Medicare Advantage Programs

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dm200
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Medicare Advantage Programs

Post by dm200 » Mon Sep 13, 2010 1:40 pm

As I approach being able to file for Medicare in a few months, it appears that signing up for a Medicare Advantage program offers many benefits. Any Diehards with knowledge/experience with these programs?

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hollowcave2
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caution

Post by hollowcave2 » Mon Sep 13, 2010 1:49 pm

I would be cautious with this because my understanding is that Medicare Advantage goes through private insurance and regular Medicare goes through government payments. So I'd check to see if you need to give up some of your Medicare when signing up for the Advantage plan. But I'd research that first.

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dm200
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Re: caution

Post by dm200 » Mon Sep 13, 2010 1:51 pm

hollowcave2 wrote:I would be cautious with this because my understanding is that Medicare Advantage goes through private insurance and regular Medicare goes through government payments. So I'd check to see if you need to give up some of your Medicare when signing up for the Advantage plan. But I'd research that first.
I also understand that the healthcare reform act, now passed into law, has made some changes that may or might reduce some of the benefits os choosing a Medicare Advantage program.

chaz
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Post by chaz » Mon Sep 13, 2010 1:59 pm

Friends with Medicare Advantage have to use a gatekeeper for referrals.

I prefer Blue Cross PPO, where I can select my doctors.
Chaz | | “Money is better than poverty, if only for financial reasons." Woody Allen | | http://www.bogleheads.org/wiki/index.php/Main_Page

dbr
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Post by dbr » Mon Sep 13, 2010 2:04 pm

I would be concerned that Advantage plans may not be sustainable to the same degree government specified Medigap plans should be. I would be worried about the ability to return to the Medicare/Medigap umbrella once that is given up to take a chance on an Advantage plan.

Ron
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Post by Ron » Mon Sep 13, 2010 2:19 pm

My son has had it for a few years. It has more benefits (i.e. eye exams) than regular Medicare which he was on previously, with a lower current price.

As to the possible changes to the program in the future? We'll change it at that time; same thing we did when he had the standard Medicare w/medigap policy and went to the current program.

BTW, he goes to the same doctors he had in the past (PCP and one specialist) with no changes nor referrals needed.

Also, drug coverage is included (with no separate fee - e.g. Part D) in the program.

- Ron
Last edited by Ron on Mon Sep 13, 2010 2:22 pm, edited 1 time in total.

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tc101
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Post by tc101 » Mon Sep 13, 2010 2:20 pm

I think this is related and will ask here rather than start a new topic.

How do we make a decision about the medicare drug benefit? My wife's father, is 85, healthy, and has never taken any drugs. He is now starting on Aricept for dementia. It costs about $210/month. Should he get on the medicare drug benefit plan, and if so, which one?
. | The most important thing you should know about me is that I am not an expert.

oljack
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Post by oljack » Mon Sep 13, 2010 2:30 pm

This is a tough call. Basically, the premiums for Medicare Advantage programs are cheaper than with Medicare plus a Medicare Supplement. However, while Medicare Advantage is mandated to cover everything that Medicare covers, there are co-pays that are not required with a Medicare Supplement. For doctor’s visits and routine care, these co-pays are fairly insignificant making the health costs of a reasonably healthy Medicare Advantage holder much less. However, should one require radiation treatments, extended therapy, several hospitalizations or other conditions requiring frequent follow-up, Medicare with a Medicare Supplement would be far less costly.

Secondly, once one has chosen the Medicare Advantage route, to switch back to traditional Medicare with a Medicare Supplement is not guaranteed. You would have to pass underwriting and, should you have a serious illness, it is almost certain you would be turned down.

And lastly, one of the reasons Medicare Advantage is cheaper than Medicare plus a Medicare Supplement is that the federal government during the Bush administration, in its desire to reduce government’s involvement in health care, actually subsidized insurance companies to enter the Medicare Advantage arena. This subsidy ran 12-14% more than it was costing the government to administer each Medicare recipient. In the new health plan bill, this subsidy is being reduced over time making it interesting to see how the insurance companies will react.

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wjo
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Post by wjo » Mon Sep 13, 2010 2:30 pm

I have experience with both through my parents (both now deceased and went through illnesses with both programs).

My dad had the Advantage -- in theory cheaper and more benefits, but run as a private insurer. Getting approvals was more difficult. A year after his death there was a runaround with the insurance company not wanting to pay for highly justified medical bills (basically care around surgery for a broken hip).

My mom had straight medicare with supplemental insurance. There was never a question about payment with these plans or the supplement. (Some issues with filing paperwork for chemo pills under part B rather than D, but that is another story and one likely just as bad if not worse with the Advantage plan).

If was up to me, I'd rather take the government plan and pay the slight extra so I would know it would be there when I needed it -- both for me and those around me.

My experience, at least - YMMV.

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Post by gkaplan » Mon Sep 13, 2010 2:41 pm

I am a federal employee and will be able to take my government health insurance into retirement. Medicare (the government's original Medicare program) will be my primary insurance in retirement, and my Federal Health Insurance Benefit Plan will be my secondary insurance. I don't see the need to enroll in a Medicare Advantage plan, nor do I see the need to enroll in a Medicare Supplement Insurance (Medigap) plan.
Gordon

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Post by ndchamp » Mon Sep 13, 2010 2:54 pm

gkaplan wrote:I am a federal employee and will be able to take my government health insurance into retirement. Medicare (the government's original Medicare program) will be my primary insurance in retirement, and my Federal Health Insurance Benefit Plan will be my secondary insurance. I don't see the need to enroll in a Medicare Advantage plan, nor do I see the need to enroll in a Medicare Supplement Insurance (Medigap) plan.
If you are at least 65 y/o at retirement, otherwise Medicare is a non-issue if you are retiring at Minimum Retirement Age (55).

classylady
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Medicare Advantage Plans

Post by classylady » Mon Sep 13, 2010 2:57 pm

I have been with a Medicare Advantage Plan (one available only in the western states) for four years and have been satisfied. My generic drugs cost $12 for a 90 day supply. I looked up Aricept which is a tier 2 drug which their mail order pharmacy will supply for $84 for a 90 day supply. As another poster mentioned, Medicare Advantage plans are currently receiving a financial advantage from the government, but this probably will change in the near future, but I know this is necessary to broaden coverage for all. Currently my co-pay to see my primary doctor is $10. I am satisfied with the doctors available for referral at a co-pay of $35. I did need to pay a $200 co-pay for each eye surgery recently.
Check out the plans available in your area. They have lots of meetings to explain their program during "open enrollment season" in the late fall.

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dm200
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Post by dm200 » Mon Sep 13, 2010 3:00 pm

Thanks for the feedback.

The provider I am considering is Kaiser Permanante. I am not concerned about referrals, etc. because we had been with them a few years ago and were pleased with care, etc. We had to leave because of employment based insurance coverage.

dbr
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Post by dbr » Mon Sep 13, 2010 3:14 pm

oljack wrote:
Secondly, once one has chosen the Medicare Advantage route, to switch back to traditional Medicare with a Medicare Supplement is not guaranteed. You would have to pass underwriting and, should you have a serious illness, it is almost certain you would be turned down.
This was my understanding. It does not seem advisable to place oneself with private insurance and be unable to recover to standard Medicare/Medigap if things go badly in the plan.

Someone might comment on the policy on that, but I would be very careful before intentionally bypassing the guaranteed open enrollment for Medigap plans which is six months after Medicare election, or maybe six months after turning 65. I could have this all wrong, so anyone that can correct this is more than welcome.

I agree a person on Government insurance who is guaranteed continuation of secondary coverage probably is fine. Megacorp retiree insurance also offers continuation as secondary, but that could be a really bad idea as corporate health insurance can be discontinued at any time and Medigap insurers could then refuse coverage at will.

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BruceM
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Post by BruceM » Mon Sep 13, 2010 3:30 pm

dm200 wrote:Thanks for the feedback.

The provider I am considering is Kaiser Permanante. I am not concerned about referrals, etc. because we had been with them a few years ago and were pleased with care, etc. We had to leave because of employment based insurance coverage.
Here in Oregon, there are multiple MA plans offered, 3 of which are large non-profits (Kaiser being one) that consistently get very high satisfaction reviews from the State's Insurance Commissioner's web site.

The advantages of a PPO/HMO model MA plan is broad coverage, an incentive to the insurer to provide preventive care for early detection of disease, not having to try to find a medical group that will accept Medicare assignment (a BIG deal around here) and not having to hassel with Medicare billings issues.

The principal disadvantages are you must live in the catchment area, you must get all but emergent medical care through the plan providers, you cannot return to Medigap coverage with guaranteed issue (as previously mentioned, you may have to undergo medical underwriting for Medigap coverage) and you are 'stuck' with the plan's providers in the event you find out you don't like the plan....although you can switch during the annual open enrollment period.

In reading through the impending changes coming up on MA plans, I think these rule changes are going to affect primarily the broad-line, for-profit insurers who got into MAs late, and have been doing some of their insurance-style shenanigens with MA plans

I have 6 years to Medicare eligibility, but knowing what I know now, I'd go with a local HMO MA plan, due to cost, incentives and consumer ratings.

I would definitely check both your state (or District of Columbia) insurance commissioner's web site for some measure of consumer feedback. In addition, check to see if your state/district Senior Health Insurance Program (SHIP), which are funded by educational grants from Medicare to provide its citizenry with comprehensive information on Medicare, Medigap and MA plans offered in the state. Here in Oregon its called SHIBA of Oregon, and I cannot imagine buying into a plan withoug going through their free publication first.

BruceM

Ron
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Post by Ron » Mon Sep 13, 2010 3:33 pm

dbr wrote:This was my understanding. It does not seem advisable to place oneself with private insurance and be unable to recover to standard Medicare/Medigap if things go badly in the plan.
My son's former medigap policy (under traditional Medicare) and his advantage plan are supplied by the same organization. Their documentation states that movement from the Advantage plan back to traditional Medicare could be done without problem, during the annual enrollment period.

FYI, here's info on the programs related to enrollment periods:

http://www.medicare.gov/Publications/Pubs/pdf/11219.pdf

- Ron

dbr
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Post by dbr » Mon Sep 13, 2010 3:41 pm

Ron wrote:
dbr wrote:This was my understanding. It does not seem advisable to place oneself with private insurance and be unable to recover to standard Medicare/Medigap if things go badly in the plan.
My son's former medigap policy (under traditional Medicare) and his advantage plan are supplied by the same organization. Their documentation states that movement from the Advantage plan back to traditional Medicare could be done without problem, during the annual enrollment period.

FYI, here's info on the programs related to enrollment periods:

http://www.medicare.gov/Publications/Pubs/pdf/11219.pdf

- Ron
Thanks, it looks like there isn't really a big concern over this. I suspect the only real mistake would be to fail to sign up for either Advantage or Medigap during the first opportunity. I still think it is a legitimate concern to be careful of a non-government secondary coverage health plan that is not an Advantage Plan or a Medigap Plan.

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Post by oljack » Mon Sep 13, 2010 3:47 pm

Ron -
If I'm not mistaken, I believe you can always switch back to original Medicare from a MA plan during the one time per year enrollment period. However, I don't believe you can obtain a Medicare Supplement policy without passing Underwriting even if the same insurance company handles both.

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Post by Ron » Mon Sep 13, 2010 3:48 pm

dbr wrote:Thanks, it looks like there isn't really a big concern over this. I suspect the only real mistake would be to fail to sign up for either Advantage or Medigap during the first opportunity. I still think it is a legitimate concern to be careful of a non-government secondary coverage health plan that is not an Advantage Plan or a Medigap Plan.
I would agree. Even in my son's case, there is no guarantee that the Advantage plan will continue (there is only a one-year contract with the government for all Advantage plans) and the rules of his provider is only for his case. I can't speak about the numerous plans on the market.

The other thing to consider - regardless if you use traditional Medicare or an Advantage plan, there is no guarantee that your current PCP/specialist will accept either coverage.

We used the provider's on-line tool to ensure that his normal doctors did accept the Advantage Plan (in addition to traditional Medicare, if he would go back on that program).

- Ron

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Lee Saage
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Post by Lee Saage » Mon Sep 13, 2010 4:07 pm

The recently enacted Patient Protection and Affordable Care Act will have an impact on both traditional Medicare benefits as well as Medicare Advantage. How these changes will affect individual beneficiaries is not clear to me but, if possible, one ought to attempt to gauge expected impacts in making coverage decisions.

The Wall Street Journal reports that the recently released Annual Report of the Medicare Board of Trustees indicated that Medicare payment rates for doctors and hospitals serving seniors will be cut by 30% over the next three years. The Washington Post had a similar story but less detail on the size of the cuts. I have not seen anything specific as to differences in the way cuts are to be applied to traditional Medicare versus Medicare Advantage but there may be such.

I will be joining Medicare in about 2 years and am trying to find out more information. If anyone has access to any analysis of how these planned cuts are to be implemented, I would be grateful to hear of it.

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Post by S&L1940 » Mon Sep 13, 2010 4:12 pm

tc101 wrote:I think this is related and will ask here rather than start a new topic.

How do we make a decision about the medicare drug benefit? My wife's father, is 85, healthy, and has never taken any drugs. He is now starting on Aricept for dementia. It costs about $210/month. Should he get on the medicare drug benefit plan, and if so, which one?
the drug plans are a nightmare - providers offer different versions for each state. We have changed several times since the benefits were first offered. It is a pain because the coverage and co-pays change from year to year and with the attempt at Medicare reform the providers are getting more complex in their offerings to circumvent new rules. you need to get online either at the state or fed level to review the options. bottom line, it is worth the effort - even though the providers make out like bandits AND bandits is accurate because the government plan was structured to get ripped off by the private providers - you will save money with the drug plan. you may not like this but AARP has one of the better offerings; at least in Florida for the meds we take.

as to Medicare Advantage, big savings and extra benefits IF, you do not have to worry about your doctor being an approved provider; IF, you do not worry about getting an appointment with the same doc every time; If, you never need to see a specialist like right away for critical care; IF, you do not mind sitting in a crowded waiting room for an hour or two; IF, you are not concerned about choosing which doc you see and which hospital you can go to. Though we could have saved several thousand in costs plus received free eye glasses and hearing aids, we chose to have as much control over our health care as possible with the traditional Medicare program.

Besides, the Advantage plans will slowly be shaved - again as part of the attempt to control run away costs. Advantage was developed to SAVE money but instead costs the feds billions each year over the traditional plan.

my two cents; be well
Don't it always seem to go * That you don't know what you've got * Till it's gone

gkaplan
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Post by gkaplan » Mon Sep 13, 2010 5:57 pm

ndchamp wrote:
gkaplan wrote:
I am a federal employee and will be able to take my government health insurance into retirement. Medicare (the government's original Medicare program) will be my primary insurance in retirement, and my Federal Health Insurance Benefit Plan will be my secondary insurance. I don't see the need to enroll in a Medicare Advantage plan, nor do I see the need to enroll in a Medicare Supplement Insurance (Medigap) plan.

If you are at least 65 y/o at retirement, otherwise Medicare is a non-issue if you are retiring at Minimum Retirement Age (55).
I shall be over sixty-five when I retire.
Gordon

sscritic
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Post by sscritic » Mon Sep 13, 2010 6:24 pm

dm200 wrote: The provider I am considering is Kaiser Permanante. I am not concerned about referrals, etc. because we had been with them a few years ago and were pleased with care, etc. We had to leave because of employment based insurance coverage.
This changes the question from "Should I sign up for medicare advantage with a for profit insurance company?" to "should I sign up for medicare advantage with an HMO that I am familiar with and am comfortable with?"

The answer to your real question is YES. I am with Kaiser. I have been with Kaiser for many years. When my signup date comes later this year, I will sign up with Kaiser's medicare advantage program. My doctor's won't change, my care won't change, only some co-pays will change (some higher, some lower). Many people don't like Kaiser, but I am satisfied and will stick with them.

Medicare has parts A, B, C, and D. Medicare C is also called Medicare Advantage.
The Different Parts of Medicare
The different parts of Medicare help cover specific services if you meet certain conditions. Medicare has the following parts:
Medicare Part A (Hospital Insurance)
■ Helps cover inpatient care in hospitals
■ Helps cover skilled nursing facility, hospice, and home health care

Medicare Part B (Medical Insurance)
■ Helps cover doctors’ services and outpatient care
■ Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse

Medicare Part C (Medicare Advantage Plans) (like an HMO or PPO)
■ A health coverage choice run by private companies approved by Medicare
Includes Part A, Part B, and usually other coverage including prescription drugs

Medicare Part D (Prescription Drug Coverage)
■ Helps cover the cost of prescription drugs
■ May help lower your prescription drug costs and help protect against higher costs in the future
From Medicare and You

mur44
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Best Source For Advice: SHIP (Free Service)

Post by mur44 » Mon Sep 13, 2010 7:19 pm

Your State Health Insurance Assistance Program
Counselor will provide the best advice for your
individual requirements. Call 1-800-MEDICARE
(1-800-633-4227) to get the SHIP (State
Health Insurance Assistance Program) telephone
number.

If you want gold standard, stay with Original
Medicare and buy a Medigap plan and Part D.
Alternatively, Original Medicare with Retiree
Employer Health Insurance would supplement.

As others have stated, Medicare Advantage
is good as long as your health is good and
your health care needs are not that high.
If you are comfortable with HMO plans, MA
is adequate.


Disclosure: I am a Volunteer NJ SHIP counselor

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ram
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Post by ram » Mon Sep 13, 2010 11:50 pm

leesaage wrote:The recently enacted Patient Protection and Affordable Care Act will have an impact on both traditional Medicare benefits as well as Medicare Advantage. How these changes will affect individual beneficiaries is not clear to me but, if possible, one ought to attempt to gauge expected impacts in making coverage decisions.

The Wall Street Journal reports that the recently released Annual Report of the Medicare Board of Trustees indicated that Medicare payment rates for doctors and hospitals serving seniors will be cut by 30% over the next three years. The Washington Post had a similar story but less detail on the size of the cuts. I have not seen anything specific as to differences in the way cuts are to be applied to traditional Medicare versus Medicare Advantage but there may be such.

I will be joining Medicare in about 2 years and am trying to find out more information. If anyone has access to any analysis of how these planned cuts are to be implemented, I would be grateful to hear of it.
I am not an insurance expert.
But in general as medicare cuts down on what they pay physicians, an increasing number of physicians will stop accepting medicare patients. A significant chunk of AMA (amer medical asso) members have said in a recent survey that they will not be accepting "new" medicare patients. ( i think about 20%) if the planned cuts are enacted. The remaining physicians will have larger patient volumes, and presumably the patients will have longer waiting times and shorter face time with the physician. These problems may be more severe with the advantage accounts because of smaller pool of physicians.(my guess, no supporting data)
It would be a good idea for patients currently on commercial insurance and soon to go on medicare to ask their current physician what insurances he/she accepts and plans to accept and take that answer into consideration before making decisions. Some physicians will keep seeing existing patients even if they change insurance to medicare. Some may not see any medicare patients and will therefore drop current patients also.

Disclaimer- I work in the medical field.
Moderators- Pl delete if it sounds political.
Ram

baldeagle
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Post by baldeagle » Tue Sep 14, 2010 12:34 am

We faced the same decision last year when we became eligible for medicare. It was very confusing for quite a while with SO MANY options compared to the 3 choices of group insurance offered by my prior employers. With much study and many marketing visits, it all became clearer, though MA plans remained the most complicated because of all their copays, etc.

The way we finally made the decsion was to make models of our annual health care needs (office visits, labs, xrays, meds, etc), one for a sick year, another for a well year, make a mix, and run the number of competing providers. For well years, all the MA plans were the cheapest (at that time). For sick years, Medigap was the cheapest, though one MA plan was in a dead heat with it.

We finally chose Medigap solution for the following reasons:

1. With a unwell spouse, the Medigap plan seemed cheaper in our models.
2. Medigap is administratively simpler than MA. Nearly everything is covered.
3. We knew we could always switch back to MA. Going from MA to Medigap would be subject to underwriting and all it's mysteries and unilateral decisions.
4. We didn't want the MA making decisions for us.
5. We were worried about MA plans becoming much costlier with the then pending health care legislation.
6. We wanted to pick our own doctors.

S&L1940
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Post by S&L1940 » Tue Sep 14, 2010 7:38 am

baldeagle wrote:We faced the same decision last year when we became eligible for medicare. It was very confusing for quite a while with SO MANY options compared to the 3 choices of group insurance offered by my prior employers. With much study and many marketing visits, it all became clearer, though MA plans remained the most complicated because of all their copays, etc.

The way we finally made the decsion was to make models of our annual health care needs (office visits, labs, xrays, meds, etc), one for a sick year, another for a well year, make a mix, and run the number of competing providers. For well years, all the MA plans were the cheapest (at that time). For sick years, Medigap was the cheapest, though one MA plan was in a dead heat with it.

We finally chose Medigap solution for the following reasons:

1. With a unwell spouse, the Medigap plan seemed cheaper in our models.
2. Medigap is administratively simpler than MA. Nearly everything is covered.
3. We knew we could always switch back to MA. Going from MA to Medigap would be subject to underwriting and all it's mysteries and unilateral decisions.
4. We didn't want the MA making decisions for us.
5. We were worried about MA plans becoming much costlier with the then pending health care legislation.
6. We wanted to pick our own doctors.
choosing a plan also depends on the demographics of your area. in Florida it is practically unheard of for docs to not accept Medicare. when I lived in metro NY I used a specialist in NYC who did not accept any plan - all payments up front and then he filed with the insurer.

when choosing the medigap coverage you become married to them. at 65 they accept anyone and there is no medical history issues. should you decide to change in later years I believe they can refuse you and rates are higher than those in your age group who joined when they were first eligible.

bottom line, there is nothing like walking into any doc's office and knowing there are no challenges or coverage problems. age has its privileges...

stay well
Don't it always seem to go * That you don't know what you've got * Till it's gone

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legio XX
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Post by legio XX » Tue Sep 14, 2010 8:00 am

mur44 pretty well sums up my experience. I researched this as I approached 65 a couple of years ago.

Medicare Advantage is an HMO. I won't repeat the rant I posted previously, but my experience with HMOs (specifically HIP) was not good and I won't go back into one unless there is no other choice.

Medigap is very expensive. I know, it costs less in different places, but where I am now, and intend to stay, the combination of Medicare B, D and Gap cost more than I was paying for my employer's medical plan and covered less.

My employer covers part-timers (all employees pay their own premiums) and allows the Medicare-eligible to stay on the plan. This turned out to be my best bet although it takes much of my part-time pay. It hurts, but not enough to drop it. Downside is that even a small change in income will make it impossible.

Just Medicare, even including B and D (costs about $125 to 150 a month) is not an option as nobody will accept it except clinics and Medicare/Aid mills. Not my idea of health care so long as I can avoid it.

I have not heard of anything coming through the pipeline that addresses these problems. If anyone knows better, please post the info.

Vic

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dm200
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Post by dm200 » Tue Sep 14, 2010 9:10 am

This changes the question from "Should I sign up for medicare advantage with a for profit insurance company?" to "should I sign up for medicare advantage with an HMO that I am familiar with and am comfortable with?"
Yes, that is the better stating of the question. We were with Kaiser Permanante at two different times over the years, and generally pleased with their medical care, etc. We had to switch because of employer offered insurance, but we would have much preferred to have stayed with Kaiser. Now, with Medicare on the horizn for me, I can go back to kaiser with the Medicare Advantage offering.

We were able to deal with all of the often-stated disadvantages of an HMO, while enjoying the benefits. We never felt that treatment was short-changed to save money. Neither, in our opinion, was access to specialists overly restricted. In fact, it was less restrictive than some other plans we have had.

S&L1940
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Post by S&L1940 » Tue Sep 14, 2010 9:18 am

for those who think Medicare is a free ride - do the math

as a couple we pay per month:
$200 for part B
$70 for D drug coverage - goes up yearly
$450 for Medigap - always higher from year to year

of course, if we were to go it alone, our coverage costs would be more than double...

stay well
Don't it always seem to go * That you don't know what you've got * Till it's gone

cubedbee
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Post by cubedbee » Tue Sep 14, 2010 9:37 am

legio XX wrote: Medicare Advantage is an HMO. I won't repeat the rant I posted previously, but my experience with HMOs (specifically HIP) was not good and I won't go back into one unless there is no other choice.
Your particular Medicare Advantage plan was an HMO, but Medicare Advantage is not an HMO. There are Medicare Advantage PPOs where you don't have to deal with PCPs, and there are Medicare Advantage fee-for-service plans where you don't even have to deal with staying in a network of providers at all.

http://www.medicare.gov/choices/advantage.asp

dbr
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Re: Best Source For Advice: SHIP (Free Service)

Post by dbr » Tue Sep 14, 2010 9:54 am

mur44 wrote:
If you want gold standard, stay with Original
Medicare and buy a Medigap plan and Part D.
Alternatively, Original Medicare with Retiree
Employer Health Insurance would supplement.
What happens when the employer discontinues the retiree insurance plan? Would it not be true that Medigap could be denied at will by any insurance carrier at that point?

I agree that A+B+D+Medigap appears to be the surest option and not necessarily the most expensive depending on circumstances and choice of Medigap plan.

What really convincing reason would there be to do otherwise than the above?

Ron
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Post by Ron » Tue Sep 14, 2010 10:05 am

cubedbee wrote:Your particular Medicare Advantage plan was an HMO, but Medicare Advantage is not an HMO. There are Medicare Advantage PPOs where you don't have to deal with PCPs, and there are Medicare Advantage fee-for-service plans where you don't even have to deal with staying in a network of providers at all.
True; this is what my son has (PPO). His provider has options for both under their MA plan.

- Ron

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jeffyscott
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Post by jeffyscott » Tue Sep 14, 2010 10:25 am

1530jesup wrote:for those who think Medicare is a free ride - do the math

as a couple we pay per month:
$200 for part B
$70 for D drug coverage - goes up yearly
$450 for Medigap - always higher from year to year
Which puts this:
oljack wrote:...the premiums for Medicare Advantage programs are cheaper than with Medicare plus a Medicare Supplement. However, while Medicare Advantage is mandated to cover everything that Medicare covers, there are co-pays that are not required with a Medicare Supplement. For doctor’s visits and routine care, these co-pays are fairly insignificant making the health costs of a reasonably healthy Medicare Advantage holder much less. However, should one require radiation treatments, extended therapy, several hospitalizations or other conditions requiring frequent follow-up, Medicare with a Medicare Supplement would be far less costly.
in perspective.

Paying $520 per month extra for separate medigap and drug coverage would seem to be pretty likely to exceed the cost of co-payments, etc. in an alternative plan :?:
press on, regardless - John C. Bogle

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Post by Ron » Tue Sep 14, 2010 10:37 am

jeffyscott wrote:Paying $520 per month extra for separate medigap and drug coverage would seem to be pretty likely to exceed the cost of co-payments, etc. in an alternative plan :?:
I did in my son's case, based upon his preimums and plan usage.

His Advantage Plan is less expensive and gives more services. His doctor visits have a higher co-pay rate than Traditional Medicare (with Medigap coverage), but at his usage level, the Advantage Plan is still better for him, at this time.

It's a challange to determine what is best (and this exercise has to be done, every year).

- Ron

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