medicare, but takes the place of regular Medicare, and you no longer use your Medicare card for medical care. You pay your Medicare Part B premium plus any extra cost (if any) for the Advantage plan. Usually very affordable. Various M.A. plans are offered through a number of providers.
Medicare and a supplement and Part D drug plan: Probably more expensive per month, but much more flexibility. You can go to any provider or facility that accepts Medicare assignment. When you go in for medical care, you present the traditional Medicare card plus your Medicare supplement card. Medicare will process and pay the portion of the expense it covers; the supplement plan picks up the remaining percentage for services approved under Medicare. When you go to your pharmacy, you present the ID card for your Part D drug plan if you opt to sign up for such a plan. You pay for Medicare part B, the monthly premium for the supplement plan, and a monthly premium for the drug plan.
Of course, you also have the option to have just traditional Medicare, pay the Part B premium, let Medicare pay what it will for medical services -- and pick up the rest of the costs out of pocket.
Goodstuff, thanks so much for further explanation of these plans. I guess I won't know what's affordable for me until I get someone to do some number comparisons for me. Someone suggested I talk to an insurance navigator. I need to do this by June 30th which is when my present plan ends. June 30th is my resignation date....no turning back now, lol.
04-11-2015 07:27 PM
On 4/11/2015 Bettyboopers said:"United Healthcare is a good company, though. They also administer AARP supplemental plans."
United Healthcare " IS" AARP. I used to not know this and attended AARP meetings for the social once a month where we had speakers, coffee and snacks. During the socializing everybody that had United Health Care hated it. I have seen wives and husbands crying quietly in a corner talking to friends. But it was always whispered, nobody dared to speak about it. The president wouldn't have allowed it. She was covered by UHC, healthy as a horse and freely admitted that she was a registered lobbyist for AARP. After 5 years she got a taste of her insurance., a broken foot at age 74 that needed to be operated on. And a 6 month wait to see the "approved" surgeon. It was during this time that my mom got sick and I had to move to take care of her. Kissed AARP goodby and havn't looked back.
Off topic, but the history of Medicare Advantage will enlighten some. I really can't remember which party, Republican or Democrat, so I am not giving a political speech here, just the facts as I have read them. There didn't used to be a Medicare Advantage Plan C.
Then somebody in Congress figured all this mess out and that millions could be made off a Plan C. And thus we are having this discussion.
In Obamacare, Congress stated very clearly that Plan C is on its way out and some rather drastic cuts were made as of Jan 1,2015. Who knows what the future holds? I have Medicare Part A and B + Blue Cross/Blue Shield. I usually pay zero for anything except cheap co-pays for meds. I had colon cancer last year and my bill was $0. I live in between 2 good size cities where an HCA hospital was built about 10 years ago and have no complaints . All my drs. , 6 of them, are about 2 miles from me. After I retired, I moved to this dinky little town to take advantage of this hospital. I use my health insurance a lot. I am living on borrowed time, but the 6 of them take very good care of me.
Re Kaiser's quality of care, someone asked why San Diego had better care than Wyoming... If you were a dr. would you rather be in sunny San Diego or Wyoming? I'm guessing most would prefer San Diego.
Re United Health Care ... that's the carrier for my retiree Medicare supplemental benefit. I haven't had any problems with them at all. But - I live in a major metropolitan area with lots of doctors.
Fortunately - all my doctors take my Medicare and UHC ... and my out-of-pocket is minimal co-pays.
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