Wellness

[granddi]

1. www.nytimes.com › 2022/04/28 › healthMedicare Advantage Plans Often Deny Needed Care, Federal ...

   16 hours ago · Medicare Advantage Plans Often Deny Needed Care, Federal Report Finds - The New York Times Advertisement Medicare Advantage Plans Often Deny Needed Care,Federal Report Finds Investigators urged...

    

   I hope you can open this article. All too often Advantage Plans deny coverage saying not approved by Medicare but that is not the truth.

[Love my grandkids]

@granddi I have Medicare and UHC and in spite of the junk mail I get trying to get me to change to an Advantage plan, I'm sticking with what I have.

5 years ago I had a cancer resection surgery, 8 rounds of chemo and 20 of radiation. I've also had a chronic problem that required numerous 2-3 day hospitalizations and a surgery  last June.

Everything was covered. Without this coverage I would have died. I'll never change to advantage. I don't need referrals to any doctor I need to see.

[teganslaw]

One has to set up an account to read the article, and I didn't want to do that. 

Many Advantage Plans deny coverage, mostly if it's out of network. I'm skeptical of those who say they pay no premium, have no deductible, everything covered and don't worry about networks. I know there are plans that have no monthly premium, but the patient is still paying somehow; they're just not stating all the details. 

As I've mentioned before, Supplements work much better for me than Advantage Plans. Maybe Advantage Plans work better for some; it all depends on their financial situation. 

[tansy]

I saw the article but, so far, I have had several surgeries under an Advantage plan with no problems.  

[kaydee50]

I just switched to an Advantage plan, not Humana.  Fortunately, I have not had to use any of the medical provisions but find the dental, vision and over the counter credit it provides very useful.  I can choose my own doctors without a referral and am covered anywhere Medicare is accepted.  So far so good.

[proudlyfromNJ]

Our Advantage plan is a PPO not an HMO. It's sixteen dollars a month. I pay more than husband as I pay for dental coverage. I see the Dentist every three month. I've had the plan for about ten years. Everyone should chose what is best for them. I have never been a sickly person.

[pdlinda]

@proudlyfromNJ   I also have a PPO Advantage plan that costs me $5.00/month . 

It's a benefit through my State Retirement system and I have nothiing but positive things to say about my coverage.

I'm in excellent health so rarely see a doctor; HOWEVER, I had 2 joint replacements in the last 5 years that both went very smoothly.  My total out of pocket for each was $100.

[Mindy D]

@granddi @Hello. The problem with the NYT is that for me, it's articles are behind a pay wall and I can not read them. 

[Love my grandkids]

@teganslaw I pay a monthly premium for my UHC supplemtal and it's worth every single penny.

[gwiz]

Eveyone's situation is different as to health status and what they can afford to pay for.  Our experience has been that with original Medicare and a supplemental plan that pays the 20% that original medicare does not we have no co-pays, we get no extra bills for anything and we can go to doctors without worrying about "networks".  When you have medical histories including cancer, open heart surgery, joint replacements you are better off with original Medicare and a supplemental plan if you can swing it financially.  I agree that "you are paying somehow"---basically you are paying up front.  Supplemental plans can be expensive, but depending on what type of medical interventions you might need you priobably come out ahead.  And there is no bother of keeping track of all the co-pays.  If you are pretty healthy an advantage plan could work for you, but as time goes on how can you predict what physical problems might crop up?  If we could predict the future that well we would all be out buying lottery tickets.