Medicare

[ceciltguitar]

Medicare advantage plans and Medicare supplements are two different things.

If you opt for original Medicare part, B, original Medicare part B pays 80% of all covered costs after you meet your deductible. The deductible is currently right around $170 a year, it may vary depending on your income.

If you have original Medicare part B, it might be wise to purchase a Medicare supplement. Look into it carefully. Medicare supplements normally pay the deductible and all your extra 20% of Medicare approved charges. I’ve never seen a Medicare supplement that included dental or vision. There might be Medicare supplements include dental and vision, but I’ve never seen one.

Medicare advantage plans are totally different. A Medicare advantage plan is where you enter into a contract with a company to provide all of your Medicare benefits. You do not need a supplement if you get a Medicare advantage plan. Most advantage plans offer a dental plan, and or a vision plan. You may still have co-pays. You are limited to only the doctors in the company’s network. You are limited to only the treatments approved by the Medicare advantage plan.

My personal experience having looked into it, and having discussed it extensively with friends, relative, and literally hundreds of patients, doctors and other medical providers, is that nearly all the time most people are better off not having a Medicare advantage plan but rather having original, Medicare with a good supplement. Then if you want a vision, plan or dental plan on your own, go ahead and do it.

This is just my observation based on my experience. Your mileage may vary. It’s definitely very important to do your own research based on your own medical conditions, your own medications, whether or not you are able to, or even want to keep your current doctors, etc. A lot goes into making a decision.

In my opinion, a very high percentage of what you pay for Medicare advantage plan goes into advertising, marketing, sales, corporate profits, exorbitant CEO salaries, huge buildings staffed with thousands of people and computers, whose job it is to deny care as much as possible in order to save more money for the company, and shareholder profits, leaving a smaller amount to go towards actual medical care.

Whatever your initial decision is, every year you have the option to change your mind and change your plan during open season, which occurs somewhere in November and early December.

[rokdog49]

This “pro position” for a private supplementary plan vs. a Medicare “Advantage” as stated above is missing some important facts and outright false in other areas. For example, under our current no fee ”advantage plan”, we have dental benefits to the tune of $500 and we can go to a Dentist outside the Network so there’s the first misnomer. This covers two visits for my wife and I and two cleanings. It costs us not a penny

Most importantly, and for the umpteenth time, with our Advantage Plan, WE PAY NO PREMIUMS.
The private supplementary plan fees can be exorbitant. If you have the money, there is no argument they will provide more benefits, but you have to pay for them and they can be quite expensive depending on what you want. Where do those premiums go if you have no medical claims in a given year? Corporate profits? Exhorbitant CEO salaries? C’mon man it’s an insurance company.
Do you get a refund? Hardly. That’s money down the toilet. Your choice though.

Folks, please at least look into what an Advantage Plan” provides with zero fees before you go buying private insurance and don’t take anybody’s word for any of this including mine . BTW, I don’t see where our “zero premium” benefits are affected by any such marketing, salaries or whatever other claims were made.They are rather good. Over $120k in medical bills last year including major surgery, radiation treatments and meds. $2000 out of pocket. We paid under $100 for prescription drugs in total.
Pretty reasonable.

[rokdog49]

Deleted post…………….

[rokdog49]

Deleted post…duplication

[David Eastwood]

Originally Posted by rokdog49

This “pro position” for a private supplementary plan vs. a Medicare “Advantage” as stated above is missing some important facts and outright false in other areas. For example, under our current no fee ”advantage plan”, we have dental benefits to the tune of $500 and we can go to a Dentist outside the Network so there’s the first misnomer. This covers two visits for my wife and I and two cleanings. It costs us not a penny

Most importantly, and for the umpteenth time, with our Advantage Plan, WE PAY NO PREMIUMS.
The private supplementary plan fees can be exorbitant. If you have the money, there is no argument they will provide more benefits, but you have to pay for them and they can be quite expensive depending on what you want. Where do those premiums go if you have no medical claims in a given year? Corporate profits? Exhorbitant CEO salaries? C’mon man it’s an insurance company.
Do you get a refund? Hardly. That’s money down the toilet. Your choice though.

Folks, please at least look into what an Advantage Plan” provides with zero fees before you go buying private insurance and don’t take anybody’s word for any of this including mine . BTW, I don’t see where our “zero premium” benefits are affected by any such marketing, salaries or whatever other claims were made.They are rather good. Over $120k in medical bills last year including major surgery, radiation treatments and meds. $2000 out of pocket. We paid under $100 for prescription drugs in total.
Pretty reasonable.

Agreed, pretty reasonable.

But, as many, many responders in this thread have pointed out, what’s good for one is not necessarily good for another.

Medicare Advantage plans vary considerably from state to state. What you have available to you may not be available to folks who live elsewhere (including the $0 premium option). Some include dental and vision; some don’t. Most of them restrict the network of available providers, which is a consideration if you like to travel, or if your current specialist is out of network.

I’m happy that your Advantage plan is working for you and your wife. There’s no Advantage plan available here in Minnesota which made any sense for me, financially or otherwise. I’m very happy with the Supplement I went with, and beyond the Part B deductible I have zero out-of-pocket expenses. Equally, I’m happy to pay as I go with my vision provider, and my dentist.

Point is - one size does not fit all, and your continued and vehement defence of your choice seems to imply that you think otherwise.

Do your own research.

[Murphy Slaw]

Originally Posted by David Eastwood

Do your own research.

Bingo.

Rarely, in history, has the best "anything" ever been the free option.

You get what you pay for.

If it sounds too good to be true......

There are mountains of information comparing supplement plans with Advantage plans.

Spend some time researching it, not just on a guitar forum.

[mike o]

Will be doing some research for sure. I know this is the place to get info from folks who went through the process

Originally Posted by Murphy Slaw

Bingo.

Rarely, in history, has the best "anything" ever been the free option.

You get what you pay for.

If it sounds too good to be true......

There are mountains of information comparing supplement plans with Advantage plans.

Spend some time researching it, not just on a guitar forum.

[dhalbert]

I found the book "Medicare for Dummies" to be extremely helpful. There are many details and it covers things thoroughly, including many "gotcha" cases.

In most states, if you switch later from Medicare Advantage to regular Medicare, your Medigap (Medicare Supplement) premiums may go up with age, and may considert your pre-existing conditions. In some states, Medigap is "community rated", and you do not pay more based on age (this is true in our state). So in those states, it's much easier to switch back and forth without a financial penalty of some kind. See https://www.medicarefaq.com/faqs/med...icing-methods/

[Photojeep]

I've been on a Medicare Advantage plan a little over 8 months and it's been very smooth sailing for me.

I have one that has no premiums ($0), gives me $120 per quarter to buy over the counter "medical stuff" (bandaids, pain relievers, heating pads, etc.), Vision and Dental coverage, $2,000 per year per ear for hearing aids ( I only wear one) and a few other things.

Did I mention there's no premium?

As someone above mentioned, Advantage plans vary by location so it's possible what I have may not be available to you but there are many, many different plans available.

And yes, as many have stated, I am limited to only certain doctors who take my Advantage plan. But then, when I had my work-provided insurance the same held true. I always had to tell the front office who my medical insurance was through and there were a few times I was told they didn't take my insurance.

One thing that is often not mentioned about Medicare Advantage plans is that you STILL MUST PAY YOUR MEDICARE PREMIUMS; which for most folks is the Part B part of Medicare.

Having said all of this, it's viral to repeat that the only one who can decide what's best for you is YOU. One of my former work colleagues decided Original Medicare was best for him. Hey, he's not me so good on him!

Like many have said, do your reading and research and take advantage of whatever resources are available to you (like a company HR Office) and remember, Medicare always gives you the opportunity to change your Medicare coverage every October 15.

Best of luck in your search,
PJ

[rokdog49]

Originally Posted by David Eastwood

Agreed, pretty reasonable.

But, as many, many responders in this thread have pointed out, what’s good for one is not necessarily good for another.

Medicare Advantage plans vary considerably from state to state. What you have available to you may not be available to folks who live elsewhere (including the $0 premium option). Some include dental and vision; some don’t. Most of them restrict the network of available providers, which is a consideration if you like to travel, or if your current specialist is out of network.

I’m happy that your Advantage plan is working for you and your wife. There’s no Advantage plan available here in Minnesota which made any sense for me, financially or otherwise. I’m very happy with the Supplement I went with, and beyond the Part B deductible I have zero out-of-pocket expenses. Equally, I’m happy to pay as I go with my vision provider, and my dentist.

Point is - one size does not fit all, and your continued and vehement defence of your choice seems to imply that you think otherwise.

Do your own research.

Nope and if you really read my complete posts on this, you would see otherwise.
I highly recommended people looking around and all that stuff about different states and doctor networks was covered. The “point is” I said that.
I also emphasized that those being in favor of pay-as-you-go supplements never once mentioned the cost of the their premiums or what they actually received in benefits. For the sake of comparison, that would have been useful.
I clearly spelled out a “real world” event in our lives and what we received vs. our “out-of-pocket”.
Our premium free program worked satisfactorily for us and I never came close to saying everyone should do what we did or that it was an end all be all solution.
I’m pretty sure I encouraged people to look around at all options…more than once.
Since I’m unable to make my point with clarity I will withdraw from the discussion.

[David Eastwood]

Originally Posted by rokdog49

I also emphasized that those being in favor of pay-as-you-go supplements never once mentioned the cost of the their premiums or what they actually received in benefits. For the sake of comparison, that would have been useful.
I clearly spelled out a “real world” event in our lives and what we received vs. our “out-of-pocket”.

Fair point. To that end, I should correct something I wrote:

I’m very happy with the Supplement I went with, and beyond the Part B deductible I have zero out-of-pocket expenses.

Of course my Supplement has a monthly premium. In my case it’s about $250 - or about $3000 a year. I also pay $17 a month for Part D prescription coverage.